Multiple Factors Hurt Teen Sleep

Only a small percentage of American teens regularly meet their sleep needs. The reason their losing valuable shuteye isn’t quite as simple as sometimes portrayed. A front page article in the Chicago Tribune earlier this week blamed sleep loss on technology such as video games and gadgets. While this is assessment isn’t untrue, it’s just one piece of the puzzle.

Teens have a tendency to be night owls even though they need more sleep than adults. The AASM recommends a minimum of 9 hours of sleep nightly for teens and adolescents. Many schools require teens to wake up very early, sometimes even before their parents. It’s not uncommon to see high school athletes report to morning practice as early as 5 a.m.

Some teens may not be able to go to sleep early enough to get the recommended hours of sleep even if they wanted. Many teens’ circadian systems are incompatible with early morning schedules. An article in the latest issue of Chronobiology International shows evidence that teens are naturally wired to stay awake later especially in the spring and summer.

The study found sleep onset times were delayed when adolescents were exposed to natural light during the evening hours. As the days become longer teens are inclined to stay up later.

The authors compared self-reported bedtimes and sleep durations to the time of sunset. Teens slept went to sleep early and slept longer during shorter winter days. Researchers presume a lighting scheme to reduce teens’ exposure to evening sunlight may help them get to sleep early during longer days.

That alone may not be enough. Turning off the television and Xbox an hour before bedtime may help. Schools too need to make adjustments so more than 21 percent of teens get enough sleep. Pushing start times forward can make students happier, more productive and even keep them out of harm's way.

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New York City Launches Offensive on Bed Bug Infestations

Bedbugs are back. Exterminators are responding to 57 percent more bed bug infestations compared to five years ago. The blood feasting bugs are hitching a ride to apartments, houses and hotels now in urban and rural areas.

Nowhere are the infestations worse than in New York City, the unofficial capitol of bed bugs. A report released Wednesday by the city’s Bed Bug Advisory Board found more than 6 percent of New York households have bed bugs.

In response, Gotham is declaring a coordinated campaign to eliminate the nighttime pests. The board recommends public education is the first step. It plans on launching an online clearinghouse for information about bed bugs.

Outside of the old adage “don’t let the bedbugs bite”, this generation is unfamiliar with the bedtime blood suckers. We’ve been blindsided because bed bugs haven’t been a problem for a lifetime. Reports of widespread infestations really only began around 2006.

Detection and elimination is difficult and costly. Allergic reactions to bed bug bites usually take about a week to occur. About a third of people won’t have an allergic reaction until after several nighttime attacks. Even if residents realize they have an infestation they may not be able to afford an exterminator. The going rate for bed bug services ranges from about $1,000 for a one bedroom apartment to $5,000 for an average-sized house.

Last year congress introduced the “Don’t Let the Bed Bugs Bite Act of 2009,” to help identify and alleviate bed bug infestations. The bill would create for bed bug inspections, especially in hotels. The critters hitch a ride home with you through your clothing or belongings after spending even one night in an infested hotel.

The Sleep Education Blog will continue to keep an eye on New York City’s campaign against bed bugs. Look for further updates as the city’s educational website launches.

Photo by Tom Simpson

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Ravens Rookie Linebacker Kindle Fractures Skull, Narcolepsy to Blame?

Speculation is rampant after the Baltimore Raven’s first pick in the 2010 NFL draft suffered a bizarre off -field injury earlier this week. Rookie linebacker Sergio Kindle will miss training camp after fracturing his skull by falling down two flights of stairs. Numerous media outlets are linking the fall to narcolepsy. A sleep specialist might respond to these reports with a healthy dose of skepticism.

The original report came from Raven’s coach John Harbaugh. He said the fall happened when Kindle turned the wrong way after waking up in the middle of the night at a friend’s home. The linebacker’s college coach Mack Brown responded with speculation that narcolepsy led to teh incident.

Here’s the problem, a person with the type of narcolepsy that could cause a falling injury would be incapable of playing sports, let alone professional football. Narcolepsy with cataplexy causes a person who is awake to suddenly lose muscle tone. These episodes are usually triggered as a response to strong emotions such as surprise or happiness.

