How Sleep Helps Your Child Learn and Grow

September 25, 2018

As elusive as sleep may be sometimes, it’s a vital part of your child’s learning and growth. Your child needs sleep to perform at his best. And, let’s be honest, it’s not all about performance. We all want academic success for our kids, but emotional stability and a positive social life are important too. These all rely on your children getting adequate sleep.

Attention and Focus

Poor sleep quality or lack of sleep alters the way the brain works. Certain regions of the brain are more highly affected by sleep loss than others. The prefrontal cortex, the portion of the brain that controls executive functions like attention and focus, experiences a decrease in activity when your child doesn’t get enough sleep. Of course, children are still learning how to apply reasoning to their thinking anyway, but when you take adequate sleep out of the equation, it gets infinitely harder.

And, it’s not just about spending enough hours in bed. Sleep efficiency, that’s the number of hours spent in bed versus the hours actually slept, has to be considered as well. A study published in Sleep Medicine found that good sleep efficiency improved performance in math and language. Reut Gruber, one of the professors involved with the study, stated that “short or poor sleep is a significant risk factor for poor academic performance that is frequently ignored.”

The good news is if you’re here reading this post, you’re not ignoring the importance of sleep.

Emotional and Social Consequences

Learning and growth take place in more than the classroom. Like academic performance, emotional and social growth and development can be hindered by a chronic lack of sleep.

While activity in the prefrontal cortex goes down with sleep loss, the part of the brain that processes emotions, called the amygdala, gets more active. It becomes particularly sensitive to anything negative. For kids, that may mean anything from a change in plans to sharing a favorite toy could lead to an emotional outburst. Studies have found that impulsive behavior and overly emotional responses decrease when kids get the sleep they need.

The success of family and peer relationships relies, in part, on sleep. And, there are things you can do to help your child get the rest he needs.

Creating a Healthy Sleep Environment

Efficient sleep starts in a healthy sleep environment. Some of these changes are small and simple, but they can heavily influence sleep success. Try:

● Checking the Mattress: A lumpy, sagging mattress could be causing nighttime wakefulness. Even tags could be at the heart of some nighttime wakings. If you’re in the market for a new mattress, medium-firm mattresses are the most comfortable and supportive no matter your child’s weight or sleep style.

● Controlling Light: Exposure to natural light helps correctly time the sleep-wake cycle. Blackout curtains, heavy drapes, and blinds can keep light out so your child’s brain doesn’t get confused. If your child is afraid of the dark, try a motion-activated night light plugged in low to the ground.

● Remove Electronics: Electronic devices like TVs and smartphones emit light that’s similar to sunlight, which can suppress sleep hormones. Not only that, even the temptation of playing with or watching devices has been shown to reduce childhood sleep quality. Keep them out of the bedroom to reduce distractions so the brain and drift off to sleep.

With a focus on better sleep, you’ll be helping your child succeed in all aspects of his life. Though it may take time to improve sleep efficiency, with consistent effort, you’ll both be resting better.

By Sarah Johnson, Guest Contributor

The Reasons For Insomnia In Children

April 25, 2016

Common Causes of Childhood Insomnia

If you’re perusing this website, it’s likely that you’re already aware of just how important sleep is for your child [1]. If your child can’t sleep, it’s as distressing for you as it is for them. Insomnia is horrible at any age [2] – there’s a reason why sleep deprivation is used as a form of torture – but it is particularly horrible for children, who need plenty of sleep to help their brains learn and develop properly. However, if your child is struggling with insomnia, don’t panic. There’s usually a perfectly simple and easily rectifiable reason for their disturbed sleep. Here are a few common causes of childhood insomnia:

