For months now, I have been
writing about the studies that are being published—seemingly by the
month—linking obstructive
sleep apnea (OSA) to more and more medical conditions, including hypertension,heart disease, mood and memory problems.
The latest research didn’t
surprise me, but it did upset me more than usual — because it concerns our children,
and the negative effects that poor sleep can have on their ability to pay
attention, learn and control their behavior.
On May 1, the results of a
study by Penn State researchers was published showing that children who have
learning, attention and/or behavior problems may be suffering from a condition
known as excessive daytime sleepiness (EDS)—even if tests indicate that they
are getting enough sleep at night.
For the study, the
researchers conducted sleep testing on 508 children, and asked their parents to
report if their child seemed excessively sleeping during the day. Then, the
children were divided into two groups: children with excessive daytime sleepiness,
and those without EDS. The results, published in the May 2012 issue of SLEEP, showed that the children in
the parent-reported EDS group were more likely to have "neurobehavioral”
problems, including behavior/conduct problems, attention/hyperactivity and
poorer performance in learning speed and working memory than children without indications
of EDS.
What surprised the
researchers was that, even if a child was in the EDS group, few also showed
signs of short (not enough) sleep when tested. As a result, the researchers did
not associate short sleep with any of the learning, attention and behavior
problems.
So, what is causing these
children’s extensive daytime sleepiness if they are getting enough sleep (at least
on paper)? Like in adults, perhaps it is not just the length of sleep time, but
the quality of sleep that determines restorative rest, or not.
A New York Times
article from April 16, 2012 entitled “Attention Problems May Be SleepRelated” also examined the
relationship between children’s sleep quality and the ability to pay attention
at school. The article was on another recent study called “Sleep-Disordered
Breathing in a Population-Based Cohort: Behavioral Outcomes at 4 and 7 Years,”
published in the Official Journal ofthe American Academy of Pediatrics.
What I found disturbing
about this article was that it pointed out that many cases of attention deficit
hyperactivity disorder (A.D.H.D.) in children may have been misdiagnosed—that
the cause of behavior such as moodiness and hyperactivity might in fact be due
to obstructive sleep apnea (OSA) or other sleep disorder, which is causing
sleep deprivation in the child. Worse, the drugs diagnosed for the A.D.H.D. are
probably making the child’s symptoms worse!
This should be a call to arms
for parents, caretakers, teachers and the medical community. If you know of a
child suffering from sleep deprivation and/or extensive daytime sleepiness, and
the symptoms that result, such as behavioral and learning problems … speak up
and suggest they get tested for a sleep disorder first.
Impairment due to EDS in daytime cognitive and
behavioral functioning can have a significant impact on children's development.
This is not to say that A.D.H.D. cannot be a true cause, but misdiagnosis of anyone—especially
a child prescribed drugs—should not be tolerated.
Stay aware of the child’s
behavior; look for clues, such as inattentive behavior and obesity, take a
child’s “sleepy” complaints seriously … and then say something. You could be
the reason a child’s neurobehavioral challenges are properly diagnosed and
treated, leading to better behavior, greater ability to learn and a happier
child.
Read the abstract of the report, “Learning, Attention/Hyperactivity, and
Conduct Problems as Sequelae of Excessive Daytime Sleepiness in a General
Population Study of Young Children.”
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