Course:KIN366/ConceptLibrary/Sleep

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Movement Experiences for Children
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KIN 366
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Instructor: Dr. Shannon S.D. Bredin
Email: shannon.bredin@ubc.ca
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Sleep is one of the dominant activities of growing children. By the time children reach the age of three, they will have spent more time sleeping than all other activities combined (Avidan & Zee, 2006). This substantial amount of sleep requirement continues across the entire childhood suggesting that sleep plays a vital role in children's health and wellbeing. Unfortunately, a recent article based on data from more than 690,747 children across 20 countries indicates that sleep durations of children have been steadily declining over the last century (Matricciani, Olds, & Petkov, 2012). In addition to multiple benefits associated with sufficient sleep, sleep deprivation is linked to decreased levels of physical activity and increased rates of obesity (Stone, Stevens, & Faulkner, 2013).

Definitions

Sleep is a natural state that is characterized by a relatively inactive nervous system, relaxed postural muscles, and practically suspended consciousness (Roberts, 2013). Furthermore, sleep is not a passive event, but rather an active process involving memory consolidation that leads to improvement in task performance (Nere, Hashmi, Cirelli, & Tononi, 2013).

The Benefits of Sleep on Task Performance

There are numerous benefits that can accrue from sleep. Sleep is particularly beneficial for children whose minds and bodies are developing (Matricciani et al., 2012). In terms of physical development, sufficient sleep has been shown to be a key factor in improving procedural tasks and declarative tasks in children (Nere et al., 2013).

The Benefits of Sleep on Procedural Tasks

Procedural tasks involve performing an action that does not require any conscious effort and awareness such as the act of walking without much thinking (Nere et al, 2013). Also, procedural tasks require implicit memory, which is acquired unintentionally without awareness of storing any new information (Fischer, Wilhelm, & Born, 2007). Sleep appears to help form implicit memory, which is particularly relevant to children due to the earlier development of brain structures underlying implicit learning than the development of structures supporting explicit learning (Fischer et al., 2007). It has been suggested that implicit memory can enable children to gradually perceive stimuli through sensory and motor inputs, hence, increasing children's ability to physically perform procedural tasks (Fischer et al., 2007). In summary, sleep is critical for implicit memory, which facilitates procedural tasks for children.

The Benefits of Sleep on Declarative Tasks

Conversely, declarative tasks require conscious awareness and efforts to absorb information (Tricomi & Fiez, 2012). The benefit of sleep for declarative learning is evident in the sequential finger tapping task for children. A sequential finger tapping task is a type of fine motor skills, which involves precise finger placement on predetermined locations such as keyboards (Sugawara et al., 2014). Children aged nine and eleven show significant improvement in finger tapping skill levels after sleep compared to those children that do not sleep (Sugawara et al., 2014). In addition, the total amount of sleep have a significant positive effect on the degree of declarative task improvement in children. It appears that as the number of hours of sleep increases (to a maximum of 12 hours), the greater the performance improvement it is (Sugawara et al., 2014). Hence, sufficient amounts of sleep is necessary for the enhancement of declarative tasks.

Risk of Sleep Deprivation

Not only is sleep deprivation associated with the loss of the sleep benefits, such as the improvement of task performance, but it also can have a strong impact on children's physical growth and development. Sleep deprivation occurs when one does not obtain adequate amounts of sleep for his or her particular age (Colten & Altevogt, 2006). Children who sleep less than their peers appear to be less physically active and more likely to be obese.

The Effects of Sleep Deprivation on Children's Physical Activity

In children, the relationship between the durations of sleep and the amount of physical activity seems bidirectional. In other words, sleep deprivation is linked to lower levels of physical activity and vice versa. In a large-scale study that comprises 68, 288 children, parent-reported inadequate sleep is associated with over 50% chance of being physical inactive (Singh, Kogan, Siahpush, & van Dyck, 2008). In other words, short durations of sleep increases the odds of physical inactivity in children. In another study involving 1,365 children indicates that low physical activity is associated with more than three times increase in the risk of reporting insomnia symptoms (Liu, Uchiyama, Okawa, & Kurita, 2000). Put differently, children who engage in lower levels of physical activity are more likely to have difficulty sleeping than those who participating in higher levels of physical activity.

The Effects of Sleep Deprivation on Children's Obesity Rates

Nowadays, childhood obesity seems to be one of the most serious public health issues. According to the reports of World Health Organization (2015), the number of obese children under the age of five reaches over 45 million globally. This alarming rate of obesity does not seem to be completely attributable to changes in physical activity and caloric intake since interventions that have targeted these behaviours alone resulting in limited success (Bouchard & Katzmarzyk, 2010). Thus, other behaviours might contribute to obesity such as sleep deprivation, which is one of the most recognized potential risk factors (Bouchard & Katzmarzyk, 2010). Specifically, in childhood, short durations of sleep appear to be associated with increased rates of obesity. Recent studies demonstrate that sleeping time is inversely related to the risk of obesity for children (Ekstedt, Nyberg, Ingre, Ekblom, & Marcus, 2013; Hjorth et al., 2014; Julia & Huriyati, 2013). In other words, as the amount of sleep decreases, the risk of being obese increases.