Changes In Circadian Rhythms

Our sleep patterns are governed by our circadian rhythms. Our circadian rhythms are our ‘body clock’, releasing hormones to make us wake up, get hungry, get sleepy and so on at certain times, in response to certain stimuli. Thing is, our body clocks aren’t set in stone. They can be thrown out of whack by various different influences. For example, our circadian rhythms evolved to judge waking and sleeping times according to the prevalence of daylight. When bright, ‘blue’ morning light seeps through your bedroom curtains, your eyes detect it through your eyelids and, even though you’re sleeping, your brain will start to produce serotonin – a chemical which wakes you up. However, artificial sources of ‘blue light’ will have the same kind of effect. Children who play on their mobile devices before bed are drenching their eyes in the ‘blue light’ which emanates from phones. This is in turn encouraging their brains to produce serotonin (despite how tired it ostensibly is), which then keeps them awake long into the night [3]. Changes in routine can also disturb your circadian rhythms. New mealtimes, new waking times, new bedtimes – all of these will confuse your child’s circadian rhythms, and perhaps disrupt their sleep. It’s this kind of profound routine change which gives recovering addicts and jet-lagged people insomnia [4]. But don’t worry. Our circadian rhythms, while easily confused, are pretty adaptable. With consistency, they’ll soon start going with the flow, and healthy sleep will follow.

Dietary Issues

Good, healthy meals eaten at fixed intervals are one of the best ways to promote healthy sleep in your children. Conversely, an unhealthy diet eaten at random times is likely to impede their sleep. Too much sugar, caffeine, and fat in the diet generally (but particularly before bed) is likely to at the very least give your child disturbed sleep, if not keep them awake altogether. Sugar is particularly bad for sleep, as blood-sugar imbalances are something to which the body responds in an urgent manner, going so far as to wake you up when it feels the need to alert you of a sugar ‘crash’ or a sugar ‘high’ [5]. Often these ‘highs’ and ‘crashes’ are artificial, brought on by too much processed sugar, but it’s still not great for a healthy sleep cycle. To keep your child snoozing as they should, make sure that they get a healthy diet.

Stress

Sad to say, our children do get stressed and anxious [6]. We all know that worrying is particularly effective at keeping us awake, and that our brains seem to delight in running all of our worries past us just as we’re trying to get to sleep. However, stress also disrupts sleep on a more insidious level. The chemical and physiological processes of stress are designed to keep us alert in order to combat the ‘danger’ we’re ostensibly stressed about. This makes sleep much harder to achieve. If we do manage to sleep when we’re stressed, it’s likely to be a light sleep, which doesn’t really regenerate us in the way that it should. If your child is experiencing unexplained insomnia, before rushing to the doctor, try some gentle investigation into sources of stress within their life.

Citations

[1] BBC, “Sleep matters”

[2] Seth Maxon, “How Sleep Deprivation Decays the Mind and Body”, The Atlantic, Dec 2013

[3] Mercola, “Sleep and Technology Don’t Mix: Why You Need to Set an Electronic Curfew”, Jun 2014

[4] Rita Milios, “Can’t Sleep? Non-Pharmaceutical Options for Treating Insomnia During Recovery”, Recovery.org, Apr 2015

[5] Donielle Wilson, “How Blood Sugar Levels Affect Your Sleep”, Doctor Doni, Dec 2014

[6] APA, “APA Stress Survey: Children are more stressed than parents realize”, Nov 2009

About the Author: Mel Rivers now works as an independent freelancer, before she did this she had a varied career in the health care sector. Prior to working in this sphere, she’d battled her own issues with addiction, and used her experiences to help deal with other people who were struggling, during the course of her day job. She works from home now, after becoming a mom to two girls.

What to know before you begin sleep training

March 24, 2016

I’m fortunate to work with the families who seek me out. If you’re looking to hire a sleep coach, it’s probably because you’ve already chatted with your sister, mother, friends, Google and possibly even strangers on the internet, in search of sleep solutions. The families who ultimately hire me are ready and highly committed to see change.

If you’re considering sleep training, whether on your own or with a sleep coach, this is the kind of thing you want to do once, do right and never have to worry about again. After working with hundreds of families over the years, these are some of my top considerations before proceeding with sleep training.

