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More Zzzs Earn A’s for Behavior at School

October 18, 2012

By Crystal Phend, Senior Staff Writer, at MedPage Today

Published: October 15, 2012
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner


 A little extra sleep can make a big difference in kids’ behavior at school, an experimental study showed.

Giving children an average of just 27 more minutes of sleep than they usually got on school nights improved their emotional stability and cut down on restless and impulsive behavior at school, Reut Gruber, PhD, of McGill University in Montreal, and colleagues found.

Taking away about an hour of sleep from a similar group of healthy 7- to 11-year-0lds had the opposite effect in the experiments reported in the November issue of Pediatrics.

“Healthy sleep is essential for supporting alertness and other key functional domains required for academic success,” the group wrote. “Sleep must be prioritized, and sleep problems must be eliminated.”

Previous, mostly observational studies have linked more sleep to better grades among teens and less sleep to development of psychiatric problems in children.

An estimated 43% of boys ages 10 to 11 don’t get the recommended amount each night, and almost two-thirds of school-age kids don’t get to bed by 9 p.m., Gruber and colleagues noted.

Moderately increasing children’s sleep is both feasible and beneficial, they concluded, arguing for parents, teachers, and students to be educated about “the critical impact of sleep on daytime function.”

For their study, the researchers randomized 34 healthy children ages 7 to 11 who had no sleep problems or behavioral or academic troubles to receive an extra hour of sleep at home each night for 5 nights or to have 1 hour taken away from their usual nightly sleep time for 5 nights. No napping was allowed.

Actinography showed that the children in the sleep extension group actually got only an average of 27 minutes more than their baseline of 9.3 hours, while the sleep-restriction group had 54 minutes cut from their similar baseline sleep time.

Those who slept less than usual had a drop in sleep fragmentation (P<0.03) reflecting better quality sleep, but they were still more sleepy during the day than before the experiment, with Modified Epworth Sleepiness Scale score rising to a mean of 6 from 4 at baseline on the 24-point scale.

Their behavior in school also worsened as assessed by their teachers, who were unaware of study group assignment, using the Conners’ Global Index Scale.

Total normalized T-scores rose from an average of 50 at baseline to 54 after sleep restriction, whereas they fell to an average of 47 points from 50 at baseline among the group that got extra sleep all week (P<0.05 for interaction).

A score of 60 or above is considered clinically significant, the researchers pointed out.

Likewise, the component T-scores for “emotional lability” — crying, losing one’s temper, or becoming easily frustrated — rose from 48 to 51 after sleep reduction but fell from 50 to 47 after extended sleep.

The restless and impulsive behavior subscale T-scores rose from 52 to 55 for those who got less sleep and fell from 50 to 47 for those who got extra sleep.

The researchers cautioned about the relatively small size of the study and convenience sample used and thus suggested that the results be considered preliminary in nature.

Primary source: Pediatrics
Source reference: Gruber R, et al “Impact of sleep extension and restriction on children’s emotional lability and impulsivity” Pediatrics 2012; DOI: 10.1542/peds.2012-0564.
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