Sleepless Britain Panorama

Our children are exhausted.

It's the new normal.

-It's bedtime.

-CHILD CRIES

It just consumes your whole life. Just one little word - sleep.

Mobile devices have taken over many children's lives and

interfered with their sleep.

I have my telly.

-IPad.

-Two iPads.

-Two iPads, iPhone.

But sleep deprivation has serious consequences.

Tonight, on Panorama, we can reveal hospital attendances in

England for children with sleep problems have tripled in ten years.

-Do they hurt or...?

-They don't hurt at all.

We uncover how unlicensed prescriptions of a sleep medicine

to both adults and children have increased tenfold

in the last decade.

I'd prefer a solution to this something different

than having to take medication the rest of his life,

so I'm willing to try anything out.

And we reveal how we're damaging our children's future by

failing to value their sleep.

Oh, I can't do it, too fast.

CLOCK TICKS

Across the developed world,

children are sleeping less than previous generations.

..as long as you guys have been alive...

Students in English schools are the most sleep deprived in Europe.

How many of you heard the phrase, "Sleep on it?"

CLOCK TICKS

You've heard that?

What's it if you go to school

and you haven't had a good night's sleep? How do you feel?

-Tiring.

-Can't be bothered walking to school.

-You can't even be bothered walking to school?

-No.

Do you find it difficult to wake up in the morning?

-ALL:

-Yeah.

I try and fall asleep in lessons, but I always get caught.

Does anyone actually fall asleep in lessons? Does that ever happen?

I've seen someone do it in my French class before.

I fell asleep in English, because we read a book

and I was reading a book and I was like that

and then just...I fell asleep.

-You were nodding off?

-Yeah.

A growing body of research shows that poor sleep jeopardises

our children's school performance AND their long-term health.

We desperately need to get children's sleep

onto the public health agenda.

We've done it with nutrition.

People now are starting to understand the perils of sugar,

the dangers of childhood obesity,

they now need to wake up to the importance of sleep.

CHILD CRIES

Well, shall we go and get our pyjamas on?

CRYING

It's not only teens who are sleeping less. Toddlers are too.

Elise is two and a half.

Elise, we're not running out of the bedroom.

Her bedtime routine with parents Jayne and Nick

starts at seven o'clock and ends at ten-thirty.

ELISE CRIES

At her age she should be getting

between 11 and 12 hours' sleep a night.

She only gets ten.

It just consumes your whole life, just one little thing,

one word - sleep.

Don't throw Betty.

Wow, poor Betty.

Right, do you want that?

Elise is part of a new generation who have grown up handling

mobile technology from a very young age.

Jayne and Nick both work.

Like thousands of parents across the country,

they use tech to entertain their child in the evenings.

'So, I end up asking her if she wants it,

'because then I can come and get stuff done.'

In everyone's perfect little world, that isn't going to happen,

but unfortunately it's the real world and it does.

There's hardly anywhere for families to turn to for quick, free advice.

Charities, like the Children's Sleep Charity, have stepped in to help.

They promote good sleep across the country,

but in their hometown of Doncaster they've gone much further.

Here, parents can refer themselves to a children's sleep service and

get an appointment with specially trained sleep advisers within weeks.

Hi! Yes, Colleen, do you want to come through?

What are you expecting to see today?

A full clinic of parents desperate for some sleep.

She looks tired.

She's shattered, yeah. Absolutely shattered.

The total hours of sleep he gets a night, would you say about an hour?

About an hour.

For seven weeks it was every night,

to the point of, it was like, "We can't do this any more."

This had been every day since he were born,

but it's been, no, it's been an all-life battle.

So, what's getting in the way of our children's sleep?

Both parents now often work,

so evenings are busier in many households.

Plus, there were no smartphones or tablets ten years ago.

Now many adults and children can't live without them.

IPad just before bed with the TV on.

How common is it that you hear that?

All the time. Absolutely all the time.

Especially with the teenagers.

It's like asking them to remove their right arm

If you ask them to get rid of the mobile or their iPad.

So, this is a new thing, a new phenomenon interfering with kids?

Yeah, absolutely.

Jayne's postcode makes her eligible for the charity's one-to-one

help to get Elise to sleep before 10.30pm.

