The Insomnia Blog - Sleep Doctor Michael Breus, PhD

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July 21, 2011

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TV, Nightmares and Children’s Sleep

Moms and Dads, here’s yet another good reason to turn off the television when your child is in the room: a new study suggests that both violence on television and evening TV-watching can disrupt children’s sleep.

Scientists at the Seattle Children’s research Institute have linked evening exposure to media and viewing violent programming at any time of day, as likely to affect the quality of young children’s sleep, making it harder for them to fall asleep and more likely to have nightmares. Media, in this case, includes television, as well as video games and online content.

Working with more than 600 children ages 3-5 years old, researchers asked parents to monitor and record their children’s media viewing for seven consecutive days. Parents also recorded their children’s sleep habits for the same time period, paying particular attention to any possible sleep problems, including:

• Difficulty falling asleep
• Nightmares and waking during the night
• Trouble waking up in the morning
• Tiredness during the day

Based on the parents’ reports, scientists discovered a significant increase in these sleep problems for children who were exposed to violent media content. Children who watched television in the evenings—after 7 p.m.—were also significantly more likely to suffer from one or several of these sleep issues.

There’s a lot of evidence that suggests media exposure can be detrimental to children and the quality of their sleep. This study provides some important details about how when, what, where, and who is watching matters.

• Children in the study watched an average of 72.9 minutes of media screen time per day
• On average, 14 minutes of this time took place after 7 p.m.
• For every additional hour of violent or evening viewing, risks to sleep increased significantly
• Children who had televisions in their bedrooms watched an additional 40 minutes per day above the average—and had more difficulties with sleep
• It did not matter whether a parent or adult was watching with their child.

As for the consequences for kids who have chronic sleep difficulties, the evidence is overwhelming. Children who develop sleep problems are at risk for a wide range of other health risks, including:

• Weight problems, including obesity
• Cardiovascular issues
• Learning difficulties and poor academic performance
• Behavior problems
• Mental health issues

These problems pose serious risks for children that can often last into adulthood. This is why it’s so important to start early and remain dedicated to helping your child develop healthy sleep habits, and to avoid the triggers that we know make sleep more difficult for young kids.

Here’s something to keep in mind about violent programming: it’s not just adult shows that can pose difficulties for young children. In fact, older children’s programming can be more of a problem for younger children, because there is so much of it, and because it is so easily accessible. In this study, researchers found no difference in the effects of violent programming that was animated verses live-action depictions of violence. This makes sense, since young children are not yet able to distinguish between “real” and “pretend.” Letting your younger child sit in on shows that your older kids are watching may expose them to frightening content that is beyond their years. The slapstick violence of many cartoons and kid-friendly comedies your 10-year-old finds hysterical—and harmless—is likely to scare your 5-year-old.

I’m not suggesting that all television or media must be off limits to young children.  It’s worth noting that researchers found no link between non-violent daytime television watching and sleep problems. Here are some suggestions for what I think is a realistic, common-sense approach:

Keep it brief: Limit overall viewing time, no matter what time of day—this includes not only television, but the Internet and video games as well. With so many options these days, it’s important to think about total media exposure, not just TV time.

Power down at night: At least one hour before bedtime, turn off all the electronic gadgets, to help your child relax and prepare for bed.

Make it count:  When your child is watching television, help him choose high-quality, age-appropriate programming that’s violence-free.

Bedrooms are for sleep: Keep your child’s bedroom media-free (well, books are okay!). This means no television, but also no computers or video game players.

Sweet Dreams,

Michael J. Breus, PhD 
The Sleep Doctor™ 
www.thesleepdoctor.com

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Everything you do, you do better with a good night’s sleep™ 
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Get Out of Bed for Better Sleep?

Outside of giving its name to this blog, insomnia can be exceptionally difficult to live with.  Insomnia is often referred to as “vague” because it is so difficult to determine what exactly is causing the sleeplessness:  underlying medical conditions, chronic pain, depression, or even another sleep disorder like restless leg syndrome.  For some, the cause could be as simple as stress.

Regardless of the cause, all insomniacs know that it can be nearly impossible to fall asleep or fall back to sleep.  If you have insomnia, you may spend hours lying in bed, tossing and turning, trying desperately to fall asleep.  You may even feel that doing so makes you feel even more stressed about not being asleep.  A new study suggests that not only is that stress keeping you awake, being in the bed itself might be contributing to your sleeplessness.

In fact, the researchers found that one of the best things to do is get out of bed.  That will help you decrease the amount of stress you feel about not being asleep, and may help you become more ready to fall asleep.  If you are stressed or worried about other things, finding ways to ‘turn your brain off’ before you get into bed may be helpful.  The medical staff involved in the study suggested that a consistent sleep routine is more likely than simply lying in bed to help you fall asleep and stay asleep.

