Over the past decade mounting evidence finds that teens are chronically sleep deprived and subsequently suffering significant health effects. Chronic sleep deprivation is becoming the norm for our high schoolers and is known to cause both mental and physical health challenges. In fact The National Sleep Foundation found that over 85% of high schoolers aren’t getting the 8-10 hours of sleep they need while over 50% of middle school students are already falling behind in their zzzzz’s.
The evidence is in: teens who don’t get enough sleep can have academic challenges, an increase risk for sleepiness-caused car accidents, inattention, risk for overweight, risk for anxiety, greater use of stimulants like caffeine or prescription medications, and mood disorders.
This is a biology thing not a laziness thing. That teenager who can’t get out of bed until 11am on the weekends is just tired and trying to catch up! Puberty changes all sorts of things in our life, one major biologic shift occurs in the brain as children morph into adults. Around the age of 12, instead of naturally falling asleep at 8 o’clock like children in middle childhood, tweens and teens’ sleep cycle shifts about 2 to 3 hours making it a real challenge to fall asleep prior to 10 or 11pm. That means those teens up and awake until 11pm are really just acting their age.
The causes of sleep loss for teens are complex. Early school start times, use of electronics, smartphones, and tablets interfere with sleep as do homework, extra-curricular activities, and sports. But so do misperceptions — the same research that found over 85% of HS students weren’t getting enough sleep also noted that >70% of parents to those tired teens felt their child was getting enough sleep! We have to make sleep a priority in our homes. Read full post »
On Sunday night I left the house for a quick run. It was 9:20pm. It’s been years since I ran in the dark and likely a decade or more since running at night made any sense in my life. As every parent knows, we’re jailed in our houses around 8pm when the kids go to bed — if exercise hadn’t yet happened it gets pushed off until “tomorrow.”
Sunday night the Fitbit was 100% of the driving force behind me putting on my running shoes. I was about 500 steps shy of my 10,000 step goal and couldn’t go to bed, in good faith, that close to success (see image below).
Crazy or perfect? I wear 2 devices now. This month I added a Fitbit to my wrist; I’d already been wearing my Shine for a year or so and had certainly had seem improvements in self-awareness, a better understanding of my sedentary days at work, and the rewards of having daily data about my movement. I exercise a lot more now compared with a year ago. The reasons are multi-factoral of course (turning 40, losing loved ones, craving exercise) but the device has unequivocally helped. Adding the Fitbit to my wrist was designed to help hone an understanding for the level of consistency 2 devices can have (on the same person). The other reason was Fitbit would allow me to “compete” and/or compare daily totals with my husband. This is 40, my friends.
No question that in short order the Fitbit has helped me understand the difference between my movement and my activity, something I’d not really spent time on previously. For example, Sunday was a day of housekeeping. I’d moved around all day doing errands, going to store to buy hangers, cleaning the closet, goofing around with the boys, but I hadn’t been out for a run or bike ride — my first glance my Fitbit was about to give me a false sense of security. I nearly got my goal (in steps) without any real, active “exercise.” Like almost 1/2 of American adults, I hadn’t gotten the 30-60 minutes of moderate-to-vigorous activity (walking briskly, running, cycling, swimming) we all crave and need. All the sudden it dawned on me — it wasn’t just the number of steps I’d had on Sunday that mattered it truly had to be about how I got them. I was 500 steps shy of my goal of 10,000 steps but the Fitbit also told me I’d only had 2 minutes, the whole day, of active time. YIPES! Read full post »
There have been 4 teen drownings around here just in the last week. I’m left with a pit in my stomach that as the sun shines and our region heats up we lose children to preventable injuries at rapid-fire pace. This happens every year; drowning is the 2nd leading cause of injury-related death in childhood (and the #1 cause of injury death in toddlers between age 1 to 4). In general there are two groups of people who drown the most: toddlers and teens. The spaces and places (and circumstances) for typical drownings for those groups are different but the foundation is the same: water, especially cold water, is always lovely on a hot day but always poses unacknowledged dangers.