Wouldn’t football cause a near constant narcoleptic response based on the sport’s violent and emotional nature? What happens when a linebacker is suddenly blindsided by an offensive guard’s block? A person with narcolepsy with cataplexy would be unlikely to last more than a few plays before collapsing.

And why would a team draft a player with the condition? Kindle fell from the first round of the NFL draft, as he was originally projected. But scouts did not seem concerned with reports claiming Kindle had narcolepsy. Knee injuries and character problems caused the draft day slide. A high level Raven’s scout said the team would have never drafted Kindle if narcolepsy was such a problem.

You may remember the Sleep Education Blog covered that story earlier this year. Kindle reportedly couldn’t stay awake in team meetings when he was with the Texas Longhorns. The same reports mentioned Kindle struggled with substance abuse.

It’s impossible to say what happened in the middle of the night earlier this week, but based on medical knowledge and past reports it’s safe to say narcolepsy with cataplexy did not cause Kindle to fall down stairs and fracture his skull. Hopefully we will learn the true cause of the injury as the story unfolds.

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Morning Larks Lead Better Careers, Chronotype Expert Claims

The business world wakes up bright and early and the evening types have no choice but to fight their natural inclination to keep up with competition. For this reason it’s the morning types that hold an advantage at the office. The body of research by chronotype expert Christoph Randler suggests people who reach their peak performance in the a.m. hours seem to be better positioned for career success.

Randler was featured this month in the Harvard Business Journal’s “Defend Your Research” series. His latest research concludes morning larks are more likely to be of the “take charge” type. A sample of 367 college students responded to surveys with questions about when they tend to be most energetic and whether they are willing and able to take action to change a situation to their advantage. The students who reported they are at their best in the morning hours more often agreed with proactive statements about themselves.

He said its proactivity that leads to better job performance, greater career success and higher wages. Randler’s earlier studies suggest the advantage starts in school. The morning bell rings bright and early at most schools, and from a young age the morning types benefit. They tend to get better grades, which gets them into better colleges and then nets them better jobs out of school. They’re poised to start work early at a high level of performance once they join the 8 to 5 business world.

Despite how it sounds, evening people aren’t condemned to a life of destitution. Research shows they’re often smarter, creative, more outgoing and have a better sense of humor than their button-down counterparts. They can thrive given a more suitable schedule and environment.

These sweeping statements are a bit of a simplification, Randler admits. Evening types can be proactive and some can slightly shift their daily sleep-wake schedules without difficulty. Other research shows our chronotypes shift towards the mornings as we age. The effect may be due to the adult responsibilities such as working and raising children.

If you don’t know whether you’re a morning or evening type there’s an easy way to tell, Randler states. Evening chronotypes sleep in an average of two hours longer on weekends, while morning chronotypes are up bright and early as usual.

Image by Joey Parsons

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Many Children in Mental Health Treatment Medicated for Insomnia

Parents and their children are both increasingly turning to the medicine cabinet to meet their sleep needs. One specific population of school-aged kids and adolescents seems to be the most medicated for sleep. Nearly a third of children in therapy for psychiatric or behavioral disorders are treated for insomnia using prescription and over-the-counter medications, a new study suggests.

Nearly all of the 1,300 participating members of the American Academy of Child and Adolescent Psychiatry said they prescribed at least one sleep medication per month. About 88 percent said they recommended over-the-counter treatments for insomnia.

Recommended medications included antihistamines and the antidepressant trazadone, which is often prescribed off-label for insomnia. Clinicians surveyed in the study also prescribed drugs with psychiatric or behavioral effects such as antipsychotics and anticonvulsants for insomnia.

The principal author of the study notes that most often the sleep medications are used to manage the effects of sleep disruption on daytime functioning. The average participating psychiatrist reported seeing about 70 children per month. Older children were more frequently treated for insomnia.

While most insomnia patients were older than six years old, clinical psychiatrists reported more than 20 percent of preschool-aged patients were affected by insomnia.

The complete study will be published in the August 1st issue of Sleep Medicine.

