5-5-15 Burning More Than the Midnight Oil - Sleep ... · 5/1/2015 6 Sleep Deprivation Academics •...

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Burning More Than the Midnight Oil:

Sleep Deprivation in Teens

Burning More Than the Midnight Oil:

Sleep Deprivation in Teens

Produced by the Alabama Department of Public HealthVideo Communications and Distance Learning DivisionProduced by the Alabama Department of Public HealthVideo Communications and Distance Learning Division

Satellite Conference and Live WebcastTuesday, May 5, 2015

1:00 – 2:30 pm Central Time

Satellite Conference and Live WebcastTuesday, May 5, 2015

1:00 – 2:30 pm Central Time

FacultyFaculty

Mary Halsey Maddox, MDAssistant Professor

Division of Pulmonaryand Sleep Medicine

Mary Halsey Maddox, MDAssistant Professor

Division of Pulmonaryand Sleep Medicineand Sleep Medicine

Department of PediatricsUniversity of Alabama at Birmingham

and Sleep MedicineDepartment of Pediatrics

University of Alabama at Birmingham

Outline - Sleep Deprivation in Teens

Outline - Sleep Deprivation in Teens

• Is it a problem?

• What’s the physiology?

• What can we do?

• Is it a problem?

• What’s the physiology?

• What can we do?• What can we do?• What can we do?

Sleep in Teens TodaySleep in Teens Today

Coffee won’t help. I’m just not a

morning person.

Amount of Sleep the Child Needs As Estimated by the Parent

Amount of Sleep the Child Needs As Estimated by the Parent

2014 Sleep in America Poll2014 Sleep in America Poll

Sleep Duration on School Nights by Age Group

Sleep Duration on School Nights by Age Group

2014 Sleep in America Poll2014 Sleep in America Poll

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Sleep in Teens TodayIdeal Sleep Time

Sleep in Teens TodayIdeal Sleep Time

Consequences of Sleep Deprivation

Does it really matter?

Consequences of Sleep Deprivation

Does it really matter?

Sleep DeprivationAdults

Sleep DeprivationAdults

Sleep Deprivation Sleep Deprivation

leep

ines

sle

epin

ess

Cumulative sleep lossCumulative sleep loss

While neurobehavioral deficitWhile neurobehavioral deficit increases, increases, subjective sleepiness may plateausubjective sleepiness may plateau

Su

bje

ctiv

e S

Su

bje

ctiv

e S

OMG…Maybe Resident Work Hours Are Good?OMG…Maybe Resident Work Hours Are Good?

NYT 2008NYT 2008

Sleep Deprivation Sleep Deprivation

leep

ines

sle

epin

ess

Cumulative sleep lossCumulative sleep loss

While neurobehavioral deficit increases, While neurobehavioral deficit increases, subjective sleepiness may plateausubjective sleepiness may plateau

Su

bje

ctiv

e S

Su

bje

ctiv

e S

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Sleep DeprivationSleep Deprivation

• This is your brain• This is your brain • This is your brain

without sleep

• This is your brain

without sleep


• Brain with sleep• Brain with sleep • Brain without sleep• Brain without sleep


• This is your brain• This is your brain • This is your brain

without sleep

• This is your brain

without sleep


• Brain with sleep• Brain with sleep • Brain without sleep• Brain without sleep

Sleep DeprivationTeens

Sleep DeprivationTeens

HealthHealthHealthHealth

BehaviorBehaviorBehaviorBehaviorSportsSportsSportsSports BehaviorBehaviorBehaviorBehavior

SafetySafetySafetySafetyAcademicsAcademicsAcademicsAcademics

SportsSportsSportsSports

Sleep DeprivationPhysical Health


• Increased cardiometabolic risk

• Increased obesity

• Increased purging, fasting and diet pills

• Increased cardiometabolic risk

• Increased obesity

• Increased purging, fasting and diet pillsIncreased purging, fasting and diet pills

• Increased IBS

Increased purging, fasting and diet pills

• Increased IBS

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• Decreased growth

• Increased neurologic problems

(seizure, headache)