Give it time – Poor sleep habits did not develop overnight. It’s not reasonable to expect a complete change in habits in a single night. Give sleep training a fair shot before evaluating success or failure.
Commit and be consistent – There is no “kinda sleep train.” You’re in or your out. If you have an awareness that you can’t commit, you’re not ready or it doesn’t feel like the right move, that’s ok too. Don’t embark upon sleep training until you’re absolutely ready.
Be healthy – Illness can limit sleep quality. An underlying health issue (something more acute, like colds, flu or ear infections) warrants holding off on sleep training until baby is well. More complex chronic issues like allergies, digestive issues or even heart conditions, could warrant some special instructions from your child’s paediatrician. Check with your doctor before beginning.
Set age appropriate goals – Goals are an important way to measure success. A four month old who sleeps through the night without feeds or a 4 year old with a nap and an early bedtime might not be appropriate. Understand what a reasonable quantity and allocation of sleep should look like for each age.
The small stuff IS the big stuff – I’ll let you in on a little secret… sleep training ISN’T about crying it out or what sleep training method you choose. Great routines, awesome timing, an ideal environments – these are what can make or break your success.
Right method for your family – Choose a strategy you can be consistent with. It doesn’t have to be cry it out. If you can’t follow through, it’s not the right method.
Have a plan – Discuss bedtime, night waking and nap time scenarios with your partner, consider options, agree to a plan and then follow through. Sleep sabotaging decisions are made at 2AM when fatigue and emotion takes over. Stick to the plan!
Engage all care providers – The more consistency you can offer, the more likely you’ll achieve success. Child care provider(s) can help in working towards those goals.
Support network – Maybe this means you and your partner, maybe this means putting a good friend or relative on standby, maybe this means hiring a sleep coach. If sleep training were easy, we’d all have sleeping babies, I wouldn’t have a job and you wouldn’t be reading this post. You’ll need a support network in place. Friends or family who are not supportive can and should be avoided.

Alright parents, what’s your best advice to share with other families?

xxoo

Krista

About the author:

Krista is a mother of 3 (+1 dog who believes she’s people), a wife to a wonderful husband, and the owner and founder of Sleeperific. Even though she’s been in the sleep consulting biz for 4 years, she still gets excited when she’s hired by a sleepy family.

Night Terrors

September 20, 2015

Night terrors are not bad dreams. You might not even know that what you’re seeing from your child is a night terror the first time it occurs.

Typically occurring in children between 3 and 12 years of age, an estimated 1 to 6 percent of children experience terrors[1].

Some characteristics of night terrors include:

Timing: Early after onset of night sleep or in early morning when coming out of a deep sleep (Night terrors occur in non-REM stages of sleep)
Yelling, screaming, shouting
Thrashing, kicking, pushing away you or objects that aren’t there
Child appears anxious, fearful or panicked
Sweating, increased heart rate
May appear awake but will not be responsive
Most significantly: child has no memory of the event (if your child recalls the event, it was not a night terror)

Risk factors

Overtiredness and fatigue
Variable sleep schedule
Significant changes or stressors in a child’s life (beginning childcare, new school, change in family arrangements, new sleep environment, etc….)
Illness or fever
Family history of partial-arousal parasomnia ie: sleep walking

How to manage?

If your child has a terror, don’t disrupt them. Ultimately, going sleep will end the terror. Speaking to or touching your child unnecessarily will prolong the terror. Stay with your child, keep him or her safe, guide back to bed as necessary, but try to keep intervention which might disrupt sleep, to a minimum. If your child is getting up and walking around during their terror, consider a gate at their door or the top of stairs, and ensuring exterior doors are not easily opened.

Prevention

The majority of night terrors are caused by overtiredness. That means if we can get the child MORE sleep, we can often prevent the terror from occurring. The easiest way to achieve more sleep is with an earlier bedtime, as little as 15 minutes can do the trick. Be diligent about following regularity in your child’s schedule until the terrors have stopped.

If terrors occur with regularity at a particular time of day, you can gently rouse your child (just enough so they might sigh and roll over and go back to sleep) in the 30 minutes prior to the regular terror. The goal of this strategy is to disrupt the sleep cycles just enough to prevent the terror.

