Sleeping, Sweating, Sitting, and Good Behavior: Relationships BetweenImpulsivity and Movementby Michele LaBotz MD, FAAP, Editorial Board Member, Pediatrics

The Canadians have done it again! In the August issue of Pediatrics, Guerrero and her colleagues from theHealthy Active Living and Obesity (HALO) Research Group in Ontario (10.1542/peds.2019-0187) released someinteresting results from a large cross-sectional study looking at relationships between impulsivity and patterns ofmovement and sleep in children 8-11 years old.

Our neighbors to the north have long been pioneers in the advancement of appropriate levels of physicalactivity.  Several years ago, they coalesced evidence-based recommendations for screen time, sleep andphysical activity into the Canadian 24-Hour Movement Guidelines for children. Their recommendations for theage group in this study:

Sweat:  60 minutes of moderate to vigorous activity/day●

Step:  Several hours of light physical activity/day●

Sleep:  9-11 hours of uninterrupted sleep/night●

Sit: Less than 2 hours of sedentary screen time/day and limit extended periods of sitting●

Guerrero et al specifically looked at associations between impulsivity and different combinations of sleepduration, moderate-vigorous physical activity, and screen time.  The data on how few children are meeting theserecommendations is a real "wake up" call; only 5% of children met all of these recommendations, and 30% ofchildren did not meet ANY of them.  Their results outline relationships between these factors, but the bottom lineis that meeting sleep and screen time recommendations have the strongest associations with reducedimpulsivity. While this cross-sectional study does not prove causation, it does lend added support to the knownbenefits of adhering to their current guidelines.  No wonder our children are struggling!

For the practicing pediatrician, there are 2 points worth emphasis when considering results of this study:

 Each child is a unique combination of impulsivity related to developmental stage and "trait impulsivity"

related to biologic/genetic factors.  This leads to a great deal of inter-individual variability on the impacts of

activity and sleep on brain function and behavior.  Some kids are going to be more sensitive to these

effects than others.

1.

Chronic sleep deprivation is not necessarily associated with sleepiness.  The nightly mantra of "I'm not

tired" uttered by many youngsters at bedtime may be truly reflective of how they feel, but is not indicative

of what they need.  Attention to the clock, good sleep hygiene, and separating children from their devices

2.

Copyright © 2019 American Academy of Pediatrics

to avoid excessive use, not only prepare children for the 9-11 hours of sleep they need each night, but is

"high yield" advice all the way around. 

Impact of Sleep Extension and Restriction on Children's Emotional Lability and Impulsivity●

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Copyright © 2019 American Academy of Pediatrics