Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.
Importance of Slow-Wave Sleep | Consequences of Sleep Deficiency | Epidemiology | Treatment
Overview
A child’s sleeplessness can have broad, detrimental effects on their cognitive and emotional wellbeing. Thankfully, there are treatment options available to restore healthy sleep.
If you have a child who suffers from sleeplessness, you may not attribute their cognitive and behavioral problems to their sleep. Symptoms of insomnia can be linked to poor behavior or other cognitive disorders, such as ADHD.
This article will show you the many causes and effects of sleeplessness in children and why having a healthy sleep schedule is essential for wellness.
Importance of Slow-Wave Sleep
Slow-wave sleep occurs during Stage N3, when the central nervous system develops and grows.
This growth is associated with the consolidation of memory and learning, and the lack of slow-wave sleep can lead to cognitive difficulties in children.
During the first part of the night, slow-wave sleep occurs during the deepest phase of NREM sleep.
Consequently, parasomnias, or sleep disruptions, are most common during this sleep cycle phase. As a result, children who suffer from sleep deficiency are most likely to be affected during the slow-wave portion of the night. [1]
Consequences of Sleep Deficiency
Generally, a lack of sleep will affect all cognitive functioning of the brain. More specifically, sleeplessness in children can result in issues in the following areas:
1) Attention
Children with sleep difficulties find difficulty concentrating on tasks and will fail to perform well on tests. The detrimental effects of sleeplessness are compounded in more complex tasks and can make learning a new task challenging.[2]
2) Cognition
Issues related to cognition include anything that has to do with the planning or executing activities.
Some examples of cognitive tasks that are affected by sleeplessness include:
- Decision making
- Motivation
- Behavior control
- Planning
- Academic performance
3) Memory
As mentioned prior in the article, sleep positively influences the consolidation of memories created during the day.
This process is vital in learning new information, and lack of sleep can severely impact a child’s ability to learn new emotional and motor tasks.
Studies have shown that children who sleep after being exposed to a new task are more likely to retain the information over a more extended period. [3]
4) Emotional Regulation
Sleep disturbances increase the risk of anxiety, moodiness, and depression in children. This finding may result from the lack of REM sleep associated with emotional memory consolidation. [4]
Parts of the brain that control emotions appear less active in sleep-deprived people.
5) Behavioral Regulation
The most reported symptom of sleeplessness in children is hyperactivity, which may be an attempt by the child to stay awake.
Children with behavioral issues at school, including bullying and oppositional behavior, are more likely to be sleep-deprived.
Children who suffer from sleeplessness show a disconnection between the brain’s risk and reward pathways. This system’s disconnection leads children to become more aggressive, risky, and defiant.[5]
Epidemiology
Parasomnias are reported in up to 88 percent of children, although most are resolved and not chronic. However, traditional disparities concerning race, ethnicity, and socioeconomic position exist, causing more people within these demographics to suffer from the harmful effects of sleeplessness. [6]
Sleep Disorders That Lead to Behavioral Issues
Often, lack of sleep is due to an underlying problem. Identifying the problem is the first step in treating the lack of sleep and, therefore, the behavioral issues. Below is a list of sleep disorders found in children and how each disorder manifests in their behavior.
1) Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) occurs when airflow is intermittently interrupted during sleep, causing disruptions in sleep quality. OSA can occur when the airflow is restricted (hypopneas) or fully obstructed (apneas).
Due to the increased effort required to breathe, habitual snoring is common in children with OSA.
Behaviors shown by children suffering from OSA include all of those listed earlier in the article, including attention issues, behavioral issues, and emotional issues.
Also, children can suffer from hyperactivity, which manifests as ADHD-like symptoms or daytime sleepiness, shown by increased napping. [7]
2) Insomnia
Insomnia is the inability or resistance of a child to sleep, with or without frequent awakening during the night.
The cause may be due to behavior, such as resistance to sleep or lenient parental rules about bedtime.
Mental health issues and neurodevelopmental conditions are commonly associated with inadequate sleep and an increased need for parental intervention.
In addition to the general effects of sleeplessness, children with insomnia often suffer from exacerbating other cognitive issues such as ADHD, depression, and anxiety. [8]
The inability to sleep or interruption in sleep caused by the uncontrollable movement of limbs is known as restless legs syndrome (RLS). Specifically, the movement of limbs is known as periodic limb movement disorder (PLMD).
RLS and PLMD are highly associated with ADHD symptoms and diagnosis. It’s common for children who have RLS to have higher levels of hyperactivity, inattention, and irritability. [9]
4) Narcolepsy
The rarest of conditions listed here, narcolepsy, is the neurological disorder of having excessive sleepiness.
Children with narcolepsy can also suffer from a condition known as cataplexy, where the entire body goes limp.
Narcolepsy is not associated with any specific cognitive impairments. However, the lack of sleep can result in difficulty with attention, mood control, and fatigue. [10]
Treatment
The treatment for sleep disorders leading to behavioral and cognitive issues depends on the child. For example, a child who has behavioral insomnia will not be treated the same as a child with OSA.
