Dr. Faith Orchard talks to freelance journalist Jo Carlowe about the impact of sleep on mental health.
As well as looking at the ACAMH Sleep Topic Guide, written by Faith and Professor Alice Gregory, we take a look at whether it makes a difference if children are larks or owls? At what point should we be concerned about sleep problems? What is the knock-on effect of poor sleep on social factors? Plus what’s in the pipeline for sleep research.
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Interviewer: Welcome to the In Conversation podcast series for The Association for Child and Adolescent Mental Health, or ACAMH for short. I’m Jo Carlowe, a freelance journalist with a specialism in psychology. Today, I’m interviewing Faith Orchard, a clinical teaching fellow and postdoctoral researcher, investigating child and adolescent mental health at the psychology department at the University of Reading. Faith has written the ACAMH sleep topic guide, together with Alice Gregory, professor of psychology at Goldsmiths in London and today, Faith will give us an overview on the subject. Welcome Faith. Can you start by introducing yourself?
Dr Faith Orchard: Yes. Thank you very much. So, as you’ve already introduced me, my name is Faith Orchard. I work at the University of Reading. I currently have two roles at the university. So, one of those is as a teaching fellow so, lecturing undergraduate and postgraduate psychology students, mostly in the area of clinical psychology and developmental psychopathology. Then, most of my time, I actually spend on research. I’m a postdoctoral researcher. I work for the Charlie Waller Institute and we do research on adolescent depression, looking at the development, the maintenance and the treatment of that difficulty in young people.
Interviewer: Okay, and what prompted your interest in this area.
Dr Faith Orchard: I originally came from a background in child anxiety and then, became quite interested in depression and specifically, the symptoms of depression and sleep came up because it’s one of the most common symptoms of depression in young people. Interestingly, actually, some recent work suggests that sleep is more common as a symptom than low mood itself, in depression, but even given that, we know very little about the role of sleep as part of child mental health and specifically, adolescent depression. I was wondering whether actually, sleep is an area we should focus on a bit more, given that it’s not a standard part of our treatment for depression. Whether perhaps, that needs more targeted input.
Interviewer: Is it part of the diagnostic criteria?
Dr Faith Orchard: It is, yes. There’s nine potential symptoms of depression, sleep problems being one of those and they can vary a bit from insomnia to hypersomnia, not getting enough sleep or getting too much sleep. But that overall sleep difficulty is always one of the most common symptoms that we see in the clinics.
Interviewer: Before we cover some of the problems that can arise with sleep, can you give a brief explanation of the two processes that influence sleep and wakefulness? So, the homeostatic process and the circadian process.
Dr Faith Orchard: Yeah, of course. So, the homeostatic process is essentially our drive for sleep, how much our body is ready for sleep or craving sleep and it works in a really simple basis that the longer we’re awake for, the more tired we’re going to feel. So, by the time we get to our usual bedtime, we’re going to be feeling pretty tired because our body’s had all that time awake and then, the sleep pressure has built up. If we go past our usual sleep time, we’re then going to start feeling really tired because that pressure is getting really, really strong.
The second system that you mentioned, the circadian rhythm, is like our body clock. Most of the cells in our body work on a clock, a typical 24-hour system and sleep is the same. Our body knows when we typically go to sleep and when we typically wake up. The combination of that sleep pressure that sleep drive, with our body clock, means that we are ready, with the release of the right hormones at night time, to then fall asleep.
Interviewer: But of course, there’s great variation between individuals. Some of us are night owls and some of us are larks. Personally, I’m a night owl and I have two children. I have a daughter who is now 16 and a son who’s 13. My daughter has always struggled to get to sleep and struggled to rise, which is very similar to my own experience growing up and even now, my son is awake the moment there’s light and he doesn’t find it difficult to get to sleep. It’s not something that’s happened as they’ve become teenagers. It’s been a pattern from a very early stage. So, it makes me wonder how much a sleep-wake pattern is influenced by genetics, clock genes and how much of it is environmental, as these are two children that have grown up in a very similar environment, in the same environment.
Dr Faith Orchard: Yeah, really good question. So, there is quite a lot of work going on around the role and the interaction between genetics and environment. We still don’t know very much about the role of genetics because it’s such a complex process. I mean, for any part of human development and sleep, being one of those areas. We do know some things. We know that genetics and environment typically interact. It’s not that you just have the genetics play a role or you just have the environment but they interact with each other. Interesting, like you mentioned, you can have quite different children that grow up in the same environment and it’s likely that you do get a little bit of an interaction, that you have a tendency towards one.
