March 30, 2004 -- Apparently, you're never too young to have sleep deprivation. A new survey finds that children in every age group from infancy to elementary school don't get even the minimum recommended levels of sleep.
And, usually, their parents are clueless about it.
"There is a clear disconnect on what parents think their children need and what the kids are really getting," says Jodi Mindell, PhD, who chairs the National Sleep Foundation task force that prepared the survey. "When you ask parents if their child gets enough sleep, most say 'yes.' When you compare that to the number of hours that children are actually sleeping, two in three parents will learn their children don't."
The Sleep in America Poll, done each year by the foundation, adds more evidence to a well-documented fact: Americans are sleep-deprived.
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"We know from all past six years of this poll that adults are not getting enough sleep," says Mindell, associate director of the Sleep Disorders Center at The Children's Hospital of Philadelphia and author of Sleeping Through the Night. "And there are many studies showing that adolescents don't get enough sleep.
"This time, it's not a question of kids losing sleep because they have to go to school earlier. The school times for children attending daycare and elementary school haven't changed," she tells WebMD. "But they are still sleeping less than they should by at least 30 minutes a night. That amounts to two lost nights of sleep each month."
Some likely reasons, suggests the survey, based on answers from 1,500 parents of young children:
- Two in three kids have at least one sleep problem several times a week, such as resistance in going to sleep, trouble falling asleep, night awakenings, or snoring. And one in three needs attention from their parents at least once a week.
- Nearly half of kids -- including one in three preschoolers -- have a TV in their bedrooms. They get about two hours less sleep each week than children who don't.
- One in four kids has at least one caffeinated beverage a day, and averages three and a half hours less sleep per week than children who don't have caffeinated drinks.
Bad Habits Start Young
But perhaps most surprising: Half of all infants are sleep-deprived; they are getting less sleep than they should -- usually falling short by about one to two hours per 24-hour period.
This suggests that even as babies, children are developing bad sleeping habits. "And that concerns me as they move on to adolescence -- when we know they don't get enough sleep," says Amy Wolfson, PhD, of the College of the Holy Cross in Worcester, Mass., who has studied infant sleep habits and the effects on their parents.
"Families really need to rethink the importance of sleep in their households," Wolfson tells WebMD. "When children don't get enough sleep, their parents don't get enough sleep." Indeed, the survey finds that parents of infants lose about 200 hours of sleep in their child's first year.
She wasn't involved in the new survey, but her own research shows that a baby's sleep deprivation at levels noted in the NSF survey creates "enough everyday stress" to accumulate to levels of a large traumatic event," says Wolfson, author of The Woman's Book of Sleep: A Complete Resource Guide.
"Parents whose babies sleep better report higher satisfaction levels in their marriage," she says. "Can we say parents will inevitably divorce if their infants don't get enough sleep? No, but it is a risk factor that should raise concern."
She says that well-meaning parents often mistakenly set the tone for their infant's poor sleep habits. "Many wait in their infant or toddler's room until they fall asleep, but when you do that, you don't teach the child self-soothing techniques."
Instead, she recommends that parents help calm their children with goodnight rituals -- such as reading a story -- and then leave before the child falls asleep. Babies who fall asleep while alone in their room are more likely to sleep the night. "Children who need you to be in the room to fall asleep are more likely to need you when they wake in the middle of night; they look for you to be there."
Another surprising finding: A slight majority of doctors -- 52% -- don't ask parents about their child's sleep habits during medical exams. The American Academy of Pediatrics initiated a treatment policy in 2002 suggesting that pediatricians should.
"That really surprises me," says Debra Babcock, MD, a pediatrician in Los Altos, Calif., who has studied sleep disorders in children at the Stanford Sleep Disorders Center.
"Although loss of sleep can weaken immunity, it's hard to say if sleep deprivation leads to any permanent impairment. But it may cause permanent behavioral problems," she tells WebMD. "There is evidence that children who show signs of attention deficient disorder are, indeed, sleep deprived. Certainly there are other reasons that kids get ADD, but being overtired may be one of them. Some kids treated for ADD, in fact, are in need of a good night's sleep."
How can you tell if your children are sleep-deprived?
- Do you have to wake them each morning? "If so, they are not getting enough sleep," says Mindell, also a professor of psychology at St. Joseph's University in Philadelphia.
- Do they sleep longer on weekends than during school days? It's another sign of sleep deprivation.
- Are they cranky, irritable, and overactive? "Compare their mood and behavior on days when they get more sleep. Once you have a marker on what kids should be like, you'll get an indication of whether they're getting enough."
Based on recommended levels, that is 14-15 hours per day for infants, 12-14 hours for toddlers, 11-13 hours for preschoolers, and 10-11 hours for kids in first to fifth grade.