Sleep and Students. John Villa, DO Medical Director

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1 Sleep and Students John Villa, DO Medical Director

2 Objectives: Importance and Benefits of Sleep States and Stages of the Sleep Cycle Sleep Needs, Patterns and Characteristics for All Ages Healthy Sleep Tips

3 Why is sleep important Key to our health, performance, safety and quality of life As essential as good nutrition and exercise to optimal health As necessary as the water we drink, the air we breathe and the food we eat, to function and live at our best.

4 Definition of sleep Sleep maybe defined as a behavioral state characterized by the following: Reduced motor activity Decreased interaction with and response to the environment Specific postures (lying down, closed eyes) Easy to reverse

5 During the sleep cycle Brain waves represent different stages NREM sleep of sleep REM sleep

6 The Sleep Cycle Alternating states and stages of sleep that occur over an 8-hour time period: NREM: Non-Rapid Eye Movement; Stages 1-3; 75% of the night REM: Rapid Eye Movement; Dreams occur; 25% of the night

7 Sleep is regulated by a two process model Sleep/Wake Restorative Process Balances Sleep and Wakefulness Circadian Biological Clock Regulates Timing of Sleep and Wakefulness

Resides in the brain and is affected by light and dark

8 Circadian biological clock The internal mechanism that regulates when we feel sleepy and when we feel alert Resides in the brain and is affected by light and dark Suprachiasmatic nuclei Optic nerve Retino-hypothalmic tract hypothalamus

9 During the sleep cycle Body temperature low Hormone levels rise and fall

10 We need consolidated, restorative sleep for: Functioning in a safe, efficient and effective way Cognitive, social and physical performance Emotional enhancement and relating well with others Learning and memory consolidation Prevention of health problems and optimal health

11 Sleep needs vary over the life cycle Children (5-12) 9 to 10 hrs/day Adolescents 9 to 9.25 hrs/day Adults 7 to 9 hrs/day

12 Sleep patterns and characteristics Children Adolescents Adults change over the life cycle experience more deep sleep shift to a later sleep wake cycle; experience daytime sleepiness need regular sleep schedule to obtain sufficient quality of sleep Older adults more likely to have medical problems, sleep disruptions, and may sleep less efficiently

13 Hours of sleep: School aged children 5 to 12 years Average is 9 to 10 hours over 24 hours Cognitive: Comprehension of real dangers (burglars) may increase nighttime fears Sleep onset difficulties Sleep maintenance difficulties

14 School aged children 5 to 12 years Social/emotional involvement: Increasing independence Increasing involvement in academic, social, athletic and family activities Increasing reliance on peers Social anxiety and need to achieve academically Electronics: TV, computer, video games, cell phones

15 School aged children 5 to 12 years Common sleep issues: Irregular sleep-wake schedules Later bedtimes Decreased nighttime sleep Increased caffeine consumption Parental presence at bedtime Daytime sleepiness

16 School aged children 5 to 12 years Common sleep disorders: Sleepwalking/sleep terrors Bruxism Enuresis Obstructive sleep apnea Insufficient sleep Inadequate sleep hygiene Restless leg syndrome/periodic limb movement

17 Education: School aged children 5 to 12 years Sleep health promotion (good sleep habits) Impact of inadequate sleep Parents, teachers and healthcare providers

18 Hours of sleep: Adolescents 12 to 18 years Average is 7 to 7.5 hours over 24 hours Only 20% of adolescents overall get the recommended 9 to 9.25 hours Sleep debt of 2 hours per school night Average school night bedtime 11 pm (12 th grade) Average school day wake times 6:30 am Non school nights 9 hours of sleep with 12:45 am bedtime

19 Adolescents 12 to 18 years Circadian factors: Two hour physiologic phase delay in sleep Later sleep onset Later wake times Tanner stage, not chronologic age Increasing large discrepancies between bedtimes and wake times on school vs. non school nights Eastward direction jet lag-like situation on Sunday night 3 to 4 hour shift

20 Common sleep issues: Adolescents 12 to 18 years Environmental and lifestyle factors Sleep wake variability Early high school times Significant daytime sleepiness Risk taking behaviors

21 Adolescents 12 to 18 years Common sleep disorders: Insufficient sleep Poor sleep hygiene Insomnia Delayed sleep phase disorder Obstructive sleep apnea Restless leg syndrome/periodic limb movement Narcolepsy

22 Adolescents 12 to 18 years Chronic insufficient sleep: Decline in school and work performance Increased use of alertness promoting agents Caffeine Stimulant medications Increased risk taking behaviors Use of drugs and alcohol Injuries: sport or occupational Motor vehicle crashes

23 Best sleep practices Appropriate sleep schedule Consistent sleep schedule Sunlight exposure early in the morning Avoid: caffeine, nicotine and alcohol Exercise early in the day Quiet evening routine with dim lights Bedtime routine

24 Best sleep practices Avoid electronics in bedroom: TV Video games Computers Cell phones Sleep conducive environment: Cool Dark Quiet Comfortable

25 In summary Sleep is a basic biological need that is essential to our health, performance, safety and quality of life. Sleep deprivation has serious negative consequences. Establishing healthy sleep practices prevents sleep problems and promotes optimal sleep. Signs and symptoms of sleep difficulties need to be identified and discussed with a health care provider.

26 Resources American Academy of Sleep Medicine National Sleep Foundation National Institute of Health

Get on the Road to Better Health Recognizing the Dangers of Sleep Apnea

Get on the Road to Better Health You Will Learn About The importance and benefits of sleep Sleep deprivation and its consequences The prevalence, symptoms, and treatments for major sleep problems/ disorders