Thousands of children and teenagers in England are being admitted to hospital for sleep disorders, with admissions for conditions such as insomnia almost doubling in seven years.
Experts have described the situation as a hidden public health problem, putting it down to rising obesity levels, excessive use of social media before bedtime and a mental health crisis engulfing young people.
The Guardian analyzed data from NHS Digital, the national information and technology partner to the health and social care system in England, which revealed that hospital admissions for under-16s with a primary diagnosis of sleep disorder rose from 6,549 in 2012-13 to 9,451 in 2017-18 and 11,313 in 2018-19.
By comparison, sleep disorder admissions for all ages rose only slightly between 2012-13 and 2018-19, from 29,511 to 30,098.
Vicki Dawson, the founder of the NHS Doncaster-funded Children’s Sleep Charity, the only free specialist service that provides support to families for children’s sleep, said the organization had been inundated with requests from families seeking help.
“We find it hard to meet the demand due to our very limited resources,” she said. “The rise will be linked to a number of factors, firstly, sleep-disordered breathing issues in children which is linked to obesity. It is commonly recognized that there is a problem around childhood obesity in the UK. What isn’t recognized is that poor sleep quality can be a driver for it, impacting on the release of hormones that manage appetite and hunger.”
Dawson said another area where they were seeing a significant rise was in children’s mental health issues “and again there is a strong link between anxiety and sleep deprivation. Unfortunately, sleep is not on the public health agenda despite the huge impact it has on all areas of wellbeing, and when it goes wrong there aren’t specialist services for families to access.”
Dawson also noted that screen activity played a role, saying there was “a real lack of understanding around the impact that screens can have on sleep”. Some research suggests the light from screens can suppress the sleep hormone melatonin, she said.
The NHS data is for sleep conditions that were severe enough to warrant admission to the hospital. This meant they were under the care of the hospital, as opposed to being an outpatient visiting for an appointment, and were usually given a bed, even if they didn’t end up staying overnight.
Most of the admissions were for sleep apnea, a serious disorder that occurs when breathing is interrupted at night. Numbers for young people’s admissions reached 7,557 in 2016-17, up from 5,675 in 2012-13.
Obstructive sleep apnoea, the main affliction of sleep apnoea, is a potentially serious disorder that causes breathing to repeatedly stop during sleep. It happens when the throat muscles intermittently relax and block the airway.
If obstructive sleep apnoea is not treated, it can increase the risk of developing high blood pressure, a stroke or heart attack.
Sleep apnea has many different possible causes. In adults, the most common cause of obstructive sleep apnoea is excess weight and obesity.
At Millpond Sleep Clinic, a private children’s clinic in London, the founder, Mandy Gurney, said the Guardian’s findings were “very worrying” and appeared to be linked to “the ever-increasing rise in obesity rates in children”.
Gurney said research shows not sleeping well also creates an imbalance in our hunger hormones, ghrelin, and leptin. “High levels of ghrelin mean we are likely to eat more often, and low levels of leptin mean we find it hard to recognize when we’re full. Due to changes in our neural pathways in the brain, when we’re tired we are also more likely to make poor food choices, such as sugary, fatty and salty foods. So it becomes a vicious cycle.”
Rachael Taylor, the founder of the Sleep Sanctuary, said the rise in admissions could be because of a range of factors, including the explosion and reliance on personal technology by teenagers and younger children.
“The blue light emitted from phone, tablet, computer and TV screens disrupts natural melatonin production, which inhibits sleep. I’m increasingly seeing more and more young children sent to bed with a screen to help them fall asleep, when it is in fact disrupting their sleep and making falling asleep more difficult,” she said.
Taylor also noted the rise of anxiety, which she said was at the heart of a number of sleep difficulties and sleep disorders and could in part be “attributed to the increasing pressures and expectations placed on our young people, an over-reliance on social media, and the creation of a 24/7 culture”.
Earlier this year, a Childwise survey found that more than half of children say they sleep with their mobile phone beside their bed.
The Guardian has previously reported on the lengths parents go to to help their children sleep, including giving them melatonin. Produced naturally by the body in dark environments to help sleep preparations, melatonin has been authorized for use by people aged over 55. It has been hailed as a less addictive alternative to insomnia drug treatments.
The number of children and young people being given the hormone has risen year on year, increasing by 25% from 92,511 prescriptions in 2015-16 to the most recent full-year figure. But specialists have expressed concern about it being given to children “off label”, with little knowledge of the long-term safety or side-effects.
An NHS spokesperson said:“These figures show that more must be done to limit the dangerous drivers of poor health, including the increasing use of social media and the rising levels of childhood obesity.
“Our NHS Long Term Plan sets out ambitious action to transform care for children, supported by record investment, but while the NHS is playing its part, other industries must step up to protect our young people’s health.”