Sleep and student wellbeing

By Education Gazette editors

Issue: Volume 99, Number 14

Posted: 3 September 2020

Reference #: 1HAAX7

A Christchurch student is highlighting the issue of insomnia in young children and wants schools to include sleep education in the curriculum.

In June, Christchurch Girls’ High School student Neela van Gerwen wrote to Secretary for Education Iona Holsted suggesting that primary schools should teach students about sleep issues.

Between the ages of seven and 10, Neela suffered from chronic insomnia and she wrote that it would strongly benefit young children if primary schools talked about how to prevent insomnia and other sleep issues.

Neela was fortunate that her mother, Jay van Gerwen, researched a range of strategies, which have mainly helped her overcome insomnia.

The Year 9 student says that she now has the occasional bad night, but is now much better at dealing with it.

“I would have three months where I was really bad on and off. It was very frustrating and tiring because I would dread going to bed because it would be such a stressful environment.

“Normally people look forward to going to bed, but back then I would do everything to try to avoid going to bed because I just found it one of the hardest things to do to get to sleep. I was often tired and upset and very emotional in the mornings.”

Endless cycle of insomnia

Neela says stress and anxiety are key causes of insomnia and can become an endless cycle.

“I might be thinking about the next day and seeing the time and thinking ‘Oh my gosh, it’s been an hour, I’m not going to get enough sleep, I’m gonna be so tired in the morning and I won’t be able to function properly and I won’t be able to go to school and learn anything because I will be falling asleep’. And that just makes the problem so much worse.”

She was prescribed melatonin, which works well for her and which she still occasionally uses. However, she also has a toolkit of strategies that see her generally getting a good night’s sleep.

“First I found that moving my clock was the best thing. It would just stress me out so much seeing the time on my clock, so I moved it off my bedside table and put it under it. It’s still there so I can check what time it is in the morning but when I roll over, it’s not right in front of my face,” she says.

Neela’s sleep strategies

Affirmations: write on a piece of paper things like ‘I will fall asleep, ‘I will get plenty of sleep’, ‘I will get to sleep eventually and I will be fine’. Put them on the wall by your bed and repeat them.
Breathing techniques: breathe in for four seconds, hold for seven and then exhale for eight seconds.
The reading technique: if you haven’t gone to sleep after about 20 minutes, get up and read for 5-10 minutes and then go back to bed. Repeat until you fall asleep. “This one has worked the best for me. When you read in bed and put the book down and go to sleep, your brain is like: ‘I thought this place was for reading’, so it’s not properly turning off,” says Neela.
Meditations and mindfulness: Try headspace.com or hypnosisdownloads.com.

Neela’s letter

Secretary for Education Iona Holsted asked Education Gazette to publish the letter, with Neela’s approval:

19 June 2020

Dear Ms Holsted,

My name is Neela van Gerwen and I am 13 years old. From the age of 7-10, I had chronic insomnia. I would lie in bed for hours. Not being able to sleep without knowing what I was doing was making it worse.

It would strongly benefit young children if primary schools talked about insomnia and other sleep issues, and how to prevent them. How much sleep is needed is covered with other things such as keeping yourself healthy, but we aren’t taught what to do if you can’t get that sleep you need. Luckily my Mum thoroughly researched insomnia for me, which is mostly how I overcame it.

Including one or two health lessons on sleep issues could reduce primary school students experiencing ongoing loss of sleep. This could be about the association in the mind between your bed and sleeping. Your mind makes connections and you want the connection to your bed to be sleeping: not going on your phone, or staying awake and reading, but sleeping.

Covering other techniques such as breathing patterns (inhale for four seconds, hold for seven, exhale for eight), affirmations and meditation would be so helpful for preventing hours of lost sleep in primary school students.

I would love to see some changes in the way we educate children about sleep issues, and especially in stressful times like these: many children are struggling to get to sleep and not knowing what to do.

Yours sincerely

Neela van Gerwen

(Abridged)

Sleep problems increasing in the Young

The area of research into children, young people and sleep is growing, but studies indicate that insomnia and sleep problems are increasing in children and young people around the world.

It’s hard to pin down how widespread sleep problems are in pre-adolescents, says Dr Dee Muller, from Massey University’s Sleep Wake Research Centre, but research from overseas and New Zealand indicates that 25 to 30 per cent of children appear to have issues with their sleep. She agrees with Neela van Gerwen that sleep health should be taught in schools.

