"5 Unexpected Things a Sleep Doctor Taught Me About Better Sleep"

From thehealthy.com

By Alex Vance

After consulting with a renowned sleep doctor, one health writer had some of her biggest assumptions about sleep challenged.

“How do you think you sleep?”

As a 39-year-old mom of three girls—ranging in age from 2 to 9—that’s a loaded question.

So when I was asked this exact question by Chris Winter, MD—a board-certified sleep medicine and neurology specialist who works with some of the world’s top professional athletes—I laid it all out there: I thought I had a pretty good handle on my sleep. I go to bed around the same time every night—unless I have some writing to do—and I’ve been tracking my sleep with an Oura Ring for around seven months.

I go to my local boot camp four to five days a week, but still like a glass of wine (or two) when my husband and I finally have time to wind down in the evenings. Sometimes the kids sleep great, sometimes they’re standing over my bed at 2 a.m. I thought I was doing OK, but I was sure there was plenty I needed to work on…right?

His answer wasn’t nearly as simple—or as predictable—as I expected.

As a renowned sleep doctor who’s consulted for some of the most iconic sports franchises (including the Boston Red Sox, Los Angeles Dodgers, Chicago Bulls, and Cleveland Cavaliers), I went into my consultation with Dr. Winter expecting to hear about rigid bedtime routines, the importance of tracking REM and deep sleep, and possibly a stern warning about screen time before bed.

Instead, I walked away with one key thought: What if I was thinking about sleep all wrong? 

1. Your insomnia might be an expectation problem—not a sleep problem

By definition, insomnia is a sleep disorder that makes it hard to fall asleep or stay asleep throughout the night, according to the Cleveland Clinic.

But Dr. Winter challenges the idea that insomnia is simply the inability to sleep—he suggests it’s a mismatch between how we think we should be sleeping and how we actually sleep.

“When you define insomnia, it [describes] a person who can’t sleep—no such thing,” he says. “Insomnia means a person is not sleeping the way they’ve determined they would like to sleep.”

He breaks down insomnia into two parts: Part A is that your sleep didn’t go the way you planned. Part B is that you’re upset about part A.

“If there’s no part B, there is no insomnia,” he says. “Meaning, if I meet somebody at a dinner party and they say, ‘It takes me two hours to fall asleep every night,’ my first question is, ‘How does that make you feel?’ And if they say, ‘I don’t care,’ then they don’t have insomnia.”

His overall point certainly challenges conventional thinking: Being awake is not, by itself, insomnia. Rather, it’s the distress we feel over being awake that defines it.

Ultimately, he says being awake at night isn’t something to fear or stress over—it’s simply a normal part of the sleep experience. “A great sleeper is equally happy in bed awake as they are asleep,” he says.

2. Screens can be part of a healthy bedtime routine

After mentioning that I often play Candy Crush in bed to drift off, I quickly added, “But I know you’re not supposed to do that.”

His response caught me off guard, to say the least: “As long as it’s not addictive and has a set start and finish, [habits like that] can be great.”

Rather than dismissing screens altogether, Dr. Winter says it’s more important to consider how you’re using them. A brief, consistent activity—whether it’s a game of Candy Crush or an episode of Jeopardy!—can become part of a healthy bedtime ritual.

“Is a television show right before you go to bed the best? Maybe, maybe not—but you’ve created a ritual now,” he says, adding these routines act as “time cues,” helping your brain recognize that bedtime is approaching. Surprisingly, he believes the same concept can help kids, too.

“With young kids, anytime you take them out, you have to give warnings [before it’s time to leave],” he says. “I like that idea for going to bed, too. You’re giving them subtle little clues—the lights dim, the temperature comes down, they watch a TV episode, whatever it is. You have little rituals that, in their mind, are telling them it’s time for sleep.”

3. Your child’s bedtime deserves a little freedom

                                                                         golubovy/Getty Images

As the conversation shifted to my three young daughters, Dr. Winter revealed an arguably radical approach to sleep: Allow kids a little more freedom at bedtime.

He says the goal is to be flexible, not careless, by maintaining a consistent wake time and the same basic bedtime routine while loosening your grip on the exact moment kids fall asleep.