The Effects of Catch-up Sleeps on Physical Inactivity and Obesity

More often than not, children seem to make up for weekday sleep deficit with longer weekend sleep. This "weekend-catch-up-sleep" seems to alter the relationship between sleep, physical activity and obesity. The relation between sleep and physical inactivity varies between weekdays and weekends. The majority of children who do not attain recommended sleep on weekdays tend to increase their sleep on the weekend, with almost half sleeping more than ten hours (Stone et al., 2013). However, these children that engage in catch-up sleep on weekends do not appear be as physical active as those who have sufficient sleep daily. As Stone et al., (2013) suggest, children who have longer weekend sleep are less physically active and more likely to be obese than those attaining recommend sleep daily. Despite children increasing their sleep over the weekend, their physical activity levels are still lower than those who get sufficient sleep across weekdays. This finding illustrates catch-up sleep over the weekend is not sufficient. Rather, sleep regularity on a daily basis is necessary for maintaining optimum amount of physical activity and maintaining a healthy weight.

However, this "weekend-catch-up" sleep may be important for lowering the risk of obesity. As a recent study demonstrates, children who maintain lower levels of sleep across the week are significantly more like to be obese that those children who have "weekend-catch-up" sleep (Spruyt, Molfese, & Gozal, 2011). Hence, "weekend-catch-up sleep" is more beneficial to our weight than without sleeping every day. To sum up, children who maintain recommended levels of sleep across the week have the healthiest and consistent levels of physical activity, as well as the lowest obesity rates.

Causes of sleep Deprivation

The causes for sleep deprivation are many and varied. A loss of sleep can simply be triggered by environmental stimuli, such as too much noise or light exposure. It can also be attributed to health issues, such as allergies or seizures (Colten & Altevogt, 2006). Even a hot room or hunger can interrupt children's sleep (Colten & Altevogt, 2006). Hence, the list of reasons for sleep deprivation is extensive. Collectively considered, electronic devices and parenting style seem to be the major factors that contribute to sleep deprivation for children.

Electronic Devices and Sleep Deprivation

The presence of electronic screen devices in children’s bedrooms is increasingly popular and common, which contributes to children's loss of sleep unfortunately. According to Kaiser (2006), in a typical day, almost all children between the ages of six months and six years use some form of electronic devices: 75% of children watch television, 16% use a computer, and 11% play either console or handheld video games. Additionally, children nowadays are spending seven or more hours each day using electronic devices (Kaiser, 2006). Although parents may believe these electronic advices can improve their children's technology skills, multiple studies demonstrate the negative effects of electronic devices on sleep:

1. Children who use electronic devices at night report fewer hours of sleep each week, late bedtimes, and frequent daytime sleepiness (Chahal, Fung, Kuhle, & Veugelers, 2013).

2. Sleep quality is significantly poorer with the presence of two or more electronic screens (Chaput et al., 2014).

3. The higher the number of screens in a child's bedroom is associated with a higher percentage of body fat and increased difficulty of falling asleep (Chaput et al., 2014).

The increasing prevalence of electronics in a children bedroom undoubtedly has a negative impact on children's sleep durations and sleep quality.

Parenting Style and Sleep Deprivation

Parenting style appears to be strongly linked to the amount of sleep a child obtains. More and more evidence is showing that children's household environment can play a critical role on their sleeping habits (Biddle, Pearson, Ross, & Braithwaite, 2010; Telama, 2009). Parents can largely control the accessibility and availability of electronic devices, which is known to be a determinant of sleep quality and durations. Most importantly, parents can directly influence their children's sleeping quantity by deciding their children’s sleeping hours (Philips, Sioen, Michels, Sleddens, & De Henauw, 2014). Besides these specific parental behaviours, the role of parenting style is closely linked to the children's sleep pattern. Parenting styles refers to parents’ beliefs, expectations and attentiveness to rules for their children (Sari & Altiparmak, 2011). Children’s average sleep durations reduces when parents engage in coercive control parenting style (Philips et al., 2014). Coercive control is characterized by the use of pressure, intrusion, and domination, which discourage the children’s independence and individuality (Philips et al., 2014). When parents score high on coercive control questionnaires, their family atmosphere appears to be negative (Philips et al., 2014). This environment can create more stress for the children, increasing the difficulties of falling asleep (Sari & Altiparmak, 2011). In short, a coercive-control parenting style can induce a stressful atmosphere, which is associated with the loss of sleep for children.

