Teen Depression & Suicide: Sleep, Early Bedtimes Protect Adolescents

A new study shows that teens who go to bed early and get enough sleep may be less likely to suffer from depression and have suicidal thoughts. The results were published in the Jan. 1 issue of the journal Sleep.

The study involved 15,659 adolescents in grades seven to 12. Data were collected from the teens and their parents.

Teens who reported that they usually sleep for five hours or less per night were 71 percent more likely to suffer from depression. They also were 48 percent more likely to think about committing suicide than teens who reported getting eight hours of nightly sleep. Both depression and suicidal thoughts were less likely in teens who reported that they “usually get enough sleep.”

Teens were more likely to have problems if their parents set a weeknight bedtime of midnight or later. They were 24 percent more likely to suffer from depression than teens who had to go to bed at 10 p.m. or earlier. They also were 20 percent more likely to think about committing suicide.

Teens with a bedtime of 10 p.m. or earlier got the most sleep. They reported sleeping for an average of eight hours and 10 minutes per night. This was 40 minutes more than teens with a bedtime of midnight or later.

“Our results are consistent with the theory that inadequate sleep is a risk factor for depression,” lead author James E. Gangwisch, PhD, told the AASM. “Adequate quality sleep could therefore be a preventative measure against depression and a treatment for depression.”

Seven percent of participants had symptoms of depression. Thirteen percent reported that they seriously thought about committing suicide during the past 12 months.

The NIMH notes that girls are twice as likely as boys to have had a major depressive episode by age 15. But males are much more likely than females to commit suicide. In 2006 suicide was the third-leading cause of death for young people between 15 and 24 years old.

Parents reported setting a wide range of bedtimes. Fifty-four percent of parents reported that their teen had to go to bed by 10 p.m. or earlier on weeknights. Twenty-one percent reported setting a bedtime of 11 p.m. Twenty-five percent reported setting a bedtime of midnight or later.

And most teens complied with the bedtime that their parents set. Seventy percent of teens reported going to bed on time. Overall, teens reported going to bed only about five minutes later on average than their bedtime.

The AASM reports that most teens need a little more than nine hours of sleep each night to feel alert and well rested during the day. But a shift in the timing of their body clock causes teens to feel sleepy later at night. This explains why it can be hard for them to fall asleep before 10 p.m.

In August the Sleep Education Blog reported that a teen’s sleep pattern may be a marker of his or her risk for developing depression. Parents can get tips for teen bed times on SleepEducation.com.

Sleep Duration & Obesity in Children

A new study examined the relationship between sleep duration and obesity in children.

The study involved 5,159 children from 13 schools in Hong Kong; they had a mean age of 9 years. Sleep times and other data were collected using questionnaires.

Results show that children with shorter sleep durations had higher body mass index scores. Children slept for more than 10 hours at night on weekends and holidays; but they slept for only a little more than nine hours on school nights.

Children who slept less than eight hours during weekdays were more than two times more likely to be overweight or obese. The risk was highest in children who did not compensate for weekday sleep loss by sleeping longer on weekends and holidays.

The Sleep Education Blog has reported on a variety of factors that contribute to sleep loss in children. These include family status, prenatal influences, inactivity and watching TV.

Other studies also have linked sleep duration to the risk of obesity. So what is a parent to do?

Don’t wait for your child to “catch up” on sleep over the weekend; help him or her get more sleep during the week to avoid building up a sleep debt.

In July the Sleep Education Blog reported that children who go to bed after 9 p.m. take longer to fall asleep; they also have a shorter total sleep time.

So make sure your child has time to wind down and get in bed before 9 p.m. each night. One way to help is to turn off the TV and the computer earlier in the evening.

What helps your children get to bed early on school nights?

Children & Sleep: Fragile Bedtimes

A new study examined the bedtimes of young children in “fragile families.” It presents the latest findings from the ongoing Fragile Families and Child Wellbeing Study.

What is a fragile family? The researchers use this term for unmarried parents and their children; these families are at greater risk of breaking up and living in poverty than more traditional families.

The study involved 3,217 children who were 3 years of age; all of them were born in large U.S. cities. The presence, time and consistency of bedtime routines were measured by parent report.

Results show that more than 80 percent of the children had a bedtime; but this bedtime was enforced for only two-thirds of the children. And only about half of these children went to bed before 9 p.m., reports CNN.

The study found that black and Hispanic children had later bedtimes than white children; they also had reduced odds of using regular bedtimes and bedtime routines.

Bedtime routines were less common in larger families and poor families; mothers with a lower level of education also were less likely to practice a bedtime routine with their young children.

