Sleep Needs, Patterns, and Difficulties of Adolescents Summary of a Workshop (2000) / Chapter Skim
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Sleep Needs, Patterns, and Difficulties of Adolescents
Sleep Needs, Patterns, and Difficulties of Adolescents
Pages 1-30
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From page 1... ...
The effects of inadequate sleep are more than mere annoyances: they affect our mood and how we perform at school, work, and home and behind the wheel. Lost sleep also accumulates over time; the more "sleep debt" an individual incurs, the greater the negative consequences, according to researchers in the field (Carskadon and Dement, 1981; Wolfson and Carskadon, 19981.
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From page 2... ...
They discussed recent efforts to facilitate meeting the sleep needs of adolescents, including consideration of later starting times for high schools and efforts to educate the public, including parents and youth, on the importance of adequate sleep. Workshop participants acknowledged the complexity of the issue and observed that additional research on the causes and consequences of adolescent sleep problems is appropriate.
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Research can also further understanding of the links between sleep difficulties ancl such outcomes as poor school performance, as well as the extent to which biological rhythms affect sleep patterns in teenagers. Viewing aclolescent sleep problems from a public health perspective suggests that public education programs ancl social marketing campaigns related to other health concerns may provide models appropriate in this area as well.
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Research indicates that working more than 20 hours a week during the school year is associated with a variety of unhealthy and problem behaviors in youth, including substance abuse, insufficient sleep, and limited time spent with families (National Research Council and Institute of Medicine, 19991. Understanding the influence of various policies, including school starting times, is important to the discussion of adolescent sleep issues as well.
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High school starting times, which typically are earlier than those of middle and elementary schools, have moved to even earlier hours in recent years. Many begin at or before 7:30 a.m., largely due to the timing and availability of school buses.
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Despite this, sleeping in on weekends allows adolescents to pay back some of their weeknight sleep debt, some workshop participants observed. Influences on Adolescent Sleep Patterns i, The various factors that influence how much adolescents sleep cluster nto two major areas.
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"While it may not be an immutable biological process," Carskadon told workshop participants, "it sets the stage for other psychosocial and environmental conditions that make it easier for these adolescents to stay awake." Adolescent development in general, she added, is "a handshake" between biology and behavior, not just one or the other. The circadian system is governed by the 24-hour alteration of light and darkness.
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From page 8... ...
Other participants noted that it is not just sleep loss that is troublesome in adolescents but also the enormous variation in their weekday/weekend sleep patterns. While some argued strongly that allowing students to sleep in on weekends was essential for reducing their sleep debt, others pointed out problems: a youngster who gets up at 6 a.m.
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It involves concerns that working too much draws young people away from school, reducing the amount of time available for homework and families. There is also growing evidence that working more than 20 hours a week during the school year is associated with a range of problems, including poor academic performance, use of alcohol and other drugs, and risk of involvement in sexual activity and delinquent behaviors (National Research Council and Institute of Medicine, 19981.
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Research conducted in Amsterdam looked at 1,500 12- to 18-yearolds with school starting times from 8 to 9 a.m. (HoEman and Steenhof, 19981.
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In Spain even the younger students don't go to bed before 10:30 p.m. School starting times are between 7:00 and 7:30 a.m.
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Other factors that should be examined are parental roles in regulating adolescent sleep patterns both individually and as part of particular cultural contexts. CONSEQUENCES OF INSUFFICIENT SLEEP What are the consequences of not getting enough sleep?
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There were pictures associated with arousing positive emotions, such as sports; arousing negative photos, such as a snarling dog; and visually interesting but emotionally neutral pictures, such as a building. The results indicated that, for a simple memory challenge, sleep deprivation has no effect; those who are sleep deprived and those who have adequate sleep perform in a similar fashion.
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. He said this study showed very similar results regarding lapse rates as those found by earlier research with the Multiple Sleep Latency Test (Carskadon and Dement, 19811.
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Dahl discussed long-term research by his group into sleep, neuroendocrine, and biological measures in adolescents who have severe depressive disorders (Dahl et al., 19961. That work indicates that the most significant biological dysregulation appears to emerge during puberty and is particularly prominent around sleep onset.
