High School and Sleep Strath Haven High School

High School and Sleep Strath Haven High School Brad Wolgast, Ph. D, CBSM University of Delaware

Who are you? • How many of you have fallen asleep in class this week? • How many here have seen someone fall asleep in class this week? • How many of you fall asleep before 10 pm? • Before 11 pm? • Who here wakes up before: • • • Before 6: 30? Before 6: 15? Before 6: 00? Before 5: 45? Before 5: 30?

What about me? • My Sleep disorder • Attended Temple University, doctorate in psychology, and board certified in behavioral sleep medicine. • Work at University of Delaware – college student sleep disorders, especially insomnia, and everything else. • My passion is sleep- and here’s a well-known secret: high schoolers have the worst deal.

What if…. • You could change one thing in one hour a day and… • Increase your SAT and ACT scores? • Increase your GPA? • Become a better athlete or musician or just be funnier? • Become more interested in your life? • Decrease the likelihood of car accidents for you and the entire student body? • Become a better friend?

Adolescent Sleep Needs How many hours of sleep do you think are optimal for adolescents and young adults? 8. 5 – 9. 25 hours Only about 9% of adolescents get at least 8 ½ hours of sleep each night. On average, most teens sleep 6. 75 hours on school nights. 10 9 8 7 6 5 (Carskadon et al. , 1980; National Sleep Foundation, 2009) 4

Well, so what?

So, why does sleep matter? • What worsens when you aren’t getting enough sleep? • Worsened thinking skills – cognition • Worsened appearance - people who sleep less are judged as less attractive • • • Worsened academic performance and GPA Worsened emotional Control Worsened motor skills – Think: driving a car Worsened perceptive skills Worsened ability to make good decisions, your reasoning Worsened ability to learn, and make memories of new information • Worsened ability to do simple arithmetic • Worsened ability to fight off colds – your immune system

Why does sleep matter? • On the other hand, some things get better with less • • • sleep! What are they? Increased ability to gain weight without trying More Impulsivity More toxins in the brain More Accidents and errors More prone to Depression Metabolic and endocrine problems Increase the risk for Dementia Increased likelihood of Diabetes Increased likelihood of Heart Disease Increase the risk of multiple types of Cancer

Specifically Adolescents • Irritability / Behavior Problems (Beebe, 2011; Sadeh et al. , 2002; Stein et al. , 2001) • Depression / Suicidal Ideation (Buysse et al. , 2008; Clarke et al. , 2015; Liu 2004; Roberts & Doung, 2014; Silverstein, 2013) • Substance Use (Bootzin & Stevens, 2005) • Poor Decision making and risk taking (Baum et al. , 2014; Venkatraman et al. , 2007) • Compromised School Achievement (Eide & Showalter, 2012; Wahlstrom, 1999, 2002) • Tardiness & Missed School (Owens et al, 2010) • Poor Concentration / Memory Retention (Baum et al. , 2014; Lufi et al. , 2011; Wolfson & Carskadon, 1998) • “It takes a sleepy student 5 hours to complete 3 hours of homework. ” Judith Owens, MD

Sleep and Sports 68% fewer sports injuries among teens with more sleep than their peers “We were surprised to find that sleep played such an important role in athletic injury. ” (Milewski interview)

How Does Your Brain Experience limited sleep?

What about the • Anger! Brain? • Sleep loss primes us to focus on negative experiences, misinterpret facial expressions and pick fights • This happens because sleep debt cuts the connection between your amygdala and your medial prefrontal cortex

What about the Brain? Donuts! Bacon! • Sleep loss corresponds with decreased activity in the frontal lobes, which controls decision making • AND more activity in the amygdala – a key player in fear detection • Put together, these changes create a brain mechanism that dulls judgement and ratchets up desire which can lead to hunger

What about the Brain? • Donuts! Bacon! • In addition, when you don’t sleep enough you get • More Ghrelin! – This hormone increases hunger • Less Leptin! – This hormone tells you when you are full • The result? ? ?

