Sharon A. Chung, PhD Clinical Researcher Youthdale Treatment Centres Sleep Research Laboratory, University Health Network Tel: 416-603-5275 Fax: 416-603-5292 sachung@uhnres.utoronto.ca www.sleepontario.com
Anything that interferes with: Feeling Rested at Night Staying Awake & Alert during the Day
Anything that interferes with: Feeling Rested at Night Being Awake & Alert during the Day Problem Interferes with School, Work or Family
INSOMNIA Difficulty Falling asleep Can t Stay asleep (keep waking up) Wake up too Early in the morning Sleep is not Refreshing
INSOMNIA Difficulty Falling asleep Can t Stay asleep (keep waking up) Wake up too Early in the morning Sleep is not Refreshing Can affect up to as many as 1 in 5 teens Signs: always Fatigued; Drinking too much Caffeine; Inattention; Irritable; Lack of Get-up and Go
Stop breathing for very, very short periods many times during the night (Obstructive Sleep Apnea)
Stop breathing for very, very short periods many times during the night (Obstructive Sleep Apnea) Signs: Excessive Daytime Sleepiness / Hyperactivity; Behavioural Problems (acting out, aggression, irritability, impulsivity); Poor Concentration & Memory; Snoring / Gasping during sleep; Unusual Sleeping Position
NARCOLEPSY Can t stop sleeping PARASOMNIA* Walking, Talking during sleep LIMB MOVEMENTS* Kicking of legs during sleep Signs: Difficulty with Awakening in the Morning; Excessively Sleepy during the day; constantly Falling asleep; *Sheets all Disarranged in the morning
YES Problems falling asleep (intrusive/circular thoughts) Wake up multiple times during the night Unrefreshing sleep
TIPS Schedule Relaxing Activities before sleep Moderate, Regular Exercise Counting Sheep Be Realistic!!
Teenagers often sacrifice sleep time when it comes to making choices about time management. But, teens need a lot more sleep than they often get
Sleep Need for Teens: 9-10 hours - most get between 7-8 hours Sleep Loss per Night: 2 hours Sleep Loss total for Weekdays: 10 hours Sleep Loss per Month: 40 hours Cumulative Loss per Month= 4+ Nights of Sleep
Grade Avg. Age Total # Male Female Sleep hours 9 14.5 29 8 14 8.1 10 15.7 20 12 8 7.6 11 16.6 18 5 11 7.2 12 17.7 29 6 20 6.8 Survey of High-School Students Evelyn Vetsis, BSc, Sharon Chung, PhD, Colin Shapiro, MBBCh, FRCPC, PhD Department of Psychiatry, Toronto Western Hospital, University Health Network
Sleep duration on school nights: Way Too Short!! > Half (54%) said that they had Difficulty Falling Asleep at Bedtime 6 out of 10: Excessively Sleepy during school Daily Problem for 1 in 7 teens 1 in 3 students admitted to Falling Asleep in class 28% reported taking Naps at School
Number of Hours Slept 8 7.8 7.6 7.4 7.9 7.2 7 7.2 6.8 Sleepy Not Sleepy Girls Grades 11 & 12
Insufficient Sleep Irregular / Late Bedtime Caffeinated Beverages Poor Sleep Quality EDS Falling Grades Extra- Curricular Activities Late for School "Sleepiness" is serious in adolescence: Two surveys of 3235 Canadian students. Edward S Gibson, Colin Shapiro, et al. BMC Public Health. 2006; 6: 116. 70% of students were Excessively Sleepy esp. 8-10am
Higher Mathematics grades Improved Ability to Learn STUDENTS WHOSE SLEEP DURATION IS APPROPRIATE FOR THEIR AGE Better Concentration & Memory Less Behavioural &/or Conduct Problems Higher GPA & IQ Sleep duration, wake/sleep symptoms, and academic performance in Hong Kong Secondary School Children. Ng et al. Sleep Breath. 2009;13(4):357-67. Short sleep duration is associated with poor performance on IQ measures in healthy school-age children. Gruber R et al. Sleep Med. 2010;11(3):289-94. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review. Dewald JF et al. Sleep Med Rev. 2010;14(3):179-89.
Bedtime Schedule Bedtime Schedule 12 10 8 6 4 2 0 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Regular Bedtime Schedule most nights A+ A A- B+ B B- C+ C C- D+ D D- F Academic Marks Irregular Bedtime Schedule A+ A A- B+ B B- C+ C C- D+ D D- F Academic Marks NOT just HOW LONG you Sleep Irregular Sleep Schedule was also linked with Poorer Academic Grades Don t Despair!! Good Sleep Hygiene Improved /Regular Sleep Schedule
DO s Regular Bed & Wake times Regular, Moderate Exercise Address Stress Unwind-Time before bedtime Keep a Bedtime Routine Hot shower/bath before bed Comfortable bed Quiet and Dark bedroom Talk to your Family Doctor about any sleep problems Try to AVOID Strenuous Activity too close to bedtime Too much caffeine (<5 hours before bedtime) Smoking (esp. close to bedtime) Large meals too close to bedtime. Alcohol ( <3 hours before bedtime). Do NOT use alcohol to put yourself to sleep. Drinking too much fluid too close to bedtime Napping where possible Stimulating Activities before sleep (i.e. difficult homework, electronic devices, exciting books or TV shows, etc) Over-the-counter remedies for sleeplessness get help from your doctor.
Adolescent Obesity Sleep <9 hr Poor Sleep Quality BMI Caloric Intake The relationship between sleep and weight in a sample of adolescents. Lytle LA et al. Obesity (Silver Spring). 2011;19(2):324-31. Associations between sleep quality with cardiorespiratory fitness and BMI among adolescent girls. Mota & Vale. Am J Hum Biol. 2010;22(4):473-5. The association of sleep duration with adolescents' fat and carbohydrate consumption. Weiss et al. Sleep. 2010;33(9):1201-9.
Sleep Schedule Regular 20.5 Avg. BMI (kg/m2) Note that an Irregular Bedtime Schedule is associated with a greater Body Mass Index (BMI). Mostly Regular 20.6 Not usually Regular 22.7 Never Regular 23.8
Adolescent Obesity Sleep <9 hr Poor Sleep Quality BMI Caloric Intake Effects of sleep deprivation on cardiorespiratory functions of the runners and volleyball players during rest and exercise. Azboy O, Kaygisiz Z. Acta Physiol Hung. 2009;96(1):29-36.; Role of sleep and sleep loss in hormonal release and metabolism. Leproult R, Van Cauter E. Endocr Dev. 2010;17:11-21.; Number and function of circulating human antigen presenting cells regulated by sleep. Dimitrov S, Lange T, Nohroudi K, Born J. Sleep. 2007 1;30(4):401-11.
Statistics Canada (2000-2004) ~14, 000 motor vehicle deaths ~¼ were in the15-19 age group Sleepiness- Related Crashes Insufficient Sleep Sleep Deprivation Poor Sleep Quality Teens & Young Adults Adults > 30 Statistics Canada. The Daily. July 16, 2008.; Sleep quality and motor vehicle crashes in adolescents. Pizza et al. J Clin Sleep Med. 2010 15;6(1):41-5.
Researchers at the University of Kentucky, Surveyed 10,000 students before and after a 1 hour delay in high school start times. In the 2 years after the change, auto collision rates (17 & 18 year-olds) fell 17%. Elsewhere in the state, crash rates in this age group rose nearly 8% Danner F and Phillips B. J Clin Sleep Med. 2008;4[6]: 533-535