University of Otago research Sleep and pre-bedtime activities in New Zealand adolescents (lead researcher, B Galland) surveyed over 4,000 young people and found that 39 per cent of adolescents who took part were getting less than the recommended hours of sleep; 57 per cent reported poor sleep quality.

Sleep changes in first 20 years

“The evidence is a bit mixed, but children and young people may be getting less sleep than they used to. This highlights why it’s so important that children are taught about sleep. Sleep changes developmentally over time in your first 20 years of life, so understanding those normal changes is really important for children.

“For children and adolescents sleep is really important for development. It plays a huge role and is why babies spend so much of their day and night sleeping. It’s really important for our developing brains and bodies.

“There tends to be quite a significant change in sleep patterns for a lot of young people when they move from pre-adolescence to adolescence because it’s very common for your body clock to shift,” says Dee.

Multiple aspects to sleep health

Sleep health is a fairly new term which recognises there are multiple aspects to sleep including getting enough sleep, quality of sleep and efficiency of sleep – being able to fall asleep, sleep continuously and get back to sleep easily in the night.

“What we find, which is a particular concern for children at school, is that not sleeping well can really affect how easy it is to learn. It impacts concentration and memory. Research backs up that we see poorer learning outcomes when there are sleep issues for children sometimes.

“The other area of concern is that sleep issues are associated with poorer mental health outcomes, including anxiety, low mood and attention difficulties. Research also indicates that insufficient sleep duration seems to play a role in the risk of obesity. And obesity is a growing issue for our young people,” she explains.

Three pillars of health

Sleep, healthy food and exercise make up the three pillars that are needed to be healthy mentally and physically from childhood, says Dee.

This is why she thinks education about sleep should begin in early childhood education and continue through to secondary school.

“I think that sleep should be included more in children’s education and I absolutely think it could be included right from the beginning in the ECE curriculum through the primary years and through secondary school – in different forms. I think we could build on the story about sleep throughout the curriculum.”

Sleep crosses the sciences and health curricula, says Dee. “If you understand how sleep works, that makes more sense in relation to the general guidelines about what we can do to support good sleep health. The nuts and bolts of how sleep works is really interesting from a science perspective.

“I’m biased, but really, sleep impacts every aspect of our waking day – we all sleep, we all need to sleep and if our young people were better informed about sleep, we could see some really long-term, positive impacts further down the track,” she says.

Devices and anxiety

International evidence backs up a connection between technology use and sleep.

“Technology can be great, but like anything in relation to sleep, you need to be mindful of timing. The timing and consistency of what we do when we are awake all make a difference to our sleep.

Anxiety is another big issue for people who suffer from insomnia, says Dee.

“If you tend to be someone who overthinks things, then it can be really difficult to go off to sleep, or to go back to sleep easily in the night.” Supporting young people to use strategies to help minimise the impact of worrying can be really helpful.

“One strategy that can work quite well is setting aside a time earlier in the day – say sometime between finishing school and before bed – to have a little worry time. Check in with a trusted person in your life to talk about anything that is worrying you or to write it down in a journal and then set it aside. So that if those worries come back to you in bed, you can think ‘No – I will go back to them tomorrow at 5pm’.”

No blame and more education

Dee says it’s important not to lay blame with young people (and adults) about their sleep habits because people can feel judged and that’s not going to help with sleep problems.

“Sleep is a tricky thing – you can’t actually make yourself sleep. You can create the environment that’s really conducive to sleep, because as Neela beautifully wrote: you want positive associations with going to bed: not associations with doing your homework in bed or getting a hard time on social media in your bed.

“It’s a great learning opportunity for children. There could be some online resources developed as well as face-to-face teaching in class. It can be quite fun to track your sleep. It can be really powerful if you are learning about sleep and use a simple sleep diary to mark down when you go to bed, go to sleep and wake up and look at that pattern of sleep across the whole week,” says Dee.

Curriculum links and resources

Sleep health education aligns with the Personal Health and Physical Development strand of the Health and Physical Education learning area of The New Zealand Curriculum.

Learning in this strand focuses on the personal health and physical development of students.

Students develop the knowledge, understandings, skills, and attitudes to meet their health and physical activity needs, both now and in the future. They learn about influences on their wellbeing and develop self-management skills that enhance their health.

Supporting resources

A mental health education resource brought to schools by NZCER and the Ministry of Education contains some relevant information and teaching ideas about sleep, sleeping patterns, and the relationship between these and mental health.

The resource, ‘Mental health education and hauora: Teaching interpersonal skills, resilience, and wellbeing(external link)’ is being distributed to all schools with students at Year 7 and above.