Pediatric Newsletter #13: childhood sleep, concussions, and more
Here is the latest of my more or less monthly newsletter on pediatric topics. In it I highlight and comment on new research, news stories, or anything else about children’s health that I think will interest parents. If you want to subscribe to it and get it in the form of an email each month there is a sign-up form at the very bottom of my home page.
Every Parent of a teenager knows that they tend to go to sleep later and are harder to rouse out of bed in the morning. It turns out that as elementary school children become early and then mid-teenagers theses changing sleep patterns are a normal result of the hormonal changes their bodies are going through.According the data in a new study, conducted with 94 children in all, children are programmed to get less sleep as they mature.
A typical 9-year-old fell asleep at 9:30 p.m. on a weekday upon first enrolling in the study and would wake up at 6:40 a.m. By age 11, the same child would go to sleep at 10 p.m. The net result for that child – and many others in the cohort of 38 children who joined the study at 9 or 10 years old – would be steadily less sleep every night.
The study is one of the few to track individual kids for longer than a year. It showed wide individual differences in these trajectories. For some children, the data show, the shift to a later bedtime without a later wakeup time was abrupt, possibly putting them at a greater disadvantage relative to their peers in school.
The American Academy of Pediatrics has suggested later school start times for teenagers, advising school start times no earlier than 8:30 for middle and high school students.
The past few years have brought increasing attention on concussions, particularly the long-term effects of repeated concussions. We need to take them seriously. But they are common, and the vast majority of children recover without any further brain issues. The optimal way to care for children following a concussion is still unknown, although there is one key principle: a child should not do anything that could lead to another head injury, such as returning to contact sports, until the symptoms of the concussion have resolved. Common symptoms are headache, vomiting, and difficulty concentrating.
Some authorities have long recommended extensive bed rest following a concussion. A new study indicates that this is not needed and does not help the brain heal any faster. In fact, the authors noted that children placed on strict bed rest tended to focus on their symptoms even more, which is not surprising to me.
You can read more about concussions — what they are, what they mean — in a blog post I wrote here.
This study is in mice, not people, but it has very suggestive findings. The bottom line was that pregnant mice who had high levels of stress hormones had smaller offspring, and low birth weight is an important marker for later problems in infants. The effect was not because the stressed mothers ate less — they actually ate more. Although the causes of low birth weight are many, it makes sense that a stressful environment for the fetus might be one of them.
While we’re talking about concussions and head injury (see above) another important study in the journal Neurology found, at least in NFL players a correlation between later degenerative brain problems and the age at which the player first began to play. At least minor head injury is almost inevitable in football. It is likely that there are many injuries that don’t reach the level of concussion but which, over time, add up. The identification of age 12 as the threshold for increasing risk for later problems makes sense from what we know about brain development in children.
We should probably file this one in the common sense department, but if you allow your child to have a small screen in the bedroom, such as from a smart phone, it will interfere with his or her sleep. I know we found that to be the case with my own son. I guess it’s good to know that research confirms that.
Measles is very much in the news these days after the outbreak of the infection in California, which was linked to higher numbers of unvaccinated children. An inevitable byproduct has been the resurrection of fear of the vaccine. Multiple past studies have debunked any links with autism or any other serious ailments. So this study is timely.
Researchers at Kaiser-Permanente studied a total of nearly 800,000 vaccine doses over 12 years and found no serious issues.