Practical Application for Parents

Due to the fact that the lack of sleep is associated with increased rates of physical inactivity and obesity, it is crucial to improve the durations and efficiency of sleep for children. The plan of care to improve children's sleep quality and quantity should involve parents as well since children tend to imitate behaviours of others according to observational learning (Anderson & Pempek, 2005). Observational learning occurs by observing and copying the actions of others without direct engagement (Huang, 2013). As a results, parents should act as role models for their children. Parents can address the issues of sleep deprivation by attempting the following recommendations to limit screen time, increase regularity of sleep schedule, and address the difficulty of falling asleep.

Limiting Screen Time to Appropriate Amount:

1. For children under the age of two, parents should encourage more interactive activities such as playing and talking instead of watching Television, videos, or DVDs (Christakis, Zimmerman, DiGiuseppe, & McCarty, 2004).

2. For children age two and up, parents should limit the screen time to 1-2 hours a day by keeping electronic devices in common areas instead of children's bedrooms (Christakis et al., 2004).

3. Parents should try to prevent children from using any electronic devices close to bedtime since it can interfere with bedtime routine (Durand, 2008).

Increasing Regularity of Sleep Schedule:

1. Determine the approximate number of hours of sleep for the child based on recommended sleeping hours and the child’s individual needs (Durand, 2008).

2. Assist the child in keeping a consistent bedtime and awake time daily by sleeping at the same time as them (do not deviate by more than one hour) (Durand, 2008).

3. When the child is awake at night, parents should try to limit the exposure of lights for him or her (Durand, 2008).

Addressing the Difficulty of Falling Asleep:

1. Parents can establish a later bedtime for the child (Durand, 2008).

2. Encourage the child to get out of bed if he or she cannot fall asleep within 15 minutes (Durand, 2008).

3. Instruct the child to stay in a different location other than the bedroom and engage in some quiet activities (e.g., reading) until he or she is tired; and then go back to bed and try to sleep again (Durand, 2008).

Similar to the wide variety of causes for sleep deprivation, there are multiple strategies to improve children’s sleep quality and quantity. The list of strategies is extensive. Parents should attempt as many as possible to find the most effective method, and tailor it to the specific needs of children. Therefore, knowing the child is necessary to ensure an effective treatment.