So for example, environmentally, we know that a good, consistent bedtime typically means you’ll go to bed earlier. So, there are things that you can do that will change your sleep pattern. However, if you imagine, like you mentioned, you’ve got an owl and you’ve got a lark living in the same house and you give them a good consistent bedtime of say, 7pm. The lark is going to absolutely excel in that situation. They’re going to fall asleep really quickly. They’re going to have that nice, reliable schedule. That will always happen, they’ll have a good quality night’s sleep. Whereas, for the owl, actually you’re going to get the opposite effect. That, although you’re giving them this nice, consistent schedule, it doesn’t play towards their natural cycle and you almost get the opposite effect. That they’re going to be quite stressed about the fact that they can’t sleep. Then, going to have a generally quite disruptive night’s sleep because you’ve tried to give them this nice, consistent early bedtime. Whereas actually, for them, going to bed at 8pm. Might then have resulted in a good quality night’s sleep because that’s what their body wants. So, although things you do in your environment can help some children, it might play against another child’s natural behaviour. Does that make sense?
Interviewer: It does. So, you seem to be saying that you do, to some extent, have to work with their natural rhythms.
Dr Faith Orchard: Yes.
Interviewer: How do sleep patterns change from infancy and childhood through adolescence and adulthood?
Dr Faith Orchard: So, sleep changes quite a lot across the course of the life span. I suppose the obvious change is quantity. So, infants, babies need a lot of sleep, and as you get older, you need less and less sleep as time goes on. That’s the really obvious one. There are other things that change a bit more, structurally. So, when we talk about adult or child sleep, we typically think about there being stages of sleep. So, what we call rapid eye movement sleep or REM, it’s better known as, and non-REM. They are the main stages and they’re things where we see changes in the brain whilst we’re sleeping as well. They categorize how our sleep looks across the night but in infants, we don’t get those stages because they’re still developing and their sleep looks quite different. So, actually structurally as well as in terms of quantity, we do see changes as we get older.
I suppose also, things like our sleep timing. So, we talked about night owls and the larks, which is that natural variability in individuals but we also do see slight changes in sleep timing across age. So, adolescence is a really nice example of that, when we get this circadian shift where adolescents actually don’t feel tired until later. But that only happens in adolescence, not other periods. There’s a slight change during that age in the time that we want to go to bed.
Interviewer: Sleep problems are common, so I presume the occasional restless night is not too concerning but at what point should one be worried about sleep? What patterns of sleep or behaviours are cause for concern?
Dr Faith Orchard: Yeah, absolutely. You’re completely right. We don’t worry too much about someone having the odd bad night’s sleep. We all do that. We’ve all had it at some point in our lives, or frequently perhaps but yeah, that’s not too much because that, although still pretty frustrating, as I’m sure you would agree if you had a bad night’s sleep. It’s not very nice the next day but the point at which we might be concerned. There’s not a hard-and-fast rule because it will vary for different people because we all have different sleep habits. We might naturally be bad sleepers. So, our cut off when it’s a real problem might be different for someone who never has a sleep problem, if that makes sense.
Dr Faith Orchard: So, what we might look out for is when the sleep problem starts interfering, I guess, with other aspects of life. So, if you start finding it extremely hard to concentrate on other daily activities, whether that might be at school. If you stop wanting to perhaps, do things that you normally enjoy doing because you’re so tired, anything where the rest of your life starts to be impacted. That might be the point at which you’re concerned.
In terms of the types of problems we might be looking out for, there is absolutely hundreds of different recognised sleep disorders. So, things like night terrors, nightmares, sleepwalking and the list goes on and on but the most common thing we typically see in young people, the thing that happens most frequently is insomnia. So, that is difficulties getting enough sleep. It might be how long it takes us to fall asleep. It might be that we wake up too early in the morning or that we’re waking up frequently in the night, but those combinations of just not enough sleep are the things that we typically see in young people.
Interviewer: Right, and I’m aware that sleep problems are sometimes referred to as an invisible risk. So, parents may not be aware that they’re happening. What are the tell-tale signs that might alert a parent to the fact that their child is not getting adequate sleep?
Dr Faith Orchard: Some of the things, like I already mentioned, looking for those general day-to-day changes. So, if you notice that your child perhaps, is a bit more irritable than normal, struggling to get on with their schoolwork, perhaps struggling with homework in the evenings. Those might be signs that there’s something going on. Sleep could be the problem.
