Can sleep contribute to "closing the gap" for Indigenous children?

he wellbeing of Australian Indigenous children has long been an issue of concern and the subject of numerous national partnerships, action plans and government policies. This is primarily because of the high incidence of health problems and academic deficits among Indigenous children in comparison with nonIndigenous children.' The aim of these government policies is to bring about a general increase in Indigenous children's health and academic outcomes. We propose that poor sleep health may be a significant and, to date, poorly addressed factor that should be considered within the discourse around closing the gap in the health and wellbeing of Indigenous children and young people. The body of literature on this issue provides very clear evidence that sleep problems in children (whether they have a physiological or non-physiological cause) have strong and causal associations with secondary deficits in academic performance, attention and learning, emotional regulation, behaviour and mood regulation, with increased likelihood of obesity, diabetes, high blood pressure, somatic health and psychological health.2 While there is a paucity of comparable data for Indigenous children, some studies are beginning to report similar findings. Recent findings on the sleep of Indigenous children suggest that this group may also be encumbered with a higher prevalence of sleep problems.' -' Among physiological sleep disturbances, secondary sleep disturbance due to asthma has been reported in non-Indigenous children, but has yet to be fully explored in Indigenous children. This is despite the greater incidence of asthma among Indigenous children compared with non-Indigenous children.4 Sleep disordered breathing (ranging from primary snoring to obstructive sleep apnoea accompanied by nocturnal hypoxaemia) has known associations with daytime deficits in neuropsychological and psvchosocial domains, and has also been found in one study to have a prevalence of 14.2% in Indigenous children.3 This study, one of the first to investigate sleep-disordered breathing in Indigenous children, found high prevalences of snoring, wheezing and restless sleep. Despite this, no further studies have been undertaken since 2004.4 Associations between all these conditions therefore remain to be explored in Indigenous children. Not only must we consider the physiological aetiology of poor sleep, but also the impact it has on both the physiological and psychosocial development of Indigenous children. Recent findings suggest links Sarah L Blunden BA( Hons), MSocSc, PhD, Clinical Psychologist and Head of Paediatric Sleep Research'