‘sleep’

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Sleep Debt And “The Great Sleep Recession”

2-13 teen sleep photoTeens in the U.S. aren’t getting enough sleep and it’s not getting better as time unfolds. After days of too little sleep we accrue a “debt” of sleep. An article out earlier this month details the long-term effects of chronically tired teens, “The Great Sleep Recession” the reality that as teens progress from middle school and into high school, the majority don’t get the sleep they need. National Sleep Foundation has found that over 85% of teens lack adequate sleep. Sleep matters: deprivation and tiredness affect schoolwork, attention, mood, interactions, unhealthy weight risk and lifelong health habits. Teens need between 8 – 10 hours of sleep each night (imagine — that means if in bed at 10:30 a teen shouldn’t hear an alarm prior to 6:30am!) but the data out this month shows a growing number of teens from all ethnicities and backgrounds are getting less than 7 hours of sleep, 2 hours less than what is recommended. This has big effects on the culture we’re rearing. Typically teens won’t naturally get tired and drift off to sleep prior 10 pm, so one way to combat this sleep deficit is to push school start times to a later hour.

Why Teens Need Sleep

Sleep deprivation changes the experience of life. There an increase in risk for anxiety and for depression in young adulthood in those who don’t get adequate sleep and it’s harder to focus, pay attention, perform at school and make decisions when we’re tired.

  • Less sleep leads to more car accidents and poor judgment. Changing the time teens start school can improve safety:
    • Delayed start time lowered one county’s teen crash rates during study, while statewide teen crash rates (that reflected schools that stayed on the same schedule) rose 7.8% over same time period.
    • In a two county comparison in Virginia, the one with an earlier start time had a crash rate of 48.8/1,000 drivers vs the county with later start times 37.9/1,000 drivers.
  • Sleep deprivation can lead to substance abuse later in life and is tied to more use of caffeine and other stimulants.
  • Caffeine in the morning and afternoon, naps throughout the day and evening and/or sleeping in on the weekend help teens cope with fatigue but these band-aids and catch-ups will not restore brain alertness like sufficient sleep does.

“Sleep Recession”: Trends From 1991-2012

Graph data adapted from: http://pediatrics.aappublications.org/content/early/2015/02/10/peds.2014-2707.full.pdf+html

Graph data adapted from: http://bit.ly/1Gm8HbQ

The recession is here, teens are more tired than they were in the 1990’s.

  • Sleep recession trending
    • Teens who get more than 7 hours of sleep in decline
    • Largest decrease in sleep in 15 year-olds.
      • In 1991 72% got >7 hours of sleep
      • In 2012 only 63% got >7 hours of sleep
  • Gender gap in adequate sleep widening as girls getting less sleep than boys

How Later School Start Times Can Help

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Sleeping With A Smartphone

460297347Turns out small screens in the bedroom may be worse for sleep than a TV. Little screens enter the room without much effort, stealing away in a pocket or backpack without notice; smartphones also grab our attention in novel ways. The light emanating from small screens is really close to our face (potentially interfering with that lovely melatonin spike before bed in ways a TV across the room cannot) and small screens are often interactive, requiring us respond or type back, provoking alertness. The first study evaluating effects of smartphones and tablets on sleep in US children is out. While the news isn’t surprising it isn’t good either.

We may be raising a really tired generation of children.

I’ve been chatting for years about trying to keep TVs out of childrens’ bedrooms. Simply put, television adds little to a child’s life when viewed right before bed. In fact ,Seattle Children’s experts Dr Michelle Garrison and Dr Dimitri Christakis have shown consuming television just before bed can cause children to have more trouble falling asleep, more nightmares, and more awakenings during the night [here’s more info–> why no TV before bed is better]. Recently though, we learned what we all likely suspected: interactive, small screens may be even worse for a child’s sleep than the TV. Tablets, TVs, iPads, and smartphones are for most adults and kids a normal part of everyday life, even during infancy and toddlerhood. 2013 Common Sense Media data finds 45% of 5 to 8 year-olds have a TV in their bedroom and 72% of children from birth to 8 report using mobile devices during the day.