I’ll admit—I internally cringed at the idea of letting my 6-year-old choose her own bedtime. But then he explained the actual process.

Here’s how it works: Parents start by setting a strict “in your room” time. It’s not necessarily “lights out” time—maybe they read a book or quietly play with toys—but leaving the room isn’t an option. (Unless, of course, there’s an emergency.)

The catch? They still have to wake up at the same time every morning, regardless of how late they stay up. The idea is that kids naturally learn how much sleep they need without bedtime becoming a nightly battle.

His overall message to kids isn’t complicated: “Sleep is very important for you. I want you to respect sleep and always put it higher on the list of priorities,” he says. “But it’s not the most important thing, nor is it something that you want to get nervous about if it goes a little sideways.”

4. Stop chasing the perfect amount of sleep

For Dr. Winter, the problem isn’t that people are failing to hit some magic target like eight hours—it’s that they’re trying to force their sleep to fit a number their body may not even need.

“If [you sleep] 11 hours and you only need eight, that’s where people struggle with [taking] an hour or two to fall asleep two to three times a week,” he explains. “Or sometimes you’ll wake up, go to the bathroom, and can’t get back to sleep right away—which is your brain essentially saying, ‘Yeah, because we’ve got what we need already.'”

Rather than believing everyone needs exactly eight hours, Dr. Winter says sleep exists on a bell curve. Most people fall somewhere in the middle, but some naturally need more sleep while others need less. Instead of comparing yourself to someone else, he encourages paying attention to the amount of sleep your body naturally settles into over time.

Individual sleep needs vary from person to person, and trying to force yourself into the sleep category you think you belong in can backfire. “We don’t really get to choose how much we sleep,” he adds.

5. The best thing you can do for your sleep? Stop trying to control it.

                                                                            vorDa/Getty Images

Throughout my conversation with Dr. Winter, one message kept resurfacing: We have to let go of the urge to control sleep. You can’t out-strategize basic biology—eventually, your brain and body take over.

“We say this all the time to our insomnia patients—nobody who is seeking sleep is not getting enough. If you’re trying to work two jobs and you’re artificially depriving yourself of it, that’s different, but eventually you’re going fall asleep—[it might] be while talking your boss or driving your car,” he cautions. “But sleep is an absolute—you can’t sidestep it.”

While we can’t always micromanage when we finally drift off, we can influence our sleep by focusing on the habits we do have a say in: maintaining a consistent wake time, exercising regularly, creating calming evening rituals, and adopting a healthier attitude toward sleep.

He adds that we’re slowly abandoning what he calls a “fear-based” economy when it comes to sleep: “I like the fact that research and media is moving a little bit away from ‘eight hours of sleep or you die,’ and more toward focusing on the things that we really can control.”

Part of that means being genuinely OK with what happens after your head hits the pillow: either you fall asleep—or you don’t.

As Dr. Winter notes, “If you come to that little zen place, you’re sort of indestructible.”

That brings me back his very first question to me: “How do you think you sleep?” I think I’m doing the best I can—and now with a lot less anxiety. And that’s a very freeing place to be.

About the expert

• Chris Winter, MD,  is a neurologist, sleep specialist, and the owner of the Charlottesville Neurology and Sleep Medicine clinic and CNSM Consulting. Dr. Winter is also the author of The Sleep Solution: Why Your Sleep Is Broken and How To Fix It as well as The Rested Child: Why Your Tired, Wired or Irritable Child May Have A Sleep Disorder—And How To Help.

https://www.thehealthy.com/sleep/unexpected-things-a-sleep-doctor-taught-me/

Millions of kids take melatonin but doctors are raising red flags

From sciencedaily.com

Source: Zhejiang University

Melatonin is now widely used to help children sleep, but scientists say the enthusiasm may be getting ahead of the evidence. A major review found clear benefits for children with conditions like autism and ADHD, yet far less data exists for typical childhood insomnia. Researchers also warn about mislabelled supplement doses and rising accidental ingestions among young kids. Experts say melatonin should be used carefully and only alongside proven behavioural sleep strategies. 

Melatonin has quickly become one of the most widely used sleep aids for children around the world. Its popularity is largely driven by the belief that it is a natural and easily accessible solution for insomnia. However, new research suggests that its rapid growth in use has moved faster than the scientific understanding of how safe and effective it truly is for children over the long term.