Other things to look out for actually, is perhaps, difficult behaviour at school. Quite often, when children are presenting with bad or difficult behaviours, quite often, it’s a sleep problem. So, if there does seem to be some difficulties going on, sleep is a good area to check. I suppose, any daytime tiredness or wanting to nap in the afternoon when they get home from school might be a sign they haven’t quite got enough sleep the night before. So, just checking for differences in routine things that seem a little bit out of the ordinary.
Interviewer: Do you think teachers are aware of that too?
Dr Faith Orchard: Some teachers, probably, if they’ve had their own experiences, themselves or have had children with similar experiences, but no, I don’t think, as a standard there’s as much knowledge out there about some of those things, as we might hope. Especially when it comes to difficult behaviours. Teachers and parents, your go-to is just that the child is misbehaving rather than necessarily, something else going on that might be leading to that. You can imagine, yourself, if you’ve had a bad night’s sleep, you could be a bit snappy and a bit irritable with people. The same thing happens with children, but they might not necessarily know, themselves, that it’s because they’ve had that bad night’s sleep.
Interviewer: How prevalent are sleep problems amongst children and young people?
Dr Faith Orchard: We think about sleep problems has been quite prevalent in children and in adolescents, but it depends what problem we’re talking about, as such. If we’re talking about the odd difficulty sleeping, you know, not quite getting enough sleep, that can be quite common. The recommended guidance for adolescents is eight to ten hours sleep a night but research seems to suggest that perhaps, less than a third of young people will actually achieve that.
So, if we’re talking about quantity of sleep being at the recommended amount, then the prevalence is quite high. But when we start talking about sleep disorders, things that might need psychological intervention, then the numbers are a little bit lower. So, it just depends really, how we’re measuring the problem and what problem it is that we’re trying to look at.
Interviewer: Okay, and I just wonder what the impact has been, of social media and the widespread use of digital devices, particularly amongst teenagers. Everybody seems to be attached to some handheld device. Has that had an impact?
Dr Faith Orchard: Simple answer is yes, there does seem to be a bit of an impact from digital devices, but there’s a lot of caveats to that. A lot of people will use, perhaps mobile phones in bed or in the evening and there won’t be any negative consequence, whatsoever and that’s absolutely fine. I’m definitely one of those people. I’m a bit of a naughty one for taking my phone to bed and twittering or being on Netflix or whatever it might be but I’m lucky that it doesn’t affect my sleep. Other people won’t necessarily have that same response and they might then struggle. So, the main effect we see of digital devices in the evening being a problem, is sleep onset, so that it takes longer to fall asleep, but we still don’t really know why the onset then gets pushed back. There’s lots of suggestions as to what might happen.
So, one thing that quite often we hear about is that blue light in devices being a problem but actually, the research is really mixed. So, some evidence suggesting that the blue light in your device makes no difference, whatsoever, to what time you fall asleep. What we do know is that if you’re on a device in the evening or in bed, chances are, your bedtime will just get pushed back because you’re doing something, rather than it being that the technology itself is having an effect on you. Does that make sense?
Interviewer: Yes, completely, it does. Is there a particular age at which sleep problems become more common and perhaps, more serious?
Dr Faith Orchard: Adolescence is, I guess, one of the particularly prevalent times where we see difficulty sleeping and that’s because of, like I mentioned earlier, this circadian shift that we get where the time that your body wants to fall asleep moves backwards. That’s challenging because, as we’ve also discussed, the school times are fixed and they’re quite early, so although adolescents naturally want to go to bed later, they are dictated to this earlier pattern. So, they’re automatically being deprived of less sleep, so we do see a lot of the negative consequences of problems in adolescence. I suppose that’s the time that we are particularly concerned about sleep in young people.
Interviewer: Okay, and let’s talk more about that link then, between sleep disturbances and mental health. What does the research tell us about sleep and its association with psychiatric disorders?