• Decreased growth

• Increased neurologic problems

(seizure, headache)

Sleep DeprivationMental Health


• Increased depression

• Increased anxiety

• Increased suicidality

• Increased depression

• Increased anxiety

• Increased suicidality• Increased suicidality

• Increased suicide attempts

• Decreased impulse control

• Increased suicidality

• Increased suicide attempts

• Decreased impulse control



• Higher Kessler Psychological

Distress score

• Lower self esteem

• Higher Kessler Psychological

Distress score

• Lower self esteem

Sleep Deprivation - SafetyRisk Taking Behavior


• Delinquency

– Property (stealing)

– Violence (fighting)

• Delinquency

– Property (stealing)

– Violence (fighting)– Violence (fighting)

• Impulse control

• Sensation seeking (Thrill seeking)

– Violence (fighting)

• Impulse control

• Sensation seeking (Thrill seeking)



• Increased drunk driving

• Increased substance abuse

– Alcohol binge drinking

• Increased drunk driving

• Increased substance abuse

– Alcohol binge drinkingAlcohol, binge drinking,

cigarettes, marijuana

– Caffeine – Early, heavy use may

lead to other drugs

Alcohol, binge drinking,

cigarettes, marijuana

– Caffeine – Early, heavy use may

lead to other drugs

Sleep DeprivationSafety


• Injury

– Double the unintentional injury risk

– Nearly double the pedestrian injury

• Injury

– Double the unintentional injury risk

– Nearly double the pedestrian injury– Nearly double the pedestrian injury

risk (virtual)

– Nearly double the pedestrian injury

risk (virtual)

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• Motor Vehicle Crashes

– Increased number of crashes

– Increased chance of numerous

• Motor Vehicle Crashes

– Increased number of crashes

– Increased chance of numerous– Increased chance of numerous

crashes

– Increased “run off the road”

crashes

– Increased chance of numerous

crashes

– Increased “run off the road”

crashes

Sleep Deprivation - SafetyDrowsy Driving


• 1% of all motor vehicle crashes;

4% of crashes involving fatality

• Drivers under 25 years involved in

• 1% of all motor vehicle crashes;

4% of crashes involving fatality

• Drivers under 25 years involved in y

>50% of police - report fatigue -

related traffic crashes each year

y

>50% of police - report fatigue -

related traffic crashes each year



• NSF poll:

– 68% of HS seniors have driven

while drowsy;

• NSF poll:

– 68% of HS seniors have driven

while drowsy;y

– 15% at least 1 time per week

• Impairments related to sleep loss

equal or greater than those due to

alcohol intoxication

y

– 15% at least 1 time per week

• Impairments related to sleep loss

equal or greater than those due to

alcohol intoxication

Sleep Deprivation

SafetyDrowsy

Sleep Deprivation

SafetyDrowsyDrowsyDrivingDrowsyDriving

Drowsy Driving What About Alabama?


• 3.4% of people in Alabama report

falling asleep driving during the

preceding 30 days (CDC 2010)

• 3.4% of people in Alabama report

falling asleep driving during the

preceding 30 days (CDC 2010)



• No laws or license restrictions

regarding drowsy driving

• No requirement for doctors to report

• No laws or license restrictions

regarding drowsy driving

• No requirement for doctors to report q p

sleep disorders

• No drowsy driving info part of

driver’s education

q p

sleep disorders

• No drowsy driving info part of

driver’s education

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Sleep DeprivationAcademics


• Multiple studies show that decreased

sleep duration is associated with

lower academic achievement

• Multiple studies show that decreased

sleep duration is associated with

lower academic achievement



• National Science Foundation Poll

– 28% fall asleep in school at least 1x/week

– 22% fall asleep doing homework

• National Science Foundation Poll

– 28% fall asleep in school at least 1x/week

– 22% fall asleep doing homework

– “A” students

• Sleep 15 minutes more than B students

• Sleep 26 minutes more than C students

• Sleep 36 minutes more than D student

– “A” students

• Sleep 15 minutes more than B students

• Sleep 26 minutes more than C students

• Sleep 36 minutes more than D student

Minute Variability vs. GradesMinute Variability vs. Grades

30

40

50

60

Weekday TST

A/B (n=1238)

