By Susan R Johnson, MD, JAAP

I still struggle getting my almost seven year old son asleep by 8pm. It seems there is a magic window. If we eat by 5pm and I start slowing down his activities by 6pm, then there is a good chance that he will fall asleep soon after reading stories at 7.30pm If I don’t have dinner ready until 6 or 7pm and slowdown doesn’t begin until 8 or 8.30pm then my son seems to get a second wind that keeps him awake and active until 10 or 10:30 pm at night. The next day is difficult for him. It is hard for him to get up, eat breakfast, and get to school on time. He is tired and more irritable the entire day. What is happening?

If you go to see an anthroposophical physician with these complaints, then chances are your child will end up with a remedy for the liver. Often Hepatodoron (made form the leaves of the vine, Vitus Vinifera, and the wild strawberry, Fragaria vesca is given. It seems that the liver is involved in our ability to have a good night’s sleep. It regulates our energy level for the next day and relates to our overall feelings of contentment or depression. The liver follows the cycle of the sun. Around 6:00 in the evening it wants to go to sleep and start to store up the sugars (glycogen) to be used for the next day. It doesn’t want to process any big meals (especially ones high in protein or fat after 3pm).

When our children (and we) stay up late at night, we affect the liver’s metabolism. It can no longer simply store sugar. Our body, by being awake and active, needs sugar in the bloodstream and so we force the liver to reverse its process and break down glycogen to provide this sugar. We get a second wind, a burst of sugar in our bloodstream, and yet we are really depleting our energy for the next day.

Our liver can’t store up the glycogen it it needs for the next day so the next day we have a liver that is depleted of glycogen.Our body then requires us to release stress hormones from our adrenal glands to keep us functioning. These hormones act to provide more sugar in the blood, but they also accelerate our heart rate, increase our blood pressure, and suppress our immunity (we get colds more easily). You can tell when stress hormones are acting since one also develops cold hands and cold feet during the day from the vasoconstriction of the blood vessels to the hands and feet.

The combination of stress hormones and too little glycogen in the liver makes us develop a craving for sugar. When we eat something really sweet (like candy or cookies), especially on an empty stomach, the excess load of sugar overstimulates our pancreas to produce too much of another hormone, insulin. Too much insulin causes our cells to take up or absorb too much sugar so that there isn’t much sugar left in our blood. We become hypoglycaemic, with a low blood sugar. We feel tired, irritable and light headed and, for children, their body movements become more impulsive and over active (less purposeful). Being hypoglycaemic makes us crave sugar again and the whole process repeats itself throughout the entire day.

Some children and adults are more sensitive to these changes than others. Their pancreas may release more insulin in response to sugar. Some children and adults release more stress hormones in response to sleep deprivation, but this physiologic response occurs in all of us. For children that already very active and have difficulties paying attention in school, going to bed early and cutting down on sugar really can help the child and family function better.

It is said that any sleep you get before midnight is restorative and counts double, and therefore it is far better to go to bed early (7 to 9 pm for a young school age child and 9 to 10 pm for an adult) and wake up early to get your work done. Maybe this is the truth in that saying by Benjamin Franklin: Early to bed, early to rise, Makes (one) healthy, wealthy, and wise.

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