This piece in The Guardian caught my eye: “Children’s lack of sleep is ‘hidden health crisis’ – NHS statistics for England show sleep disorder admissions for under-16s was almost 10,000 last year” (here). The Guardian analysed NHS data, revealing that admissions with a primary diagnosis of sleep disorder among those aged 16 and under has risen from 6,520 in 2012-13 to 9,429 last year.
So – what is causing this increase in children presenting with sleep problems?
“Sleep issues are a huge problem … it’s a hidden public health crisis,” said Rachael Taylor, a child sleep consultant at The Sleep Sanctuary, quoted by The Guardian. “There is a lot of sleep anxiety being diagnosed at the moment; it’s a new area that we are looking at, dealing with more children who have anxiety and it is coming out in sleep issues.”
Vicki Dawson, the founder of the NHS Doncaster-funded the Children’s Sleep Charity, suggested the rise was partly down to technology and the fact that the blue light from screens suppresses the production of the sleep hormone, making it harder to fall asleep. “We are increasingly seeing families where both parents are out working and this can mean that bedtime becomes later, bedtime routines may be rushed or abandoned all together,” she said. Dawson added: “A good sleep routine is key in supporting a better sleep pattern. Diet can play a role too. We see children and young people who are consuming a lot of sugar and even energy drinks to try to compensate for the sleep deprivation that they are experiencing. This then has an impact on night-time sleep.”
Sleep issues are significant: in the USA between 15% to 28% of adults have a sleep disorder; 10% have chronic insomnia. Of these 48.0% report snoring; 37.9% reported unintentionally falling asleep during the day at least once in the preceding month and 4.7% reported nodding off or falling asleep while driving at least once in the preceding month! A major cause is obstructive sleep apnoea effecting 9-21% of women and between 24-31% of men. While many are not getting enough sleep: 37% of 20-39 year-olds and 40% of 40-59 year-olds report short sleep duration.
But what about mental health?
Chronic insomnia can increase a person’s chances for developing anxiety disorders and depression, according to a study conducted by Dag Neckelmann, MD, PhD, of the Department of Psychiatry at Haukeland University Hospital in Bergen, Norway (published in the July 1, 2007, issue of the journal SLEEP) demonstrated that Chronic insomnia can increase a person’s chances for developing anxiety disorders and depression.
The study collected date from 25,130 adults from two general health surveys conducted over a 10-year period. Compared to the group of participants without chronic insomnia in both surveys, the group with chronic insomnia had increased associations with anxiety disorders and depression. Those subjects who reported that they had insomnia during the initial survey had a higher risk of developing an anxiety disorder during the second phase of the study conducted 10 years later.
Yet there is a “chicken and egg” issue here – insomnia seems be a contributing cause of mental health issues… yet mental health issues can cause insomnia.
“Focusing on chronic insomnia as a symptom of both anxiety and depression may result in the early detection of a mental disorder, as well as the detection of other illnesses or conditions that may be present,” says Neckelmann.
So wherever you start… it’s a “vicious circle” – stress. anxiety and depression can cause insomnia… yet insomnia can expose children to mental help problems… and so on. So doctors must take note: insomnia may be an early or even the first symptom of depression and anxiety.
Which brings us back to the children – of course we should have good bedtime routines… yet I believe we should be looking at mental wellbeing of children with insomnia… stress, anxiety and depression are each a potential cause of the rise in such cases.