Here are my top five tips to help you create and maintain a successful sleep routine:

1. Set aside a Power Down hour before bedtime. Stop work. No chores.  Do something relaxing like take a warm bath, engage in light reading, or watch TV if that’s relaxing for you (avoid the news channels).
2. Go to bed and get up at the same time 7 days a week—no matter what!
3. Schedule in at least 30 minutes of exercise most days of the week. You can break up these minutes into pockets of 10 minutes if you have to. Here’s an idea: Expose yourself to bright, morning natural light (a good thing for calibrating the body’s natural clock) with a brisk walk before breakfast, then again at lunch, and after dinner.
4. Avoid caffeine after 2 pm in the afternoon. Don’t forget hidden sources like soda, and some headache medicines.
5. Adopt some mind-, body-, and sleep-friendly practices like meditation, massage, or yoga. 

It’s best to associate being in bed with being asleep, not with being awake and stressing about not being asleep.  A healthy sleep routine can help you do so, and though it seems a little contradictory, so can getting out of bed if you’re really struggling to fall asleep.

 

Sweet Dreams,

 

Michael J. Breus, PhD

The Sleep Doctor™

Everything you do, you do better with a good night’s sleep™

www.thesleepdoctor.com

twitter: @thesleepdoctor

Facebook: www.facebook.com/thesleepdoctor

Will Super Mario™ Keep Your Child From Slumberland?

Does this scenario play out in your home before bed time?

“But Dad, I can’t save it in the middle of my level!”

“And I just got the superpowers to shoot cupcake bombs from my turtle machine gun!”

“How could I possibly turn this off and get ready for bed?”

“How about 20 more minutes and then I will get ready? Or better yet can you bring my PJ’s and toothbrush in here?”

There are many parents who ask me about videogames before bed: are they harmful for sleep? And with the transition from summer vacation, where bedtime rules are often more relaxed, to back to school with bedtime stresses, I am getting this question frequently.

A new study published in The Journal of Clinical Sleep Medicine (2010) may be able to shed a little bit of light on the subject.

Previous research indicated that pre-sleep video game play was in fact disruptive to pre-teen sleep. Currently the research would suggest that stimulating, nighttime video-game playing by adolescents leads to:

• Later bedtimes
• Insufficient sleep
• Increased daytime tiredness

But these behaviors are also consistent with being a teenager, so more detailed information was needed to better answer this question.

Research groups decided to look directly at the effect of pre-sleep video-game playing on adolescents’ ability to fall asleep, but the results were mixed. One group reviewed 11 adolescents (average age: 13) and found that playing videogames for 1 hour between 6 – 7 p.m.,  on average, lead to a 22 minute increase in the time it took them to fall asleep, versus a group of adolescents who did not play video games.  Another study reviewed a group (average age: 25) and found only a mild increase in the time it took to fall asleep (2.3 min) after playing video games for 2 hours and 45 min, however these participants went to bed at 2 a.m. and were almost two times the age of the first group! So it easily could have been their age or that the late bedtime was what made them so sleepy that they fell asleep so quickly.

This most recent study’s results were in fact the opposite of what you might have expected. A group of 13 male adolescents (average age: 16) was asked to either play a video game (Call of Duty 4: Modern Warfare) before bed or watch a DVD (March of the Penguins), used as a control condition.  The research showed:

• Video gamers fell asleep on average in 7.5 minutes, while the same teens fell asleep on average in 3 minutes when watching the movie before bed
  • This was not a tremendous difference, as expected from previous research
  • Video gamers reported that they felt less sleepy after playing the video game, versus when they were watching the DVD
    • I think several kids actually fell asleep while watching the video - this speaks to either a boring movie, or teen sleep deprivation!
    • The heart-rate of both groups remained the same during the experimental conditions, within normal resting limits
    • The cognitive alertness of both groups remained the same during experimental conditions, both showed mild increases
    • REM sleep and Slow Wave Sleep in both groups remained the same during experimental conditions

So what does this mean for us as parents?

We already know that teenagers like to stay up late and sleep late due to their internal biological clock (circadian rhythm).  As a result of their new “Night Owl” status they have some time to fill, and since electronic media is so prevalent, many will choose to play games, talk, or text late into the evening. The effects of pre-sleep video game playing seems small in this group (remember these were 16 year olds). The experiment was limited in that it did not review other activities that could be sleep promoting: reading, meditation, listening to soft music, etc.

The jury is still out and the science is mixed on video game use before bedtime – so my advice

1)      Try and keep your teens on a regular bedtime schedule, this will always help with better sleep

2)      Try to find activities that are more sleep promoting before bed in this age group, since you are fighting an uphill battle with their biology anyway.

3)      If it is a huge battle, which can cause emotional responses before bed, it may be better to either find another time for the video games –  or you could place a timer on the TV so that right before bed is just not an option!

 

Sweet Dreams,

 

Michael J. Breus, PhD

The Sleep Doctor™

www.thesleepdoctor.com