Only 48% of school age children in the United States get 9 hours of sleep most weeknights, according to new research being presented at the American Academy of Pediatrics (AAP) 2019 National Conference & Exhibition in New Orleans. Those who do, the study suggests, are significantly more likely to show a positive outlook toward school and other signs of "childhood flourishing," a measure of behavioral and social well-being.

An abstract of the study, "Sounding the Alarm on the Importance of Sleep: The Positive Impact of Sufficient Sleep on Childhood Flourishing," will be presented on Saturday, Oct. 26, at the Ernest N. Morial Convention Center in New Orleans.

"Chronic sleep loss is a serious public health problem among children," said abstract author Hoi See Tsao, MD, FAAP. "Insufficient sleep among adolescent, for example, is associated with physical and mental health consequences including increased risk of depression and obesity and negative effects on mood, attention and academic performance."

"As healthcare providers, we want every child to reach his or her full potential, Dr. Tsao said. "Our research shows that children who get enough sleep are more likely to demonstrate measures of childhood flourishing in comparison to children with insufficient sleep."

Researchers analyzed responses from parents and caregivers of 49,050 children ranging in age from 6-17 years old in the combined 2016-2017 National Survey of Children's Health. They answered questions on how many hours of sleep a randomly selected child in their household slept on an average weeknight. For the study, sufficient sleep was defined as sleeping greater than or equal to 9 hours on an average weeknight.

For individual flourishing markers, the caregiver was asked if the child showed interest and curiosity in learning new things; cared about doing well in school; did required homework; worked to finish tasks started and stayed calm and in control when faced with a challenge. Prior research suggests that the more flourishing markers children have, the more likely they are to have healthy behaviors and fewer risky behaviors. A combined flourishing measure was created to identify children for whom caregivers felt met all five individual flourishing markers.

The researchers found that sufficient sleep, reported in 47.6% of the 6 to 17-year-old children, was positively associated with several individual flourishing markers, as well as the combined childhood flourishing measure. Compared with children who did not get 9 hours of sleep most weeknights, those who did had 44% increased odds of showing interest and curiosity in learning new things, 33% increased odds of doing all required homework; 28% increased odds of caring about doing well in school; 14% increased odds of working to finish tasks started, and 12% increased odds of demonstrating the combined flourishing measure.

The analysis adjusted for age, federal poverty level, time spent in front of a television, time spent with computers, cell phones, video games and other electronic devices, adverse childhood experiences (including abuse, neglect and other potentially traumatic experiences) and mental health conditions.

The researchers also identified risk factors associated with insufficient sleep, which included lower levels of parental or caregiver education, children living in families at lower federal poverty levels, increased duration of digital media usage, increased number of adverse childhood experiences and the presence of mental health conditions.

Dr. Tsao said the study reinforces the importance of increasing efforts to help children get the recommended amount of sleep for their age. She said efforts should especially focus on digital media usage, bedtime routines, the length of the school day and school start times.

"Interventions like these may help children demonstrate more measures of childhood flourishing, enhance their development and give them brighter futures," she said.