This really isn’t meant to be a finger-waggy post. This is meant to inform us all with refreshers to the opportunity we all have when living near water with children in our midst. Forward these reminders to anyone you can think of who may benefit. We may never know if we prevent a death but it sure is worth the effort to keep trying…
Drowning Statistics & Risks:
- Drowning is second leading cause of injury-related death in children in our country following motor-vehicle crashes. In general, the risks come from improper attention to the risks of water, improper supervision, and surprise (i.e. the current moves faster than expected, the water is colder, the child toddles into the pool while no one sees in a matter of seconds).
- Toddlers AND teens are the most likely groups of people to drown; risks are higher for boys than for girls. Toddlers drown because of improper supervision, teens tend to drown because of improper awareness of risks. In fact it’s also where you are that matters. Data has found, for example, that you’re at a 6-fold increase risk for drowning when visiting a friend’s home with a pool.
- Cold water, alcohol & drug use (for teens or supervising adults), and distractions increase risk for a drowning or near-drowning event.
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As teens nestle into their deep, unrestricted summer sleep, let’s think clearly about setting them up for success in the upcoming school years. Today there is a pressing need for our attention and our action. An opportunity to improve the lives of teens exists this upcoming week here in Seattle and I suspect, in ways, the outcome will inform the nation. The School Board is revisiting their commitment to do an analysis of feasibility & community engagement in 2015 around start times and will discuss this next week. They’ll vote July 2nd.
Nationally, there is mounting pressure to move school start times later for middle and high-schoolers due to a known health impediment: teens don’t naturally fall asleep until around 10pm and yet need 8 1/2 to 10 hours of sleep for good health. If you do the math and consider a need to eat in the morning and commute, if school starts prior to 8am it’s unlikely teens are set-up to get the rest they need.
The far majority of high schools in the US may make it impossible for teens to get necessary sleep with an average start time prior to 8am. The CDC’s Youth Risk Behavior Survey in 2011 showed that 69% of U.S. high school students get fewer than 8 hours of sleep on school nights, and 40% get 6 or fewer hours.
I touched base with Dr Maida Chen, a sleep expert about why this movement matters so much. “I have to start by saying that it is impossible to place a ‘price’ on the health, safety and achievement of a child,” she told me. She mentioned she’d spent significant time this week documenting the evolving data and cost-effectiveness of moving school start times. She’s written, “Rational start times, which align with students’ fundamental sleep needs, are a cost-effective and scientifically robust approach to improve equity, opportunity gap, and academic achievement on a large-scale with the greatest positive impact on students at the most disadvantage.” Translation: this makes sense and will affect a large amount of teens.
We should always be driven to do what is best for the child, and not what is convenient for society. And ultimately, there’s no money that will take back the life of a child who has died in a sleepy driver related accident – a known consequence of early start times ~Dr Maida Chen
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OMG, it’s a good day for Washington. Yesterday Governor Jay Inslee signed Bill 6065 into law. Bill 6065 bans the use of tanning beds for minors in Washington State. The bill will prohibit those under age 18 the right to use an indoor tanning device. Those facilities that break the law — they’ll be fined up to $250 per violation starting in mid-June. Children and teens with a doctor’s prescription can use the tanning bed (this will happen VERY rarely). If I were able to pass for a teen (let’s be honest, that was gone years ago) I’d sign up immediately for the undercover work. I’m that fired up in ensuring this law works…
For data & numbers (if you’re looking for that) on indoor tanning risks read: Clear And Present Danger: Indoor Tanning
I’m emotional about this as a survivor of malignant melanoma. That’s why I cried when I read this news. I cry because I’m excited and overwhelmed about the hope for turning the tide on rising melanoma diagnoses in children, teens, and young women and I cry because I am also reminded by the stories of loss. I never thought my career in medicine would connect me with politics. It’s moments like this that I’m so glad our public health officials and politicians work hard. Legislation helps and does improve the chances of success for us living into old age.