Dr Faith Orchard: So, sleep is often identified as a symptom of many psychiatric disorders, so very common in areas of anxiety and depression, for example, and in ADHD. So, we know that it’s already identified as a recognised part of the difficulty, but it comes up as a co-occurring problem with many disorders. What we also are starting to see in the research, is that there’s a growing evidence base that sleep actually might play a causal role for lots of psychiatric disorders. So, evidence suggesting that if you have a sleep problem at one time point, if you then come back and look at individual at a later time point many years later, perhaps, they are more likely to have gone on to develop various psychiatric disorders than those that didn’t have the sleep problem in the first place. There does seem to be actually, quite a significant link in the role that sleep can play. I suppose, further supporting that evidence of that causal relationship, we’re also seeing evidence coming out around when we treat sleep, suggests that there is a knock-on effect on some symptoms of things like anxiety and depression. That those symptoms can improve, as well as the sleep problems improving. So, really quite a strong link between the difficulties.
Interviewer: Is there anything known about physiologically, what’s happening to make it causal in terms of…?
Dr Faith Orchard: Good question. I think that’s an area we still need to do a lot more work on. People are starting to look at the link. We know things. There seems to be some genetic links for example, but lots of other areas as well. There’s a lot of work going on around cognitions, actually that there’s possibly some things that would underpin both problems. For example, if we worry a lot about our sleep, we’re likely to worry a lot about other things as well. You can see that could be some underlying traits that we have as individuals that might just lead to both problems. But yeah, it’s a really early time for that area of research, really and we’re still trying to learn lots about why that might exist.
Interviewer: Thanks. You talked about the association between anxiety, depression and insomnia. Can you say a little bit more about how it happens and what the knock-on impact is?
Dr Faith Orchard: Yes, of course. I suppose an obvious link is that, as I’m sure many people out there know if they have had problems sleeping, is that if you’re stressed, you’re probably more likely to struggle to sleep. So unsurprisingly, I guess, we get a similar response with anxiety and depression, that if you’re worrying or you’re ruminating in bed at night and thinking lots of bad thoughts, it’s going to be harder to fall asleep. We know, generally, that anxiety and depression are quite linked with sleep problems. Particularly, trouble getting to sleep but we still don’t know that much about perhaps, the difference between anxiety and depression. Why those problems are linked to sleep, where that might come from. We’ve done some work recently, actually, which has been quite interesting, looking at trying to distinguish a little bit more about how anxiety and depression might differ. We found, in a study that we’ve just done, that with young people with anxiety, they report having sleep problems, particularly on school nights, but not on weekends, which might suggest that their sleep is linked to their worries around school. That might be about socializing or it might be about their performance at school. Whereas, with young people with depression, they report having a sleep problem every night of the week, weekdays and weekends, which is quite interesting. We’re starting to see perhaps, a slight distinction between the disorders in how their sleep problems present. That’s a really early finding. We do want to replicate that to be confident but I think it is quite important that we start to think about how those problems will manifest for different young people.
Interviewer: Yeah, that’s quite exciting. I’m assuming they make a difference to the types of interventions and I want to ask you about those but just looking on the knock-on effect of poor sleep on children and young people. What is the impact on, for example, exacerbating other symptoms of mental illness, impact on cognitive skills, relational and behavioural issues, educational chances and so on?
Dr Faith Orchard: Yes, I mean you’ve mentioned a lot of the links that already exist. There’s a really good, strong evidence base for how sleep has an impact on a whole range of social factors, educational factors. We know that you’re more likely to perform worse at school if you’re not sleeping very well. As we’ve discussed, lots of implications of your kind of mental health or your well-being, perhaps. Not necessarily talking about developing disorders, but that you might feel more sad or low or more anxious. Also, links with various physical health problems as well. There really is a whole host of difficulties that can come up but this is when we’re talking about persistent sleep problem. The odd night’s sleep isn’t going to lead to these difficulties, but if we are seeing those problems frequently, that’s when we might see impacts on psychosocial difficulties.
Interviewer: If a child or young person is suffering from sleep disturbances, where do they or their parents go to get help?
Dr Faith Orchard: The first point of call should always be the GP, go and talk to the GP about what might be going on. It does vary quite a bit depending on location, where you’re based, as to what they can offer. If it is that there isn’t much on offer, there’s actually some really, really brilliant guidance available online or books as well, about how to work with sleep problems. We have pretty good evidence around how to change sleep problems. So, it’s not too difficult to get your hands on some good suggestions as to what you can do.
Interviewer: Okay. Is there something you would recommend, a particular website?
Dr Faith Orchard: Well, ACAMH, obviously will have a nice topic guide available to look at different ways in which you can work with sleep and we will suggest various websites and books that you can go to. One suggestion. Alice Gregory, who co-wrote the sleep guide with me, she has a book called Nodding Off, which covers a whole range of topics about what sleep looks like across the lifespan, but does also touch on what the interventions can look like and what your tips and tricks might be for helping to improve sleep. So, that is a good go-to if you’re interested in reading a bit more.
