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Want your children to grow up with good cognitive functioning and mental health? Then make sure they get enough sleep.

Good quality sleep is increasingly rare among children and teenagers these days due to a variety of lifestyle factors.

Research have consistently shown that a good night’s sleep is vital for cognitive functioning and good mental health. With this widespread deficiency, it is no wonder that mental health issues among young people and children are more prevalent globally.

Think about it. If you didn’t get enough sleep the night before, would you be able to function well at your job or do your daily tasks effectively in the morning? How would your mood be, waking up with less than adequate sleep?

Most likely, you’d be grumpy. You would get ready for work or do daily chores while feeling groggy. Such circumstance could also affect your decision-making ability; you’re likely to make more mistakes.

How would that be for a child or teenager who has not reached the maturity to be independent in solving problems, planning the day and seeking help when needed? Not easy.

Can you imagine how difficult it must be for a younger person to deal with the lack of sleep, with continued experience of frustrations that snowball throughout the day because of a bad start in the morning?

Research show that toddlers and young children with a history of sleep problems have a higher risk of poor mental health and developing psychological disorders as adults.

More recent studies on children’s sleep have linked poor sleep to mental health issues even before they reach their teens.

Children and teenagers who have disturbed sleep and daytime sleepiness also tend to display externalising behaviours (such as angry outbursts) and internalising behaviours (such as becoming withdrawn and having low mood).

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How sleep affects mental health

Let’s take a look at how sleep, cognitive function and emotional regulation are interconnected.

We know from years of neuropsychological research that sleep is crucial for cognitive function, emotional regulation and overall development. With children and teens still developing mentally, it is important for them to have adequate sleep so that they grow into well-adjusted adults.

Cognitive function involves information processing, memory recall, decision-making, planning and much more. We need adequate cognitive function to be able to plan, organise and coordinate our daily tasks.

The inability to execute such tasks would easily lead to disappointments and frustrations, therefore disrupting the day.

Emotional regulation – the ability to be aware of emotions and to know what to do about them – also suffers with poor sleep.

We have brain centres that are responsible for emotion regulation. But due to lack of sleep, the areas of the brain that are responsible for emotions become less efficient.

This can trigger mood disturbances such as feelings of anxiety and depression, as well as behavioural problems.

Children who experience sleep difficulties typically do poorly at school as they are unable to concentrate in class and have trouble processing and responding to instructions.

They are also more likely to have daytime sleepiness. Such poor cognitive function then becomes a barrier to learning.

Poor cognitive function also tends to increase impulsivity in children’s responses. This means they react without thinking, and this can bring about trouble as they may make unhelpful decisions in response to daily challenges.

The lack of cognitive function could also contribute to difficulty in emotional regulation, subsequently amplifying the frustrations experienced as a result of ineffective skills of the mind. It’s a vicious cycle, and if not managed appropriately, the dangerous combination of poor decision-making and emotional regulation can lead to negative coping strategies.

What is important to note is frustrations and negative coping strategies in children and teens do not exist in a silo – they affect the rest of the family too.

Incidences of frustrations can upset and disrupt daily family routine as well as their own schedule, subsequently affecting mental health.

This is because routine is known to be one of the main contributing factors to good mental health. It gives us a sense of control.

Disruption of routine affects emotional regulation because it makes it harder for us to have autonomy.

Tips for better sleep

What can be done to help children and teens get better sleep? The first thing to do is to practise sleep hygiene.

We know about hygiene in general, e.g. washing hands often to prevent spread of germs, bathing regularly and brushing our teeth for dental health; but what about sleep hygiene?

Sleep hygiene is the practice of putting things in place to facilitate sleep. These include addressing physiological, biological, behavioural, cognitive, social and environmental factors that affect sleep.

Biological and physiological factors include aspects like nutritional intake and physical condition.

For instance, if you drink caffeinated or energy drinks in the afternoon or evening, you’re likely to stay awake longer at night.

Eating too much just before bedtime also affects sleep. In this case, good sleep hygiene is avoiding stimulating substances and overeating before bed.

Some children have sleep apnoea, which is a medical condition where breathing during sleep repeatedly stops and starts, causing the lack of oxygen supply to the body.

This results in the child feeling tired and having daytime sleepiness even after sufficient sleep duration. It is important to note that if a child or teen snores and if his or her breathing stops momentarily during sleep, parents should seek medical attention for treatment.

Behaviourally, intense physical activities in the evening keeps the body warm and the mind excited, both of which prevent relaxation for sleep. In order to sleep easier and better, it is good to focus on relaxing at night and not get overly excited.

The bedroom should be a comfortable place and conducive for sleep. The bed should be reserved only for sleep and not stressful activities such as playing games or doing homework.

In this digital age, children and teens (even adults) are exposed to screens daily.

We spend a significant portion of our lives looking at our smart phones, tablets, laptops and TV. Prolonged screen exposure affects brain activities that can disrupt sleep. Blue light emitted by devices, as well as contents, excite the brain so we tend to stay awake.

Screen time can also disrupt routine, including bedtime. So good sleep hygiene means stopping screen time about one hour before sleep to allow the brain to relax. Seek help

Children and teens who have moderate to severe sleeping problem can benefit from psychosocial intervention.

There are many evidence-based treatments such as cognitive-behavioural therapy for insomnia (CBT-I) and behavioural treatments that can help them sleep better.

What research have shown about sleep and mental health is that they’re bidirectional – good sleep predicts better mental health and well-being. The opposite is also true – better mental health and well-being will also, over time, improve sleep.

With such strong empirical evidence from science, it would be good for decision makers and relevant health practitioners to incorporate these findings into the public health agenda, school curriculum and clinical practice.

It is beneficial to include the promotion of sleep hygiene as an integrative part of policies targeted at children and adolescents for their well-being.

Children with adequate sleep are better learners, happier individuals and functional members of society. A sleepy child is a moody and disruptive child.

Whether we are parents, older siblings or relatives, we should play our role in facilitating good sleep in children, to chart them towards better mental and emotional health. Collectively, we can help nurture a well-adjusted, well-rested generation.

Professor Alvin Ng Lai Oon
School of Medical and Life Sciences
Email: @email

This article was first published in The Star, 15 July 2024.