Melatonin appears to provide clear benefits for sleep difficulties in children with neurodevelopmental conditions. Yet for children without these conditions, strong evidence remains limited. Researchers are also concerned about inconsistent dosing in over the counter products, use without medical supervision, and a growing number of accidental ingestions. Taken together, these concerns point to the need for more caution, stronger regulation, and clearer evidence based guidance when melatonin is used to address sleep problems in children.

Melatonin may help some kids sleep—but experts warn the popular “natural” sleep aid may not be as harmless as many families think. Credit: Shutterstock

Why Families Are Turning to Melatonin

Sleep difficulties are becoming increasingly common among children and teenagers. Poor sleep can influence emotional regulation, cognitive development, and overall health. As parents look for quick and convenient solutions, melatonin supplements have become widely used because they are easy to obtain, often come in child friendly forms, and are widely perceived as a safe alternative to prescription medications.

Despite that perception, melatonin is actually a hormone that affects more than just sleep cycles. It plays roles in regulating the immune system, metabolism, and reproductive processes. Research on melatonin use in children is still uneven. Many studies only examine short term outcomes or focus on specific clinical populations. Because of these limitations, researchers say there is an urgent need to carefully evaluate the safety, effectiveness, and appropriate use of melatonin in paediatric care.

Review Examines Global Melatonin Use in Kids

A narrative review published in World Journal of Paediatrics, by researchers at Boston Children's Hospital explored the rapid rise of melatonin use among children and adolescents worldwide. The review analysed clinical evidence related to melatonin's effectiveness, safety profile, and patterns of real world use.

Researchers found a clear mismatch between the widespread use of melatonin and the limited amount of long term scientific data available. The review also highlighted concerns about inappropriate use, inconsistent product quality, and the lack of strong regulatory oversight for sleep supplements marketed to children.

Evidence Shows Benefits for Some Children

According to the review, melatonin use among children has increased sharply over the past decade. This growth is especially noticeable in countries where the supplement is sold over the counter.

Strong clinical evidence supports melatonin's short term benefits for children with neurodevelopmental disorders such as autism and attention deficit hyperactivity disorder. In these cases, melatonin can help children fall asleep more quickly, extend total sleep time, and improve overall quality of life for caregivers.

Limited Data for Typically Developing Children

The situation is less clear for children who do not have underlying developmental conditions. Research in this group is limited and often inconsistent. Most randomized clinical trials have been short in duration and focus primarily on older children or teenagers. As a result, researchers cannot draw strong conclusions about younger children, even though melatonin use in that age group is becoming more common.

Long term safety data are especially limited. Scientists still have unanswered questions about whether melatonin could influence puberty, immune function, metabolism, or neurological development when used over extended periods.

Safety Concerns About Melatonin Products

The review also highlights several safety issues that may occur outside controlled clinical environments. Testing of commercial melatonin supplements has revealed major differences between labelled doses and the actual amount of melatonin contained in some products. In some cases, supplements contained several times the stated dose or unexpected compounds such as serotonin.

Data from paediatric poison control centres also show a sharp increase in accidental melatonin ingestions among children. Young children appear particularly vulnerable, often due to gummy formulations that resemble candy and improper storage at home. These findings suggest that the risks associated with real world melatonin use may be higher than previously assumed.

Experts Urge Careful and Limited Use

Researchers caution that melatonin should not be treated as a quick fix for childhood sleep problems. Although it can be useful in certain carefully selected situations, particularly when guided by a healthcare professional, it should not replace thorough sleep assessments or behavioural interventions.

The review stresses that both clinicians and caregivers should view melatonin as a biologically active hormone rather than a harmless supplement. Without stronger evidence and better regulation, routine or unsupervised use could expose children to unnecessary risks while drawing attention away from proven non pharmacological strategies that support healthy sleep.

Behavioural Sleep Strategies Remain First Line Treatment

The findings have important implications for paediatric medicine, public health policy, and caregiver education. Behavioural approaches to sleep should remain the primary treatment for childhood insomnia. These strategies include maintaining consistent bedtime routines, limiting screen exposure before bed, and setting age appropriate sleep expectations.

