Thursday, November 13, 2014

Sleepy Heads

By: Kelli Tapley M.D. _ Physician at Birmingham Pediatric Associates

While we encourage our adolescent patients to get enough sleep, we are aware that few are actually getting the recommended 8.5-9.5 hours each night. Results from a National Sleep Foundation poll showed that as many as 59% of 6th-8th-graders and 87% of high school students in U.S. get less than the recommended amount of sleep on school nights and the average amount of school-night sleep obtained by high school seniors is fewer than 7 hours. However, 71% of parents believed that their teen was getting sufficient sleep.

For the first time the American Academy of Pediatrics has weighed in on the topic of adolescent sleep. In August the AAP issued a policy statement on school start times, urging middle schools and high schools to “begin classes no earlier than 8:30 am”, citing research showing the “average teenager in today's society has difficulty falling asleep before 11 p.m. and is best suited to wake up at 8 a.m. or later.”

But why is it happening and why weigh in now? Is it simply that they have too much to do before going to sleep (i.e. homework and after school activities)? Or is it due to electronic devices (i.e. iphone, ipad, TV) in their bedrooms?

Yes, to all of the above but there’s more going on here. Hormonal changes in adolescents result in a delay in the secretion of nocturnal melatonin causing a decrease in “sleep drive.” Additionally, there is potential link between screen time and disruption of circadian rhythm. Caffeine also plays a role in shorter sleep duration, increased wake time after sleep onset and increased daytime sleepiness.

The effects of sleep insufficiency are long lasting and potentially fatal. Restricted sleep has been found to increase risk of car crashes, delinquent behavior, depression, and difficulty maintaining focus and attention, and obesity.

While there are schools in the US that currently delay starting their day until after 0830, most do not. The Center for Applied Research and Educational Improvement, citing a study done in Minnesota in which school districts delayed start times for 9-12 grades until 0830, reported higher GPAs, significant increase in attendance rates as well as graduation rates, statistically less depression, as well as fewer school counselor visits for emotional problems and psycho somatic complaints. Not to be understated, 92% of their parents reported they were “easier to live with.”

The problem won’t be resolved simply by delayed school start times. The AAP also suggests Pediatricians make sleep part of their well-child care visits with adolescents by educating parents and young people on how much sleep they need on a regular basis and that extra sleep on weekends and caffeine use are not substitutes for regular sufficient sleep. Parents should set bedtimes and enforce a “media curfew.”

  For more information on the UM study

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