Improving sleep in socioeconomically disadvantaged children
Children from lower-income households tend to experience shorter sleep duration, frequent awakenings during the night, and poor sleep quality.
Socioeconomically disadvantaged children have a higher rate of sleep difficulties than their higher-income peers. Poor sleep in children is related to decreased academic, social, and emotional functioning. Lower-income children tend to experience shorter sleep duration, frequent awakenings during the night, and poor sleep quality.
Children with lower socioeconomic status tend to have inconsistent bedtimes, with increased caffeine consumption, and a higher rate of electronic use in the bedroom. They tend to stay up later and watch television in their rooms. They may also be exposed to more noise or share a bedroom with multiple people. Many of these children do not have their own bed or share their bed with another person. Some of these children sleep on a sofa or floor regularly. Parents of these children may not be educated or may not understand the importance of appropriate sleep hygiene.
A recent study from St Joseph's University and The Children's Hospital of Philadelphia demonstrated that interventions and education are beneficial. They assert that 3 small changes can be made to a child's sleep habits to substantially improve the child's sleep and daytime functioning. Researchers found that an educational brochure, provided to the parents of the 152 children in their study group, increased parental sleep knowledge and positively increased intentions of the parents to help improve the sleep hygiene of their children.
The simple 3-step message for the parents was to 1) have their children in bed by 9:00 PM, 2) have no electronics in the bedroom, and 3) avoid all caffeine. Children in this study were also given beds through the Beds for Kids program, which significantly helped to promote sleep duration.
This study highlighted the importance of a positive sleep environment in promoting better sleep among children who are socioeconomically disadvantaged. Understandably, the children did better when they had their own bed to sleep in nightly. Attrition was high in this study and many of the families did not respond to correspondence to their homes after the initial visit. Unfortunately, this can happen in low-income study groups who may move more frequently, use prepaid cell phones, or avoid answering phones to avoid collection agencies. Despite these limitations, the preliminary findings showed that sleep hygiene education is important and can improve the sleep of socioeconomically disadvantaged children.
Having a handout to give parents, as well as to any patient with sleep issues, about the importance of good sleep hygiene would be an important addition to your practice. In my next blog, I will share with you a handout that I have created that you can give to your patients. I give it to all my patients and have “cured” many sleep issues with the good sleep hygiene practices that patients learned through a simple handout.
Sharon M. O'Brien, MPAS, PA-C, is a practicing physician assistant and health coach in Asheville, NC.
- Mindell JA, Sedmak R, Boyle JT, Butler R, Williamson AA. Sleep well!: A pilot study of an education campaign to improve sleep of socioeconomically disadvantaged children. J Clin Sleep Med. 2016;12(12):1593–1599