If terrors persist, and recur at least 3x per week, talk to your child’s doctor. There could be contributing factors to the night terrors, like sleep apnea or restless leg syndrome.

References

[1] Rosenberg, Robert S. Sleep Soundly Every Night, Feel Fantastic Every Day. New York: Demos Health, 2014. Print.

About the author:

Dressing Baby for Sleep

September 14, 2015

Season’s change is upon us. Kids are back to school, leaves are becoming more colourful and nights have a chill that we haven’t felt for months. With the arrival of cooler weather, we need to be dress baby for bed differently than we did in the warmth of summer. But adding extra layers can be tricky when seasonal temperature changes are subtle. How do we go about dressing baby for sleep?

I encourage parents to keep their bedrooms cool at night. If you’ve flipped your pillow over for the cool side, you know exactly what I’m talking about. Sleep is more likely when you’re not hot. Studies show the ideal room temperature for sleep is around 60-67 degrees Fahrenheit or 15.5 – 19 degrees Celsius. Layer up with clothing and coverings from there. For safety reasons, it is very important that you not overdress your infant. Over heating increases the risk of SIDS. It has also been shown that using a fan can decrease the risk of SIDS by over 70%.

Keeping children too cool can disrupt sleep, and obviously too warm can do the same. So what should my baby wear to bed?

How do I go about dressing baby for sleep?

How to dress baby for a great night sleep

A tog is a warmth rating. Think of each tog as a thin layer of cotton. If you use fleece sleepers or have a warmer sleep sack, you’ll likely want to leave a layer (or two) out. Use caution if you need a hat on your infant as well for sleep. It makes more sense to keep your home slightly warmer.

As always, trust your judgement and assess your child’s comfort when dressing your baby for bed. There’s variability in humidity, the warmth of the layers, and with your child’s own internal thermostat. Fingers which are cool to the touch might be ok, especially in young babies. Infants aren’t terribly good at regulating their temperature. Icy hands or cold feet are likely to disrupt sleep.

Resources:

National Sleep Foundation

About the author:

Sleep is Crucial For Your Child’s Mental Health

June 23, 2015

Getting regular, restful sleep is absolutely crucial for mental health, but according to the 2003 National Survey of Children’s Health, 15 million children and teens aren’t getting enough. Learn more about how important sleep is for your children, and how you can help them get more of it.

Sleep and your child's mental health

Sleep and Mental Health

North American adults, teens, and children are all at risk of sleep deprivation, and it’s a big problem, because sleep deprivation is a risk factor for mental illnesses like depression and anxiety. As well as this, people with existing mental illnesses tend to suffer from sleep problems. This means there’s what’s known as a “bidirectional link” between sleep and mental illness: people who have sleep problems are more at risk of developing certain mental illnesses, and people with mental illnesses are likely to have insomnia and other sleep disturbances.

According to studies that examine brain chemistry and brain activity, getting a good night’s sleep on a regular basis is important for mental acuity and emotional stability. For example people who don’t get enough sleep are more likely to be emotionally volatile, and to have reduced cognitive function that can negatively affect their work or school performance. If the problem isn’t addressed, sleep deprivation can easily turn into a vicious cycle where lack of sleep causes minor emotional or cognitive problems that exacerbate sleeping difficulties.

What Does this Mean for Your Child?

While the link between sleep and mental health has been well established in adults, it was only recently, in May 2015, that scientists confirmed the existence of a similar link in children. The study, carried out at the Norway University of Science and Technology, found that when young children have serious sleep problems, they have a higher risk of developing psychiatric problems during childhood.

The study looked at the sleeping routines of children as young as four, and concluded that four year old children with serious sleeping problems had a higher risk of developing psychiatric issues by as early as six years old. The most common sleep disorder children are affected by is insomnia; in the Norwegian survey, around 16.6% of four year olds were affected.

