Auburn scientist shines a light on children’s sleep

The adage “get a good night’s sleep” is grounded in everyday wisdom, decades of research and a few mysteries. Just a few decades ago, the scientific community knew little about why children need sleep or what factors influence their nightly snoozes.

Renowned sleep expert Mona El-Sheikh, the Leonard Peterson & Co. Inc. Professor in Auburn University’s College of Human Sciences, has been working over 20 years to fill this gap and unravel lingering questions about children’s sleep: a topic that piqued her interest, in part, because of sleep’s primacy in our lives.  

“My interest in sleep started with the realization that it’s related to many outcomes in children and adults,” she said. “Although there was not much research out there on children, we could extrapolate from the adult literature that sleep is related to being happy during the day, our mood and mental health.”

El-Sheikh, who was the recipient of the Southeastern Conference’s 2021 Faculty Achievement Award for Auburn, has published over 180 studies about sleep and received significant funding — over $12 million  — from multiple entities, including the National Heart, Lung, & Blood Institute, the Eunice Kennedy Shriver National Institute of Child Health And Human Development and the National Science Foundation for her multi-decade research.

She has brought together a talented team of collaborators within Human Development & Family Science, including Distinguished Professor Joseph Buckhalt, Professor Stephen Erath, Associate Professor Ben Hinnant, and Professor Thomas Fuller-Rowell. Together, they are chipping away at what influences children’s sleep and how sleep influences children’s lives.

Children’s sense of security, sleep

Anyone who has spent a night camping — attuned to any sounds that could signal an unwanted animal visitor — knows that feeling unsafe can wreak havoc on their sleep. In fact, El-Sheikh says a sense of security, whether sleeping in the woods or at home in a comfortable bed, is a key factor in children being able to sleep well.

“All of us need what we call a sense of security to be able to sleep. This goes throughout our evolutionary history,” she said. “If we don’t have that sense of security, the body gets into hypervigilance and physiological arousal — higher heart rate, higher blood pressure that interrupts sleep.”

A wild animal in the woods isn’t the only experience that can trigger this stress response; El-Sheikh has found a variety of everyday triggers can influence a child’s perceived security.

“Stress can come from the family, peers, from experiences of discrimination — it all can create that fight or flight response over time,” she said.

Conflict between parents in the home is one factor El-Sheikh has studied extensively. While disagreements are par for the course for people choosing to live together, El-Sheikh says that the adverse conflict is “intense, frequent and prevalent.”

When two parents are engaged in this type of conflict in front of the children, whether physical aggression, verbal sparring or even the silent treatment, it can ignite insecurity in a child and decrease the quality and quantity of their sleep. El-Sheikh and her team have also investigated how family aggression can have a long-term impact on adolescents’ health.

Contrary to some colloquial advice, El-Sheikh’s research suggests it is beneficial for parents to resolve conflict in front of their children, instead of behind closed doors. That way, the children can see that a repair was made between their parents.

The dynamic between parents is one of many factors that can affect children’s sense of security. El-Sheikh has also found that a child’s secure attachment to their parents, believed to be forged early on in childhood, is linked to better sleep.

Specifically, in one of her past studies with 258 fifth and sixth graders, she discovered that children’s stronger attachment to parents was connected to improved sleep across multiple dimensions, including consistency of bedtime and satisfaction with their sleep.

Peers also influence children’s sleep; what happens on the playground may play a role in their ability to sleep well at night. For example, El-Sheikh and her collaborators conducted a study with 272 adolescents and uncovered teenagers exposed to violence among their peers reported lower sleep quality and greater sleepiness.

Security-disrupting behaviors among peers can arise from both physical and verbal behaviors, according to El-Sheikh’s research.

“We’re looking at socio-economic discrimination, such as being told ‘Oh, you’re not dressed in the latest fashion’ and ‘I don’t like your hairstyle,’” she said. “We’ve examined how children respond to racial and ethnic discrimination.”

Besides a sense of security, El-Sheikh and her collaborators have also explored how children’s home environment can impact their sleep. They found that a house temperature of between 71° F to 73° F is optimal for sleep.

Chaos within the house can also influence children’s sleep, such as inconsistent structure and family behaviors.  “A good message for parents of younger ones is to have a consistent sleep routine to help the child sleep, so maybe you read to them every night, turn the lights off and monitor caffeine intake,” El-Sheikh said. “Consistent bedtime routines are very important.”

How sleep influences children’s health

Babies spend more than half of their day asleep, while children need between eight and 10 hours, said El-Sheikh. While sleep comprises a large chunk of children’s lives, scientists are not entirely sure of the benefits they reap from getting good sleep.

“We have identified many aspects of children’s sleep that were not in the literature before,” she said. “What we’ve found is that sleep (in children) is related to mental health, physical health, body mass index and performance in school.”

Within children’s physical health, El-Sheikh says sleep is linked to frequency of illnesses, headaches and immune system functioning. Sleep’s role in mental health encompasses depression, anxiety and externalizing problems like aggression.

What’s more: El-Sheikh and her collaborators have discovered that children who experienced sleep difficulties, including trouble staying asleep, had greater mental health challenges as teenagers.

Sleep’s scoping impact on humans’ minds and bodies is rare. “There are few aspects of biological behavior or processes that can be related to so many things,” El-Sheikh said.

The good news: this close connection between sleep and health outcomes also provides ripe opportunities for intervention. In other words, enhancing sleep has the potential to help children’s holistic health, said El-Sheikh.

These sleep interventions can begin right in the home. A good place to start is to grasp what getting a good night of sleep means.

“When we’re talking about sleep, we’re not only talking about duration. We’re also talking about consistency in sleep schedules, and we’re also talking about quality,” El-Sheikh said.

Depending on the family and their situation, El-Sheikh said some factors may not be readily changed. For example, a family may not have the financial means to keep their home or apartment at the recommended temperature. To the extent possible, El-Sheikh says it can be helpful for parents to monitor their environment and reduce adverse triggers.

“Monitoring is a very important one for children,” she said. “What we mean by that is monitoring electronic use — not having a television in their room and making sure they’re charging their phones outside of their room. The sounds and dinging on social media at night can interrupt quality.”

Avoiding caffeine and exercising close to bedtime can also help improve sleep quality. El-Sheikh says that taking some of these small steps to monitor children’s sleep can lead to big impacts and protect children from adverse health outcomes.

“If children are monitored well, even in high-risk environments, but are sleeping adequate amounts of consistent sleep, they tend to be protected from mental health problems and poor academic performance,” she said.

In this way, El-Sheikh describes sleep as a protective factor – and a “great equalizer” – that can help shield children from adverse factors in their lives. While parents can do their part to help their children’s sleep within their means, El-Sheikh also says systemic change is important.

“We need intervention at multiple levels, including school education about the importance of sleep as another health behavior and at the community level,” she said.

El-Sheikh has previously gathered an international group of researchers to Auburn to discuss practical strategies to address children’s sleep – and she hopes to continue to see the translation of these sleep research findings into applied changes that can benefit children and the community.

In the meantime, El-Sheikh will continue churning out basic research findings with her collaborators. She says studying sleep never gets old.

“I’m so glad I began researching sleep. Sometimes you don’t know you’re passionate about an area for a little bit and you don’t know how long it will capture you. But it has lasted for me since 2000.”