Kids Need Good Sleep Hygiene

 

Penn State University researchers recently confirmed their suspicion that toddlers and preschoolers who consistently get a good night’s sleep “show higher levels of socioemotional and learning engagement, executive functioning, and academic outcomes [during kindergarten]… compared with children with lesser amounts of sleep.”  Ten hours or more of sleep every night predicted a smoother social adjustment to kindergarten and better school performance in the children who participated in the study:

These findings suggest that efforts to promote children’s K adjustment should be especially attuned to child sleep before K start. Good sleep hygiene (eg, organized bedtime routines, limited screen access, and bedtimes before 9 Pm) may be as critical for the well-being of children as it is for adults.

 

By the time children turn 5 years old, the American Academy of Sleep Medicine and the National Sleep Foundation recommend 10 to 13 hours of sleep per 24 hours. Since most kids have abandoned their daytime naps by then, those hours of sleep must occur at night.

Parents understand the importance of adequate and restful sleep for their children’s physical, mental, and behavioral health and well-being. When they feel their kids need some help with sleep hygiene, some parents will ask their pediatrician for bedtime advice and tips to get kids to stay asleep all night long. Melatonin — an over-the-counter sleep aid available in tablet, capsule, liquid, and gummy preparations — frequently enters the conversation. The CDC says the use of melatonin has become increasingly popular in recent years: 

Melatonin is an endogenous neurohormone that regulates the sleep-wake cycle. It is used therapeutically for insomnia in adults and for primary sleep disorders in children. Melatonin is regulated by the Food and Drug Administration (FDA) as a dietary supplement. Various synthetic melatonin preparations are widely available over the counter (OTC) in the United States with sales increasing from $285 million in 2016 to $821 million in 2020.

 

Melatonin is generally a safe intervention for children who have difficulty establishing and keeping healthy sleep habits. But as its use increases, so too does the risk for potential adverse side effects. In 2020, the nation’s poison control centers reported that melatonin was the most frequently ingested substance in children. In fact, the number of accidental ingestions of melatonin has soared more than 500% in the last 10 years, Molly Walker discovered:

Children ingesting melatonin, which is generally used to treat insomnia and sleep disorders, accounted for 4.9% of all pediatric ingestions reported to poison control centers in 2021, a 530% jump from 0.6% in 2012, reported Karima Lelak, MD, of Children’s Hospital of Michigan in Detroit, and colleagues.

In addition, pediatric hospitalizations related to melatonin poisoning rose during the study period. Five children required mechanical ventilation and two died, the authors wrote in the Morbidity and Mortality Weekly Report.

 

Walker breaks down the data:

Nearly all (94%) were unintentional, occurred in the home (99%), and managed on-site (88%). Most involved boys age 5 or younger.

A large majority (83%) of children were asymptomatic, though gastrointestinal, cardiovascular, and central nervous system symptoms were most common among symptomatic children.

However, 27,795 children required treatment at a healthcare facility. While most (72%) were discharged, 15% were hospitalized and 1% required intensive care.

 

The study found the threat of melatonin poisoning loomed larger during the pandemic:

The largest annual increase in pediatric melatonin ingestions coincided with the onset of the COVID-19 pandemic. Unintentional ingestions were the primary drivers of this increase. This might be related to increased accessibility of melatonin during the pandemic, as children spent more time at home because of stay-at-home orders and school closures. Further, reports of increasing sleep disturbances during the pandemic might have led to increased availability of melatonin in the home. This pandemic-related increase in accessibility and availability might have contributed to increased exposures in children.

 

While commonly used, the study demonstrates that melatonin isn’t always safe, especially when it unintentionally gets into the hands of young, unsuspecting children.

Getting kids on a good sleep schedule starts early and may take some time to establish. Progress during early childhood is often interrupted by developmental and behavioral issues (separation anxiety, night terrors and nightmares, for example), illnesses, stress, and travel. Parental patience and kindness are needed to help get them through the night safely and restfully.

 

source http://www.thepediablog.com/2022/07/20/kids-need-good-sleep-hygiene/