B/C (n=1371)

C/D (n=390)

D/F (n=61)0

10

20

30Bed Times

P<0.0001

Sleep DeprivationSports


• Slowing of psychomotor vigilance

(athletes)

• Decreased performance

• Slowing of psychomotor vigilance

(athletes)

• Decreased performance

– Accuracy

– Consistency

– Accuracy

– Consistency



• Conversely – Increasing sleep time

increases consistency, accuracy,

and psychomotor vigilance

• Conversely – Increasing sleep time

increases consistency, accuracy,

and psychomotor vigilance

Sleep DeprivationSports Psychomotor Vigilance

Sleep DeprivationSports Psychomotor Vigilance

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Sleep DeprivationSports PerformanceSleep Deprivation

Sports PerformanceTennis players serving accuracy before and after Tennis players serving accuracy before and after

3 days of sleep restriction3 days of sleep restriction

Sleep Extension - SportsSleep Extension - Sports

Sleep in Teens Today –A Reminder

Reported Amounts

Sleep in Teens Today –A Reminder

Reported Amounts

Sleep Deprivation in TeensIs it a Problem?

Sleep Deprivation in TeensIs it a Problem?

Sleep

SleepDebt

SleepDebt

SleepDebt

YES!

SleepDebt

The Science of SleepThe Science of Sleep

The New YorkerThe New Yorker

“I dreamed I got 8 hours of sleep.”

Science of SleepWhy Do We Need Sleep?

Science of SleepWhy Do We Need Sleep?

• To remember

• To react

• To regulate (Heal)

• To remember

• To react

• To regulate (Heal)• To regulate (Heal)• To regulate (Heal)

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Science of SleepTo Remember




Science of SleepTo React (Emotional Control)


• Sleep - deprived volunteers viewed

emotional images

– Increased response of the

• Sleep - deprived volunteers viewed

emotional images

– Increased response of the



p

“emotional brain” (amygdala)

– Weaker connection amygdala –

PFC = less emotional control

p

“emotional brain” (amygdala)

– Weaker connection amygdala –

PFC = less emotional control

Science of SleepTo Regulate

Science of SleepTo Regulate

• Numerous studies demonstrate sleep

is necessary to mediate health

– Ghrelin and Leptin

• Numerous studies demonstrate sleep

is necessary to mediate health

– Ghrelin and Leptin

– Interleukins and Cytokines

– Insulin and Cortisol

– Cardiovascular function

– Cell reproduction (Cancer)

– Interleukins and Cytokines

– Insulin and Cortisol

– Cardiovascular function

– Cell reproduction (Cancer)

Science of SleepScience of Sleep• Process S (Homeostatic Process)

• Process C (Circadian Process)

• Process S (Homeostatic Process)

• Process C (Circadian Process)

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Science of SleepIt Changes


• Sleep need decreases through life

• Newborns Toddlers School

Age Teens Adults

• Sleep need decreases through life

• Newborns Toddlers School

Age Teens Adultsgg



• Our bodies will only stay

awake so long

• Our bodies will only stay

awake so long

Science of Teen SleepScience of Teen Sleep• Process S requires

more hours awake

to cause sleepiness

• Process C

• Process S requires

more hours awake

to cause sleepiness

• Process C

demonstrates a

natural delay in

melatonin release

demonstrates a

natural delay in

melatonin release

Science of Teen SleepDelay in Melatonin

Science of Teen SleepDelay in Melatonin

Physiology of Teen Sleep Delay in Melatonin


• Species manifesting Juvenile Phase Delay

– Homo sapiens (humans)

– Macca mulatta (Rhesus monkeys)

• Species manifesting Juvenile Phase Delay

– Homo sapiens (humans)

– Macca mulatta (Rhesus monkeys)( y )

– Octodon degus (degu) [some ?]