A study out this past week in Pediatrics shows small screens in the bedroom have a troubling effect on children’s sleep. Read full post »

Move The Clock: 30 Minutes For 3 Days

clock - daylight savingThe end of daylight saving time is upon us…in fact today is the day you want to think about it most if you have children in your house. Here’s why: prepping for the transition may save you some pain, and some sleep. Although a one-hour shift in time may not seem a big deal to adults, many of us with young children have learned the hard way that this transition isn’t as easy for toddlers and young children — often “falling back” doesn’t equate to an extra hour of sleep on Sunday morning. Some things in life are definitely NOT guaranteed during parenthood.

Dr. Maida Chen, director of the Pediatric Sleep Center here at Seattle Children’s says it perfectly. “The first thing to know is that younger children, especially, are not going to budge their ‘body clocks’ just because the time on the clock face changes.  As a parent, be prepared for an earlier morning start on Sunday and Monday.”

Can 30 Minutes Make A Difference?

Would cutting the difference help (i.e prepping for the 1-hour shift in advance)? Well, I think so, especially after consulting some sleep experts. Enter Dr. Maida Chen again, my friend and sleep expert (ahem, and Power Mama of 3) and Dr. Craig Canapari, a sleep expert, father and blogger out East. Dr. Canapari suggests cutting the difference and softening the change by moving your child’s sleep period later by 30 minutes for three days before “falling back.” That means today (Thursday) is the day to start thinking about it. This way you’ll get them 1/2 way to the time change and making going to bed at the “new time” easier. For example, if bedtime is 8pm now, move bedtime tonight and for the next three nights to 8:30pm (that’s the new 7:30 starting on Sunday). Read full post »

Shifting To An Ideal Bedtime For School

We know children are sleeping less now than they did 30 years ago. Our children are unfortunately more tired and can suffer side effects in life because of it. Studies show that school-age children who create a sleep debt (chronic sleep deprivation) and are chronically tired have a more difficult time completing school work, they don’t score as well on tests, they may be more distractible, they can have difficulty maintaining attention, and they may be at higher risk for having an unhealthy weight. Even if your kids have already started school, you can provide a boost for your child’s attention, mood, and health by focusing in on sleep.

Starting out the year with better habits can help everyone at home (ahem, wouldn’t it be nice to avoid late evening battles?). If you’re not already there, think about moving to ideal bedtimes during the next couple of weeks.

How Much Sleep Do Children Need?

Sleep debt is created when we don’t sleep enough — it causes kids to crave “catch-up” sleep like those after-school naps, sleeping in until noon on the weekends, or falling asleep in the carpool on the way home. That being said, each child’s sleep need can be a bit different but in general children need:

  1. sleep needsPreschoolers: 11-12 hours of total sleep
  2. School-age children: 10-11 hours total sleep
  3. 12 year-old to teens: 8 1/2-10 hours total sleep

5 Ways To Support Good Sleep

  • Keep to an 8pm bedtime for young children. Move bedtime back slowly (move it by 30 minutes every 3-5 days) to prime your child for success and avoid battles!
  • 10pm bedtime for children age 12 & up is age-appropriate. More info here.
  • Habits: No screens 1-2 hours prior to bed, no caffeine after school, no food right before bed.
  • Exercise or move 30-60 minutes a day to help kids sleep easier
  • No sleeping with cell phones (create a docking station in the kitchen)
  • Don’t use OTC medications (cough & cold, for example) to knock your kids out and get them to sleep. Using medications that have a side effect of drowsiness can cause sleepiness to extend into daytime which can negatively affect school and sports performance.