The study also found that the reverse was true: young children with psychiatric symptoms had a higher likelihood of developing sleep disorders than children who didn’t have psychiatric symptoms. This is especially true of ADHD, which causes sleep problems in up to 50% of children with the disorder.

What to Do if Your Child has Sleeping Problems

This doesn’t mean, of course, that all children with sleep problems will develop psychiatric symptoms or mental illnesses. For most children, as well as most adults, sleeping problems are transient, lasting only a few weeks or a few months. For children especially, establishing healthy regular sleep routines is difficult, even for children who don’t have actual sleep disorders. However, there’s a lot you can do to help your child establish a healthy sleep routine, and teach them about the importance of sleep.

Establish a set bedtime and try not to deviate from it.
Make sure their bed is comfortable and isn’t too hot or too cold.
Avoid distractions in the hour before bed, for example, with a “no TV/computer” rule. Instead, opt for bedtime stories or soothing music.
Kids sleep better when they spend time playing outdoors, so encourage your children to take part in sports or other outdoor activities.

Transient sleep issues are absolutely normal, and there’s typically no reason to be worried if your child has difficulty with a new bedtime or a change in sleeping habits. But if their problems persist for more than a few months, or get worse over time, then seeking help is definitely a good idea.

Citations

Centers for Disease Control and Prevention. Children’s Mental Health. Accessed June 9, 2015.

Child Development Institute. Child Psychology and Mental Health. Accessed June 9, 2015.

DA – Helping Children With Addiction. Helping an Addicted Child. Accessed June 9, 2015.

Eureka Alert Press Release. Children’s Sleep and Mental Health are Related. Silje Steinsbekk and Lars Wichstrøm (2015). Stability of Sleep Disorders From Preschool to First grade and Their Bidirectional Relationship With Psychiatric Symptoms. Journal of Developmental & Behavioral Pediatrics: May 2015. Volume 36, Issue 4. pp 243-251.Accessed June 9, 2015.

Harvard Health Publications Newsletter (2009). Sleep and Mental Health. Accessed June 9, 2015.

Healthy Children. Sleep and Mental Health. Accessed June 9, 2015.

Summer Sleep

June 9, 2015

Ah summer. We Canadians wait ALL year for this kind of weather (certainly when comparing it to this). But summer can wreak havoc on child sleep schedules and routines. Here’s some ways summer impacts sleep, and real strategies you can use to try to keep you child on track.

Light

Longer days, early mornings and late nights. Sounds like a recipe for a great summer, but long term, that can cause trouble for sleep routines. Pick up some of these or bring some black garbage bags (be prepared to double or even triple layer them) and painter’s tape if you’re travelling. For those who are travelling to cottages this summer: The sun sets even later and rises earlier in the north and often cottages have bigger windows to enjoy the long days. Don’t let light delay bedtime or encourage an early morning riser.

Temperature

Apparently 20 degrees is ideal for sleep, which seems far too cool for me, especially with those scorching summer days. Generally about 1 degree cooler than temperature in your home during the day is fine. Adjust your child’s clothing and coverings accordingly.

Noise

Late night barbeques at the neighbours, older children biking the streets, even the birds chirping in the early mornings can impact sleep. Mitigate with white noise. There’s are dedicated white noise machines on the market, but you may be able to repurpose something already within your home. An oscillating fan (set up out of reach, especially for children in beds), a dehumidifier, even a radio tuned to static with the volume quite low will work.

Vacations

Travel is a great experience for your family and inevitably, sleep might be more difficult when you’re away from all the comforts of home. Bring what you can (within reason) to keep everyone comfortable. As much as possible, try not to deviate too much from your regular sleep patterns. I certainly don’t want parents to feel they’re a slave to the sleep schedule while they’re trying to enjoy a vacation.

The biggest rule is to not undo all the good work you’ve been doing. Some kids are pretty flexible but some aren’t. Trust your comfort zone but also your child and their ability to get back into their routines when you return home.