The authors suggest that children who lack a bedtime and bedtime routine may fail to get enough sleep; the quality of their sleep also may be poor. This can increase their risk for behavioral and cognitive problems.

"What we find is that disadvantaged populations or lower-education populations have worse health outcomes,” lead author Lauren Hale, PhD, told CNN. “And it turns out they have worse sleep problems. Sleep patterns and sleep routines matter because they have both long-term and short-term implications for health and cognitive development."

In July the Sleep Education Blog reported that children who go to bed after 9 p.m. take longer to fall asleep; they also have a shorter total sleep time.

Another recent study showed that a simple, nightly bedtime routine helps young children sleep better.

On Sunday the San Francisco Chronicle published a review of the new book NurtureShock. One chapter of the book describes how sleep loss is affecting child development. You can read and comment on this chapter online.

Learn more about sleep and children on SleepEducation.com.

Parents: Help Kids Go Back to Sleep for School

You have all the school supplies on the list. You have new outfits or uniforms for your child to wear.

(Or you’ve pulled out the clothes that big brother or sister used to wear; they can be “new” again.)

In your head you anticipate all the upcoming changes to your daily schedule. It’s time to go back to school. But are your kids ready to go back to sleep?

Children tend to shift their sleep schedule during the lazy days of summer. They stay up late at night and then sleep late in the morning. So when the first day of school arrives, having to wake up at the crack of dawn can be a shock to the system.

To deal with this problem, sleep experts advise you to help your children begin to adjust their sleep schedule in the days before school starts.

For example your child can start going to bed and waking up 15 minutes earlier each day. This will be much more effective than if he or she tries to go to bed two hours earlier on the night before the first day of school.

Other tips for parents:

- Dim the lights earlier in the evening; let in sunlight earlier in the morning. The brain uses these lighting cues to help set the internal “body clock” that regulates sleep patterns.

- Begin having meals at the times when your children will eat during the school week. Meals are an important timing cue for the body’s sleep-wake cycle.

- Determine what time your child will need to wake up in the mornings for school; then set a

bedtime that will allow your child to get enough sleep. Teens need about nine hours of sleep each night; younger students need up to 11 hours of nightly sleep.

- Start practicing a regular bedtime routine with your child.

- Keep the TV and computer out of your child’s bedroom.

Get more tips to help your child sleep better.

Learn more about helping your child go back to sleep for school on SleepEducation.com. Read more sleep tips for students.

Physical Activity & Improved Sleep in Children

Do children really sleep better if they’ve been more active during the day? A new study from New Zealand may confirm what parents have long suspected.

The study involved 519 children who were 7 years old. Their activity was measured for 24 hours by an actigraph that they wore on their waist.

Results show that children who were more active during the day fell asleep faster at night. As their mean daytime “activity count” increased, their time to fall asleep decreased.

Overall, the children took 26 minutes to fall asleep on average. Each hour of daytime inactivity increased the time it took children to fall asleep by 3.1 minutes.

Children who fell asleep faster also slept longer, reports the BMJ Group. Every 11-minute drop in the time it took to fall asleep was associated with an extra hour of total sleep time.

In the journal Sleep in 2008, the same research team published an early analysis of the same sample of 7-year-old children. The study found that their average sleep time was about 10 hours.

Their average bedtime was 8:15 p.m.; their average rise time was 7:07 a.m. Children who went to bed after 9 p.m. slept about 41 minutes less than other children.

On weekend nights the children slept about 27 minutes less than on school nights; although they went to bed about 30 minutes later on weekends, their morning rise time was only slightly later.

There also was a seasonal effect, with children getting the least sleep in summer. They slept about 40 minutes longer in winter, 30 minutes longer in fall and 15 minutes longer in spring.

The study also found that children who slept less than nine hours at night were three times more likely to be overweight or obese. The increased risk remained even after controlling for factors such as TV watching and sedentary activity.

The AASM recommends that school-aged children get about 10 to 11 hours of sleep each night. Learn more about sleep and children on SleepEducation.com.

Image by Elke Noda

How to Help Your Child Sleep Better

A new study confirmed that poor “sleep hygiene” has a negative effect on the sleep patterns of young children.

The study analyzed data from a national poll of 1,473 parents and caregivers; their children ranged in age from newborns to 10-year-olds. The poll included questions on sleep habits and sleep patterns.

Having a late bedtime after 9 p.m. was associated with sleep problems across all ages. Children who went to bed late took longer to fall asleep; they also had a shorter total sleep time.

Having a parent present when the child falls asleep also affected all age groups; these children woke up more often during the night.

