DiversityNursing Blog

This Is What’s Keeping Teens From Getting Enough Sleep

Posted by Erica Bettencourt

Mon, Feb 16, 2015 @ 11:21 AM

By 

Up to a third of teens in the U.S. don’t get enough sleep each night, and the loss of shut-eye negatively impacts their gradesmental well-being and physical health. Biologically, adolescents need fewer hours of slumber than kids — but there’s a bigger reason for teens’ sleep loss, according to a new study in the journal Pediatrics.

Katherine Keyes, an assistant professor of epidemiology at Columbia University, looked at survey data from more than 270,000 eighth-, 10th- and 12th-grade students at 130 public and private schools across the country, gathered between 1991 and 2010. Each student was asked two questions about his or her sleep habits: how often they slept for at least seven hours a night, and how often they slept less than they should.

She found that over the 20-year study period, adolescents got less and less sleep. Part of that had to do with the fact that biologically, teens sleep less the older they get, but Keyes and her team also teased apart a period effect — meaning there were forces affecting all the students, at every age, that contributed to their sleeping fewer hours. This led to a marked drop in the average number of adolescents reporting at least seven hours of sleep nightly between 1991–1995 and 1996–2000.

That surprised Keyes, who expected to find sharper declines in sleep in more recent years with the proliferation of cell phones, tablets and social media. “I thought we would see decreases in sleep in more recent years, because so much has been written about teens being at risk with technologies that adversely affect the sleep health of this population,” she says. “But that’s not what we found.”

Instead, the rises in the mid-1990s corresponded with another widespread trend affecting most teens — the growth of childhood obesity. Obesity has been tied to health disturbances including sleep changes like sleep apnea, and “the decreases in sleep particularly in the 1990s across all ages corresponds to a time period when we also saw increases in pediatric obesity across all ages,” says Keyes. Since then, the sleep patterns haven’t worsened, but they haven’t improved either, which is concerning given the impact that long-term sleep disturbances can have on overall health.

Keyes also uncovered another worrying trend. Students in lower-income families and those belonging to racial and ethnic minorities were more likely to report getting fewer than seven hours of sleep regularly than white teens in higher-income households. But they also said they were getting enough sleep, revealing a failure of public-health messages to adequately inform all adolescent groups about how much sleep they need: about nine hours a night.

“When we first started looking at that data, I kept saying it had to be wrong,” says Keyes. “We were seeing completely opposite patterns. So our results show that health literacy around sleep are not only critical but that those messages are not adapted universally, especially not among higher-risk groups.”

Source: http://time.com

Topics: mental health, studies, pediatrics, health, research, sleep, teens, insomnia, childhood obesity, grades

Docs urge delayed school start times for teens

Posted by Erica Bettencourt

Tue, Sep 02, 2014 @ 02:30 PM

By Michelle Healy

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Let them sleep!

That's the message from the nation's largest pediatrician group, which, in a new policy statement, says delaying the start of high school and middle school classes to 8:30 a.m. or later is "an effective countermeasure to chronic sleep loss" and the "epidemic" of delayed, insufficient, and erratic sleep patterns among the nation's teens.

Multiple factors, "including biological changes in sleep associated with puberty, lifestyle choices, and academic demands," negatively impact teens' ability to get enough sleep, and pushing back school start times is key to helping them achieve optimal levels of sleep – 8½ to 9½ hours a night, says the American Academy of Pediatrics statement, released Monday and published online in Pediatrics.

Just 1 in 5 adolescents get nine hours of sleep on school nights, and 45% sleep less than eight hours, according to a 2006 poll by the National Sleep Foundation (NSF).

"As adolescents go up in grade, they're less likely with each passing year to get anything resembling sufficient sleep," says Judith Owens, director of sleep medicine at Children's National Medical Center in Washington, D.C., and lead author of the AAP statement. "By the time they're high school seniors, the NSF data showed they were getting less than seven hours of sleep on average."

Chronic sleep loss in children and adolescents "can, without hyperbole, really be called a public health crisis," Owens says.

Among the consequences of insufficient sleep for teens, according to the statement:

 

  • Increased risk for obesity, stroke and type 2 diabetes; higher rates of automobile accidents; and lower levels of physical activity.
  • Increased risk for anxiety and depression; increased risk-taking behaviors; impaired interpretation of social/emotional cues, decreased motivation and increased vulnerability to stress.
  • Lower academic achievement, poor school attendance; increased dropout rates; and impairments in attention, memory, organization and time management.

Napping, extending sleep on weekends and caffeine consumption can temporarily counteract sleepiness, but they do not restore optimal alertness and are not a substitute for regular, sufficient sleep, the AAP says.

Delaying school start time is a necessary step, but not the only step needed to help adolescents get enough sleep, Owens says. "Other competing priorities in most teenagers' lives are also components of this problem," she says, including homework, after-school jobs, extracurricular activities and electronic media use. Computers and television screens, she adds, "produce enough light to suppress melatonin levels and make it more difficult to fall asleep."

