Sleep Matters

DEPRIVED: Dr. Arif Khan says the region’s children don’t sleep enough, which causes problems for the parents as well.

The region’s children aren’t getting enough of it.

BY Dr. Arif khan

Shakespeare referred to sleep as “nature’s soft nurse.” But in today’s world, many of us have moved away from appreciating the goodness of sleep to regarding it as a deterrent and a waste of time.

Perhaps it is best manifested in Thomas Alva Edison’s own words when he said: “I never found need of more than four or five hours’ sleep in the twenty-four hours. I never dream. It is real sleep. When by chance I have taken more, I wake dull and indolent.” And even further, Margaret Thatcher mocked it by saying: “Sleep is for wimps.”

According to multiple studies, we spend nearly a third of our lives sleeping. So, if someone were to end up living 96 years, 32 of those would be dedicated to sleep.

Physiologically and historically, we know sleep is an essential part of our twenty-four hours’ circadian rhythm. It has three main functions, the first of which is restorative. Meaning, it restores essential elements in our body that have depleted during the day. Furthermore, growth hormone secretion, cell division and protein synthesis are all important functions that occur when we sleep.

The second function is neurological. Sleep consolidates our memory. Many students tend to stay awake the night before a test to cram more information and reproduce it the next morning. However, what they do not realize is that whatever information they have been trying to memorize will not get consolidated unless they enter a certain phase of sleep.

The third function of sleep is psychological, almost giving respite from daytime stimuli. It is like rebooting your hard drive, switching it off for a while and then switching it on so that it is all reset.

If you do not get proper sleep, you will swiftly begin to feel its effect. In children, it causes a number of problems, the first of which is daytime sleepiness which affects the child’s learning, as well as their effectiveness and ability to grasp and understand things during the daytime. It also affects the child’s behavior in that the child becomes fidgety, hyperactive and sometimes misdiagnosed with attention deficit hyperactivity disorder, even though it is the lack of sleep that is the main culprit.

Children can also develop a habit of eating excessively if they have a chronic lack of sleep, leading to obesity and other health issues. Sleep deficiency also impacts the social interaction that children share with their peers, their parents and their teachers. In short, the lack of sleep impacts every aspect of our body, which in turn affects our health as well

Sleep deprivation does not affect children alone. Lack of sleep in kids can lead to problems for their parents, such as disruptive sleeping patterns, frustration, aggression and reduced efficiency at work, along with negative health effects in general.

Sleep has been defined as a reversible state of reduced awareness of selective responsiveness to the environment. Although we have reduced awareness when we sleep, we still have an element of responsiveness and the ability to respond to specific selective stimuli. The best example of this is new mothers who do not respond to any stimuli after they sleep because of exhaustion, but if their child whimpers, they wake up without needing a second call.

It is extremely important to understand the pattern and consistency of sleep in children when dealing with any symptom. Children can either be extremely hyperactive during the daytime or experience excessive daytime sleepiness. Symptoms also include a number of behavioral issues, such as aggression.

Each of these children need to have their sleep history examined in detail. Broadly, sleep disturbances can be divided into insomnia (which includes problems with sleep onset association and problems with limit setting during nighttime sleep), hypersomnia, parasomnia, circadian rhythm disorders, sleep related movement and breathing disorders and others. Many of these are quite common in childhood. The most common of these, however, is insomnia in which patients face difficulty falling asleep, mainly due to learned behavior over many years.

I always describe sleep as a behavior to parents which can be learned and relearned. If you find that children have difficulty going to sleep, it is usually because they have adopted this behavioral pattern over a number of years, and will likely take anywhere between a few months to a year to go back to a normal sleeping pattern.

One of the most crucial aspects of managing sleep in children is identifying the root cause of the problem. Parents usually fail to pay attention to this.

Once sleep deficiency has been identified, the patient should be referred to someone who is qualified to handle the issue and provide proper medical advice.

Occasionally, we see organic causes of sleep difficulties and sleep disturbances, or intermittent waking up phenomena. This could be because of health issues such as breathing problems, epilepsies or parasomnias, and these have to be managed by a neurologist or a sleep medicine physician.

As a general rule to maintain healthy sleeping patterns, I usually recommend being consistent with your sleeping schedule. Maintain a short bed time routine involving activities such as taking a bath, changing into comfortable clothes and reading a story. Stop engaging in stimulating activities a few hours prior to sleeping. Turn off the television, stay away from computers and video games at least an hour before sleeping and avoid distractions in the bedroom.

Fran Lebowitz, a humorist in 1950 described life as something you do when you cannot get to sleep. The irony is that if you don’t get to sleep much, it is likely that your lifespan will be affected.

Dr. Arif Khan, Consultant Pediatric Neurologist, American Center of Psychiatry and Neurology.


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