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Everyone knows that sleep is critical for growing children and their mental and physical health. Regular, high-quality sleep habits help children consolidate memory and learn better. A lack of sleep contributes to childhood depression, anxiety and even risk of suicide, along with physical health problems, including risk of injury. The challenge is making sure kids log those valuable zzz’s.

There are three main components of high-quality sleep for children. First, they need enough total hours – sleep duration. Sleep quality is important, too – sleeping soundly during the night with few disruptions or awakenings. And, finally, there’s sleep timing – essentially, a consistent schedule, with bedtime and risetime about the same across the whole week.

Even when you know how important good sleep is, it’s easy for sleep duration, quality and timing to get knocked off track. It can happen for infrequent reasons, such as the pleasant chaos of a holiday, or the disturbances that accompany pandemic life. Healthy sleep habits are hard to maintain for everyday mundane reasons, too, such as parent-child disagreement, busy schedules and older children’s leisurely weekend behavior. But there are ways for families to get sleep back on course.

As a child development researcher and family therapist, I study parenting and family behaviors that create healthy environments for children’s sleep patterns. In particular, I help parents to develop consistent and nurturing routines. Sleep patterns are set early, and parents play an important role in nurturing children’s perspectives and attitudes. Here’s the overarching advice I share with families, no matter the age of their kids.

1. Set and model family values about sleep

Children are observant learners. They pay very careful attention to both the spoken and unspoken rules of their clan.

To get everyone in the household sleeping well, sleep can’t be something that only children must care about, while adults who have freedom and power joke about their own unhealthy habits. If sleep seems like punishment, rather than the gift for health that it is, children will be likely to resist it.

Adults need to talk the talk and walk the walk that sleep is a priority for everyone in the family. Be a role model. If you’ve fallen into a habit of binge-watching TV into the wee hours, for instance, work on reining that in. Use positive language about your own sleep. Pay attention to what you say, and what you communicate through your own habits, reinforcing that it’s important to the whole family to get sleep and have energy for the next day. Don’t make the mistake of discussing bedtime as a chance for adults to get distance from the kids.

2. Know your child

Remember, every kid is unique, so don’t expect one-size-fits-all sleep advice to work universally. A child’s temperament plays a significant role in the duration, quality and timing of their sleep. For instance, a feistier child may not adapt as quickly to a sleep schedule over the first year. And temperament is a pretty stable part of who your child is and will continue to be.

A parent’s job is to keep encouraging routines and setting limits – but with ongoing warmth and sensitivity about the characteristics of the one-of-a-kind child you have.

When you’re exhausted and struggling with a child’s behavior, it can be hard to stay positive. My recommendation is to use the daytime hours wisely as investment in your relationship. Be proactive about noticing the good in your kid. Remind yourself that your child is their own person, learning in lots of ways throughout the day, and that child development is a marathon, not a sprint, for positive change. Sleep regressions or other sleep difficulties, like night awakening or changes in sleep habits, are opportunities for growth, not punishment.

By laying this groundwork, it becomes easier to tap into a positive and respectful attitude during times of stress. Remind yourself that change over time is more important than control over a given moment. After all, strained parent-child relationships can actually lead to continuing sleep and behavioral problems in young children.

3. Aim for consistency, with some flexibility

In my practice, I see two common – but opposite – mistakes that parents make around sleep.

First, many parents let go of rules and boundaries altogether. Often this happens as a result of what children bring to the equation: personal temperament or age-related phenomena. For instance, the peak in behavioral aggression that can come in toddlerhood or the shift in sleep timing that comes in adolescence can cause some parents to just throw in the towel and give up.

Alternatively, other parents become rigid. They see conflict around sleep as a struggle for power that the adult must win.

I argue that balance is key. Parents should adopt a consistent approach that fits with the sleep values they’ve been clear about all along. But they must also remain flexible to help children adapt routines to their own unique needs.

For example, all children at all ages should have a regular bedtime and risetime. However, parents may be open to a collaborative plan with older children about what those times should be, or attending to patterns and cues from younger children, working on a reasonable compromise that takes into account the needs of the individual child. Parents’ message about the importance of sleep should never waiver.

