Why talk about sleep?
As a pediatric neuropsychologist, it is my job to help families figure out why their children are struggling. Whether they come in because their child has a hard time focusing in school, having temper tantrums when they are told “no”, or having trouble retaining what they are learning in school, there is a common element that must always be carefully assessed; sleep.
Sleep is one of the most important foundations for healthy brain (and body) development and yet it is also one of the most overlooked and ignored! Why is this? Perhaps because we live in a culture where being busy and productive is a sign of success. Where we consistently prioritize getting more done than feeling well. After all, we can always double up on the caffeine if we are tired tomorrow, right? What we fail to acknowledge are the systemic and additive effects of missing out on sleep.
Implications of Poor Sleep
Children and adolescents who average less than 8 hours of sleep per night are considered sleep-deprived. These young people:
- Perform almost indistinguishably from a child with ADHD, Combined Type on measures of attention, response control, inhibition, and executive functions
- Have a reduction in the ability to remember positive memories, causing mainly negative memories to be retained. Folks with chronic sleep-debt have higher incidences of depression, anxiety, alcohol and drug problems, sexual acting out, cigarette smoking, emotional outbursts, and suicidal behaviors. (Suicidal behaviors in sleep-deprived children and adolescents are significantly higher, even for those who are not depressed or using substances.)
- Have difficulty differentiating between hunger and satiation, causing appetite issues, metabolism malfunction, and weight gain.
- Perform lower on tests and show a decrease in overall academic performance.
- Have a higher incidence of sports-related injuries.
- Have a higher rate of car accidents (the #1 cause of death for teenagers). Brain impairment of insufficient sleep is similar to alcohol intoxication, with reduced reaction times, awareness of traffic, and the ability to remain alert.
Why do we sleep?
Although our bodies are resting during sleep, our brains are actively engaged in providing survival functions, like eliminating toxins, repairing muscles, creating new neurons and pathways, conserving and storing energy, modulating our immune system, and managing our executive functions and psychological states. Sleep allows us to consolidate memories, and yes, that does include all of the new concepts our kids are exposed to at school. Said a different way, sleep allows our children to learn, to pay attention, to fight off disease, to heal from injuries, to feel good about themselves, and to grow into adults. Wow!
The teenage sleep conundrum
Teenagers have a biological tendency to go to sleep as much as two hours later than their younger counterparts. Their natural time for sleep is around 10:45 pm and the brain remains in the sleep mode until about 8:00 am. They are biologically more alert in the evening. This makes it difficult or impossible to fall asleep early enough to obtain the 8-10 hours of sleep recommended before having to wake early for school. Further, teenagers are not dreaming as much as they once did. They are waking up for school during the time they would normally be having the dream-rich, rapid eye movement (REM) stage of sleep. This is important because dreaming serves to help us solve problems we face in our waking lives, process emotions, and incorporate new memories into long-term storage. Research has shown that when deprived of dream-filled REM sleep, we experience more tension, anxiety, depression, poor concentration, a decrease in coordination, weight gain, and even hallucinations.
Some school districts have used this research to inform policy and have elected to have later start times for high school students. These districts have been followed closely to look at what, if any changes were found when adjusting start times. Academic gains included an increase in GPA, fewer absences and tardies, and less sleeping in class. Behavioral changes included lower rates of depression, less use/ abuse of caffeine, and a significant drop in the rate of risky behaviors (sexual, drug/ alcohol, safety related). There was also an enormous drop in car crashes for the teens attending those schools, ranging from 6-70% fewer motor vehicle accidents, with the higher rates being associated with later start times. There is little doubt why the Center for Disease Control (CDC), American Medical Association (AMA), and the American Academy of Pediatrics (AAP) have all issued policy statements regarding pushing high school start times to 8:30 a.m. or later.
Please come back next month to learn tips and tricks to improve your family’s sleep!
Yours In Health,
Dr. Kym Larson