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      Cognitive, Behavioral, and Functional Consequences of Inadequate Sleep in Children and Adolescents

      Pediatric Clinics of North America
      Elsevier BV

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          Abstract

          This article summarizes correlational, case-control, quasi-experimental, and experimental studies that have examined whether sleep during childhood and adolescence is related to daytime functioning. Published findings suggest that inadequate sleep quality and/or quantity can cause sleepiness, inattention and, very likely, other cognitive and behavioral deficits that significantly impact children and adolescents in functional settings. This article then integrates findings from longitudinal studies within a developmental psychopathology model. Important questions remain, but evidence supports the integration of sleep screening and interventions into routine clinical care and also supports advocacy for public policy changes to improve the sleep of children and adolescents. Copyright © 2011 Elsevier Inc. All rights reserved.

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          Most cited references97

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          The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review.

          Insufficient sleep, poor sleep quality and sleepiness are common problems in children and adolescents being related to learning, memory and school performance. The associations between sleep quality (k=16 studies, N=13,631), sleep duration (k=17 studies, N=15,199), sleepiness (k=17, N=19,530) and school performance were examined in three separate meta-analyses including influential factors (e.g., gender, age, parameter assessment) as moderators. All three sleep variables were significantly but modestly related to school performance. Sleepiness showed the strongest relation to school performance (r=-0.133), followed by sleep quality (r=0.096) and sleep duration (r=0.069). Effect sizes were larger for studies including younger participants which can be explained by dramatic prefrontal cortex changes during (early) adolescence. Concerning the relationship between sleep duration and school performance age effects were even larger in studies that included more boys than in studies that included more girls, demonstrating the importance of differential pubertal development of boys and girls. Longitudinal and experimental studies are recommended in order to gain more insight into the different relationships and to develop programs that can improve school performance by changing individuals' sleep patterns. Copyright 2009 Elsevier Ltd. All rights reserved.
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            Sleep schedules and daytime functioning in adolescents.

            Sleep and waking behaviors change significantly during the adolescent years. The objective of this study was to describe the relation between adolescents' sleep/wake habits, characteristics of students (age, sex, school), and daytime functioning (mood, school performance, and behavior). A Sleep Habits Survey was administered in homeroom classes to 3,120 high school students at 4 public high schools from 3 Rhode Island school districts. Self-reported total sleep times (school and weekend nights) decreased by 40-50 min across ages 13-19, ps 120 min) reported increased daytime sleepiness, depressive mood, and sleep/wake behavior problems, ps < .05, versus those sleeping longer than 8 hr 15 min with less than 60 min weekend delay. Altogether, most of the adolescents surveyed do not get enough sleep, and their sleep loss interferes with daytime functioning.
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              Evidence for the validity of a sleep habits survey for adolescents.

              To examine the validity of self-reported survey estimates of sleep patterns in adolescents through a comparison of retrospective survey descriptions of usual school- and weekend-night sleep habits with diary-reported sleep patterns and actigraphically estimated sleep behaviors over a subsequent week. High school students completed a Sleep Habits Survey about the previous 2 weeks and then wore an actigraph (AMI, Ardsley, NY) for 8 days while keeping a daily sleep diary. Matched-pair t tests assessed average differences between survey and diary reports and between survey and actigraph estimates. Pearson correlations assessed the extent to which survey reports were in agreement with diary reports and actigraphy estimates. 302 high school students (196 girls, 106 boys) in grades 9-12 from five high schools. School-night survey total sleep times and wake times did not differ from sleep amounts reported in the diary or estimated by actigraphy; survey bedtimes were slightly earlier. On weekends, survey total sleep times and wake times were longer and later, respectively, than estimated with actigraphy and reported on diaries. Moreover, school- and weekend-night survey variables were significantly correlated both with diary and actigraphy variables. Strengths of the associations were consistently greater for school-night variables than the corresponding weekend-night variables. The findings support the validity of the Sleep Habits Survey estimates in comparison with diary and actigraphy. Strengths and limitations for survey measures of high school students' usual sleep/wake patterns are discussed.
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                Author and article information

                Journal
                Pediatric Clinics of North America
                Pediatric Clinics of North America
                Elsevier BV
                00313955
                June 2011
                June 2011
                : 58
                : 3
                : 649-665
                Article
                10.1016/j.pcl.2011.03.002
                3100528
                21600347
                b2210b68-1e24-476f-a460-f42e4d7c4b62
                © 2011

                https://www.elsevier.com/tdm/userlicense/1.0/

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