( y )

– Octodon degus (degu) [some ?]



– Rattus norvegicus (laboratory rat)

– Mus musculus (laboratory mouse)

– Psammomys obesus (fat sand rat)

– Rattus norvegicus (laboratory rat)

– Mus musculus (laboratory mouse)

– Psammomys obesus (fat sand rat)y ( )y ( )

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Physiology of Teen SleepDelay in Sleep Phase Observed Worldwide

Physiology of Teen SleepDelay in Sleep Phase Observed Worldwide

• 6 Continents –• 6 Continents –

Developed and

Undeveloped

Countries

Developed and

Undeveloped

Countries

Teen Sleep –The Perfect Storm

Teen Sleep –The Perfect Storm

Physiology +

Environment

Physiology +

Environment

Circadian MisalignmentCircadian Misalignment

• Teens are biologically programmed

to go to sleep after 11:00 pm

• Teens are biologically programmed

to go to sleep after 11:00 pm

Science of Teen SleepPhysiology


• Likewise, teens are biologically

programmed to wake up after 8:00 am

• Likewise, teens are biologically

programmed to wake up after 8:00 am



Science of Teen SleepEnvironment


“Tommy can’t play now, but he might be able to squeeze you in between soccer and his piano lesson.”

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• School start times

• Sports

• Extracurricular activities

• School start times

• Sports

• Extracurricular activities• Extracurricular activities

• Jobs

• Bus schedules

• Social commitments

• Extracurricular activities

• Jobs

• Bus schedules

• Social commitments



• ELECTRONICS and the

24 HOUR SOCIETY

• ELECTRONICS and the

24 HOUR SOCIETY

Proportion of Parents with No Formal Rules for 6

Behaviors by Age Group

Proportion of Parents with No Formal Rules for 6

Behaviors by Age Group

Science of Teen Sleep “Sleep Regulation”

Science of Teen Sleep “Sleep Regulation”

SleepSleep

HomeostaticSleep DriveHomeostaticSleep Drive

S h lS h l

< 7 hours

12p12p 6p6p 12a12a 6 am6 am

SleepSleep

6a6a

CircadianWake DriveCircadian

Wake Drive

AlertnessLevel

AlertnessLevel

SchoolSchool

Science of Teen SleepWeekend Make-up SleepScience of Teen Sleep

Weekend Make-up Sleep• Discrepancy between weekday and

weekend bedtime / wake-up

associated with learning deficits

• Discrepancy between weekday and

weekend bedtime / wake-up

associated with learning deficits

and behavior problems

• Results in greater difficulty sleeping

on Sunday night

and behavior problems

• Results in greater difficulty sleeping

on Sunday night

Science of Teen SleepWeekend Make-up SleepScience of Teen Sleep

Weekend Make-up Sleep• Leads to a permanent “Jet Lag”

– Can last days – 1 day for every

time zone crossed

• Leads to a permanent “Jet Lag”

– Can last days – 1 day for every

time zone crossed

– GI problems, fatigue, somnolence,

depressed mood

– GI problems, fatigue, somnolence,

depressed mood

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Physiology of Teen SleepIdeal Sleep Time

Physiology of Teen SleepIdeal Sleep Time Physiology

+Environment

Physiology +

Environment

Circadian MisalignmentSleep Deprivation

Circadian MisalignmentSleep Deprivation

So What Can We Do?So What Can We Do?• Educate

• Advocate

• Educate

• Advocate

What Can We Do?What Can We Do?• Educate

– Importance of bedtimes

• Kids without parent set bedtimes

sleep 30 minutes LESS a night

• Educate

– Importance of bedtimes

• Kids without parent set bedtimes

sleep 30 minutes LESS a nightsleep 30 minutes LESS a night

than kids with set bedtimes

sleep 30 minutes LESS a night

than kids with set bedtimes


– Impact of electronic devices

• Kids with electronics in their

bedrooms sleep 30 minutes

• Educate

– Impact of electronic devices

• Kids with electronics in their

bedrooms sleep 30 minutesbedrooms sleep 30 minutes

LESS a night than kids without

electronics

bedrooms sleep 30 minutes

LESS a night than kids without

electronics


– Importance of schedule

and limit - setting

• Schedules should be maintained

• Educate

– Importance of schedule

and limit - setting

• Schedules should be maintained• Schedules should be maintained

on weekends to avoid weekend

oversleep and social “jet lag”