Have a great summer friends!

xoxo Krista

Prescription meds and your child’s sleep

June 4, 2015

The Detrimental Effects that Prescription Medication Can Have on Childrens’ Sleep

Prescription Medications and your Child's Sleep

A recent story published in the Huffington Post highlighted the alarming rise in the number of children who are routinely prescribed medications such as antipsychotics for disorders such as ADHD, with as many as one of every three visits to child psychiatrists resulting in the receipt of a prescription for such medications. This is the case despite the fact that the FDA has found that drugs such as those approved for conditions such as schizophrenia, can be incorrectly or needlessly prescribed for conditions they were not originally intended for, including ADHD, autism, Asperger Syndrome, etc.

Another more recent study (published in the March, 2015 edition of the American Journal of Public Health) found that very young children (up to the age of four) who were registered with Medicaid in 36 states, are taking psychotropic drugs, despite a complete lack of efficacy and safety data to support their use in such young patients.

The Unnecessary Prescription of Medication

Some of the most common drugs prescribed to children are used to treat ADHD, depression/anxiety and psychosis/bipolar disorder. Black and Hispanic children were one half to one third as likely to be taking some type of psychotropic medication. Researchers concluded that while some of these children may indeed have brain injuries and other conditions which merit the use of this type of medication, “if these medications are being used solely for behavioural control, then it seems that need to better assess these children and see if they might be better served by the use of evidence-based behavioural interventions.”

Harmful Side-Effects of Some Prescription Medication, including Insomnia

There are many other issues surrounding prescription medications, which are a great source of worry for paediatricians and parents alike. One study carried out by scientists at Harvard University has found that four out of five children admitted into hospital are treated with medications which have not been previously tested on kids. It is known that children metabolize medications differently from adults, so that the opposite effect to that desired, may occur. Moreover, it can be all too easy for children to overdose on even seemingly innocuous medications, like cough medicine. Finally, many prescription drugs can interfere with the quality of sleep, leading to serious consequences in the long run (long-term sleep deprivation has been linked to everything from memory loss to an increase in the biomarkers that cause brain damage.

Prescription Medications and Sleep

Anti-depressants (such as Prozac, Zoloft and Paxil), also known as SSRIs (Selective Serotonin-Reuptake Inhibitors) are commonly prescribed to children and adults alike; indeed, they are now the first-line treatment for mild-to-moderately serious depression, seasonal affective disorder, bulimia and anxiety. Unfortunately, side-effects include both drowsiness and insomnia and agitation. Medications commonly prescribed for ADHD (which enhance alertness) can also make it more difficult for children to get a good night’s rest.

Many medications commonly used to treat heart conditions or asthma, can cause insomnia, night awakening and nightmares, while decongestants often cause wakefulness at night time. Meanwhile, some over-the-counter medicines (such as cough syrup, which contains alcohol) can hamper REM sleep and cause frequent night waking, and pain relievers made with caffeine can also interfere with sleep. Even herbal medications can have case overstimulation and insomnia; St John’s Wort, often taken for depression, is one such medication, so it is vital to build a greater awareness of the effects that any herbal remedy your child is taking, can have on their sleep patterns.

If your child has ADHD, depression or any other condition for which they have been prescribed a psychotropic medication, make sure to discuss alternative possibilities (such as behavioural therapy) with their doctor; the key is to find the most natural solution possible, through a combination of behavioural changes (changes to routine), the avoidance of stimulant foods such as caffeine and sugar, and natural relaxation techniques (yoga and mindfulness meditation work wonders when it comes to lowering stress levels and establishing the clarity of mind that can lead to a greater sense of sleepiness).

The dedicated team at Sleeperific will devise a personalized plan, if you are worried that your child will never get a good night’s sleep (or allow you to do the same). Through trusted, safe methods and a caring approach, they can help your whole family achieve a greater sense of calm, health and happiness.

Citations:

Medicaldaily.com, Sleep Deprivation: 7 Dangerous Effects Of Long-Term Sleeping Problems, accessed May, 2015.

Medscape.com, Psychotropic Meds Prescribed for Medicaid Preschoolers, accessed May, 2015.