"The bottom line is if school starts at 7:20 there is no way for the average adolescent to get the 8½ to 9½ hours of sleep they need," Owens says

Research on student performance in schools that have reset the start clock, including Minneapolis Public Schools, "shows benefits across the board," says Kyla Wahlstrom, director of the Center for Applied Research and Education Improvement at the University of Minnesota.

"We've found statistically significant evidence that attendance is improved, tardiness is decreased and academic performance on core subjects, English, math, social studies and science, is improved. And now we have evidence that on national standardized tests such as the ACT, there's improvement there, too," Wahlstrom says.

Obstacles commonly cited to changing school start schedules, include curtailed time for athletic practices and games, reduced after-school employment hours for students and significant impact on bus scheduling and other transportation arrangements, she says, adding, "This is a major policy change that schools have to grapple with if they want to embrace the research about what we know about teens."

According to U.S. Department of Education statistics approximately 43% of the more than 18,000 public high schools in the U.S. have a start time before 8 a.m.; just 15% started at 8:30 a.m. or later.

In some school districts that transport students great distances, buses are picking up students as early as 5:45 a.m., "so there's also a safety element" to early start times, says Terra Ziporyn Snider, executive director of the advocacy group Start School Later.

Other major health organizations, including the American Medical Association and the Centers for Disease Control and Prevention, have all highlighted insufficient sleep in adolescents as a serious health risk, as has U.S. Education Secretary Arne Duncan, Snider says.

"What's unique about the American Academy of Pediatrics' statement is that it's very specific," she says. "It says very clearly that high school and middle schools should not start before 8:30 a.m. for the sake of the health and sleep of our children. They draw the red line."

Source: http://www.usatoday.com

Topics: school, time, early, education, doctors, children, sleep, teens, students

Poor sleep and sleep habits in adolescence may raise health risks

Posted by Alycia Sullivan

Fri, Oct 26, 2012 @ 03:20 PM

From CNN

sleepLack of quality sleep for adults may negatively impact heart health. Evidence now suggests that sleep problems during adolescence may increase health risks as well.

The research appeared Monday in the Canadian Medical Association Journal.

"When most people think about cardiovascular risk factors and risk behaviors, they don't necessarily think of sleep," said Dr. Brian McCrindle, senior author and cardiologist at SickKids in Toronto, Ontario. "This study ... shows a clear association between sleep disturbance (in adolescents) and a greater likelihood of having high cholesterol, high blood pressure and being overweight or obese."

"These findings are important, given that sleep disturbance is highly prevalent in adolescence and that cardiovascular disease risk factors track from childhood into adulthood," noted Dr. Indra Narang, the lead study author and director of sleep medicine at SickKids.

The researchers examined data from the 2009/2010 school year for adolescents in the Niagara region of Ontario.

More than 4,000 ninth-grade students completed questionnaires asking about their sleep duration, quality, disturbances, snoring, daytime sleepiness and the use of any sleep medications during a period of one month.  Their average age was 14.6.

The students also answered questions about their physical activity, time spent in front of a computer or television and nutrition.

Researchers studied participants' height, weight, waist circumference, cholesterol levels and blood pressure. They adjusted for those with family history of cardiovascular disease, so they could be confident of the association found.

Participants slept, on average, 7.9 hours during the week and 9.4 hours on weekends. The Centers for Disease Control and Prevention recommends adolescents get 8.5 to 9.5 hours of sleep a night.

Almost one in five reported their weeknight sleep as "fairly bad" or "bad." One in 10 said the same was true for their weekend sleep. In addition, almost 6% of respondents said they had used medications to help them sleep.

"What happens with these kids is they have very poor sleep habits and sleep hygiene, so they're sleepy and tired and have poor energy during the day, so they hop themselves up on caffeinated beverages and then that just perpetuates their problem and a lot of them wound up taking some kind of sleep medication," McCrindle said. "So they get in a cycle."

Narang said 6% was "quite a lot" of adolescents taking over-the-counter and prescription medication to help them sleep.

"It really shows that some adolescents are experiencing very disturbed sleep that they're then needing sleep medication," she said.

Common sleep disturbances reported by the adolescents included waking up during the night or early in the morning, not being able to fall asleep within a half-hour, feeling too hot or too cold, having to use the restroom and bad dreams.

Those who reported sleep disturbances more often consumed soft drinks, fried food, sweets and caffeine, the research showed. They also reported less physical activity and increased screen time. In addition, the adolescents with shorter sleep routines reported less physical activity and more screen time.

In the short term, poor sleep impairs daytime function.

"It can affect (your) learning, it can affect (your) memory," Narang added.

Parents concerned about their child's sleep can intervene in several ways.

McCrindle suggests trying to minimize media use in the bedroom.

"Do (the adolescents) really need to have a TV, a computer, all their video games in the bedroom?" he asked.

Instead, ensure kids have down time before bedtime.

Narang feels consumption of high-energy caffeine drinks may largely be to blame.

But the big picture, she says?

"Everybody involved in the health care of a child - a nurse, a physician, a teacher - needs to promote well sleep, and that would involve a certain number of hours a sleep and routine of sleep," Narang said.

The routine would keep them on the same sleep schedule all week long, she added.

Topics: sleep, poor health, lack of sleep, adolescents

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