Interviewer: Okay, and talking about the interventions and techniques, what is available to help and support children and young people who have sleep problems?
Dr Faith Orchard: Again, it does depend on the sleep problem that we’re talking about but insomnia being the most common one, the treatment that we work with for insomnia is what we call cognitive behaviour therapy, CBT, designed for insomnia. That, basically covers a nice range of fairly simple techniques focused on cognition, our thoughts and perhaps, our worries about sleep. One of the big problems we have when we’re experiencing sleep problems is that we’re then worried about the next night’s sleep and that will then make it harder to sleep. You get into a bit of a vicious cycle but we can also work with the behaviours around sleep. These are things like what we can do, ourselves in the evening. Not drinking caffeine or coffee at night, not being on digital devices in the evening, perhaps. We can also think about our bedroom environment, making sure that the bedroom is quite dark and quite cool and that we’re not watching TV in bed. Thinking about that bedroom being really associated with sleep, rather than anything else.
Also, thinking about the structure or the routine around the time that we go to sleep. Quite counter-intuitively, lots of people try to go to bed earlier if they’re struggling to sleep because they want to catch up on sleep. But actually, your body is not ready for sleep at that time, so it’s better to go to bed later because you’re more likely to be tired and then, you’ll get a proper night’s sleep. Things like that, some advice around sleep timing as well, will also be part of CBT.
Interviewer: And will GP’s refer children on to specialists or will they give that advice, themseves?
Dr Faith Orchard: It really varies. Again, depending on where you’re based, unfortunately and some healthcare trusts do have better systems in place for referring on for CBT, others don’t. Some trusts are offering a sleep app called Sleepio, which I’m sure many people will be familiar with. Some clinical psychologists developed this app a while ago now, for adults and it started to be used across various NHS trusts. It’s got really, really good results for adults with insomnia. They’re also piloting it now in young people as well, to see how that works with teenagers. So it’s getting better, the access, but we do still have a bit of a way to go to make sure that everybody has access to that type of support.
Interviewer: Can you just talk a bit more through some of the CBT methods that are used with children?
Dr Faith Orchard: Really similar to adults. Again, thinking about the bedroom, thinking about the routine in the evenings and the same kind of structuring of sleep habits, but there’s obviously various things that we do want to adapt slightly for young people. Often, children might sleep in the same room as a sibling and if we’re trying to change bedtimes, there’s a bit of negotiation around how that might work. Also, if we’re saying that a child needs to go to bed later to get their body back into a good sleep cycle, that would have a knock-on effect for the parent who might not want to go to bed at 11 o’clock or 12 o’clock. It’s a bit more that, I guess, we have to negotiate a lot more with families around what is going to be feasible and we really need parents on board. If we’re saying that a teenager shouldn’t nap when they get home from school, that might be really hard to resist. Having the family on board to help support that young person to not go and have that nap, can be particularly helpful. So, the techniques apply across both. It’s just how we implement them.
Interviewer: Right, and this is whole family approach.
Dr Faith Orchard: Ideally, yes. Doesn’t always work that way but that’s what we would like, is everyone to be on board.
Interviewer: And what evidence is there to show good efficacy for these methods when used with children?
Dr Faith Orchard: Really good evidence. Well, very good evidence with adults. The evidence base is growing for young people. It’s still kind of in its infancy, but we’ve got a number of what we call randomized controlled trials RCT’s, where we conduct quite a controlled piece of research to ensure that we can really confidently be sure that the treatment has worked. We’ve got a number of those that are starting to come out on adolescents and in children but it is still smaller but everything that’s come out so far, looks particularly promising. It seems to work for those groups.
Interviewer: Are there any interim results that you can share?
Dr Faith Orchard: Nothing that we’ve done ourselves, particularly. We’re piloting some more brief interventions at the moment, looking at perhaps, one or two sessions, rather than the standard six to eight sessions that you often see with CBT-I. Those results are looking really good. We’ve been doing work delivering sleep interventions with populations with anxiety and depression. So, a little bit different but we’re seeing really, really great improvements almost immediately, after one to two sessions with sleep timing. So, young people going from taking two hours to fall asleep to taking ten minutes to fall asleep, almost instantly, but that’s just from learning the right techniques of what to do. Young people often just don’t know those things, intuitively.