Kwikmed, The Facts About Prescription Medication and Children, accessed May, 2015.

Everydayhealth.com, Is Your Medication Making You Lose Sleep?, accessed May, 2015.

Pharmacist.com, Psychotropic drug use among preschool children in the Medicaid program from 36 states, accessed May, 2015.

NYtimes.com, SSRIs, accessed May, 2015.

Technological sleep sabotage

March 30, 2015

We’re all becoming increasingly reliant on technology for communication, reading and entertainment. But the screens that we use in everyday life (computer monitors, televisions, tablets, smartphones etc Related Site. …) have a particularly negative impact on sleep, especially when used in the evening (ie: when most of us are probably using them).

Using tech is a one-two punch of sleep sabotage. Both the content and the devices (yes, the media and the message) themselves can be detrimental to sleep.

The Content

A stressful email from a colleague or boss. The latest news from a war torn country. One last game of Candy Crush Saga. Not only are we losing sleep time to those, but we’re stressing ourselves out when we’re supposed to be relaxing and letting go. Anxiety leads to more cortisol production which further delays sleep, which can lead to more anxiety. It’s a vicious cycle.

The Devices

Here’s what you need to know about light. Pay special attention to blue light. Blue light is present in the spectrum of natural light. It corresponds to the part of the spectrum between 430nm and 500nm.

While any light can inhibit melatonin secretion, blue light does it bigger and badder than it’s other rainbow friends. A study out of Harvard compared the effects of exposure to blue light to exposure to green light. The blue light suppressed melatonin for twice as long as the green light and shifted circadian rhythms by twice as much (3 hours vs. 1.5 hours).[1] Blue light meant later and less restful sleep.

So what does composition of light does a screen typically contain?:

Yes, the majority of the light we get from our screen IS blue light. Today, 90% of flat screens are made with LEDs. A high proportion of the light those very screens are emitting is blue. And in the case of e-readers, tablets, smartphones and computer screens, you’ve probably got that screen within about 15 inches of your face. So, what does that mean for sleep? Less melatonin (which means a less quality of sleep) and more difficulty falling asleep (which means less quantity of sleep). Generally, if you’re lucky enough to fall asleep, you wake up feeling like you haven’t slept, or at least not well. The following diagram compares melatonin levels with a print book versus and E-reader.[2] You can see the melatonin levels are lower AND they clear away later; meaning it’s hard to fall asleep, sleep is not a high quality and it’s hard to wake up. So what can we do? How can we protect ourselves, and especially our older older children (teens) who are the most vulnerable?

How to protect your sleep

1) Do not use tech before bed. This is easier for the young kiddos (avoid television, tablet or computer time for a period of at least 2 hours before bedtime). For the older children (teens) and adults, let’s be serious. This probably isn’t possible. A “do not do” approach isn’t sustainable for the majority of us. While limiting it’s use is important, try rearranging tasks – finishing up your email first, then cleaning the kitchen.

2) Invert Black and White on your device Macs, iOS and some e-Readers have this function built in. There are some apps which can be downloaded to do this in your selected web browser. It’s not a perfect solution, but can help, simply by decreasing the quantity of light you’re staring at.

3) Blue light shields I’m not sure how well these work, but companies like BlueLight Shield and Ocushield offer screen protectors that claim to block or limit blue light from their devices.

4) Orange Glasses Not exactly fashionable, but blue light blocking glasses can be helpful. I ordered something similar from Amazon. Stay tuned for my evaluation.Anyone with a high amount of technology in their lives is susceptible. But you don’t have to lose sleep over it. Be sensible, take some precautions and you can balance your screen time AND a healthy sleep.