• Schedules should be maintained

on weekends to avoid weekend

oversleep and social “jet lag”

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What Can We Do?What Can We Do?• Advocate

– Drowsy driving

• http://sleepfoundation.org/

drowsy driving advocacy

• Advocate

– Drowsy driving

• http://sleepfoundation.org/

drowsy driving advocacydrowsy-driving-advocacy

• Drowsy driving education

in drivers education

– Delayed school start times

(AAP Statement)

drowsy-driving-advocacy

• Drowsy driving education

in drivers education

– Delayed school start times

(AAP Statement)

AAP StatementAAP Statement

AAP StatementHighlights


• Teens in the United States are

chronically sleep deprived, yet

physiologically they cannot go to

• Teens in the United States are

chronically sleep deprived, yet

physiologically they cannot go to

sleep routinely before 11:00 pm and

cannot wake routinely before 8:00 am

sleep routinely before 11:00 pm and

cannot wake routinely before 8:00 am



• Sleep deprivation negatively

impacts learning, mood, behavior,

safety and health

• Sleep deprivation negatively

impacts learning, mood, behavior,

safety and health

• Junior High and High Schools

should not start before 8:30 am

• Junior High and High Schools

should not start before 8:30 am

Supporting DataDelayed School Start /

Quantity of Sleep

Supporting DataDelayed School Start /

Quantity of Sleep

Supporting DataSleep Time in Teens

Supporting DataSleep Time in Teens

5050

6060

7070

Percent of teens getting >8 hours sleep Percent of teens getting >8 hours sleep at various school timesat various school times

00

1010

2020

3030

4040

7:307:30 7:357:35 8:008:00 8:008:00 8:058:05 8:208:20 8:358:35 8:358:35 8:358:35 8:558:55

Series1Series1

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Supporting DataTeen Mood Improvements

Supporting DataTeen Mood Improvements

PARENTS overwhelmingly reported their TEENS were

easier to live with

Supporting DataAcademic Improvements

Supporting DataAcademic Improvements

Supporting DataMotor Vehicle Crashes

Supporting DataMotor Vehicle Crashes

• Decreased crash rates

in several districts

– 16% (Kentucky)

• Decreased crash rates

in several districts

– 16% (Kentucky)

– 65% (Minnesota)

– 70% (Wyoming)

– 65% (Minnesota)

– 70% (Wyoming)

In Conclusion…a Word From Ben Stein


“Sleep makes people calmer, more

alert, less fearful – just plain happier,

or so I see around me and in me.

“Sleep makes people calmer, more

alert, less fearful – just plain happier,

or so I see around me and in me.



I am sure that if this great nation

were to concentrate on getting more

sleep, we would be a happier, more

confident people, and that by itself

would be a major achievement.”

I am sure that if this great nation

were to concentrate on getting more

sleep, we would be a happier, more

confident people, and that by itself

would be a major achievement.”

Thank YouThank You

• AAP

• COA/UAB

• Judy Owens

• John Garcia

• AAP

• COA/UAB

• Judy Owens

• John Garcia

My FamilyMy Family

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ReferencesReferences•• CarskadonCarskadon Sleep 1980 (Sleep in Teens TodaySleep 1980 (Sleep in Teens Today--Ideal Sleep Time)Ideal Sleep Time)

• SLEEP 2003; 2:117-126 and SLEEP 2003; 2:117-126 (Sleep

Deprivation)

•• Sleep deprivation brain pictures courtesy of Judy OwensSleep deprivation brain pictures courtesy of Judy Owens

•• Sleep Medicine Reviews 18 (2014) 75e87 (Sleep Deprivation)Sleep Medicine Reviews 18 (2014) 75e87 (Sleep Deprivation)