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Review: "Inception" Limited Science, Spectacular Fiction

If all dreams were like “Inception” I would never sleep.

Every dream in the film seems to end unpleasantly. Try going to sleep knowing you’ll likely get mauled by a mob of angry rioters or stabbed in the chest by a beautiful French woman. It doesn’t sound pleasant.

Not to give away the film’s convoluted plot, but the dream world is a violent place where everything happens for a reason. In that sense Christopher Nolan’s vision is more “The Matrix” than the ICSD-2.

That isn’t to say “Inception” is a bad movie, it’s actually fantastic. Just don’t expect it to be an educational experience. The film has its own rules Nolan reportedly came up with well before he reinvented the Batman franchise.

“Inception” is a heist movie at its core. Only instead of breaking into a money vault ala “Ocean’s 13” the protagonists try to crack companies’ deepest secrets. A fugitive Leonardo DiCaprio assembles a global team of highly skilled specialists for one last job. His roster includes a dream architect (Ellen Page), a master of disguise (Tom Hardy) and a chemist/ anesthesiologist (Dileep Rao).

The squad infiltrates dreams by drugging their target and hooking themselves up to a special suitcase. Once inside, the dreamer’s subconscious, or the dream world’s citizens, tries violently to drive them out. Die in the dream and you wake up. Except for that aforementioned one last job where the stakes are higher. Die there and you go to dream limbo where you’ll spend agonizing many decades alone waiting to wake up.

Alternatively, falling or waiting for time to run out also wakes up the dreamer. But minutes in the real world can last hours or days inside dreams within dreams within dreams. Each level of the dream hierarchy is more difficult to penetrate, with a more advanced subconscious security system.

And there are still more rules, involving “dream totems” and gravity. It’s all complicated but if you suspend your disbelief you’re in for some incredible set pieces.

There is some real-life basis to this science fiction. “Inception” was inspired by Nolan’s lucid dream experiences.

Lucid dreaming involves being aware that you are dreaming while you’re still asleep. Most people are unable to have lucid dreams unless they train themselves using pre-sleep “autosuggestion.”

The process is somewhat like how the Ellen Page character designs dreams. You can prepare yourself to see certain images and recognize the bizarre events of the dream. The same sort of rehearsal process can be used to improve learning or treat recurring nightmares.

Some of the rules inside of the dreams also apply. Most of us have woken from the “kick effect” of falling dreams. It doesn’t happen for most people but death can occur in the dreams of the elderly or terminally ill. Multilayered dreams can also occur outside of “Inception.”

The rest of the concepts of “Inception” fall well into the realm of psychobabble. It doesn’t take a clinical sleep specialist to know you can’t dive into someone else’s dreams and steal their secrets. But you can influence them by suggestion. A lifetime in dream limbo is also ridiculous, though it works well as a plot device within the film.

“Inception” is a wildly original movie in a summer movie sea of sequels and remakes. Go see “Inception” right away, or better yet see it twice. Don’t wait for it to come out on DVD.

Photo by Warner Bros. Pictures

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New Parents Lose Six Months of Sleep, says Unscientific Survey

Prospective parents usually go into the final months of pregnancy bracing for months of poor sleep. New information about the amount of sleep most lose may surprise even the most experienced mothers and fathers.

There’s a report out that parents lose an average of six months of sleep in the first two years of raising a child.

There’s good reason to be suspicious about this seemingly inflated statistic. The information came from a completely unscientific survey conducted by a bed and mattress manufacturer. We’ll share the results anyway, but take them with a grain of salt.

The surveyors reached out to 1,000 parents in the United Kingdom earlier this July as part an event called “National Love Your Bed Week.”

Almost two thirds of parents reported getting about three and three-quarters hour of sleep, including naps during the first two years of raising a child. Silentnight Beds supposedly did the math. The press release reports those parents missed out on six months of total sleep during that period. About 1 in 10 parents had less than two-and-a-half hours of uninterrupted sleep.

There’s no way to verify any of these statistics, but it doesn’t take a peer-approved clinical study to know new parents will lose sleep. Luckily the Sleep Education Blog and Sleepeducation.com have some advice to get some sleep while raising a newborn.

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