References

1 J. J. Gooley, S. M. Rajaratnam, G. C. Brainard, R. E. Kronauer, C. A. Czeisler, S. W. Lockley, Spectral Responses of the Human Circadian System Depend on the Irradiance and Duration of Exposure to Light. Sci. Transl. Med. 2, 31ra33 (2010). (available here)

2 A.Chang, D. Aeschbach, J. F. Duffy, C. A. Czeisler, Evening use of light-emitting eReaders negatively affects sleep, circadian timing, and next-morning alertness. PNAS 2015 112 (4) 1232-1237; published ahead of print December 22, 2014, doi:10.1073/pnas.1418490112 (available here)

GERD and baby sleep

March 12, 2015

GERD (GastroEsophageal Reflux Disease) is a chronic digestive disease. GERD occurs when stomach acid or sometimes, stomach content, flows back into the esophagus. This acid laden reflux irritates the lining of the esophagus and causes GERD. It looks a lot like this:

Whenever there is discomfort, that can be a significant barrier to sleep. If a family suspects their child is uncomfortable, or their GERD is not well managed, we work with that child’s physician to ensure they are comfortable before proceeding with any sleep training.

From a personal perspective, I can tell you it’s no fun to parent through GERD. From a professional perspective, I can tell you that these are the families most in need of support, sleep is clearly impacted, and in my anecdotal observations in working with families; GERD diagnosis seems to be increasing.

In the past week I’ve attended several continuing educations events, with one physician indicating that GERD is likely overdiagnosed[1] (notable pediatric gastroenterologist Warren Shapiro, MD), while the other indicated that it was underdiagnosed[2] (notable pediatric sleep expert, Judy Owens, MD). The jury is out and it’s difficult to know if the instances of GERD are increasing or if more of these cases are being caught.

Symptoms

Some symptoms of GERD include[1]:

Recurrent vomiting
Poor weight gain or even more extreme, a failure to thrive
Irritability
Poor sleep
Bad breath
Respiratory concerns including coughing, asthma, Apnea
Recurrent pneumonia
Esophagitis (inflammation that may damage tissues of the esophagus)
Dysphagia (difficulty swallowing) or feeding refusal
Upper airway symptoms (ear infections, throat infections, vocal issues, tooth enamel/dental issues)

Severity of reflux in infants is often focused on weight gain, respiratory issues and pain. If a baby is gaining well, reflux is still a significant matter, but the baby who is not gaining well is obviously a more serious concern. If your baby is exhibiting a combination of the symptoms above, please discuss the possibility of GERD with your child’s physician or pediatrician.

Treatment Options

There are some easy things parents can do to mitigate some of these symptoms[1]:

• Ensure baby is not over eating (easier for bottle fed babies than breast fed… small volumes more frequently is more desirable than larger volume less frequently)

• Consider non-prone sleeping position (elevated mattress; only for non-rolling babies. ALWAYS place an infant on their back to sleep unless you have discussed GERD with your physician and an alternative position is medically indicated)

• Consider trial of hypoallergenic formula

• Consider thickened formula (medically supervised)

There are a number of different pharmacological approaches to treating GERD[1]:

1. Antacids – effectively neutralizing the acids.

2. Pro-kinetics – which can encourage the esophogael sphincter to close, and have the stomach empty more rapidly and frequently, so the acid can’t get to where it’s a problem.

3. Surface Agents – coating the lining of the esophagus so it’s protected.

If medication is unhelpful, or the severity indicates further treatment, surgical intervention is also an option.

I encourage families to consider chiropractic treatment as well. There doesn’t seem to be a body of scientific evidence that would indicate a chiropractor would be helpful in preventing GERD. However, I can tell you in my professional experience and in an isolated case study, chiropractic adjustments have been helpful to improve symptoms of GERD.

The good news is that most babies will outgrow GERD as their digestive system matures. Until then, there are treatment options worth exploring to help make your baby more comfortable. When GERD is well managed, we can then go about addressing better sleep.

[1] Warren Shapiro, MD, The Incidence , Pathophysiology and Treatment GERD During Infancy, Presentation

[2] Judith A. Owens, MD, The Assessment and Management of Common Behavioral Sleep Problems in Children, Presentation at The Hospital for Sick Children Pediatric Sleep Symposium 2015, Toronto.

For further information:

Mayo Clinic

National Sleep Fountation

Positive Health Wellness