•• CarskadonCarskadon Sleep 1980 (Sleep in Teens TodaySleep 1980 (Sleep in Teens Today--Ideal Sleep Time)Ideal Sleep Time)

• SLEEP 2003; 2:117-126 and SLEEP 2003; 2:117-126 (Sleep

Deprivation)

•• Sleep deprivation brain pictures courtesy of Judy OwensSleep deprivation brain pictures courtesy of Judy Owens

•• Sleep Medicine Reviews 18 (2014) 75e87 (Sleep Deprivation)Sleep Medicine Reviews 18 (2014) 75e87 (Sleep Deprivation)

•• J J PediatrPediatr. 2014 May ; 164(5): 1085. 2014 May ; 164(5): 1085––1090 International Journal of 1090 International Journal of

Obesity Obesity –– numerous SLEEP, Vol. 36, No. 8, 2013 Sleep Breath. numerous SLEEP, Vol. 36, No. 8, 2013 Sleep Breath.

2012 Dec;16(4):12112012 Dec;16(4):1211--8 (Sleep Deprivation Physical Health)8 (Sleep Deprivation Physical Health)

•• Sleep 2012; 35 (4) 455Sleep 2012; 35 (4) 455--460 / 460 / JAMA Pediatr. 2013;167(7):647-655

(Sleep Deprivation Mental Health)(Sleep Deprivation Mental Health)

•• J Youth J Youth AdolescAdolesc 2010; 33: 6332010; 33: 633--641 / J Youth 641 / J Youth AdolescAdolesc, 2011; 40: , 2011; 40:

916916--930 / JAMA 930 / JAMA PediatrPediatr. 2013;167(7):647. 2013;167(7):647--655 (Sleep Deprivation 655 (Sleep Deprivation

Safety Safety –– Risk Taking Behavior)Risk Taking Behavior)

•• J J PediatrPediatr. 2014 May ; 164(5): 1085. 2014 May ; 164(5): 1085––1090 International Journal of 1090 International Journal of

Obesity Obesity –– numerous SLEEP, Vol. 36, No. 8, 2013 Sleep Breath. numerous SLEEP, Vol. 36, No. 8, 2013 Sleep Breath.

2012 Dec;16(4):12112012 Dec;16(4):1211--8 (Sleep Deprivation Physical Health)8 (Sleep Deprivation Physical Health)

•• Sleep 2012; 35 (4) 455Sleep 2012; 35 (4) 455--460 / 460 / JAMA Pediatr. 2013;167(7):647-655

(Sleep Deprivation Mental Health)(Sleep Deprivation Mental Health)

•• J Youth J Youth AdolescAdolesc 2010; 33: 6332010; 33: 633--641 / J Youth 641 / J Youth AdolescAdolesc, 2011; 40: , 2011; 40:

916916--930 / JAMA 930 / JAMA PediatrPediatr. 2013;167(7):647. 2013;167(7):647--655 (Sleep Deprivation 655 (Sleep Deprivation

Safety Safety –– Risk Taking Behavior)Risk Taking Behavior)

ReferencesReferences•• Am J Epidemiol2007;166:1053Am J Epidemiol2007;166:1053––1058 / J of 1058 / J of AdolAdol Health 53 Health 53

(2013) 785e790 / JAMA (2013) 785e790 / JAMA PediatrPediatr. 2013;167(7):647. 2013;167(7):647--655 (Sleep 655 (Sleep

Deprivation Safety)Deprivation Safety)

•• Drowsydriving.org (Drowsy Driving)Drowsydriving.org (Drowsy Driving)

•• http://sleepfoundation.org/sites/default/files/4http://sleepfoundation.org/sites/default/files/4--

State%20of%20the%20States%20ChartState%20of%20the%20States%20Chart--9.5.20149.5.2014--FINAL.pdf FINAL.pdf

•• Am J Epidemiol2007;166:1053Am J Epidemiol2007;166:1053––1058 / J of 1058 / J of AdolAdol Health 53 Health 53

