Sleep patterns in children and adolescents

First created | 10/10/2011

Last edited |

Written by Maurice M. Ohayon, MD, DSc, PhD
Reference to cite:

Ohayon MM. Sleep patterns in children and adolescents. SleepEval.com Website. Oct 2011.
Ohayon MM, Carskadon MA, Guilleminault C, Vitiello MV. Meta-analysis of quantitative sleep parameters from childhood to old age in healthy individuals: developing normative sleep values across the human lifespan. Sleep. 2004 Nov 1;27(7):1255-73. Free PMC

Four age-related changes have been consistently demonstrated in polysomnographic (PSG) studies of sleep architecture:
- total sleep time (7-29),
- sleep efficiency (7,9-14,17-23,25-29,30-36), and
- slow wave sleep (7,8,10, 12-18, 21-28, 31,33, 35,37-39) all decrease, while
- wake after sleep onset (12-14,16,17,19,21,23,28,29, 32,33,36,37,40) increases with age.

Why such discrepancies between the studies?
Several factors may be responsible for the difficulties identifying age trends in sleep architecture of apparently healthy subjects. For example: small sample sizes; inconsistency in controlling factors that may influence sleep, such as mental or physical illness; insufficient screening for sleep disorders.

METHODS

TARGETED STUDIES

Non-clinical studies
Participants aged 5 to 18 years
measures of sleep characteristics by "all night" polysomography (PSG)
or measures of sleep-wake patterns obtained by questionnaires.
data presented numerically
published between 1960 and 2003 in peer-reviewed journals.

VARIABLES ANALYZED

Sleep latency (SL)
Sleep efficiency (SE)
Total sleep time (TST)
Stage 1,
stage 2,
slow wave sleep (SWS),
REM
REM latency
Minutes awake after sleep onset (WASO)
Bedtime & rising time

QUESTIONNAIRES

Number of studies: 21
Number of subjects: 24,617
Age range: 5-18 years
Data examined:

Bedtime,
rising time and
sleep duration for weekdays and weekends.

Europe versus USA

BEDTIME

RISING TIME

NIGHTTIME SLEEP DURATION

POLYSOMNOGRAPHY OR ACTIGRAPHY

Number of studies = 18
Number of subjects = 1,186 ¨Age range: 5-18 years
Variables examined: TST, SL, SE, WASO, REM, S1, S2, SWS

SIGNIFICANT CHANGES

TST
Percentage stage 2
Percentage SWS
Percentage REM

TOTAL SLEEP TIME

PERCENTAGE OF STAGE 2

PERCENTAGE SWS

PERCENTAGE REM

Discussion

QUESTIONNAIRES

Age effects for weekdays and weekends

Bedtime,
rise time,
total sleep time

Country effects

Weekday rise time & TST,
weekend bedtime, rise time,
TST

Interaction effects

Weekday bedtime,
rise time,
TST
weekend bedtime & TST

European studies focused more on younger samples than did US studies.
Patterns across age were reasonably consistent.

Interactions likely reflect socio-cultural differences.

PSG

Significant age-related changes in:

TST,
Stage 2 Sleep,
SWS,
REM

Extremely large variability.
Methodology may contribute to differences.

Careful controls and protocols are needed.

CONCLUSION

Normative data can provide a framework for understanding changes with age across time.

Societal and cohort differences may emerge as well-controlled studies emerge.

MORE INFORMATION

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