The National Sleep Foundation’s 2014 poll found that children are getting less-than-recommended sleep, but parents can play a powerful role in establishing good sleep habits for their kids.

By Karen Appold

Results of the National Sleep Foundation (NSF) 2014 Sleep in America Poll1 show that the majority of school-aged children aren’t getting the amount of sleep that the NSF recommends. However, the survey reveals that parents can play a critical role in having their children get enough Zs by setting boundaries regarding electronics use, limiting evening activities, enforcing rules, and setting a good example.

The study was comprised of 1,103 adults who are parents or claim parental responsibility for at least one child aged 6 to 17 in their household. The sample was randomly drawn from a probability-based online panel designed to represent the US population.

Three of the poll’s main goals were to examine: the sleep quality of both parents and children; the presence and impact of various types of electronic devices in parents’ and children’s bedrooms; and the prevalence and enforcement of rules and their relationship with children’s sleep, as well as other factors.

According to Helene Emsellem, MD, poll task force chair and medical director at The Center for Sleep and Wake Disorders, Chevy Chase, Md, the NSF chose to focus its 2014 poll on sleep in the modern family because they felt that the family unit has a strong impact on sleep and sleep behaviors, which merited closer inspection.

By featuring the topic, the task force hopes that increased parental awareness of sleep needs and factors interfering with sleep will lead to changes at a family level. These changes would enhance both sleep duration and quality and, in turn, improve overall health for the entire family, said Emsellem.

Surprising Findings

Helene Emsellem, MD, task force chair, 2014 Sleep in America Poll, and medical director at The Center for Sleep and Wake Disorders, Chevy Chase, Md

In particular, Emsellem found the extent of electronics use at night by adults surprising, as well as the role modeling effects seen with their children.

For example, 26% of parents sent or read e-mails and text messages after initially going to sleep; 15% of children were reported to do this as well. However, more than half of the children (52%) who reported sending or reading e-mails or texts after going to sleep had a parent who reported doing this as well.

“Another illuminating fact was that the biggest obstacle to obtaining a good night’s sleep for both children and adults was overscheduling,” said Emsellem.

When polled about common factors that interfere with their sleep or their child’s sleep, evening activities ranked highest on the list for both parents and children, while other factors such as temperature, inside noise, and homework (for children) were also reported obstacles to sleep.

Kristen Knutson, PhD, NSF Sleep in America Poll scholar and associate professor, University of Chicago Department of Medicine, was surprised at how common electronics are in children’s bedrooms, even among younger children. According to parent responses, 75% of children keep at least one electronic device in their bedroom.

She also was surprised at how many children leave these devices turned on after going to bed. But interestingly, the poll found that children frequently mirror their parents’ behavior when it came to devices being on or off during sleep. That is, 35% of parents and children reportedly both leave devices on, while 32% of parents and children reportedly both leave devices off; the remaining third is split between parent/child contrasting on/off.

Orfeu M. Buxton, PhD, NSF Sleep in America Poll task force member and assistant professor, Harvard Medical School, and associate neuroscientist, Brigham and Women’s Hospital, Boston, was pleasantly surprised to find that the vast majority of parents (about 9 out of 10) felt that sleep is a priority for children to thrive. Specifically, 97% of parents believe sleep is “extremely” or “very” important to their child’s health/well-being, and 96% report it is “extremely” or “very” important to their child’s school performance. “I think this is a cultural shift from a few decades ago, when getting sleep was almost akin to being lazy,” Buxton said.

A Closer Look at the Results

According to the poll, as adolescents move through their teenage years they become a highly sleep-deprived part of the population. (See Figure 1.)

Figure 1. Children’s sleep duration on school nights, by age group.
Figure 1. Children’s sleep duration on school nights, by age group.

More than half (56%) of 15 to 17 year olds sleep 7 hours or less per night, compared to 8% of 6 to 11 year olds. Likewise, only 10% of the older group sleep 9 hours or more, compared to 69% of the youngest group. On a school night, the average hours of sleep for kids aged 6 to 11 was 8.8 hours; for 12 to 14 year olds, that number decreased to 7.9 hours per night; and for 15 to 17 year olds, the number was just 7.1 hours per night. (See Table 1.)