If melatonin is used, the review recommends starting with the lowest effective dose, limiting the duration of treatment, and using it only under medical supervision. Researchers also emphasize the need for stronger oversight of melatonin products designed for children, clearer labelling standards, and more long term clinical research. These steps could help ensure that children receive safe, effective, and evidence based support for healthy sleep.

https://www.sciencedaily.com/releases/2026/03/260315004407.htm

Sleep quality affects kids' academic performance

From news24.com

Children who have trouble sleeping tend to do worse in school than their peers who get a good night's sleep, a new study suggests.

Researchers in Brazil looked at children age seven to 10 who attended Sao Paulo public schools. They found kids with symptoms of sleep disorders or sleep breathing disorders earned lower grades than those without problems sleeping, on average.

13% of children with difficulty sleeping had failing grades in Portuguese, compared to 9%of those without sleep problems.

Likewise, 25% of kids with disrupted sleep had failing math grades, versus 8% of children without trouble sleeping. "Because [symptoms of sleep disorders] and particularly [sleep breathing disorders] are highly prevalent, we suggest that all health professionals and educators become aware of this striking effect and take appropriate actions to solve or mitigate what could very well constitute a public health issue," researchers led by Luciane Bizari Coin de Carvalho from the Universidade Federal de Sao Paulo wrote.

Experts estimate that roughly one-quarter of US children have disrupted sleep at some point during childhood. Erratic bedtime hours and anxiety, either at school or at home, may contribute. Other children may have unrecognised sleep disorders, such as sleep walking, nightmares or insomnia, or sleep breathing disorders, like sleep apnoea.

Underlying medical problems

Some medications, including those for asthma or attention-deficit/hyperactivity disorder, can affect sleep. The underlying medical problems may also cause sleep disturbances. Poor sleep among children has been tied to obesity, which in the long run increases the risk of heart disease and diabetes. And poor school performance has been linked to early dropout rates, so the new findings may have implications beyond getting a good night's sleep, researchers said.

From 1999 to 2001, the researchers distributed 5 400 questionnaires asking about symptoms of sleep disorders and sleep breathing disorders to children in Sao Paulo public schools. Then they looked at the Portuguese and Math grades of 2 384 children whose parents filled out and returned the questionnaire.

The study team found about 31% of the children had symptoms of sleep disorders  such as difficulty falling or staying asleep, or feeling sleepy all the time  and close to 27% had sleep breathing disorders.

Those students' grades were significantly lower than the grades of kids without sleep disorder symptoms. In Brazil, grades are based on a scale of 0 to 10, with 5 considered a passing grade. Average Portuguese grades were 6.6 for kids with sleep problems, compared to 7.1 among those with no sleeping trouble.

Likewise, children with symptoms of sleep disorders or sleep breathing disorders earned an average grade of 6.3 in Maths, compared to 7.1 for other children, according to findings published in the journal Sleep Medicine.

Importance of sleep in children

Dr  Carl Bazil, a neurologist and director of the division of epilepsy and sleep at New York Presbyterian/Columbia University Medical Centre in New York City noted that this study fills a research void. "There's growing information, mainly in adults, that you need good quality sleep to process and learn new information," Bazil told Reuters Health. "It stands to reason that, if anything, sleep would be more important in children, but there's very little information in children about sleep disturbance and learning." Research has shown that sleep deprivation might affect certain parts of the brain, especially the frontal lobes.

The frontal lobes control executive function, which is the ability to make decisions, form memories, plan for the future and inhibit socially undesirable behaviour like fighting with a classmate. However, the new study can't say definitively that sleep problems were to blame for poor grades, researchers said. "This study doesn't prove that a sleep disturbance causes decreased academic performance," Bazil said, "but it shows an association."

Basically every category of sleep disturbance the authors looked at correlated with decreased academic performance." The researchers relied on parents' reports of their children's sleep, rather than bringing kids into a sleep lab overnight, for example.

