#17 - Anxiety and Sleep ... in Kids
Sleep is a need and a powerful reward!
14 years ago I started treating school kids with sleep problems. It was - and still is - ahead of the curve. A lot of people don’t realise school kids can have sleep problems.
These kids often became scared in the evening, and found it hard to fall asleep.
The best help they could get was from their parents. Specifically, they needed their parents nearby.
In the 2000s my view was criticised. These were just anxious kids. Kids who could be treated with anxiety treatments.
In 2011, we published our study adapting CBT for insomnia from adults to these kids.
And it worked.
I do believe that traditional CBT for children’s anxiety (CBT-A) would help their sleep. Usually alot of studies have shown that CBT-A improves sleep-related problems. When I worked with colleagues at the Centre for Emotional Health at Macquarie Uni in Sydney, we used traditional sleep diaries - but we didn’t find much change in their sleep.
And that was after 10-12 sessions of CBT-A.
Thing is, the CBT for insomnia we developed improved these kids’ sleep … in 6 sessions or less.
And it helped many of those kids move out of their parent’s bedroom, and finally back into their own room.
It meant these kids could go to school camps.
And a lot of that had to do with alleviating their anxiety at night using sleep techniques.
Sleep and Anxiety
Ronald Dahl and Allison Harvey proposed back in 2007 that sleep and anxiety were ‘opponent processes’. This means they work in direct opposition to each other.
When someone is highly anxious, they go into what’s called hyper-arousal. This means they’re incredibly alert. That’s the opposite of being sleepy.
But there is a flip-side to this.
Here’s an example.
A couple of years ago I had a bad night’s sleep. It happens, and sometimes we cannot explain why it happens. But thankfully it’s just a single night amongst many good nights of sleep.
The next day I had to have a filling in my tooth at the dental surgery. I remember the bright, yet warm light staring me in the face. And I remember feeling sleepy, because I hadn’t slept well the night before. And I gave into this sleepiness. That doesn’t mean I fell asleep in the dentist’s chair, but more like I didn’t give a toss about the drill vibrations or noises, the cold rush of water in my mouth, the funny tastes, or much else. So I did close my eyes - and just enjoyed that sensation of closing my eyes. Focusing on the pleasure from finally being allowed to close my eyes was bliss. Sleep after all is a need and a powerful reward!
It dawned on me that it was a good example of how sleepiness can dampen anxiety.
This means it doesn’t have to always be anxiety winning the fight. Sleep can too.
We’ve moved beyond seeing if sleep and anxiety improve from the CBT we developed. Now we’re interested in the scientific question of HOW does improving sleep improve anxiety?
The HOW question
There have been a number of different pathways suggested about sleep’s link with anxiety. But there’s a new one that we’re intrigued with. And it has to do with REM sleep.
REM stands for Rapid Eye Movement, which is what happens during REM sleep. We also dream during REM sleep and our muscles become paralysed so we don’t act out our dreams.
But the interesting thing about REM sleep is it’s potential role in processing our emotions.
For the past couple of years we’ve been performing EEG recordings of the children we are treating with CBT for insomnia - recording them before and after the treatment. We’re hoping to learn if REM sleep is actually involved in the reductions in anxiety we’re seeing in the kids we treat.
Now you may not care about the HOW question - that’s fine. You might think, as long as the kids sleep better and feel less anxious then that’s the main thing. That’s fine too.
And if that is what you’re interested in, then we can help you learn this.
If you’re a parent, you can learn how to do this with your kids.
If you’re a health professional, you can learn how to do this with your clients.
We’re calling it KID WINK, and it will be an online educational video series. We were planning for it to be released in March, but it looks like we’ve been distracted with other events.
But it will come out - and it’s going to be great !