I see this as a big win for public health, but also feel this as a big win for me as a mom. I really do want to survive to see my kids grow old. Just this week I had to catch my breath while reading about the death of movie star James Rebhorn. Once you’ve had cancer this happens all the time. You’re reading something seemingly innocuously and then you stumble. “Holy moly,” you think, “sorry to hear that guy died.” Then you read how he died (melanoma) and the huge lump comes into your throat. “That could’ve been me.” So many unexpected reminders of the fortune to be alive after having a skin cancer diagnosis. Read full post »
New 2014 recommendations are out for improving our prevention efforts for children. Parents can help ensure children get what they deserve at check ups. The updates to recommendations for wellness check-up are written to guide physicians but parents are a key voice in ensuring it all happens!
Updated 2014 Recommendations For Check-Ups
Some relevant changes to prevention/screening for children:
- Infants: All infants need a pulse oximetry screen at or after 1 day of life to screen for heart defects. The test is non-invasive (just requires a technician, nurse, or doctor put an oxygen probe on their arms and legs). More information on the test here. Ideal time for testing is between 24 and 48 hours of life. If your baby is born at home or outside the hospital, go in to see pediatrician for the screen on day 1 or 2! Toddlers should be screened for iron deficiency risk at 15 and 30 months of age.
- Children: All children should be screened for depression every single year starting at age 11 years. Don’t ever shy away from discussions about mood with your pediatrician. In addition, all children are recommended to have cholesterol screening at age 9-11. I reviewed ways to prevent heart disease and cholesterol screening policy statement here.
- Teens: All teens need an annual check-up (a complete check-up will provide some time alone with doctor and nurse; mom or dad will be asked to leave for at least part of the visit). All teens need HIV screening test at age 16-18 (or sooner) and girls get their first pap smear at age 21.
5 Things Parents Need To Know About Check-Ups
- Read full post »
I was up helping my son for the majority of the night. He’s got a stomach bug (which he got from his brother) therefore I was up dealing with the enormous mess that comes with vomiting in the middle of the night. I know you know my woe. This is the second round of this bug at our house so I was clearly exhausted when 6 am rolled around.
First thing I reached for was my cup of coffee. Pretty typical for a working mom just trying to get by. As I write about caffeine, from my perch in this dear coffee town, I’m in no way suggesting we parents should ditch the latte! In fact the health benefits of moderate coffee intake during adulthood continue to unfold amidst ongoing small concerns. The pendulum seems to swing back and forth on the health benefits lurking in coffee. Moderation, like always, is key.
Yet when it comes to children, we may be more lax about caffeine intake than ideal. Caffeine consumption is pretty high in the US with more than 70% of children having caffeine on a daily basis. New research out today evaluating trends in caffeine intake from 1999 to 2010 illuminates the shifts in our children’s consumption. The researchers summed it up best here:
Mean caffeine intake has not increased among children and adolescents in recent years. However, coffee and energy drinks represent a greater proportion of caffeine intake as soda intake has declined, and generally have higher concentrations and amounts of caffeine than soda.
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Tanning beds are a known carcinogen. Word on the street (or in the hallway) may not reflect true knowledge of the dangers. I know plenty of cancer survivors who use tanning beds. Therefore it’s obvious to me that there is a clear disconnect between the science of tanning risks and our insight.
Although you may think tanning beds are a thing of the 1990s, widespread use continues. In fact, new research published today in JAMA Dermatology finds that 35% of adults in Western countries have used a tanning bed during their life while 14% have used a tanning bed within the last year. Tanning beds deliver ultraviolet (UV) radiation that damages skin cells or cells in our eyes. The Center for Disease Control explains it this way, “Indoor tanning exposes users to both UV-A and UV-B rays, which damage the skin and can lead to cancer. Using a tanning bed is particularly dangerous for younger users; people who begin tanning younger than age 35 have a 59% higher risk of melanoma. Using tanning beds also increases the risk of wrinkles and eye damage, and changes skin texture. Indoor tanning is a known and preventable cause of skin cancer, skin aging, and wrinkling.”