4. Manage household issues that influence sleep

Research shows that certain problems outside the bedroom create immediate and long-term risk for children’s sleep quality. These include exposure to second-hand smoke, excessive or evening-timed blue light exposure from screens and conflict in the home. Dealing with these factors will likely pay dividends when it comes to your kids getting a good night’s sleep.

Good sleep hygiene is a family affair. It’s never too late to nudge habits in a good direction and recommit to everyone getting the rest they need. Your child’s sleep habits can be a critical building block of lifelong wellness.

Erika Bocknek, Associate Professor of Educational Psychology, Wayne State University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Over 90% of the world population has the virus that causes chickenpox lying dormant in their nervous system. Most people contract the varicella zoster virus, or VZV, when they get chickenpox as children. For around a third of these people, this same virus will reactivate years later and cause shingles, also called herpes zoster.

While most people are familiar with the painful rash that VZV causes for shingles, a wide spectrum of other complications can also occur even without visible skin symptoms. Among the most severe is stroke, in particular ischemic stroke, which occurs when the blood supply to the brain is restricted by narrowing arteries or blocked by a clot.

People with shingles have an approximately 80% higher risk of stroke than those without the disease, and this risk stays elevated for up to a year after the rash has resolved. Stroke risk is nearly doubled for those with the rash on their face, and tripled for those under the age of 40.

The mechanism behind this long-term stroke risk is mostly unknown. Some researchers have proposed that direct infection of the arteries may be the cause. However, some features of VZV infections suggest that this is not the full picture. A common theme of VZV infections is chronic inflammation that spreads beyond the original infection site, which can persist for weeks to months after the virus is no longer detectable and presumably dormant again.

I am a neurovirologist, and my lab studies how VZV contributes to neurological disorders such as stroke and dementia. In our recently published research, we found that VZV reactivation triggers the formation of cellular sacs, or exosomes, carrying proteins that contribute to blood clotting and inflammation. An increase in these proteins may lead to an increased risk in stroke.

Exosomes carry blood clotting proteins

Exosomes are small vesicles, or fluid-filled sacs, made inside cells throughout the body. They’re like duffle bags that carry cargo, such as proteins and nucleic acids, from the cell to distant tissues. Although critical for essential biological functions like communication between cells, exosomes can also play a key role in disease progression and are drug targets for many diseases.

We wanted to see whether shingles patients develop exosomes that carry proteins involved in blood clotting, increasing their risk of stroke. So we isolated exosomes from the blood of 13 patients at time of shingles rash and compared them to exosomes isolated from healthy donors.

When we analyzed the contents of these exosomes, we found that shingles patients had nine times higher levels of clotting proteins than healthy patients. Moreover, we found the exosomes of shingles patients still had elevated levels of these proteins three months after their initial rash.

To functionally confirm that the contents of these exosomes can induce clotting, we exposed platelets – cell fragments involved in blood clotting – of healthy people to exosomes from either shingles patients or healthy people. We found that exposing platelets to shingles exosomes triggered them to clump together and form aggregates with other types of blood cells, as they would in forming a blood clot.

These findings suggest that exosomes may be a potential mechanism for how the varicella zoster virus increases stroke risk for shingles patients.

Considering stroke with shingles

A Food and Drug Administration-approved vaccine to prevent shingles, Shingrix, is available for adults age 50 and older and immunocompromised adults age 18 and older. However, those at highest risk of stroke are under the age of 40 and are ineligible for Shingrix. A large group of these individuals were likely not vaccinated for chickenpox as children, as the chickenpox vaccine was only approved in the U.S. in 1995 and uptake by adults was quite low at the time. While vaccination with the chickenpox vaccine significantly reduces the risk of shingles, it is still possible for a latent infection to reactivate and cause the disease.

While our study provides evidence for a potential way that shingles can cause an increased risk of stroke during and soon after infection, further research on how long this risk persists is needed. We are conducting follow-up studies to evaluate how long patients may have an increased tendency to form blood clots after their shingles infection has resolved. These longitudinal studies will also examine whether exosomes can be used as a biomarker to monitor stroke risk after shingles.

Meanwhile, we hope that our findings may provide a potential target for treatment development, and encourage people to get vaccinated for shingles.

Andrew Bubak, Assistant Research Professor of Neurology, University of Colorado Anschutz Medical Campus

This article is republished from The Conversation under a Creative Commons license. Read the original article.