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Analysis of data from the National Highway Traffic Safety Administration estimates that up to 100,000 police-reported crashes annually are related to drowsiness (Knipling and Wang, 19951; among drivers age 15 to 24, more than 1,500 fatalities each year are associated with such crashes. (National Highway Traffic Safety Administration, 19991.
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IDENTIFYING AND INTERVENING IN CLINICAL SLEEP PROBLEMS The workshop also explored the issue of clinically diagnosed sleep disorders, beyond sleep deprivation, caused by phase delay or behavioral decisions. When clinicians in adolescent medicine see patients, according to Iris Litt, professor of pediatrics and director of the Division of Adolescent Medicine at Stanford University School of Medicine, they begin with a series of questions.
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Some hypothesize that with the decreased frequency of tonsillectomies in children, more sleep apnea is occurring in adolescents from upper airway obstructions. The delayed sleep phase syndrome has many of the characteristics of sleep loss described throughout the workshop.
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In teenagers, as in adults, many who are depressed don't seek help from mental health care professionals. They will, however, often see their primary care physicians because of sleep difficulties, which can provide an opportunity to diagnose and intervene in the depression.
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Understanding Adolescent Sleep Disorders Mark Mahowald, director of the Minnesota Regional Sleep Disorders Center, noted that sleepiness has long been seen as a sign of laziness, boredom, slothfulness, work or school avoidance, depression, and drug and alcohol abuse. Sleepiness in anyone, certainly adolescents, is due to either volitional sleep deprivation or, more importantly from a clinician's standpoint, a diagnosable and treatable sleep disorder.
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22 SLEEP NEEDS,PATTERNS,AND DIFFICULTIES OFADOLESCENTS morning chores but because they are calling in their sleep debt. Students need to understand that sleep is important.
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Sleep medicine experts have both an opportunity and a professional responsibility to integrate scientific data and help broaden understanding of sleep problems and their treatment. CHANGING SCHOOL STARTING TIMES Among the responses proposed to alleviate adolescent sleep problems, some school districts have considered changing their school starting times.
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These students also reported less overall sleepiness, less daytime sleepiness, and less depression, as well as higher grades than their peers in the other schools. These findings do not indicate causality that a later starting time will cause improvement in academic grades but do show a statistical relationship between these two variables that may be explained by such things as less struggle to stay awake in class when starting times are later.
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Forty-five percent said they gave that reason because it allows more sleep. Workshop participants emphasized that later school starting times are not a panacea for adolescent sleep problems, nor do they work well for all students or all school districts.
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The array of institutions and groups is very broad: parents and families; schools, including teachers and their organizations, school counselors and psychologists, school administrators and superintendents; health care professionals, including physicians and nurses and their associations, such as the American Academy of Pediatrics and the Society for Adolescent Medicine; businesses that employ youth; and higher education, including medical schools, schools of public health, colleges of education, and schools of government and public affairs. Government has a critical role to play, as U.S.
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This poll also found that 60 percent of children complained to their parents about being tired. Nearly a quarter of parents with children living at home and 23 percent of adults without children favor later school starting times (National Sleep Foundation, 19991.
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In the policy arena, consideration of such issues as changes in school starting times must compete against very real concerns about the financial implications, the impact on the variety of reform efforts, and the effect on extracurricular activities seen as important to strengthening adolescents' connection to their schools. A starting point for both education and policy analysis is the science behind adolescent sleep needs and difficulties.
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From page 29... ...
Participants noted that additional research on young people would help to both disentangle the factors contributing to adolescent sleep problems and assess their long-term effects. In particular, more documentation of sleep debt and its size in high school students is needed, comparing students without a sleep debt to those with a large sleep debt.
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From page 30... ...
issues related to sleep that · How can more complete and methodologically sound comparisons be drawn between adolescent sleep patterns in the United States and those in other industrialized countries? · What are the costs and benefits of measures to counter the problem of inadequate adolescent sleep?
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