Interviewer: And this sort of help, is it easy to access? Do many young people miss out, either because it’s not available or because they go unidentified?
Dr Faith Orchard: Yeah. I think a lot of people miss out and I think a big issue, as you just mentioned, is that identification. So, we’ve recently been doing some work with schools. I think schools could play a really great role in helping with some of these difficulties and so, we’ve just been piloting some sleep workshops where we invite young people to come along and talk to us about their sleep problems. We can offer them some advice and anyone could self-refer into them, so we’re not putting any strict rules in place about who can and cannot do it.
Interestingly, some of the feedback we’ve had from young people is that they just didn’t realise how much of a problem it was until they started making changes. I think that identification really is key but access is still difficult, especially if the problem isn’t at a level where it’s causing a huge impact but there’s just some small niggling difficulties that young people are experiencing. I think if we can get into schools and do a little bit of education around it, that would be a really good way to go.
Interviewer: And is that in the pipeline?
Dr Faith Orchard: Yeah, definitely. We’re in the early stages of it at the moment, piloting it locally in schools, but definitely looking to do some larger scale studies around being able to evaluate it.
Interviewer: Right, and these sleep workshops that you mentioned. Is that in Reading where you’re based or is that nationwide?
Dr Faith Orchard: Yeah, so we’re doing it in Berkshire in our team but there are other people that are trying out similar systems, but in different locations. Actually, been some really good work done in Australia on doing sleep workshops in schools, so we’re trying to model a little bit on some of the stuff that they’ve done but there are other teams in the UK that are piloting programs as well. People who are doing it are generally, quite early stages of doing it in the UK, but I think the more of us that start trying it, the quicker we can get it rolled out across the country.
Interviewer: Faith what, new is in the pipeline that you’d like to mention?
Dr Faith Orchard: We’ve touched on a few things already, I suppose. Working with schools, I think is a really exciting way that we can go. The other thing I didn’t go into too much detail about is the fact that we’re trying to look at how we can develop really brief interventions for sleep. The reason for that is that it’s pretty hard to get hold of any type of support through the NHS because funding is so limited and places are really limited as well. Actually, if we can offer brief treatments, there might be quick and cost-effective ways of doing it. That’s something that we’re really excited about and getting good effects from, like I said, one or two sessions of intervention. We also are just starting to know a lot more about the roles of genetics that we’ve talked about and also, what might be causing some of those relationships between sleep and mental health. I think, as that field grows, it’s going to be really exciting for us just to know a lot more about what is going on for some of those young people.
Interviewer: You’ve written the sleep topic guide for ACAMH. Can you give a short summary of some of the themes that you’ve included in this?
Dr Faith Orchard: Yeah. This is something that I’ve co-written with Professor Alice Gregory. We both have slightly different expertise on sleep. We’ve worked together to put this topic guide together for ACAMH. Some of the things we talked about are generally, what sleep is, how does sleep look in the body, in the brain? Some of the things we’ve talked about in terms of sleep stages and sleep timings, circadian rhythms. Also, thinking about that relationship between sleep and mental health, is something that we touch on and what treatment for insomnia looks like. So, what we’ve discussed today but just in a bit more detail and with resources for where people can go to get more detail on that area.
Interviewer: Great. Faith, finally, is there anything you’d like to say that I haven’t asked or perhaps as a takeaway message for those listening to this podcast?
Dr Faith Orchard: Yes. I think the main thing for me, really, is I think it’s absolutely brilliant that there’s a lot more focus on sleep than there was five years ago, ten years ago. There’s a lot more work in the field in terms of research and clinically and in the media, we’re starting to get a lot of media attention as well, which is so great. I think we can all really play a role in trying to promote good sleep habits, ourselves, in our own families. I mentioned earlier, a really good place to go to look, for any listeners, is Alice Gregory’s book, Nodding Off. That’s quite a recent publication that she’s written for the layperson or also, for experts in the field as well. It’s definitely been a great go-to resource for me and that covers lots of information about what sleep looks like across the whole lifespan. Infancy, all the way up to old age and what we can all do to help make our sleep better.
Interviewer: Faith, thank you ever so much. You can find Faith Orchard and Professor Alice Gregory’s topic guide on sleep on the ACAMH website www.ACAMH.org and Twitter @acamh. ACAMH is spelled A-C-A-M-H.
Close: This podcast was brought to you by The Association for Child and Adolescent Mental Health, ACAMH for short.