The study is "far from perfect", Bazil said. But, "It's a first step in emphasising that sleep in children is something that's important, not only to prevent them from being sleepy but to make sure that they learn. I think this study will help raise awareness that sleep is particularly important in children."

https://www.news24.com/Life/Sleep-quality-affects-kids-academic-performance-20130819 

4 strategies for supporting children with insomnia

From happiful.com

Help your child get the best night’s sleep possible, with these tips

Exhausted parents tend to breathe a sigh of relief as their children grow out of the sleep-broken baby and toddler years. But, for some of us, this isn’t the end of night-time woes, as sleep problems can blight older children, too. If your family is going through this, you’re not alone. A 2021 study by NHS Digital found that 29% of six to 10-year-olds, and 38% of those aged 11 to 16, regularly struggled with sleep.

It’s easy to feel powerless when your child is experiencing insomnia, but it can be overcome. “The key to resolving children’s sleep issues is to work out what is causing them,” says Vicki Beevers, CEO of The Sleep Charity. “Often, it’s more than one thing, and the list of potential causes is vast.”

Bedroom environment, anxiety, medical issues, temperature, diet, and bedtime routine are just a few of the factors that may play a part.

Once you’ve identified possible causes, you can take action. And though no single solution will work for everyone, these easily actionable strategies offer a good starting point to help promote a more restful night for the whole family.

Keep a sleep diary

If you’re trying to understand possible reasons for sleeplessness, a sleep diary is a proactive way to help establish patterns. “You can find out from a diary the average sleep duration of your child, and the times they wake and go to sleep,” says Vicki. “This can be helpful in identifying where their body clock is prior to sleep intervention.”

A sleep diary can also contribute to understanding trends around diet, naps, or bedtime routines. Keeping this kind of record for a few weeks can not only help to determine potential sleep disruptors, but also provides useful data if you decide to seek advice from your GP for your child’s problems. If you think this could work for you, there’s a downloadable sleep diary you might find helpful on The Sleep Charity’s website (thesleepcharity.org.uk).

Pay attention to time

All children require different amounts of sleep, and if your child isn’t falling asleep on going to bed, they may simply not be tired, in which case an adjusted bedtime could help. Think about the time they tend to nod off, and whether it could be beneficial to make lights-out a little later. This could prevent extra time spent in bed feeling wakeful, and becoming stressed before drowsiness kicks in.

In fact, long minutes (or hours) spent not being able to nod off can upset children, and an awareness of how long they’ve been trying to get to sleep can make matters worse.

“Clock-watching can increase anxiety,” says Vicki. “So removing any clocks from the bedroom may help with this.”

Embrace mindfulness and breathwork

Simple mindful activities before bed can aid the wind-down process. Reading is an obvious one, but other gentle activities can work too – anything from colouring and drawing to yoga, or jigsaws.

After lights-out, you can encourage the mindfulness to continue with simple breathing techniques, which focus the mind and promote feelings of calm. Introduce your child to ‘box breathing’: breathe in for a count of four, hold the breath for four seconds, then exhale to a count of four, and hold again for four, then repeat.

Try deep-pressure stimulation

Weighted blankets are designed to provide light, evenly distributed pressure on the body, mimicking the feeling of being hugged. As such, they can be an effective tool to help children feel calm when dropping off to sleep, and may prove especially helpful in cases where anxiety is a cause of sleeplessness, thanks to their swaddling effect.

Make sure you buy from a reputable supplier and choose the appropriate weight – a weighted blanket should be no more than 10% of the child’s bodyweight. The Royal College of Occupational Therapists (rcot.co.uk) has a useful guide to weighted blankets as a sensory-based intervention.

Whatever approach you choose, remember not to expect an instant result. “Sleep issues often get worse before they get better when new strategies are introduced,” warns Vicki. “Therefore, it’s important to try anything new for at least two weeks to see if it makes any difference. Consistency is key when it comes to addressing sleep problems.”

https://happiful.com/4-strategies-for-supporting-children-with-insomnia

The growing sleep problem that’s keeping your family up all night

From telegraph.co.uk

Bad sleeping habits start earlier than you might think – here’s how to spot them in your children 

Anecdotal evidence suggests an insomnia epidemic among children CREDIT: getty

Yasmin Shaheen-Zaffar woke at 2am to the sound of her 15-year-old daughter, Verona, pacing her bedroom. “She’d get so stressed she couldn’t sleep. In the morning she was snappy and forgetful,” says Yasmin, 51, from Harrogate, North Yorkshire. “Her tiredness led to meltdowns. I was worried about her mental health.”