Sleep_Table1-350

Based on current research, the NSF recommends that children ages 6 to 10 get about 10 to 11 hours of sleep per night, and that children in the older age groups get 8.5 to 9.5 hours per night. Based on the poll results, “This falls as much as 2 hours short of the recommended sleep times,” said Emsellem, who graduated from The George Washington University (GW) School of Medicine in 1977 and has been in practice for 33 years.

Related to this sleep deficit was the fact that many parents underestimate their children’s sleep needs. According to the poll, 46% of parents believe their child needs only 8 hours of sleep per night or less to be at their best.

Given the wide-ranging effects of inadequate sleep, including its impact on health, mood, and behavior, it is important that children get the sleep they need, Knutson said. This can affect their lives today as well as in the future. In fact, the NSF even advises parents to talk to their child’s teacher about their alertness during the school day. They should ask teachers to inform them if their child ever falls asleep in school, Buxton pointed out.

Say Goodnight to Electronics

Kristen Knutson, PhD, NSF Sleep in America Poll scholar and associate professor, University of Chicago Department of Medicine

By turning off electronics—TVs, tablets, smartphones, laptop or desktop computers, and/or video games—while sleeping, kids may gain an extra hour of sleep every night. “Using electronics at night can impair sleep both through noise and the light it emits as well as through mental stimulation,” Knutson said. “Therefore, it is not surprising that children who sometimes leave these electronics on after bedtime get less sleep on average.”

The poll found that 3 out of 4 children ages 6 to 17 keep at least one electronic device in the bedroom (and sometimes turned on) while sleeping. “Ideally, these devices should not be in the bedroom,” Buxton said. “If they are, at least try to turn them off or set them to automatically be off or silent during sleep times.”

Having electronics in the bedroom was significantly associated with a child’s age; older children have more electronics. For example, while 72% of children as a whole have at least one device in their bedrooms, 89% of teens aged 15 to 17 years have at least one device in their bedroom. In addition, the median number of devices in a child’s bedroom also increased with the child’s age: one device for age 6 to 11; two devices for age 12 to 14; and three devices for age 15 to 17.

Sleep_Table2-350

This increased access to electronics is important because, as the poll discovered, whether a device is turned on or off overnight has a big impact on the amount of sleep that children get. According to the results, only 25% of parents of teens who leave devices on rate their teen’s sleep as “excellent.” By comparison, nearly double the percentage of parents of teens rated their child’s sleep as “excellent” when devices are off (45%). (See Table 2.)

Likewise, “fair or poor” sleep was more frequently reported for children who sometimes leave devices turned on at night—more than twice as likely, in fact. While 9% of children who sleep with electronics always off were reported to have “fair or poor” sleep, that number jumped to 19% among children leaving electronics on overnight. (See Figure 2.)

“It is critical that we provide education for parents regarding their children’s sleep needs and the impact of electronics and their sleep environment on getting adequate amounts of sleep,” said Emsellem, whose work at the Center for Sleep & Wake Disorders involves educating parents, parent/teacher associations, and school systems regarding the optimal timing for the school day.

Figure 2. Sleep Quality by the presence of an interactive device.
Figure 2. Sleep Quality by the presence of an interactive device.

Avoid Evening Overload

Today’s American families often juggle very busy schedules. Overscheduled evenings and homework left for the last minute can both delay getting to bed at a reasonable hour, if sleep is deemed less important. “Fit in what’s truly necessary,” Buxton advised. “We’re simply more efficient and productive when we’ve had regular rest than when we’re rushing on deadline.”

More than one-third (34%) of parents reported that scheduled evening activities impacted their child in getting a good night’s rest and even more (41%) cited these activities as challenging their own sleep.

One in four (28%) parents reported that in the last week, homework made it more difficult for their child to sleep well at night.

In addition to limiting activities, the NSF advises parents to encourage activities such as reading or listening to music before bedtime instead of watching TV, playing video games, or surfing the Web. NSF also suggests creating a sleep-supportive bedroom and home environment, dimming the lights prior to bedtime and controlling the temperature. A temperature above 75 degrees Fahrenheit and below 54 degrees will disrupt sleep, they report.

