Your child struggling to focus? Look at her sleep patterns

How often do you come across children with sleep issues who also have behavioural problems?

We often see children with underlying clinical or subclinical issues also report sleep-related difficulties. They may face difficulties in falling asleep (e.g. racing thoughts that don’t stop) or staying asleep (e.g. frequently waking up with recurring thoughts or nightmares). Lack of sleep worsens psychiatric and behavioural issues resulting in even more difficulties with sleep. There is sufficient clinical evidence to demonstrate that mental health concerns like (but not limited to) hyperactivity, obsessive thinking, inattention, chronic irritability, and pervasive moodiness lead to sleep-related difficulties.



Why does this happen?

Sleep is responsible for rebooting and rebalancing neurotransmitters in the brain (e.g. adenosine, GABA, serotonin and dopamine) which play a vital role in cognition, mood, executive functioning and regulation abilities. Additionally, sleep is responsible for consolidating and organising long-term memory as well as processing, sorting and settling emotional experiences. The absence of sleep creates imbalance in these abilities and emotional regulation, eventually leading to difficulties in daily activities and heightened daytime emotional dysregulation.

What are the key factors affecting sleep quality in children?

Quality of sleep in children is affected by duration, timeliness, depth of sleep, number of interruptions and the restorative quality of sleep (how rested one feels after sleeping adequately).




What should parents do?

Parents can help children improve quality of sleep by doing the following,

• Being aware of their child’s sleeping habits and routine. Tracking how many hours they are sleeping, sleep time, waking time and if they are feeling rested
• Healthy sleeping habits include having a fixed time to go to bed, bedtime rituals (e.g. brushing, reading, evening bath, shutting off devices) and having a fixed time to wake up in the morning
• In situations where it is difficult or not possible to track sleep habits and routine (e.g. in case of adolescents) parents can look for secondary indications of disturbed sleep. These could include school avoidance, daytime sleepiness, sleeping in class, emotional eating, increase of intake in sugary drinks and caffeinated beverages, snoring, moving a lot during sleep and inexplicable increase in irritability.

When does a child require medical intervention?

Common red flags in kids that signal the need for medical intervention are,

• Child frequently taking more than 30 minutes to go to sleep
• Child frequently complaining that they are finding it difficult to go to sleep
• Multiple episodes of middle of the night awakening

Complaints of a child sleeping in class, difficulty concentrating could also indicate the need for further investigation
The need for a medical intervention will be decided by the reviewing doctor. In children, sleep difficulties are typically addressed using strategies like building a regular sleep routine and occasionally using short-term medication.

(Durgesh Nandan Jha)