School-based mindfulness improves sleep quality in children

By James DuckerReviewed by Emily Henderson, B.Sc.Jul 6 2021

A new study exploring the benefits of mindfulness in the brain showed that children slept 74 minutes more on average after starting basic mindfulness exercises at school.

Children Meditating. Image Credit: wavebreakmedia/Shutterstock.com

Helping children at risk lower stress through mindfulness training

The benefits of practicing mindfulness in various forms, from meditation to breathing exercises, has gained an increasing amount of attention in recent years to the benefits associated with such practices.

Although meditation is a longstanding practice in many countries, deciphering the neurological, physiological, and other physical benefits has been challenging for researchers.

In a new pioneering study to be published in the Journal of Clinical Sleep Medicine by scientists at the Stanford University School of Medicine, basic mindfulness was shown to improve sleep quality in children.

The researchers used polysomnography techniques measuring brain activity to assess how school-based mindfulness training, including teaching children how to relax and manage stress by focusing their attention on the present, changes the children's sleep.

Children in the study lived in low-income, primarily Hispanic communities in the San Francisco Bay Area. Two locations were chosen, with one community receiving the mindfulness intervention and the other serving as control. Both had high rates of crime and violence, and families faced such stressors as food insecurity and crowded, unstable housing.

Such conditions often lead to poor sleep, says the study's principal investigator, Victor Carrion, MD, and Endowed Professor for Child and Adolescent Psychiatry. Carrion, who directs the Stanford Early Life Stress and Resilience Program, launched the study to help youngsters manage the effects of living in a stressful environment.

To fall asleep you have to relax, but they have a hard time letting their experiences go.  They don't feel safe and may have nightmares and fears at night."

The instructors used the Pure Power Curriculum, developed by a nonprofit called PureEdge, and is available to schools for free in both Spanish and English. Specifically, the curriculum consists of training in bringing one's attention to the present; exercises for slow, deep breathing; and yoga-based movement. The exercises were practiced twice a week for two years in all elementary and middle schools in the studied community.

During those exercises, instructors also taught children what stress was and encouraged them to use the techniques to help them rest, but importantly did not give any instruction on sleep-improvement techniques such as maintaining consistent bedtimes. This is crucial as scientists also wanted to assess the indirect benefits of the training.

The researchers then recruited a subsample of children who received the curriculum. 58 children were examined who received training and 57 who did not. They then conducted three in-home sleep assessments, which were done before the curriculum began as well as after one year and after two years.

Assessments measured brain activity during sleep using an electrode cap on the child’s head, which was combined with measures of breathing, heart rates, and blood oxygen levels.

Mindfully trained children had more sleep and better sleep over time

At the start of the study, researchers found that children in the control group slept 54 minutes more, on average, and had 15 minutes more REM sleep per night than children in the group that later received the training

The children who received the curriculum slept, on average, 74 minutes more per night than they had before the intervention. They gained almost half an hour of REM sleep. That's really quite striking. There is theoretical, animal, and human evidence to suggest it's a very important phase of sleep for neuronal development and for the development of cognitive and emotional function."

Dr. Ruth O'Hara, a sleep expert, and Professor of Psychiatry and Behavioral Sciences at Stanford

The sleep patterns of both groups examined also evolved differently. Children in the control group showed a gradual reduction in sleep by 63 minutes, which is in line with sleep reductions typically seen in later childhood and early adolescence. In contrast, the children who participated in the curriculum gained 74 minutes of total sleep and 24 minutes of REM sleep.

"It makes intuitive sense that children who didn't participate in the curriculum decreased their sleep, based on what we know about what it's like to be a kid this age," said the study's lead author, Christina Chick, a postdoctoral scholar in psychiatry and behavioral sciences. "Older children are possibly staying up to do homework or talk or text with friends. I interpret our findings to mean that the curriculum was protective, in that it taught skills that helped protect against those sleep losses." Hormonal changes and brain development also contribute to changes in sleep at this age, Chick noted.

Concerningly, the average amount of sleep that study participants in both groups received was low, Chick said, noting that at least nine hours of sleep per night is recommended for healthy children.

The researchers hypothesized that children might experience improvements in sleep via reductions in stress. However, the children who gained the most sleep during the study also reported increases in stress, perhaps because the curriculum helped them understand what stress was.

Despite being primarily an observational study that did not establish key mechanisms of causation, the correlation between mindfulness training and sleep improvement shows the benefits of incorporating such exercises. This is particularly of value as findings from this study suggest changes also last, which benefits children further throughout their formative development.