DC Child Accident & Safety Blog

If the post-holiday gift haul has overwhelmed you with a wave of electronic diversions, a story in the Los Angeles Times issues a kind of tsunami warning. It’s a bad idea, says a study published in the American Journal of Preventive Medicine, to put a TV in a child's bedroom.

For most American households, says The Times, it’s too late: In the U.S., 7 in 10 kids between 8 and 18 have a television in their bedroom.

As research has long shown, more "screen time" is linked to higher rates of obesity. (See our post about screen time and fitness .) The new study says that not only do kids with a TV in their bedroom tend to watch more TV, but compared with television watched in other household settings (the family room), the screen time a kid logs in the bedroom is associated, hour for hour, with more belly fat, higher triglycerides (blood fats) and overall greater risk of developing heart disease and diabetes.

The new study compared kids with about the same diets and the same levels of physical activity. The ones with a TV in their bedrooms had more cardiometabolic risk factors—that is, test results indicating greater risks to heart function and greater insulin resistance—than the ones who must watch TV in one of their home's common rooms.

The study’s lead author said that beyond the effects of sitting too long in front of a TV, a television in the bedroom has the potential to disrupt sleep patterns and interfere with shared family meals. Sleep deprivation is another risk factor for obesity and metabolic dysfunction. And family mealtimes seem to promote more healthful eating, lower obesity rates and less use of alcohol, drugs and tobacco by kids.

Vicky Rideout, an independent consultant who has written extensively about children's media exposure and its effects, told The Times that "Research has consistently shown better outcomes for kids who don’t have a TV in their bedroom than for those who do, whether we’re talking about obesity, sleep or academic achievement."

In addition to removing the TV from the kids’ rooms, Rideout wants parents to pay attention to all newer technologies as well. "Keep an eye on your child’s smartphone and computers too, because food companies are now marketing games, websites and mobile apps designed to boost consumption of foods kids should be eating less of, not more of," she told The Times.

When you’re sleepy you’re more likely to make mistakes. And, it appears from research presented last month at a conference of the American Academy of Pediatrics, lack of sleep puts adolescent athletes at greater risk of injury.

Researchers studied middle- and high-school athletes in grades 7 to 12 for nearly two years. They found that those who slept eight or more hours every night were significantly less likely—68 percent—to be injured playing their sports than those who regularly slept less.

The study admittedly was small—it surveyed kids at only one California school. And it relied on students remembering and communicating accurately. But the premise, really, is a no-brainer: Insufficient sleep is not good for you, in many ways.

In addition to their sleep habits, students were asked about what sports they played, the time they spent playing sports either at school or in other programs, if they used a private coach, if they participated in strength training and how much they enjoyed their athletic endeavors. Split nearly evenly between boys and girls, 112 of the 160 students completed the survey, which was done in conjunction with Children’s Hospital Los Angeles.

The study’s author, Dr. Matthew Milewski, said, “While other studies have shown that lack of sleep can affect cognitive skills and fine motor skills, nobody has really looked at this subject in terms of the adolescent athletic population.”

In addition to hours of sleep per night being clearly associated with the incidence of injury, results showed that the higher the grade level of the athlete, the higher the likelihood of injury. Each additional grade level was associated with a 2.3 higher chance of getting hurt playing sports. No other element—gender, duration/hours of participation, number of sports played, strength training, private coaching or “fun” factor—showed a significant association with injury.
Milewski said that the association between higher grades/ages and increased chance of injury might reflect the cumulative effect of playing sports for several years as well as the fact that older kids are bigger, faster and stronger.

As reported on MedPage Today, the injuries involved multiple body parts. Most common, however, were injuries to the hand or wrist, knee, shoulder, ankle, back and head.

More than 38 million children participate in organized sports each year, according to MedPage Today. Approximately 1 in 10 is treated for a sports injury. Milewski said about half of all injuries probably are related to overuse, and half of those are probably preventable.

During the school study, nearly 6 in 10 athletes were injured; nearly 4 in 10 were hurt multiple times.

As MedPage reports, the Centers for Disease Control and Prevention and the National Sleep Foundation define insufficient sleep for high schoolers as fewer than eight hours per night. And the eight-hours threshold in this age group, Milewski said, is regularly missed—approximately 7 in 10 high schoolers don’t sleep that much. More than 3 in 4 four students involved in the survey said they slept fewer than eight hours. (See our post about how teenagers’ love of texting contributes to sleep deprivation.)

