Thank You - Grand Rounds 4.42

Thanks to The Blog that Ate Manhattan for hosting Grand Rounds 4.42 this week and including a post about women and sleep from Teen Health 411.

This week was really interesting, and as someone who does not watch Seinfeld, I loved all the funny clips!

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Labels: Grand Rounds, Healthline, Sleep

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Women and Sleep

There was an interesting article 7/3/08 in Ms.Magazine by Gayle Greene suggesting that trouble sleeping may be related to fluctuating hormones, which can be more difficult to deal with than usual, at several particular points in a woman's life. In particular, Ms. Greene reported that twice as many women have trouble sleeping than men and that about 67% of women report frequently having trouble sleeping.

Of course, we know that stress can lead to insomnia, as can being poor, subjected to violence, being hot, or eating or exercising too close to bedtime. However, Ms. Greene suggests that we also sleep worse when our hormones are fluctuating - at menarche, during puberty when surges of estrogen and progesterone occur, and the estrogen increases cortisol levels, promoting a stress response, before our periods start, after childbirth, and during menopause.

One way that the fluctuating hormones impact sleep is because changes in hormone levels make us hot - hot flashes for sure, but did you know that women with PMS have higher body temperatures, as do women taking birth control pills?

There are some interesting facts about women and sleep at the National Sleep Foundation as well as some good sleep tips for everyone.


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Labels: Healthline, Sleep, Teen Health

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Sleep Awareness

March 3-8 is National Sleep Awareness Week, and just FYI healthy adults are supposed to get 7-9 hours of sleep each night. Unfortunately, the CDC reports that from 1985 to 2006 the number of adults reporting fewer than six hours of sleep each night has increased in all age groups, particularly among people between the ages of 30 and 64.

Curious about whether this sleep loss in their parents transferred to preteens, the Palo Alto Medical Foundation asked preteens on We're Talking, Too: Preteen Health how much sleep they got a night (on average) and were surprised to learn that 52% of the first 317 youth who answered the survey reported they got less than eight hours of sleep a night. Another 38% reportedly got 8 to 9 hours sleep each night and only 10% reported that they got 10 or hours hours of sleep each night, which by the way is the recommended amount.

Chronic loss of sleep has a cumulative effect on physical and mental health, can reduce the quality of life and productivity, increase the use of health-care services, and result in illnesses and injuries. According to the National Sleep Foundation, children aged 5 to 12 require 9 to 11 hours of sleep a night and adolescents require 8.5 - 9.5 hours each night.

If you are having trouble getting a good nights sleep, talk to your doctor and make sure you are:

• keeping a regular sleep schedule;
• sleep in a dark, quiet, well-ventilated room with a comfortable temperature;
• avoiding stimulating activities within 2 hours of going to bed; and don't go to bed on an empty or full stomach.

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Labels: Health Fact, Healthline, Sleep

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Summer Slugs: How Much Sleep Do Teens Need?

Gracious, what is a parent to do! Another morning watching my teens drag themselves from slumber barely before noon, having gone to bed at 11 PM the night before. Another discussion about getting enough exercise, eating fruit with their breakfast, remembering their vitamins, doing a little required summer reading or Latin grammar homework, and planning a family activity for the day in addition to what they want to do, which is read, jump on the trampoline, play with the dog, and lounge around with friends.

Granted, there has been activity during our three months of summer. We have taken a wonderful vacation, the eldest is leaving for a two-week Japanese immersion camp soon, and we will do a week-long community service trip next week. We have even nicknamed this summer the "summer of responsibility" because both kids (12 and 15) have learned how to do the laundry, have done chores every day including taking the trash and recycling out, vacuuming, walking the dog (twice), dusting, doing dishes, and making some of their own meals, but neither one cleans up the dog poop without being asked or knows how to clean a bathroom, yet.

I am frustrated with the lack of enthusiasm about all the activities we are not doing together, and wonder if they would be better off if I had demanded the eldest work a little, and the youngest attend at east a day camp for a week or two. I am not trusting that all this resting is really justified by the intensity of our school year, which is the excuse I get when I probe into why they need 12 hours of sleep a night and activities requiring very little motion is all they seem to want to do. When I do get them to the beach, or on day trips with visiting friends and relatives, they seem perfectly happy and content to be out in the world, but left to their own devices, I get slug-o-rama!