Verona is far from alone in her struggle with insomnia. Sleeplessness in teens and young people is on the rise: the number of children admitted to hospital with (unspecified) sleep disorders rose by almost 50 per cent between 2012 and 2017.

There are – as yet – no more recent figures, but anecdotal evidence suggests that, since the pandemic, excessive screen time, compounded by a sugary diet and anxiety from the hangovers of lockdown, have created an insomnia epidemic among children.

Clare Cogan is a psychotherapist and clinical hypnotherapist who specialises in treating teenagers. "I’ve noticed a huge rise in insomnia among my young patients,” she says. “It’s incredibly concerning.”

Teens need eight to 10 hours’ sleep a night. However, they are susceptible to insomnia because their bodies start releasing melatonin later than during childhood – a change which disrupts their circadian rhythm (body clock) meaning they fall asleep later, and wake up later.  

Melatonin is a hormone that your brain produces in response to darkness. It helps with the timing of your circadian rhythm and with sleep. Being exposed to light at night can block melatonin production. “This is thought to be for evolutionary purposes, so teenagers can develop independence without threat or interruption,” says Cogan. “But of course, they have to get up for school in the morning.”

Why our children are struggling to sleep 

Experts put the recent rise down to lifestyle and behavioural changes – especially involving screens. Blue lights that devices emit – 95 per cent of teens own a smartphone – block melatonin production. “The majority of teenagers bring some kind of technology into the bedroom, adding to the amount of screen time they get each day and affecting multiple areas of their lives,” says US paediatrician and sleep consultant Nilong Vyas. “Experts are becoming increasingly concerned about the effects of blue light from these electronic devices on the sleep-wake cycle.” 

Verona’s sleep problems started during lockdown in March 2020, when she kept her smartphone in her bedroom to socialise online. “Prior to that I hadn’t allowed electronics in her room, but she told me she felt lonely,” says Yasmin, a parenting coach at Polyvagal Teen.

When she couldn’t sleep, Verona would get into bed with her mother or pass out on the sofa at 4am. “In the morning she was so groggy it was horrendous,” says Yasmin. “She’d started panicking about her A-levels. She was crying a lot. She’d forget to take her folders to school. I worried she’d have an accident crossing the road.”

Dr Vyas says sleep deprivation during adolescence can cause problems with mood, emotions, and academic performance. “Teens experiencing fragmented sleep are more likely to have interpersonal issues with their peers, and chronic sleep loss can lead to a weakened immune system and some mental-health conditions. Some desperate parents are turning to sleeping pills – often inappropriately,” she says.

The rise – and downsides – of sleeping pills 

Recent NHS data analysed by The Pharmaceutical Journal found prescription sleeping drug use among children under 18 has almost tripled in the past seven years – over 60,000 were prescribed synthetic melatonin in March 2022, compared with 20,881 in April 2015.

Melatonin supplements increase the body’s natural supply of that hormone. While available over the counter in countries such as the US, melatonin is prescription-only in the UK – and not licensed for children, unless they are diagnosed with ADHD or are on the autistic spectrum. However, some frazzled parents appear to be buying melatonin online.

Dr Sophie Bostock urges caution around its use. “One review of the effectiveness in adults with chronic insomnia suggested that melatonin added just eight minutes to overall sleep,” she says. “I’m worried young children are learning to rely on an external substance to help them sleep.”

Global clinical guidance recommends CBTi (cognitive behavioural therapy for insomnia) as a first line therapy before drugs. CBTi focuses on re-education to strengthen the patient’s natural sleep processes and address unhelpful thoughts and behaviours that interfere with sleep.

“It has only just started to be used for parents and children with ADHD and Autistic Spectrum Disorder, but pilot results are promising,” says Dr Bostock. “Key ingredients include keeping regular bedtimes and routines, only using the bed for sleep, dimming lights and avoiding screens at least an hour before bed.”

Yasmin Shaheen-Zaffar, meanwhile, found a solution in calm advice and compromise. Verona, now 18, is only allowed her phone in her room three days a week, to give her body a chance to rest. Her mother says: “Verona was dismissive at first and it took a while to implement. But she’s sleeping eight to 10 hours a night now.”