References

  1. Anderson, D. R., & Pempek, T. A. (2005). Television and very young children. The American Behavioral Scientist, 48(5), 505-522. doi:10.1177/0002764204271506
  2. Avidan, A. Y., & Zee, P. C. (2006). Handbook of sleep medicine. Philadelphia, PA: Lippincott Williams & Wilkins.
  3. Biddle, S. H., Pearson, N., Ross, G. M., & Braithwaite, R. (2010). Tracking of sedentary behaviours of young people: A systematic review. An International Journal Devoted To Practice And Theory, 51(5), 345-351. doi:10.1016/j.ypmed.2010.07.018
  4. Bouchard, C., & Katzmarzyk, P. T. (2010). Physical activity and obesity. Champaign, IL: Human Kinetics.
  5. Chahal, H., Fung, C., Kuhle, S., & Veugelers, P. J. (2013). Availability and night-time use of electronic entertainment and communication devices are associated with short sleep duration and obesity among Canadian children. Pediatric Obesity, 8(1), 42-51.doi:10.1111/j.2047-6310.2012.00085.x
  6. Chaput, J., Leduc, G., Boyer, C., Bélanger, P., LeBlanc, A. G., Borghese, M. M., & Tremblay, M. S. (2014). Electronic screens in children's bedrooms and adiposity, physical activity and sleep: Do the number and type of electronic devices matter?. Canadian Journal of Public Health, 105(4), e273-e279. Retrieved from http://search.proquest.com/docview/1612456438?pq-origsite=summon
  7. Christakis, D. A., Zimmerman, F. J., DiGiuseppe, D. L., & McCarty, C. A. (2004). Early television exposure and subsequent attentional problems in children. Pediatrics, 113(4), 708-713. doi:10.1542/peds.113.4.708
  8. Colten, H. R., & Altevogt, B. M (2006). Sleep disorders and sleep deprivation: An unmet public health problem. Washington, DC: National Academies Press.
  9. Durand, V. M. (2008). When children don't sleep well: Interventions for pediatric sleep disorders: Therapist guide. Oxford; New York: Oxford University Press.
  10. Ekstedt, M., Nyberg, G., Ingre, M., Ekblom, Ö., & Marcus, C. (2013). Sleep, physical activity and BMI in six to tenyear- old children measured by accelerometry: A cross-sectional study. International Journal of Behavioral Nutrition & Physical Activity, 10(1), 82-91. doi:10.1186/1479-5868-10-82
  11. Fischer, S., Wilhelm, I., & Born, J. (2007). Developmental differences in sleep's role for implicit off-line learning: Comparing children with adults. Journal of Cognitive Neuroscience, 19(2), 214-227. doi:10.1162/jocn.2007.19.2.214
  12. Hjorth, M. F., Chaput, J., Damsgaard, C. T., Dalskov, S., Andersen, R., Astrup, A., & ... Sjödin, A. (2014). Low physical activity level and short sleep duration are associated with an increased cardio-metabolic risk profile: A longitudinal study in 8-11 year old Danish children. Plos One, 9(8), 1-9. doi:10.1371/journal.pone.0104677
  13. Huang, C. (2013). Contexts of a person's prior intentions facilitate observational learning in 2.5-year-old children. Cognitive Development, 28(4), 374-385. doi:10.1016/j.cogdev.2013.05.003
  14. Julia, M., & Huriyati, E. (2013). Sleep and physical activity pattern of obese children. International Journal of Pediatric Endocrinology, 14, 243-258. doi:10.1186/1687-9856-2013-S1-P108
  15. Kaiser, H. J. (2006). Media family: Electronic media in the lives of infants, toddlers, preschoolers and their parents. Retrieved from http://statistical.proquest.com/statisticalinsight/result/pqpresultpage.previewtitle?htm
  16. Liu, X., Uchiyama, M., Okawa, M., & Kurita, H. (2000). Prevalence and correlates of self-reported sleep problems among Chinese adolescents. Journal of Sleep Research & Sleep Medicine, 23(1), 27-34. Retrieved from http://www.journalsleep.org/
  17. Matricciani, L., Olds, T., & Petkov, J. (2012). Clinical Review: In search of lost sleep: Secular trends in the sleep time of school-aged children and adolescents. Sleep Medicine Reviews, 16203-211. doi:10.1016/j.smrv.2011.03.005
  18. Nere, A., Hashmi, A., Cirelli, C., & Tononi, G. (2013). Sleep-dependent synaptic down-selection (I): Modeling the benefits of sleep on memory consolidation and integration. Frontiers in Neurology, 41-17. doi:10.3389/fneur.2013.00143
  19. Philips, N., Sioen, I., Michels, N., Sleddens, E., & De Henauw, S. (2014). The influence of parenting style on health related behavior of children: Findings from the ChiBS study. International Journal of Behavioral Nutrition & Physical Activity, 11(1), 1-23. doi:10.1186/s12966-014-0095-y
  20. Roberts, L.W. (2013). The academic medicine handbook: A guide to achievement and fulfillment for academic faculty. Dordrecht, SH: Springer New York.
  21. Sari, H. Y., & Altiparmak, S. (2011). Sleep and parenting styles in preschool children in Turkey. International Journal of Child Health and Human Development, 4(2), 203-212. Retrieved from https://www.novapublishers.com/catalog/product_info.php?products_id=22420
  22. Singh, G. K., Kogan, M. D., Siahpush, M., & van Dyck, P. C. (2008). Independent and joint effects of socioeconomic, behavioral, and neighborhood characteristics on physical inactivity and activity levels among U.S. children and adolescents. Journal of Community Health, 33(4), 206-216. doi:10.1007/s10900-008-9094-8
  23. Spruyt, K., Molfese, D. L., & Gozal, D. (2011). Sleep duration, sleep regularity, body weight, and metabolic homeostasis in school-aged children. Pediatrics, 127(2), e345-e352. doi:10.1542/peds.2010-0497
  24. Stone, M., Stevens, D., & Faulkner, G. (2013). Maintaining recommended sleep throughout the week is associated with increased physical activity in children. Preventive Medicine, 56(2), 112-117. doi:10.1016/j.ypmed.2012.11.015
  25. Sugawara, S. K., Tanaka, S., Tanaka, D., Seki, A., Uchiyama, H. T., Okazaki, S., . . . Sadato, N. (2014). Sleep is associated with offline improvement of motor sequence skill in children. Plos One, 9(11), e111635. doi:10.1371/journal.pone.0111635
  26. Telama, R. (2009). Tracking of physical activity from childhood to adulthood: A review. Obesity Facts, 2(3), 187-195. doi:10.1159/000222244
  27. Tricomi, E., & Fiez, J. A. (2012). Information content and reward processing in the human striatum during performance of a declarative memory task. Cognitive, Affective & Behavioral Neuroscience, 12(2), 361-372. doi:10.3758/s13415-011-0077-3
  28. World Health Organization. (2015). Childhood overweight and obesity. Retrieved from http://www.who.int/dietphysicalactivity/childhood/en/
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