In my opinion it’s worth your time to figure out ways to ban indoor tanning for those in your home.
Education and tanning have an unfortunate relationship. Going to college actually increases your exposure to the carcinogen. In the JAMA study, researchers found that 55% of university students have used a tanning bed and 43% have used a tanning bed within the last year. Indoor tanning is a known real threat to human health, on par with the risks incurred from things like cigarettes. It’s predicted the rate skin cancer due to indoor tanning will continue to surpass the number of lung cancer cases caused by smoking. Smoking causes other health problems (elevated BP, heart disease) so the comparison is imperfect. That being said, researchers explain that indoor tanning is a relatively new behavior that has grown in popularity, whereas smoking rates are declining in the US and other Western countries.
Teens And Tanning:
- The JAMA study found 19.3% of adolescents (< 19 years) in Western countries have used a tanning bed. Read full post »
Miami-Dade County Corrections Department Photo from the nydailynews.com
Justin Bieber was arrested early this morning in Florida for a DUI. The smirk on his face is a bit misplaced. While it’s no longer a surprise when we hear about a celebrity’s challenge with drugs and alcohol, Bieber serves up a perfect moment for education. I mean this kid (he’s 19 years old) really could have killed himself last night. Thank goodness he’s only in jail. You got Bieber Fever in your house? Now’s the moment to step in. The number one thing parents must remember is that data and research consistently show that a parent’s opinion and guidance on avoiding alcohol remains the most powerful influence over a teen’s decision to drink alcohol underage.
Check out this powerful infographic on girls and alcohol. One in five high school girls binge-drink. 1 in 5!
Alcohol-related injuries kill over 5,000 teens every year. Bieber’s decision-making presents a huge opportunity to protect our own children. I’m reposting this data because we just can’t forget how powerful we are, as parents, when protecting our children as they grow. Our job today is simply to remember our super power–that we have influence. Don’t brush this story off as “Bieber’s a mess and an outlier.” Lamborghini or not, every teen is at risk for making this kind of choice.
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Our children are growing up with mixed messages about alcohol and drugs, at least that’s how it feels to me here in Washington. It seems to me we’re grappling with using pot and what to do with alcohol as a community. As our state legalized marijuana use this past year, we sent a big flare into the sky. It’s possible we really do one thing and then say another in front of our children and teens, particularly at times of celebration. No question they are watching. Can you seriously imagine a pro football game without beer ads or a holiday party without booze? I can’t. The great luck is that we have profound influence over our children (tah dah!); we have a huge opportunity to help them survive.
One of the biggest mistakes parents to teens make is to believe that they no longer have influence on their kids — Lara Okoloko, LICSW
I read a tweet about a month ago suggesting that perhaps we should never drink alcohol in front of our children. At first glance it seemed somewhat absurd — that we’d ban a legal adult substance from our lives as parents to young (or teen) children that we can enjoy and drink (even in moderation) all because of the risk that our children may abuse it if they saw us drink while children. However when I read the statistics on teens and alcohol it got me thinking that perhaps I needed to be more thoughtful, not only how I talk about this but how I live with my children these next 15 years. At first glance, avoiding alcohol just seems like an inconvenient annoyance. Yet I started to read the data I recognized the incredible opportunity we all have to speak clearly and repeatedly about alcohol and risk with our children, early on.
Parents are the #1 influence on whether teens choose to drink (or smoke weed). Experts really stress we need to share data and opinions with our teens before they start drinking. The hope is that when we explain how we feel, when we share facts, when we clearly articulate that alcohol could kill a teen or their friends, that we can help our children understand their actions can greatly affect their happiness and their survival. I really don’t think I’m over-framing this in terms of survival. Teens are 3 times as likely to be in a fatal crash than older, more experienced drivers and the 3 main causes of fatal crashes among teens are drunk driving, speeding, and distracted driving (think cell phone). Alcohol-related car accidents are the leading cause of death for teens and young adults.
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