The Elusive Good Night's Sleep

I know, I haven't posted the past 2 weeks. This is what happens when you have to move and lack internet for a week.

Sleep is a very important part of our lives. After all, we spent roughly 1/3 of our lives sleeping. There are several theories on why, exactly, we need sleep. My favorite is the converting of short-term memory to long-term memory. Essentially, if you don't get enough sleep, you won't learn anything new. But for now, I'm going to focus on how much we need and how to get that sleep. In fact, this was the focus of a recently published article that has caught the attention of many news sites.

It's more than just memory, though. Getting less sleep than you need can result in poor academic performance. According to a small study by the American Academy of Sleep Medicine, this effect is as much as binge drinking or smoking marijuana, independent of other risk factors such as psychiatric disorders.

Sleep has also been linked to weight, particularly in adults. A recent study published in Pediatrics shows that getting less than the recommended amount of sleep in infancy and childhood is linked to obesity by age 7. Indeed, even how much a parent sleeps can affect how much the child sleeps, and thus his or her risk of obesity later in life.

Finally, sleep is the time when many hormones are released. For children, the most important of these is growth hormone. That's right--if children don't get enough sleep, they might not grow properly. As an aside, the unbalance of hormones is likely part of the reason why lack of sleep can lead to obesity--the body produces hormones to increase alertness, which promote deposition of fat for future use.

So clearly sleep is important. But how much do we need?

The amount of sleep we need is entirely based on age. Infants sleep most of the day, while adults only need 8 hours or so. Infants also don't sleep at 'normal' times, because they are accustomed to being in the womb and rocked to sleep while mom was awake and walking, and awake when mom was resting. When adults don't get enough sleep, they tend to develop quick tempers and have low energy. When children don't get enough sleep, though, they tend to become hyperactive. Many parents have experienced this with infants that cry more when they aren't put to bed on time.

By two months of age or so, the circadian rhythm starts to develop. This is our body's innate way of telling time, and is based on light clues. In a completely cut-off environment, a normal circadian rhythm lasts about 25 hours. Of course, we don't live in a world where the day is 25 hours long, so this is where the light cues come in.

One of the first things we, as pediatricians, do when we hear a child is not getting enough sleep is to ask about sleep hygiene. Where do you sleep? What time do you go to bed? What time do you get up? What else is in your room?

Lack of light triggers the release of melatonin, a hormone that helps us feel sleepy and fall asleep. If your room is filled with light, even lights from computers, iPads, televisions, etc, you could inhibit your release of melatonin and have a harder time falling asleep. So, one of the first things we recommend is to get those computers and televisions and whatnot out of the bedroom. Even if you don't use them right before bed, the lights that stay on can influence your melatonin production. You can also condition yourself unintentionally into not associating the bedroom with sleep, but rather with activity.

Getting up and going to bed at the same time every day, even on weekends, can also help your body just get used to going to sleep at the same time. I realize this isn't ideal for adults, but there's no reason kids shouldn't have a consistent bedtime.

Finally, as we get older (by early elementary school), our sleep cycles become more consistent and average out to 90 minutes each. Waking in the middle of a sleep cycle can be very disorienting, and can make you feel tired all day. So, bedtime and alarms should be planned so there is a multiple of 90 minutes in the sleep time. In other words, you should try to ensure you are getting 6 hours, 7.5 hours, 9 hours, or 10.5 hours of sleep (depending on age, with younger kids needing more sleep), rather than 8, 10, or 6.5 hours.

This is only an introduction, and I'm sure I'll talk about it more in the weeks to come, but to not bore you too much, I'll leave it there for now.

Have additional questions? Leave them in the comments!