In general, the best way to treat a child with sleeping issues is to do away with the cause of the sleep distress.
For children with OSA and other breathing issues, the most common cause is tonsillar enlargement. The treatment or removal of the tonsils could lead to more restful and less interrupted sleep. [11]
Some conditions are best treated by first addressing other neurological ailments of the child.
ADHD and anxiety are both strongly associated with insomnia and RLS. The treatment of the conditions can reduce the sleep disorder and an improvement in sleep quality. [12][9].
Medication is an option for conditions like RLS, with iron supplements and anticonvulsants showing a reduction in sleep interrupting symptoms. [13]
The best way to begin treatment is by consulting with a professional. A physician can diagnose sleep issues during a sleep test and start your child on a treatment plan for better sleep.
Conclusion
The best way to help your child is to stay aware of their sleeping and behavioral habits.
Communicate with teachers, babysitters, and your child to understand how they are sleeping and behaving.
Finally, please consult with a professional on how your child can be helped through their struggle for quality sleep.
References:
- Kirsch, D. (2021, February). Stages and architecture of normal sleep. Retrieved from https://www.uptodate.com/contents/stages-and-architecture-of-normal-sleep
- Beebe, D. W. (2011). Cognitive, behavioral, and functional consequences of Inadequate sleep in children and adolescents. Pediatric Clinics of North America, 58(3), 649-665. doi:10.1016/j.pcl.2011.03.002. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21600347/
- Desrochers, P. C., Kurdziel, L. B., & Spencer, R. M. (2015). Delayed benefit of naps on motor learning in preschool children. Experimental Brain Research, 234(3). doi:10.1007/s00221-015-4506-3. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26645305/
- Simon, E. B., Oren, N., Sharon, H., Kirschner, A., Goldway, N., Okon-Singer, H., . . . Hendler, T. (2015). Losing neutrality: The neural basis of Impaired emotional control without sleep. Journal of Neuroscience, 35(38), 13194-13205. doi:10.1523/jneurosci.1314-15.2015. Retrieved from https://www.jneurosci.org/content/35/38/13194
- Shochat, T., Cohen-Zion, M., & Tzischinsky, O. (2014). Functional consequences of inadequate sleep in adolescents: A systematic review. Sleep Medicine Reviews, 18(1), 75-87. doi:10.1016/j.smrv.2013.03.005. Retrieved from https://pubmed.ncbi.nlm.nih.gov/23806891/
- Petit, D., Touchette, E., Tremblay, R. E., Boivin, M., & Montplaisir, J. (2007). Dyssomnias and parasomnias in early childhood. PEDIATRICS, 119(5). doi:10.1542/peds.2006-2132. Retrieved from https://pubmed.ncbi.nlm.nih.gov/17438080/
- Quan, S., Archbold, K., Gevins, A., & Goodwin, J. (2013). Long-term neurophysiologic impact of childhood sleep disordered breathing on neurocognitive performance. Southwest Journal of Pulmonary and Critical Care, 7(3), 165-175. doi:10.13175/swjpcc110-13\. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24511452/
- Armstrong, J. M., Ruttle, P. L., Klein, M. H., Essex, M. J., & Benca, R. M. (2014). Associations of CHILD Insomnia, Sleep movement, and their persistence with mental health symptoms in childhood and adolescence. Sleep, 37(5), 901-909. doi:10.5665/sleep.3656. Retrieved from https://pubmed.ncbi.nlm.nih.gov/24790268/
- Silva, G. E., Goodwin, J. L., Vana, K. D., Vasquez, M. M., Wilcox, P. G., & Quan, S. F. (2014). Restless legs syndrome, sleep, and quality of life among adolescents and young adults. Journal of Clinical Sleep Medicine, 10(07), 779-786. doi:10.5664/jcsm.3872. Retrieved from https://pubmed.ncbi.nlm.nih.gov/25024656/
- Narcolepsy in children and adolescents. (2006). Narcolepsy and Hypersomnia, (pp. 105-114). Retrieved from https://doi.org/10.3109/9781420019254
- Venekamp, R. P., Hearne, B. J., Chandrasekharan, D., Blackshaw, H., Lim, J., & Schilder, A. G. (2015). Tonsillectomy or adenotonsillectomy versus non-surgical management for obstructive sleep-disordered breathing in children. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd011165.pub2. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26465274/
- Herman, J. H. (2015). Attention deficit/hyperactivity disorder and sleep in children. Sleep Medicine Clinics, 10(2), 143-149. doi:10.1016/j.jsmc.2015.02.003. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26055862/
- Durmer, J. S., & Quraishi, G. H. (2011). Restless legs Syndrome, PERIODIC LEG movements, and Periodic limb movement disorder in children. Pediatric Clinics of North America, 58(3), 591-620. doi:10.1016/j.pcl.2011.03.005. Retrieved from https://pubmed.ncbi.nlm.nih.gov/21600344/