'At the minute, she's saying, "I don't want to get in bed,'

"I don't want to go to sleep."

We'll give her her milk, and from that point she's, you know,

running round, she'll pick up the tablet and watch things on that.

-Is the TV on at this point?

-Yeah.

-The technology, as far as the lights on any screen...

-Yeah.

-..will keep her awake.

-Yeah.

-We do ask that parents switch it all off an hour before bedtime...

-Right.

-..to give the brain time to relax.

-Mmhm.

Our bodies release a hormone called melatonin when the sun goes down,

which makes us feel sleepy.

But the blue light from TVs,

smartphones and tablets tells our brains it's daytime,

which reduces melatonin, making going to sleep much harder.

And did you think that because she's quiet when she's in front of

-the tablet that that must be kind of calming her down?

-Yeah.

I mean, I wouldn't have thought that just having the television on,

even if she isn't looking at it,

would be affecting what's going on inside her brain.

-Do you think that'd be difficult for you?

-To stop that?

It probably would, because she will...

she will have a tantrum about it, I know she will.

THEY LAUGH

92% of families say their child's sleep issue is resolved after

using the Doncaster clinics,

yet a sleep service like this is rare in the UK.

In most parts of the country,

families must depend on their GP, who may refer them to

a specialist consultant which can take four months.

What's the worst you've seen

in terms of how bad poor sleep can affect a family?

We've seen some really terrible situations.

Family break-up. We've seen parents that have had to give up work.

We've even had cases of breakdowns, you know, parents really

suffering with their mental health because of the lack of sleep.

More than 80% of children in the UK have

a mobile phone by the age of 12...

..and 90% by the age of 15.

Could we get a hands-up who perhaps use a mobile phone

in the last hour before going to bed?

-So, pretty much all of you.

-HE LAUGHS

Teachers at this school in Yorkshire have become concerned that

poor sleep is affecting students' performance.

And so, what you have here, this is like a mini-sun.

Working with Panorama, sleep expert Guy Meadows

has come to give these pupils some sleep education.

It's rarely covered in most schools.

But you may actually know that some of them actually have what's

called a blue light filter in them.

If you swish up from the bottom,

and if you press this button here, if you watch the screen...

What happened to it?

Most of the 11- and 12-year-olds in this classroom say they're on

their phones at bedtime.

Why did this school decide to prioritise sleep and make it

an important issue for students and parents?

If a child hasn't enough sleep, it is a huge barrier,

an enormous barrier for the child to try and overcome,

just so they can engage at a level playing field with the other

children within their class or with their peers.

And what kinds of things are you seeing?

The behaviours are exhibited in many ways.

I mean, you obviously see the children who are quite

obviously tired and distracted.

You see the children whose energy levels drop

during the course of the day.

And we know that you're twice as likely to solve a problem

after a good night's sleep compared to a poor night's sleep.

The teacher and parents of these children told us they're

worried they aren't getting the sleep they need.

They each get around seven hours' sleep a night.

At their age, doctors recommend children should get between

nine and eleven hours.

-So, did you learn anything new today?

-Yeah.

-Yeah.

That you can turn the blue light off on your phone.

Yeah, or else you can't get to sleep.

Do you think you'd find it hard to give up using phones and tablets?

-Yeah.

-Yeah.

-Our mum tries taking it off me, but I don't let her.

Because, like, you're just texting your friends

and they text back and you can't not text back.

So, it's not just the light from the phones, but also, like, you feel

-like you can't switch your phone off...

-Yeah.

-..because you might be missing out on something.

-Yeah.

Even with a blue light filter,

technology gets in the way of good sleep.

What I would like to do now is some little exercises with you.

Guy will test their concentration,

short-term memory and ability to solve problems.

Just to find out how lack of sleep

might be affecting your daytime performance.

Most parents to all they can to help their children get on at school...

I can't do it, it's too fast.

..yet they don't prioritise their sleep.

I think what we need is a bit of a shift in our culture,

in our education around sleep,

and to recognise that, actually,

sleep is one of the most powerful

performance enhancers known to human kind.

And if you are serious about your child's academic performance,

then schools and parents should be really helping their children

to get good quality sleep on a regular basis.