Read full post »

Let Them Sleep, Start School Later

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 »

Let The Teens Sleep

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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3 Reminders For Summer Sleep

Bed as throneOur house is teeming with excitement about the impending reality: it’s almost summer break. As the hard-core school, sports and carpool coordination chaos eases up, you wanna know one thing I’m really hoping for this summer break? A bit more sleep. I do a great job protecting my children’s sleep and a mediocre job protecting my own. I work on sleeping with my cell phone off and away from while getting 7 to 8 hours of sleep but reality is my phone has a tendency to creep back up next to the bed and I am often up early to start working. Clearly I’m not unusual in this way. Parenting and sleeping a lot don’t necessarily go hand in hand. Studies find 14% of grade school children are still getting their parents up. The news is grim when it comes to sleeping with our phones, even 4 out of 5 teens say they sleep with their phone (on or near the bed). It’s becoming clear that quality sleep is one of the most undervalued power solutions to preserving wellness in our families. The more data I review, the more I know we have to get the word out on the value of sleep and the way that we protect it as we raise our children. Culturally, this is a swim upstream; we’re bred to revere those who do so much during the day they are left with limited sleep at night. Some new data, a funky article ending, and a 4-minute TED talk lay the foundation for my 3 quick reminders: Read full post »

Consistency May Be The “Secret Sauce”

Consistency may be the “secret sauce” in parenthood. Anything from helping children survive temper tantrums to helping your children eat more diverse foods, providing consistency with expectations and daily routines may be the very special thing we do that allows our children to thrive. Like most challenges in life, talking about and identifying the need for consistency is easy, implementing it throughout our daily lives is much more of a challenge. Finding and securing a consistent bedtime is one place where this “secret sauce” may really work. New data on sleep patterns for young children drives this point home. Getting your children to bed at the same time each night is powerful.

A study out today in Pediatrics evaluated data from over 10,000 children in the UK. As a part of a larger study (UK Millennium Cohort Study) researchers collected bedtime data at age 3, 5, and 7 years for children. They found children with nonregular bedtimes had more behavioral difficulties. Further, as children progressed through childhood there was incremental worsening in children’s behavior scores as they were exposed to more and more inconsistent bedtimes. Read full post »

Why Do Babies Wake Up At Night?

Most babies wake up at night. And although some superhero babies sleep 10-12 hours straight starting around 3-4 months of age, most infants wake up during the night and cry out for their parents. There are scientific reasons and some developmental and behavioral explanations for these awakenings. I spoke with my friend Dr Maida Chen, a pediatric pulmonologist, mother to three, and director of the Pediatric Sleep Disorders Center to put a list together regarding why babies do this. Leave questions and comments below if we can explain more. I’ll author a follow-up blog on ways you can help your baby when they wake up, too.

10 Reasons Babies Wake Up At Night:

  1. Sleep Cycle: Babies wake up during the night primarily because their brain waves shift and change cycles as they move from REM (rapid eye movement) sleep to other stages of non-REM sleep. The different wave patterns our brains make during certain periods define these sleep cycles or “stages” of sleep. As babies move from one stage of sleep to another during the night, they transition. In that transition, many babies will awaken. Sometimes they call out or cry. Sometimes they wake hungry. It’s normal for babies (and adults) to wake 4-5 times a night during these times of transition. However, most adults wake up and then fall back to sleep so rapidly that we rarely remember the awakening. At 4 months of age, many parents notice awakenings after a first chunk of deeper sleep. This is normal, and often due to development of delta wave sleep (deep sleep). The trick for parents is to do less and less as each month of infancy unfolds during these awakenings; we want to help our babies self-soothe more and more independently (without our help) during these awakenings so that sleeping through the night becomes a reality. Read full post »

Help Your Anxious Child: Blow Colors

This is a little trick I use to help coach anxious children whose minds just seems to “spin.” Patients have given me great feedback over the years that “blowing colors” really helps. Sometimes it’s for children and teens who can’t drift off to sleep, sometimes for those who are worriers, and sometimes for those who get anxious or overwhelmed at school. Blowing colors is a great exercise to return to regular belly breathing patterns, buy time and space for mindfulness, and improve control over feelings of overwhelm. See if it helps…

Greatest thing is–this is a good tool for a child or teen to regain control.  They can use the exercise anywhere, at any time. Lots of children and teens who get anxious feel ashamed of their anxiety and don’t want to reach out for help. Reassure them that no one will ever know they’re blowing colors or changing the hue of a room. Practice at home before bed, in school during moments of overwhelm, or even remind a child or teen they can blow colors while out with friends or at a sleepover.