How do I send my sleepless teen to sleep?

Fi Star-Stone is a child development specialist and parenting expert. She offers six tips to help your child fall asleep naturally:

• Talk about the importance of sleep with your child from a young age.
• Try teaching good night time habits in a way children can understand, such as by explaining that shuteye recharges the body.
• Introduce a “switch off point” for phones and devices nightly, ideally an hour before bed.
• If your child resists, consider a “switch off box” where the whole family puts their devices.
• Don’t put pressure on yourself – you don’t need to create a strict routine for every day.
• Aim for a realistic bedtime for school nights, and keep some structure on weekends.
• 
  

https://www.telegraph.co.uk/health-fitness/mind/the-growing-sleep-problem-thats-keeping-you-up-all-night/

More women than men struggle to fall asleep in both Europe and the US, study finds

From ktvz.com

If tossing and turning in bed most nights was a contest on crummy sleep, women win.

A new study comparing poor sleep among more than a million adults and children in the United Kingdom, the Netherlands and the United States found women experience more insomnia problems than men in all three countries.

The trend emerges during puberty, “suggesting sex hormones, among other social factors such as stress or parenting,” might contribute to the development of insomnia in women, according to the study published Monday in the journal Nature Human Behavior.

Women also use more sleep medications than men, the study found. Yet despite the female struggle to fall asleep and use of sleep aids, women didn’t report more daytime sleepiness.

The results suggest that “recommendations for appropriate sleep duration and quality should be sex-specific,” the study said.

Americans win insomnia prize

Another “booby prize” went to Americans — they were 1.5 to 2.9 times more likely to have insomnia than their counterparts in the UK and the Netherlands.

Across all three nations, insomnia was more frequent in people spending more than nine hours a night in bed and adults 65 years and older. Adults between 26 years and 40 years of age were the least likely to toss and turn trying to fall asleep.

Besides women, smokers, people who are overweight and people of non-European origin were most likely to experiencing poor sleep, the study found.

Other worrisome findings: More than half of kids between the ages of 14 and 17 reported sleeping less than the doctor-recommended eight to 10 hours per night. Teenagers were also most likely to report sleepiness than other age groups. Symptoms of insomnia, such as difficulty falling and staying asleep, increased as children grew.

On the whole, poor sleep quality and insomnia problems were more prevalent than short sleep duration for all three nations.

The study compared sleep studies on 1.1 million people from the US, the UK and the Netherlands. The study was not able to compare sleep quality to health conditions that might affect sleep, such as sleep apnea, substance abuse and other chronic medical conditions.

While some of the research was done in sleep labs using objective measurements, most relied on what people said about their sleep habits and quality. Such research isn’t as robust, the authors said, but the size and scope of the research does give doctors insights into daily functioning.

What to do?

Fight back against insomnia and other sleep issues by adopting some tried-and-true healthy sleep habits.

• Go to bed and get up at roughly the same time every day, even on weekends
• Exercise regularly to reduce stress and improve sleep. Just walking on a daily basis will help
• Don’t eat fatty or spicy foods close to bedtime that might upset your stomach
• Avoid caffeine — in coffee, tea and sodas — after 3 p.m.
• Avoid excessive alcohol ingestion at least four hours before bedtime, and do not smoke
• Be careful not to nap more than 45 minutes during the day
• Keep your bedroom well-ventilated and pick a comfortable sleep temperature setting that’s between 60 and 67 degrees Fahrenheit (15 to 20 degrees Celsius)
• Block out all distracting noise and get rid of any light, even the blue light from your charging station for phones and laptops

https://ktvz.com/health/2020/11/16/more-women-than-men-struggle-to-fall-asleep-in-both-europe-and-the-us-study-finds/

Q&A: ‘Insomnia is a persistent problem’ for kids

From healio.com

By some estimates, 52% of youths may experience insomnia symptoms at some point during their childhood. However, there are “notable limitations” in the current medical literature, experts wrote in Sleep.