(2013) 785e790 / JAMA (2013) 785e790 / JAMA PediatrPediatr. 2013;167(7):647. 2013;167(7):647--655 (Sleep 655 (Sleep

Deprivation Safety)Deprivation Safety)

•• Drowsydriving.org (Drowsy Driving)Drowsydriving.org (Drowsy Driving)

•• http://sleepfoundation.org/sites/default/files/4http://sleepfoundation.org/sites/default/files/4--

State%20of%20the%20States%20ChartState%20of%20the%20States%20Chart--9.5.20149.5.2014--FINAL.pdf FINAL.pdf

(Drowsy Driving)(Drowsy Driving)

•• Sleep Deprivation Academics Sleep Deprivation Academics –– Information courtesy of Judy Information courtesy of Judy

Owens and National Sleep FoundationOwens and National Sleep Foundation

•• Child Child DevelDevel., 1998, ., 1998, VolVol 69:4, pg 87569:4, pg 875--887 (Minute variability vs. 887 (Minute variability vs.

grades graph)grades graph)

•• Asian J Sports MedAsian J Sports Med. 2012 Mar;3(1):15. 2012 Mar;3(1):15--20.20. (Sports (Sports

Psychomotor Vigilance Graph)Psychomotor Vigilance Graph)

(Drowsy Driving)(Drowsy Driving)

•• Sleep Deprivation Academics Sleep Deprivation Academics –– Information courtesy of Judy Information courtesy of Judy

Owens and National Sleep FoundationOwens and National Sleep Foundation

•• Child Child DevelDevel., 1998, ., 1998, VolVol 69:4, pg 87569:4, pg 875--887 (Minute variability vs. 887 (Minute variability vs.

grades graph)grades graph)

•• Asian J Sports MedAsian J Sports Med. 2012 Mar;3(1):15. 2012 Mar;3(1):15--20.20. (Sports (Sports

Psychomotor Vigilance Graph)Psychomotor Vigilance Graph)

ReferencesReferences•• PhysiolPhysiol BehavBehav. 2013 Aug 15;120:93. 2013 Aug 15;120:93--6 (Sports Performance 6 (Sports Performance

Graph)Graph)

•• MahMah. Sleep 2011; 34(7);943. Sleep 2011; 34(7);943--950. (Sleep Extension Sports Graph)950. (Sleep Extension Sports Graph)

•• Sleep in America Poll, 2014 (Sleep in Teens Today Sleep in America Poll, 2014 (Sleep in Teens Today –– Reported Reported

Amounts GraphAmounts Graph

•• Walker. NYAS 2005 /Walker. NYAS 2005 / Trends in Neurosciences, Vol.28 No. 8Trends in Neurosciences, Vol.28 No. 8

•• PhysiolPhysiol BehavBehav. 2013 Aug 15;120:93. 2013 Aug 15;120:93--6 (Sports Performance 6 (Sports Performance

Graph)Graph)

•• MahMah. Sleep 2011; 34(7);943. Sleep 2011; 34(7);943--950. (Sleep Extension Sports Graph)950. (Sleep Extension Sports Graph)

•• Sleep in America Poll, 2014 (Sleep in Teens Today Sleep in America Poll, 2014 (Sleep in Teens Today –– Reported Reported

Amounts GraphAmounts Graph

•• Walker. NYAS 2005 /Walker. NYAS 2005 / Trends in Neurosciences, Vol.28 No. 8Trends in Neurosciences, Vol.28 No. 8Walker. NYAS 2005 / Walker. NYAS 2005 / Trends in Neurosciences, Vol.28 No. 8 Trends in Neurosciences, Vol.28 No. 8

August, 2005 August, 2005 (Science of Sleep to Remember Graph)(Science of Sleep to Remember Graph)

•• YoosYoos. Current Biology, 17, 877. Current Biology, 17, 877--878. (Emotional Control)878. (Emotional Control)

•• J Physiol. J Physiol. AnthropolAnthropol. 2012; 31(1):5 (Process S & C. 2012; 31(1):5 (Process S & C