This is because, when we're asleep, our brains aren't resting.

They're incredibly active,

consolidating and storing all that we've learnt during the day.

While we're asleep, memories that were stored away

during the day that were in short term storage,

that are just sitting there,

haven't been properly hard-wired

into our brain, are transferred up to our cortex

and are hard-wired for the future

so that we can retrieve that information if we need it.

If you haven't slept as well, you won't have processed your learning

during the night in the same way.

Guy will give the children

a new evening routine to encourage better sleep.

Ways to do this include

going to bed earlier and at the same time every night...

..eating a snack like a banana or porridge,

and avoiding fizzy drinks, chocolate or coffee...

..a bath or shower 30 minutes before bedtime...

..and no TV, phones or tablets in the hour before bed.

When a child has a serious sleep problem, they can be referred

to a hospital sleep lab for

overnight monitoring and investigation.

Families must wait many months for an appointment.

This sleep service at Sheffield Children's Hospital has seen

a ten-fold increase in referrals

over the past decade.

For many parents,

this is kind of a last chance saloon, isn't it?

They've tried a lot of different things

and this is their last option

of trying to work out why their child won't sleep.

It can be for some families, but not all of them.

Some of our families come on with a known condition

and it's just assessing that condition.

There are other families that do come that are kind of...

really kind of at the end of their tether with the child's sleep.

Lack of sleep awareness means that

many parents don't know what's best for a child's sleep,

even when it's being observed overnight in hospital.

I had one parent who had a full bottle of Lucozade,

and the child drank that full bottle of Lucozade

over the course of the night, woke up and drank it,

and that's got caffeine in it.

I actually questioned the parent,

they didn't realise it had caffeine in it.

Ten-year-old Harley is spending the night under observation in the lab.

He gets an average of five hours' sleep a night.

He should be getting nearly ten.

Hello! Hi.

-You must be Harley.

-Yeah.

Hello, I'm Jenny. Nice to meet you.

Nice to meet you, too.

-So it takes you a while to go to sleep.

-Mmm.

-And do you wake up in the middle of the night?

-Yeah.

Yeah. What happens when you wake up?

I shout on my mum.

He gets up at, like, four, five o'clock, and then he's up, ready...

-For the day?

-Yeah. School uniform and everything on, so...

What's it like when you're at school, Harley?

It's all right. I don't get on with people very well, though.

-Really?

-Yeah.

-Do you think sleeping badly has got anything to do with that?

-Yeah.

-In what way?

-Cos, let's say they're saying I can't play with them,

I'll just get moody and stroppy and that with them.

But then I get told off.

-So...

-He's got to be prompted constantly

by teachers to do his work, and if he's not constantly

got someone on his back prompting him,

-then his work won't get done.

-What medication does he take?

I've got it in my bag.

I think it's melatonin.

'Harley has been prescribed a synthetic version of melatonin,

'the hormone that makes us feel sleepy.'

-Yeah, it is melatonin.

-Yeah, but it's got a different name.

-Circadin.

Melatonin.

It made a difference to start off with,

but now it's not, he's back again to how he was.

Do you think that the solution might be taking tablets,

or do you think the solution might be

doing something a bit differently?

I'd prefer the solution be something different than having

to take medication for the rest of his life,

so I'm willing to try a different outlook to help him to sleep.

Right, so these are the wires, OK? We're going to stick...

-Do they hurt, or...

-They don't hurt at all.

Melatonin is only licensed for use by those over 55.

But GPs can prescribe it to younger people

at their own discretion.

NHS data analysed by Panorama shows NHS England spent nearly

£14 million on unlicensed melatonin in 2015 -

ten times more prescriptions than a decade ago.

Leading consultants have told us prescribing to children

has become increasingly common,

and it might not even help them in the long run.

A lot of these medications are not licensed for children.

I think a lot of children are prescribed medication

which may initially have some benefit,

but the benefit then wanes and they don't have

any means of improving their sleep habits.

What are you measuring with all of these wires?

We are looking at brainwaves, which help us with the sleep staging.

We record eye movements to help us identify REM sleep

and when someone's becoming drowsy.

And then we pop some stickers on their legs,

and that's to look for limb movements,

and then we're also looking at respiratory things as well.