To help fill in some of the research gaps, Julio Fernandez-Mendoza, PhD, CBSM, DBSM, an associate professor of psychiatry at the Sleep Research & Treatment Center at the Penn State University College of Medicine, and colleagues examined the natural history of insomnia symptoms in the transition from childhood to adolescence in a random, general population sample of 421 youths for an average of 7.8 years. The mean age of the youths was 8.8 years at baseline and 17 years at follow-up; 53.9% of the participants were male, and 21.9% were from underrepresented racial groups.

In an interview with Healio Primary Care, Fernandez-Mendoza discussed some of the study’s findings, how primary care physicians can screen for childhood insomnia, why socio-demographic factors are important to consider, treatment options and more.

Q: What are the most important unanswered questions regarding childhood insomnia?

A: As of today, and beyond our study, one of the most important unanswered questions is the relative contribution of behavioural vs. biological factors in the etiology and pathophysiology of childhood insomnia. In other words, although for many children insomnia is behavioural in nature, such as resisting going to bed or needing the presence of an adult to fall asleep, in some children insomnia does share the same underlying mechanisms with adult insomnia, and these have not been disentangled yet.

Q: What are the most effective ways that PCPs can screen for insomnia in children?

A: Asking very straightforward 1-minute questions to both the parent and the child on whether they have difficulty falling asleep and/or difficulty staying asleep. In addition, screening for other sleep symptoms, such as loud snoring, daytime sleepiness, difficulty waking up in the morning and restless sleep can also help determine whether the child will receive appropriate care or referral so their sleep issues do not go untreated.

Q: What evidence from your study suggests that insomnia is more than a “transient phenomenon” in most children? Why is it important to recognize this?

A: Only 30% of young children with insomnia are fully remitted by adolescence, which means that insomnia is a persistent problem during this developmental period associated with biological and psychosocial changes. In our study, we point toward specific social determinants and clinical conditions that contribute to such persistence, including childhood behavioural, mood and neurological disorders, childhood obesity and adolescence substance use.

Q: What are some effective integrative and behavioural therapies for childhood insomnia?

A: Most cases of childhood insomnia can be effectively treated with behavioural therapies, such as use of bedtime pass, bedtime fading or graduated extinction. Paediatric behavioural sleep medicine specialists are best equipped to provide these services; however, there are standard protocols that can be disseminated and implemented in primary care with adequate consultation.

Q: Why are socio-demographic factors important to the understanding childhood insomnia ?

A: Females, racial/ethnic minorities and those of low socioeconomic households had a greater risk of persisting or developing insomnia in the transition from childhood to adolescence. Specifically, in 75% of children who identified as a racial/ethnic minority, primarily Black, their insomnia continued to persist in the transition to adolescence. Socioeconomic status also played a role: children who identified as a racial/ethnic minority and children who identified as non-Hispanic white and lived in low socioeconomic households were 7 and 2.5 times more likely, respectively, to not fully remit from their insomnia in the transition to adolescence as compared to children who identified as non-Hispanic white and lived in higher socioeconomic households.

These findings are an indicator that social determinants of health, arising from racial, gender and economic inequalities, also play a role in the chronicity of insomnia as early as childhood and, thus, PCPs should play close attention to these at-risk children and not regard their insomnia as an unimportant health problem that will naturally improve with development.

Q: When do you recommend pharmaceutical treatments for children with insomnia? What treatments are safe and effective in this population?

A: Pharmaceutical treatment is not recommended as a first-line therapy for insomnia in children.

There are effective behavioural treatments for both young children as well as adolescents, including cognitive-behavioural therapy for insomnia, that should always be used first. These treatments are evidence-based and not simply sleep hygiene education. We need to better integrate these therapeutic options at the front-line in primary care and paediatrics.

Pharmacological approaches in treatment-resistant insomnia in youth and in specific populations, such as those with neurodevelopmental disorders, are similar to those used in adults, except the more common approach of relying on over-the-counter melatonin. However, the latter is overused by providers and parents alike and requires better knowledge from the clinician as it is a compound that, if correctly formulated, can be a good chronobiotic (a drug that regulates the circadian clock) but not so much a good hypnotic (a drug that increases sleep).

https://www.healio.com/news/primary-care/20201104/qa-insomnia-is-a-persistent-problem-for-kids