Children who don’t get enough sleep can suffer from

Image: The images show the differences in gray matter volume (red areas) between children who get adequate sleep and children who do not sleep, both at the start of the study and at a two-year follow-up visit. The areas marked in red are structures responsible for decision making, impulse control, memory and mood regulation.
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Credit: University of Maryland School of Medicine

Elementary school-age children who get less than nine hours of sleep per night have significant differences in certain brain regions responsible for memory, intelligence and well-being compared to children who get the recommended nine to 12 hours of sleep per night, according to a new study under led by researchers from the University of Maryland School of Medicine (UMSOM). Such differences correlated with greater mental health problems, such as depression, anxiety and impulsive behavior, in those who did not sleep. Insufficient sleep was also linked to cognitive problems with memory, problem solving and decision making. The findings are published today in the journal Lancet Child and Adolescent Health.

The American Academy of Sleep Medicine recommends that children ages 6 to 12 regularly sleep 9 to 12 hours a night to promote optimal health. To date, no research has been done on the long-term impact of insufficient sleep on the neurocognitive development of pre-teens.

To conduct the study, the researchers examined data collected from more than 8,300 children ages 9 to 10 who participated in the Adolescent Brain Cognitive Development (ABCD) study. They examined MRI images, medical records, and surveys completed by the participants and their parents at the time of enrollment and during a two-year follow-up visit at ages 11 to 12. The ABCD study, funded by the National Institutes of Health (NIH), is the largest long-term study of brain development and child health in the US.

“We found that children who did not get enough sleep at the start of the study had less than nine hours a night, less gray matter or volume in certain brain regions responsible for attention, memory and inhibition control compared to children with sound sleep. habits,” said study corresponding author Ze Wang, PhD, professor of diagnostic radiology and nuclear medicine at UMSOM. “These differences persisted after two years, a worrying finding that suggests long-term harm to those who don’t get enough sleep.”

This is one of the first findings demonstrating the possible long-term effects of sleep deprivation on neurocognitive development in children. It also provides substantial support for current sleep recommendations in children, according to Dr. Wang and his colleagues.

In follow-up assessments, the research team found that participants in the adequate sleep group tended to sleep gradually less over two years, which is normal as children enter their teens, while the sleep patterns of participants in the insufficient sleep group did not change much. The researchers controlled for socioeconomic status, gender, puberty status and other factors that can influence how much a child sleeps and affect the brain and cognition.

“We tried to match the two groups as closely as possible to help us better understand the long-term impact of too little sleep on the pre-adolescent brain,” said Dr. Cheek. “Additional studies are needed to confirm our finding and to see if interventions can improve sleep habits and reverse neurological deficits.”

The American Academy of Pediatrics encourages parents to promote good sleep habits in their children. Their tips include making getting enough sleep a family priority, sticking to a regular sleep routine, encouraging physical activity throughout the day, limiting screen time, and completely eliminating screens an hour before bed.

The study was funded by NIH. Fan Nils Yang, PhD, a postdoctoral researcher in Dr. Wang is a co-author of the study. Weizhen Xie, PhD, a researcher at the National Institute of Neurological Disorders and Stroke, is also a co-author on the study. UMSOM faculty members Thomas Ernst, PhD, and Linda Chang, MD, MS, are co-principal investigators of the ABCD study on the Baltimore site but were not involved in the data analysis of this new study.

“This is a pivotal study that highlights the importance of long-term research into the developing child’s brain,” said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Reece. Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine. “Sleep can often be overlooked during busy childhood days filled with homework and extracurricular activities. Now we see how damaging that can be to a child’s development.”

About the University of Maryland School of Medicine

Now in the third century, the University of Maryland School of Medicine was chartered in 1807 as the first public medical school in the United States. Today it remains one of the fastest growing, leading biomedical research companies in the world – with 46 academic departments, centers, institutes and programs, and a faculty of more than 3,000 physicians, scientists and allied health professionals, including members of the National Academy of Medicine and the National Academy of Sciences, and a distinguished two-time winner of the Albert E. Lasker Award in Medical Research. With an operating budget of more than $1.3 billion, the School of Medicine works closely with the University of Maryland Medical Center and Medical System to provide nearly 2 million patients with research-intensive, academic and clinically based care each year. The School of Medicine has nearly $600 million in outpatient funding, with most of its academic departments ranked highly among all medical schools in the nation in research funding. As one of seven professional schools that make up the University of Maryland, Baltimore campus, the School of Medicine has a total population of nearly 9,000 faculty and staff, including 2,500 students, interns, residents, and fellows. The combined School of Medicine and Medical System (“University of Maryland Medicine”) has an annual budget of more than $6 billion and an economic impact of nearly $20 billion on the state and local community. The School of Medicine, which ranks as the 8th highest among public medical schools in research productivity (according to the profile of the Association of American Medical Colleges) is an innovator in translational medicine, with 606 active patents and 52 start-up companies. In the last US news and world report ranking of the Best Medical Schools, published in 2021, the UM School of Medicine is ranked #9 among the 92 public medical schools in the US, and in the top 15 percent (#27) of all 192 public and private American medical schools. The School of Medicine works locally, nationally and globally, with research and treatment facilities in 36 countries around the world. Visit

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