So, that's everything on.

It's two hours since he turned in and he's still awake?

He's still awake at the moment.

Just can't seem to settle.

This is... this is poor quality sleep.

The investigation showed no physical reason for Harley's sleep problem.

The specialist team will continue to work with his family

to try and establish the cause of his poor sleep,

looking at changes to his bedtime routine

and reviewing his sleep medication.

There's another reason that

poor sleep is increasingly common for children -

obesity.

More than a third of today's teenagers are overweight or obese,

leaving them more likely to suffer from sleep apnoea,

a serious sleep disorder.

Why are obese people more likely to suffer from sleep apnoea?

Apnoea is kind of the posh term for a pause in breathing.

It's to do with the extra fat around the airway.

Um, so, obviously when you go to sleep

you lose a little but of muscle tone around airway,

so any extra pressure on your airway can then affect

how that functions while you're asleep.

Sleep apnoea cases in children have risen by 25% since 2012.

DEEP SNORING

Yet we now know that while obesity can cause sleep problems,

poor sleep can also lead to obesity.

It's a vicious cycle.

So we have two hormones in our body

that control whether we feel hungry and whether we feel full.

And the balance of those hormones, certainly from the adult research,

are abnormal when people haven't had enough sleep.

So it may well be that the hormonal imbalance

is what drives people to want to

eat more if they haven't had enough sleep.

13-year-old Ellie is overnighting in the sleep lab.

She gets as little as two and a half hours' sleep a night.

The lab is investigating whether a medical condition like sleep apnoea

might be behind it.

Ellie's poor sleep began after she badly broke her foot six years ago.

How old was she when she had her accident?

-I was seven.

-Seven.

She had to learn to stand and walk again,

and she started putting on weight.

So we noticed the weigh gain there with the cheeks and that.

When you're sat there not exercising,

the weight just come on.

We kept her off chocolate, we kept her off crisps.

Ellie would wake up because of the pain,

so then we'd be up about two in the morning.

Then it got me tired. It were like having a newborn baby again.

This is... This is clean for her.

This is clean.

-This is where you try and get your sleep?

-Yeah.

'Ellie has been on a diet for six months,

'and she's lost two and a half stone.'

So, at the moment you're trying a personal trainer.

You're on a diet now?

-Yes.

-I'm not allowed any carbs after four

and I've got to have lots of protein

and vegetables and fruit.

Sometimes I just... I get sick of it.

Today, Ellie is booked in to see a nurse from the sleep lab

for a follow-up.

They've ruled out everything, like, night-terrors, sleepwalking,

and you didn't have obstructive sleep apnoea. Didn't show

any signs. That's negative, so that's good.

With sleep apnoea ruled out, the hospital suspects that Ellie

might just need a better sleep routine.

What technology do you have in your room?

I have my telly.

IPad.

-IPhone.

-Two iPads.

-IPads, iPhone.

Do you use these to settle off to sleep?

Before I go to bed, like,

I might sit on my phone or my iPad for a bit.

With her sleep pattern, do you know, like, her weight gain,

if she doesn't sleep,

does that affect her weight and things like that?

-Definitely, definitely.

-Right.

That's why, when she were dieting, when she's had weeks where

she hasn't slept right well and we've been at training

and she's gained weight and I'm thinking,

-"How can she?"

-You know when you're tired?

I did a night shift on Friday night,

I couldn't eat, and then when I did come round

I wanted to eat and craved all the fattiest food you can imagine.

The research backs this up. Not only is

poor sleep thought to affect our hormones,

it's also shown to make us want unhealthy foods.

There's been some excellent studies done in the States with teenagers -

it showed that if you sleep-deprive teenagers

they eat about 9% more calories.

And they're more likely to choose sugars, starchy foods.

And if you added that up over an entire year

they would be increasing their weight

by about four kilos during the year.

Ellie's new routine includes no tech an hour before bed,

and a later bath time.

It might help both her sleep and her weight loss.

Does it ring true to you that when you've had a bad night,

you don't want to exercise, you're hungry for the wrong kinds of foods.

Did that ring bells?

Yeah, um, sometimes when I've had a really terrible night's sleep,

then I'm just like, "Oh, do I have to go training today?