Where are the parenting experts when I need one? I tend to suggest activities, some of which have been accepted- a little beading, some cooking or baking, crafts, art, a card game or ten, and a couple of really long walks - but it is like pulling teeth. I try to take my own advice and let them take responsibility for planning some of our days, or portions of the day, but I feel the social pressure to keep them busy, build a college resume, encourage them to work of study skills, get ready for the school year, talk to me about meaningful issues, clean out their drawers, read a newspaper to get the perspective of someone, anyone, outside of themselves, but the usual results are I throw in the towel, work a little, garden, or curl up with a good book myself - what a total (comfortable, cozy, relaxing) waste of time.

Thanks for listening and as always, any advice is appreciated.

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Labels: Sleep

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Teens and Younger Kids are Having Trouble with Sleep

A research article in the February 15th Journal of Clinical Sleep Medicine found that 22% of middle and high school students say they never get enough sleep, and 60% have difficulty falling asleep at least once a week. The research was conducted with 238 students in Pueblo, Colorado, and the results were disturbing. Kids with the highest GPAs were getting the most and best quality sleep and were less likely to be having trouble concentrating in class. Related research at Northwestern University found that getting an extra hour of sleep each night also may reduce the risk of being overweight.

If teens have trouble sleeping, they should remember to avoid caffeinated beverages (including soda) after noon, and not smoke. Teens should not be falling asleep in class. If they are, try to help them get more rest and if that fails, consult your physician. Teens need at least 8 hours of sleep a night and middle school students should get 10 hours of sleep a night.

Click here to link to a previous Teen Health 411 post on sleep.

Resources:
The National Sleep Foundation

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Sleep in the news

The National Sleep Foundation issued an alert this week reminding parents about the importance of sleep. There was reminder to help younger kids get the sleep they need on Halloween including these tips:

• Let the Fun Begin... Early!: Get an early start on Halloween activities to maximize the time your children get to be out having fun while still getting to bed at a reasonable hour. Start trick or treating in the late afternoon; it will soon be dark out anyway.
• Moderation, Moderation, Moderation: Pay close attention to the amount of candy children ingest. Too much candy may lead to stomach aches and illness during the night. In addition, many soft drinks and some chocolates contain caffeine that may keep them awake.
• Nix Nightmares: Watch your child closely to ensure that he/she is not anxious. If he/she seems nervous or frightened, spend some extra time comforting him or her. Do not decorate a younger child’s room with potentially frightening images (ghosts, tombstones, witches). Note, however, that nightmares and nighttime fears are common disorders with children. Sleep deprivation, anxiety and changes to a child’s sleep routine may increase the likelihood of these and other sleep related issues.
• Manage Expectations: Discuss the plan for the day and put an emphasis on the fact that you will be keeping to the regular sleep schedule, if only because school starts at the regular time the next day. After an evening of trick or treating and parties, schedule for follow up fun like sorting candy for another day. This will give kids something to look forward to.
• Wind Down Time: Naturally, kids will be excited. Allow enough wind down time and follow normal sleep habits (such as a bath or shower before bed and story time) to help your child settle down to sleep after an exciting evening.
• Maintain Regular Sleep Schedules: Keep normal sleep routines and try to stick with your child’s usual bedtime (remember, your child will be extra tired after the time change since it will actually be later at night than before the time change). A tip for adjusting to standard time is to alter bed times slightly over several days rather than make the change all at once. Have children stay up approximately 15 minutes past their normal bedtime each day starting on the Thursday night before standard daylight time begins.

The alert also included a link to a Newsday.com article by Brittany Davies about early start times and the sleep deprivation it instills in teens. I am surprised that more schools are not allowing for later start times for teens, which would also keep them in school longer in the afternoon, prime trouble-finding hours when parents are at work and teens tend to be unsupervised.

Finally, the alert discussed the high prevalence of sleep-disordered breathing (SDB) in overweight children and teens. It seems that obstructive sleep apnea (OSA) and central sleep apnea were linked to obesity. OSA occurs when the muscles in the back of the throat are not able to keep the airway open and central sleep apnea when the brain fails to send the signal to breathe during sleep.

The health consequences of sleep apnea include elevated risk for developing diabetes, hypertension, and depression. The primary symptom of sleep disorders is excessive sleepiness, which is linked to higher rates of behavior problems as well as education problems. Parents should be aware of the sleep problems associated with weight gain and address these concerns with their pediatrician.

Resources:
Sleep Smart Tips for Teens
We're Talking Teen Health

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Labels: Sleep

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