Children 3 years of age and older had a shorter total sleep time if they had a TV in the bedroom; they also obtained less sleep if they had no consistent bedtime routine.

Children 5 years of age and older slept less if they regularly consumed caffeine.

The authors concluded that good sleep hygiene helps young children sleep better. Basic tips that parents should put into practice include:

- Letting children fall asleep independently
- Putting children to bed before 9 p.m.
- Establishing a bedtime routine that includes reading
- Helping children avoid caffeine
- Keeping a TV out of the bedroom

In May the Sleep Education Blog reported that a simple, four-step nightly routine helps children sleep better. Children fell asleep faster, and they had fewer and shorter night wakings.

In March the blog reported on TV, children and bedtime. Studies indicate that watching TV can have a negative effect on children’s sleep.

Learn more about sleep and children on SleepEducation.com.

The Young & the Restless: Children, TV & Bedtime

The AP reports that there is some controversy over a bedtime TV program for children. “The Good Night Show” is a three-hour block of programs for children between the ages of 2 and 5. It airs from 6 p.m. to 9 p.m. on the PBS Kids Sprout network.

A network executive says the show is a helpful tool in the “real world” where most homes have a TV on at night. It’s a better viewing option for children than other programs that are on at the same time.

But critics say that parents should be interacting with their children instead of plopping them in front of the TV at night. They also say that TV viewing can make it harder for children to fall asleep. It stimulates them when they should be winding down.

Research shows that there is good reason to be concerned. Studies indicate that watching TV can have a negative effect on children’s sleep.

A study in 1999 involved 495 children in kindergarten through the fourth grade. Increased TV viewing at bedtime was linked to bedtime resistance, delayed sleep onset, sleep anxiety and short sleep duration.

Research also shows that sleep problems frequently occur when children have a TV in their bedroom.

A 2007 study involved children who were 5.5 years of age. Having a TV in the bedroom was associated with sleep problems. Forty-one percent of the children had a TV in their bedroom.

You might think that this problem is unique to children in the U.S. But it is common in other countries as well.

One study involved children between 6 and 12 years of age in Japan. Watching TV, playing video games and surfing the Internet had a negative impact on sleep. Children were more active before bedtime if they had a TV or video game system in their bedroom.

About 18 percent of children in a Chinese study had a TV or computer in the bedroom. These children had later bedtimes and wake times, and shorter sleep durations. They also were more likely to display bedtime resistance and sleep anxiety.

In a study from Belgium, teens with a TV set in their bedroom went to bed later and spent less time in bed. Teens who watched more TV also woke up later and were more tired.

It’s clear that parents should keep the TV out of their child’s bedroom. While you’re at it, take the computer out of the bedroom too.

You also can help your child wind down for bedtime by turning off the TV and the computer earlier in the evening.

Parenting Challenges: Children & Bedtimes

At 7:30 p.m. you begin your nightly bedtime ritual for your 8-year-old. A relaxing, warm bath. Brush the teeth. You talk about what happened during the day. Read a favorite bedtime story. Sing a lullaby. It ends with a kiss goodnight.

At 8:30 p.m. your child quickly drifts off to sleep for a solid 10 hours. Then he or she wakes at 6:30 a.m., bright, perky, happy, and ready for the day ahead.

Sounds great. Almost perfect. Ideal. Nostalgic and Cleaveresque. But is it really possible?

Even the Obama girls are supposed to be in bed by 8 p.m. in the White House. That news caused a bit of a guilt trip for Dr. Perri Klass.

In a New York Times article she admits how far she missed the mark with her kids.

“I’m not sure any of my three children ever had a regular bedtime before 9:30 or 10.”

And she notes that this was in the 1980s. At that time there were fewer technological distractions competing for our attention at night.

No Internet and e-mail. No cell phones. No double-disc, extended edition, bonus-feature DVDs. No TiVo.

OK, so maybe there was Super Mario Brothers. But overall, wasn’t it easier for both parents and kids to wind down at the end of the day?

Today the challenge seems greater. So it’s even more important for parents to create a calming bedtime routine for their children. This includes a consistent “lights out” bedtime each night.

The bottom line: Are you giving your child the opportunity to get enough sleep each night? Roughly 11 to 12 hours for a preschooler? About 10 to 11 hours for an elementary-school student? Around nine to 10 hours for a middle-school student?

If not, the cost can be great for your child’s health and well-being. And it can make your life miserable as a parent. Tantrums. Outbursts. Crying. All-around meltdowns. You know that it can get ugly.

So how are you doing in the bedtime battle? Do you feel like you’re on the losing side? Or do you have an award-winning bedtime routine for your children?

Learn more about sleep and children.