1. Maximising future potential in Australian children: the role of sleep Dr Sarah Blunden Centre for Sleep Research University of South Australia

2. Total time in bed has significantly decreased from 1985 to 2004 (30min; 5% change; p<.0001) (Dollman and Olds 2008)

3. When children don’t sleep enough…. Clear evidence of reduced: Neuropsychological function Memory, attention, intelligence Emotional stability Depression, anxiety, self esteem Psychosocial function Aggression, hyperactivity, peer relations, families, drug and alcohol misuse Performance school performance, sport Physiological health immune, cardio vascular and endocrine systems (weight status)

4. Memory and attention is worse in children who do not sleep Blunden et al Journal of Pediatrics, 146 (6): p. 780-6.

5. Poor behaviour scores are worse in children who don’t sleep Blunden et al Journal of Pediatrics, 146 (6): p. 780-6

6. Students who don’t sleep are more likely to repeat grades.. Blunden & Chervin Journal of Paediatric Child Health, 44(5):237-42: Students in behavioural units compared to mainstream controls. Students in behavioural units: Had worse sleep (quantity or quality). They were 5 times more likely to have sleep disturbance Had more ‘Ds’ and ‘Es’ than those who did sleep well (teacher report) A = top of the class B = above average C = average D = below average, almost failing E = failing F = bottom of the class Had worse parentally reported school performance (Blunden & Chervin 2009) They are NOT less intelligent – just have worse sleep

7. What can we do? Make sure children use GOOD SLEEP HYGEINE This means: No TV/computer games 1 hour before bed. Make sure the bedroom is comfortable (temperature, light, noise) Set bedtimes and wake times Ensure relaxing and regular bed time routine – special time, worry time, relaxation techniques. Reading with Mum or Dad has a very strong and positive effect on children sleep health.

8. Relevant references Blunden SL, Lushington K, Kennedy D, Martin J, Dawson D. Behaviour and neurocognitive performance in children aged 5-10 years who snore compared to controls. Journal of Clinical and Experimental Neuropsychology (2000) 22(5) 554-568) Blunden SBlunden S, Lushington K, Lorezen B, Kennedy D (2001). Neuropsychological performance in children who snore compared to non-snorers. Australian Journal of Psychology, 53 (suppl) p139Lushington KLorezen BKennedy D Blunden S, Lushington K, Kennedy D. Cognitive and behavioural performance in children with sleep related obstructive breathing disorders. Sleep Medicine Reviews (2001) 5 (6) 447-461 Blunden, S., Lushington, K., Lorenzen, B., Wong, J., Balendran, R., Kennedy, D. (2003). Symptoms of sleep disordered breathing remain largely untreated at the primary heath care level. Sleep and Breathing, 7 (4):167-176. Blunden, S., Lushington, K., Lorenzen, B., T Ooi, T., Fung, F., Kennedy, D. (2004). Are sleep problems under-recognised in general practice? Archives of Diseases in Childhood, 89 (8): 708-712. Blunden SL, Lushington K, Lorenzen, B, Kennedy, D, Martin J. (2005). Neuropsychological and psychosocial function in children with a history of either snoring or disorders of initiating and maintaining sleep. Journal of Pediatrics, 146 (6): p. 780-6. Blunden S. Beebe D. (2006). The contribution of intermittent hypoxia, sleep debt and sleep disruption to daytime performance deficits in children: Consideration of respiratory and non-respiratory sleep disorders. Sleep Medicine Reviews, 10 (2): 109-118 Blunden, S.L., Hoban, T. Chervin, RD. (2006). Sleepiness in children. Sleep Medicine Clinics, 1 (1) p. 105 -118.). Dillon J, Blunden SL, Ruzicka D, Guire K, Champine D, Weatherly M, Hodges E, Giordani B, Chervin RD. (2007). DSM-IV diagnoses and obstructive sleep apnea in children before and one year after adenotonsillectomy. American Journal of Child and Adolescent Psychiatry; 46 (11):1425-36 Blunden SL, Chervin RD. (2007). Sleep problems are associated with poor outcomes in remedial teaching programs. Journal of Paediatric Child Health, 44(5):237-42: Epub 2007. Blunden SL, Nair D. (2009). An unusual clinical phenomena – a case of bedtime ritual with apparent sexual overtones. Clinical Child Psychology and Psychiatry published online November 13 2009 DOI:10.1177/1359.1045.0933090. Blunden, SL, Chervin RD. (2009). Sleep, performance and behaviour in Australian indigenous and non-indigenous children: an exploratory comparison. Journal of Paediatric Child Health published online November 2009 doi:10.1111/j.1440-1754.2009.01610.

9. Websites www.unisa.edu.au/sleep www.sleepeducation.net.au