Enforce the Rules

While limits are good for kids and adolescents, it is in their nature to test them. Buxton advised educating middle school-aged adolescents now about the tremendously positive impact that good sleep habits have on all aspects of their lives, including social, school performance, and health. “By the time they are in high school, they will likely have developed healthy sleep habits,” he said.

In particular, Knutson advised setting rules on how late a child could use electronic devices and how late a child could consume caffeine. Parents also should set appropriate and consistent bedtimes, she said. Parents who regularly enforce rules that restrict these behaviors have children who sleep more on average.

According to the poll, children get more sleep when parents establish rules about bedtime, including electronics usage. “We recommend that parents create a plan for when their child should use electronic devices in the bedroom, especially around bedtime, and consider limits on their own electronics by way of setting a healthy example,” Buxton said.

Sleep_Table3-350

Children with established bedtime rules sleep an average of 1.1 hours more than children whose parents do not have such rules. Based on the results, parents reported having fewer rules as the child’s age increased. While 70% of parents reported having all six rules (bedtime, TV, caffeine, smart/cell phone, computer/tablet, and video games) in place for their children age 6 to 11, that number was cut in half, to 35%, for children age 15 to 17. In fact, one-quarter (25%) of parents reported having none of these sleep-related rules for children age 15 to 17. That number for both ages 6 to 11 and 12 to 14 was only 3%.

As the poll revealed, established rules have a positive impact on a child’s sleep, across the board. The most significant average increases involved rules about how late the child can watch television (0.6 hours of additional sleep), the child’s established bedtime (1.1 hours of additional sleep), and how late the child can have caffeine drinks (1.6 hours of additional sleep). (See Table 3.)

Incidentally, Knutson noted that caffeine consumption is not recommended for children at any time of day. However, the study found that caffeine intake even 6 hours before bedtime caused sleep disturbances. Adults should cease caffeine use by 2 pm, according to NSF recommendations.

In addition, a good rule of thumb for bright light, especially screen use of any kind, is to limit these within an hour or two before bedtime to avoid the directly activating effects of bright light, and melatonin-suppressing effects of this light.

Practice What You Preach

Parents serve as role models for their children. A healthy home starts by having parents practice healthy sleep habits that they then instill in their children. Given the prevalence of electronics in American homes, it is important that parents be vigilant about their children’s use of electronics in the bedroom.

The poll found that 65% of children whose parents have an interactive electronic device in their bedroom also have at least one device in their own bedroom. By comparison, the poll found that only 24% of children had a device in their bedroom if their parent did not. “Setting a good example encourages children to follow suit,” Buxton said.

What’s Next?

In light of the poll’s results, Emsellem plans to continue to advocate for adequate time allocation for sleep. She also recommends that families have rules regarding bedtime so that teens have more time to sleep. In addition, promoting the fact that sleep is a critical element of good mental and physical health will remain a priority for her work.

“A good night’s sleep is as important as diet and exercise to long-term well-being,” said Emsellem, who treats all disorders of sleep and wakefulness including sleep apnea, insomnia, narcolepsy, and circadian rhythm disorders.

Meanwhile, Buxton believes that parents need greater support in guiding their children to get enough sleep. “It’s simple to say ‘get enough sleep,’ but it’s not always easy to work that out with kids who want autonomy and are stretching their wings. This is especially the case if they already have a smartphone and an excess of devices in the bedroom, while the parents have the same barriers to regularly getting a good night’s sleep,” he said.

“We haven’t fully thought through the impact of a constantly connected culture, but it seems that it is not the best thing for human health and wellness,” Buxton added. “Our devices could serve us on our schedule, and limit ads, notifications, and content from content-providers using technology that never sleeps.”


RT

Editor’s note: View full results of the NSF 2014 Sleep In America Poll here.

Karen Appold is a contributing writer to RT.
For further information, contact [email protected]


References

  1. National Sleep Foundation. 2014 Sleep in America Poll: Sleep In The Modern Family. March 26, 2014. Accessed here.