If parents needed another reason to nag their kids, the greater risk of getting hurt at play is a pretty good one: Tell your kid to log off of Facebook, turn off the smartphone and go to bed.

Earlier this year, our post about infants with breathing problems during sleep cautioned parents to monitor the quality of their baby’s slumber. But simply getting a baby to sleep and keeping him or her in a restful state can be one of the more bedeviling challenges of early parenthood.

A new study published in the journal Pediatrics might save some parents from constant worry if they’re getting bedtime routine right.

As reported on MedPage Today, certain behavioral techniques for getting babies to sleep by themselves, such as initially remaining in the child’s room, can be effective without any adverse emotional outcomes in the long term for either the kid or the parents.

The study followed up with 6-year-olds who had been studied as infants. Any problems with the youngsters were not significantly more common among those who had been “trained” to sleep alone versus those who hadn’t.

Many parents worry about long-term harm if they don’t respond immediately to a crying baby in a crib, having been influenced by older practices of letting a kid “cry it out” that causes harmful distress.

But the study showed that "camping out" to get kids to fall asleep and "controlled comforting" to help learn how to settle down on their own by gradually lengthening intervals at which parents respond to crying improved infants' sleep. It also reduced depression among mothers by 60 percent.

Among the 225 families followed through the child’s sixth birthday, there were no differences between the group that underwent behavioral training and the one that didn’t in outcomes for:

• sleep habits;


• parent-reported psychosocial functioning;


• child-reported psychosocial functioning;


• chronic stress as measured by cortisol (a hormone produced in response to stress) levels on a nonschool day;


• child-parent closeness;
  
• conflict between parent and child;


• overall quality of the relationship between parent and child;


• disinhibited attachment (emotionally and socially remote behavior);


• depression, anxiety and stress scores in the mother;


• authoritative parenting (deemed the optimal parenting style demonstrating warmth and control).

The researchers noted that their inability to follow up on about one-third of the families initially involved with infants meant the study couldn't rule out small harms or benefits long term. But, they concluded, “Nonetheless, the precision of the confidence intervals make clinically meaningful group differences unlikely."

“…[P]arent education programs that teach parents about normal infant sleep and the use of positive bedtime routines could effectively prevent later sleep problems," they concluded.

For more information, see “Getting Your Baby to Sleep” on the website of the American Academy of Pediatrics.

A milestone in child development, at least for many parents, is when the kid finally sleeps through the night. But a recent study suggests that it’s a good idea for parents to monitor how the wee ones are sleeping as well as how long.

Published in the journal Pediatrics, the study shows that children who have problems breathing while they sleep are more likely to experience behavioral problems such as hyperactivity and aggressiveness when they get older. They’re also more likely to have emotional issues such as difficult peer relationships.

Researchers from the University of Michigan and the Albert Einstein College of Medicine at Yeshiva University followed the sleeping patterns of more than 11,000 children for six years. They found that kids who snored, breathed heavily through their mouths and experienced apnea—long pauses between breaths during sleep—were at risk.

Collectively known as sleep-disordered breathing (SDB), the problem peaks when children are between 2 and 6 years old, but can occur when they are younger. Approximately 1 in 10 children snores regularly and 2 to 4 in 100 have sleep apnea, according to the American Academy of Otolaryngology–Health and Neck Surgery (AAO-HNS). Common causes of SDB are enlarged tonsils or adenoids, but be wary of the “quick-fix” of tonsillectomy—as we have reported, that surgical procedure is often unnecessary, and to conclude that tonsils contribute to sleep disorders requires careful diagnosis.

Quite simply, the study’s authors said, “Parents and pediatricians alike should be paying closer attention to sleep-disordered breathing in young children, perhaps as early as the first year of life.”

Although earlier studies indicated sleep problems could signal later difficulties, they involved only small numbers of patients, short follow-up of a single symptom or limited control of individual traits such as low birth weight that could be responsible for some symptoms.

In the new, more substantial study, children whose symptoms peaked between the ages of six and 18 months were much more likely to experience behavioral problems when they were 7 compared with children who breathe normally during sleep. Children whose SDB symptoms persisted throughout the evaluation period, and were most severe at 30 months, expressed the most severe behavioral problems.

Researchers theorize that SDB might be responsible for behavioral problems because of its effect on the brain. Decreased oxygen levels and increased carbon dioxide interrupts the restorative process of sleep and disrupts various chemical systems. Such malfunctions can impair one’s ability to pay attention, plan ahead and organize. They also impede one’s ability to regulate emotions.

To learn more about SDB and treatment options, consult the AAO-HNS fact sheet.