Sleep & your Brain & Several 20 Year old Male Athletes Slept 5 Sports Testosterone levels hours a night for 5 nights dropped to the level of 30 year old men Not actually 30

Auto Accidents: Minnesota, Wyoming In 2005 the Mahtomedi School District moved start times from 7: 30 am to 8: 00 am During that school year, auto accidents among 16 -18 year olds in the district decreased by 65% In 2012 the Jackson Hole School District moved start times from 7: 35 am to 8: 55 am. During that school year, auto accidents among 16 -18 year olds in the district decreased by 70% (Wahlstrom et al, 2014 – UMN CAREI Studies)

Why is this happening to me, now?

Adult Human Biological Clock (Smolensky and Lamberg, 2000)

Human Biological Clock: Adult vs. Adolescent melatonin secretion stops 09: 00 22: 30 Adolescent melatonin secretion starts

What Can Be Done? Beyond Sleep Hygiene • 7 Strategies for helping you get better sleep • We will begin in the afternoon and work our way through the night • Be cautious of quick sleep hygiene forms. • Sleep hygiene should be personalized to be useful. • Consider this: Keep your bedroom dark. • Does anyone here have any trouble waking up? • Guess what?

What Can Be Done? Prepare for a good night: (1) Napping • Napping is an amazing way to boost brain power • Late naps diminish people’s ability to fall asleep at bedtime • A nap immediately after school for 20 -40 minutes works!

What Can Be Done? Prepare for a good night: (2) Bed is for Sleep • If your kids are studying or using their electronic devices in bed – they are making it harder for their brain to know when it’s time to go to sleep…

What Can Be Done? Prepare for a good night: (3) Caffeine is not a your friend • Caffeine hides fatigue temporarily • Any caffeine can interrupt the development of the brain at least before the age of 18 • (AAP says: none is best) • Caffeine lasts in your system for how long?

What Can Be Done? (3) Caffeine is not your friend • How much caffeine? • Coke bottle, 20 oz/58 mg • Monster Energy Drink 160 mg/16 oz • 5 -hour Energy, 2 oz, 200 mg • Mc. Donald’s Mc. Cafe 16 oz, 145 mg • Dunkin’ Donuts 16 oz, The FDA recommends an adult consumes no more than 100 about 300 mg (increased in 2015) 200 mg of caffeine in a 3 to 4 hour period, and not more than 400 • Starbucks 16 oz, 330 mg

What Can Be Done? Prepare for a good night: (4) Shower before bed • How many of you shower before bed instead of in the morning? • Serves a double purpose….

What Can Be Done? Prepare for a good night: (5) Powering Down • Use a blue light eliminator on ALL electronic devices after dinner (autoset) • f. lux, nightshift

What Can Be Done? Prepare for a good night: (5) Powering Down • Power down and turn devices off an hour before bed • Yes, really! It actually works! • If not an hour, at least 30 minutes • This clears the head and helps promote sleep Not powering down

What Can Be Done? Prepare for a good day: (6) Wake up well • Hate your alarm? • Try a dawn simulating bulb or clock • Up Light • Phillips Dawn simulator clock

What Can Be Done? Prepare for a good day: (6) Wake up well • Q: How do you make the last ten minutes or hour of sleep essentially worthless? • A: Snooze

What Can Be Done? Prepare for a good day: (6) Wake up well • What if you could choose your morning: • either sleep until 6: 45 am or • be woken up three times between 6: 20 and 6: 45 am • What would you choose? Clocky, the runaway alarm clock, $30.

What Can Be Done? Prepare for a good week: (7) Avoid Jet Lag • Weekend Jet Lag • Any guesses?

If the rate for adults is 2 in 3, what do you think the rate is for high school students?

Sleeping in on weekends is normal and can help you catch up, but sleeping beyond two hours past school day rise times will le to Jet Lag

So what do the experts say? School should start after 8: 30 am for 6 th through 12 th grades. - National Sleep Foundation, 2009 - Arne Duncan, US Secretary of Education, 2013 - American Academy of Pediatrics, 2014 - American Medical Association, 2016 - Center for Disease Control, 2016 - And many more

What can I do? • Join Start School Later at www. startschoollater. n et • Their Goal: assist students and families in helping school districts change start times to 8: 30 or later for high school and middle schools

Sleep well! Brad Wolgast, Ph. D, CBSM University of Delaware bradw@udel. ede

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