"Do I have to have that?

"Can I just, like, have a sandwich

"or can I have McDonalds or something like that?"

But I did learn quite a lot.

Two and a half-year-old Elise

has been given a new, earlier bedtime routine.

Until now, settling her has taken up to three hours.

We don't know how Elise is going to react to the change of it all,

cos she's been so used to doing what she does.

-Shall we take it upstairs?

-Shall we take it upstairs?

Taking the tablet away from her on a night

and switching the television off,

is that going to create a tantrum?

Elise, come on. It's not playtime now, is it?

SHE CRIES

We're nervous, apprehensive, fearful that it won't work,

and there's a lot of pressure on it as well.

You kind of feel like it's the last resort.

-No!

-Come on, into...

-No!

The charity agrees a routine that parents are comfortable with.

One option is gradually retreating away from a child's bedside

as they fall asleep.

-Whee!

-Whee!

Jayne and Nick have gone for the alternative.

They will put Elise to bed and leave the room.

Don't go!

We're just going to go out there, darling.

When she cries, they should return briefly to settle her,

repeating until she falls asleep.

Daddy!

Parents today are more likely to be

gentler with their children than a generation ago.

Many worry that allowing a child to cry

could do them long-term damage.

SHE CRIES

Any feisty child will protest and want their own way.

It's helpful, I think, for parents to think about other situations

where a child may cry, but nonetheless they would promote that.

Say, for example, having your child vaccinated.

We know it's in their best interests, so we still do it.

Night-night, it's OK.

What evidence is there that it doesn't harm a child if they cry

as they're learning how to put themselves to sleep?

We do have some really very, very reassuring research

on this exact point.

And what they found was there was absolutely no difference between

children who'd had the intervention

and children who'd had no intervention at all.

So managing child behaviour in an appropriate way

has no long-term repercussions for the child,

and to the contrary, has really positive benefits for the family.

It's a very personal choice,

and there is no right or wrong method.

But letting a child cry before

returning quickly does not harm them,

even though, like many other parents,

Jayne has struggled with it.

You just get this rack of guilt cos you've just made your child cry.

It just makes you feel the most terrible person in the world.

After only two days of using this approach,

it seems to be working for Elise, Jayne and Nick.

I think not using the tablet and not using the television

has calmed her down so now,

-in two nights, we're an hour and a quarter earlier than...

-Yeah.

..what became the norm.

Welcome back.

It's a week since these pupils in Yorkshire

were given tech-free sleep routines.

All of your friends are, like, texting each other and stuff

and then you can't be in the conversation,

-but you get used to it.

-You get used to it.

It's annoying, but it helps sleep.

It's meant they're sleeping an average of an hour more a night.

They've re-done the tests, and the results are striking.

So, the first exercise that we did was your memory tests.

And what we actually found is that your memory tests improved by 57%.

And then we did a little focus and attention exercise,

and actually you guys improved

your ability to be focused and attentive by 44%.

And then the final test that we did was the problem solving exercise

and we found that your problem solving ability increase by 61%.

So well done!

These results are backed up by existing research that shows

only an hour less sleep over three consecutive nights

can significantly affect brain performance.

Some amazing research showed that if children are sleep deprived

by just an hour, it can actually reduce their

cognitive academic performance by up to two whole years.

So it's the equivalent of them being two whole years behind.

We take sleep for granted, but it's becoming increasingly clear that

a child who sleeps well is

more likely to be able to perform at school,

to control their emotions,

to stay well and to maintain a healthy weight.

Most children's sleep problems can't be prescribed away.

We need a change in attitudes so we value good sleep as a vital part

of our children's health and wellbeing.

If you could manufacture a pill that improved your cognitive function,

that improved your emotional regulation,

that stopped you reaching for

the biscuit tin and having the munchies in the afternoon,

you'd be a millionaire.

And actually, it's there. That is what sleep can help you with.

And it's free.

Did you imagine that just

-simple things like this could solve your problems?

-Not at all.

-Not at all.

-And what's frustrating about that,

the thing is, you get so much advice about diet and food

and five-a-day and seven-a-day and whatever the norm is today,

but you don't get any advice about sleep.