Adolescent Sleep and Community Impacts
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1 Adolescent Sleep and Community Impacts Andrew Vosko, PhD Associate Provost and Director, Transdisciplinary Studies Program Assistant Clinical Professor Claremont Graduate University Claremont University Club 4/3/2018
2 Adolescent sleep has attracted international press
3 The scientific literature surged in adolescent sleep studies 1600 Publications on PubMed Retrieved with the Search Term: "Adolescent sleep"
4 Sleep Health objectives of Healthy People 2020
5 Sleep Health objectives of Healthy People %
6 How much sleep do humans need? Policy and research In 2014, the American Academy of Pediatrics issued a policy statement recommending high school start ties at 8:30 am or later
7 Adults are getting less sleep than they used to Sleep Jun 1; 35(6):
8 What are the detrimental effects of sleep deprivation? Fatigue Mental Health Effects (Depression) Decision-making Impairment Reaction Time Slowing Attention Deficits Metabolic Health (Obesity, Metabolic Syndromes) Neurodegenerative Diseases Exacerbate Other Health Conditions Irritability Cancer? Motor Vehicle Accidents Pediatrics September 2014, VOLUME 134 / ISSUE 3
9 What are the detrimental effects of sleep deprivation? Fatigue Mental Health Effects (Depression) Decision-making Impairment Reaction Time Slowing Attention Deficits Metabolic Health (Obesity, Metabolic Syndromes) Neurodegenerative Diseases Exacerbate Other Health Conditions Irritability Cancer? Motor Vehicle Accidents
10 The Zeitgeist of Early to bed, early to rise Are teens just bad at making healthy decisions for themselves?
11 What are the factors affecting unhealthy adolescent sleep behaviors? Biological 2 Process Model Environmental Light Puberty and Hormones Social Autonomy, social activities, weekend warriors, caffeine consumption School Start Times
12 Modeling the biological control of sleep: The two-process model
13 Circa + dia
14 Sample Actigraph showing human rhythms -Two types of rhythms -Entrained v. Free running
15
16 What s your chronotype? -Each of us is genetically predisposed to be somewhere on the spectrum of larks and owls. -Larks and Owls each have their own personality traits -You can take the isolated skin cells of a lark or owl and be able to tell what that person s sleep habits are
17 Comparison of subject chronotype with fibroblast period length 2008 by National Academy of Sciences Steven A. Brown et al. PNAS 2008;105:
18 Chronotype changes across the lifespan: A delay during adolescent years Biological clocks delay, but school starts earlier Roenneberg, Till et al. Current Biology, Volume 14, Issue 24, R R1039
19 Why does the school start time remain misaligned with adolescent chronotypes? Allow earlier commutes Transportation limitations Time for homework Time for extra-curricular activities Childcare needs Part-time work Roenneberg, Till et al. Current Biology, Volume 14, Issue 24, R R1039
20 How does chronotype misalignment affect performance? Time to learn: How chronotype impacts education, Volume: 6, Issue: 4, Pages: , First published: 10 October 2017, DOI: ( /pchj.178)
21 Many biological and social factors exacerbate this misalignment and sleep deprivation Nutr Rev Oct 1; 72(Suppl 1): Published online 2014 Oct 15. doi: /nure
22 Strategies to address this misalignment Time to learn: How chronotype impacts education, Volume: 6, Issue: 4, Pages: , First published: 10 October 2017, DOI: ( /pchj.178)
23 Scientific Evidence and Delaying School Start Times Most evidence to date is in the form of expert opinion and observational studies These data largely support that delaying school start times is related to improvement in weekday sleep, daytime sleepiness, attendance, mood and performance at school But there is very little evidence in the form of systematic reviews, longitudinal studies, experimental data
24 Scientific Evidence and Delaying School Start Times Data supports that delaying school start times improved weekday sleep and reduced daytime sleepiness. Some studies also support decreases in depression and caffeine use. Some studies support large decreases in vehicular accident rates. *For some parameters, effect size is small
25 Resource for case studies on school start times
26 Why not just delay start times? Allow earlier commutes Transportation limitations Time for homework Time for extra-curricular activities Childcare needs Part-time work
27 But delaying start times as the only means to address this is limiting Biological 2 Process Model Environmental Light Puberty and Hormones Social Autonomy, social activities, weekend warriors, caffeine consumption School Start Times Change practices at home, include sleep hygiene education in health class, change high stakes testing times at schools
28 Take away messages: 1) Increased interest and attention around adolescent sleep health is part of a trend as we learn more about the importance of sleep, although there is still much we don t know 2) Adolescents are not getting enough sleep according to national guidelines. Chronic sleep deprivation has many detrimental effects 3) There are both biological and social reasons why adolescents go to bed and wake up later 4) Misaligning chronotype to environment creates cognitive, mood and behavioral challenges 5) The data that we do have, albeit limited, supports delaying school start times for better sleep (still not clear on performance), safety 6) But there are important considerations if delaying start times. This is a luxury for many.
29 Adolescent Sleep and Community Impacts Thank You!
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