•• CurrCurr. Biol. Dec 29;14(24):R1038. Biol. Dec 29;14(24):R1038--9 / 9 / HagenauerHagenauer et al., et al., DevelDevel

NeurosciNeurosci, 2009 (Delay in Melatonin), 2009 (Delay in Melatonin)

Walker. NYAS 2005 / Walker. NYAS 2005 / Trends in Neurosciences, Vol.28 No. 8 Trends in Neurosciences, Vol.28 No. 8

August, 2005 August, 2005 (Science of Sleep to Remember Graph)(Science of Sleep to Remember Graph)

•• YoosYoos. Current Biology, 17, 877. Current Biology, 17, 877--878. (Emotional Control)878. (Emotional Control)

•• J Physiol. J Physiol. AnthropolAnthropol. 2012; 31(1):5 (Process S & C. 2012; 31(1):5 (Process S & C

•• CurrCurr. Biol. Dec 29;14(24):R1038. Biol. Dec 29;14(24):R1038--9 / 9 / HagenauerHagenauer et al., et al., DevelDevel

NeurosciNeurosci, 2009 (Delay in Melatonin), 2009 (Delay in Melatonin)

ReferencesReferences•• Sleep Medicine 12 (2011) 110Sleep Medicine 12 (2011) 110––118 / Sleep Medicine 8 (2007) 118 / Sleep Medicine 8 (2007)

602602––612 (Observed Worldwide)612 (Observed Worldwide)

•• Sleep in America Poll, 2014 (Lack of Rules)Sleep in America Poll, 2014 (Lack of Rules)

•• Sleep Regulation / Weekend MakeSleep Regulation / Weekend Make--up Sleep (Judy Owens)up Sleep (Judy Owens)

•• NASSP Bull. 2002;286(633):3NASSP Bull. 2002;286(633):3––21 (Delayed School Start)21 (Delayed School Start)

•• Sleep Medicine 12 (2011) 110Sleep Medicine 12 (2011) 110––118 / Sleep Medicine 8 (2007) 118 / Sleep Medicine 8 (2007)

602602––612 (Observed Worldwide)612 (Observed Worldwide)

•• Sleep in America Poll, 2014 (Lack of Rules)Sleep in America Poll, 2014 (Lack of Rules)

•• Sleep Regulation / Weekend MakeSleep Regulation / Weekend Make--up Sleep (Judy Owens)up Sleep (Judy Owens)

•• NASSP Bull. 2002;286(633):3NASSP Bull. 2002;286(633):3––21 (Delayed School Start)21 (Delayed School Start)

•• Graphed from Graphed from Wahlstrom’sWahlstrom’s Data: NASSP Bull. Data: NASSP Bull.

2002;286(633):32002;286(633):3––21 (Sleep Time in Teens)21 (Sleep Time in Teens)

•• NASSP Bull. 2002;286(633):3NASSP Bull. 2002;286(633):3––21 (Teen Mood Improvements)21 (Teen Mood Improvements)

•• NASSP Bull. 2002;286(633):3NASSP Bull. 2002;286(633):3––21 (Academic Improvements)21 (Academic Improvements)

•• J J ClinClin Sleep Med. 2008;4(6):533Sleep Med. 2008;4(6):533––535 / NASSP Bull. 535 / NASSP Bull.

2002;286(633):32002;286(633):3––21 (Motor Vehicle Crashes)21 (Motor Vehicle Crashes)

•• Graphed from Graphed from Wahlstrom’sWahlstrom’s Data: NASSP Bull. Data: NASSP Bull.

2002;286(633):32002;286(633):3––21 (Sleep Time in Teens)21 (Sleep Time in Teens)

•• NASSP Bull. 2002;286(633):3NASSP Bull. 2002;286(633):3––21 (Teen Mood Improvements)21 (Teen Mood Improvements)

•• NASSP Bull. 2002;286(633):3NASSP Bull. 2002;286(633):3––21 (Academic Improvements)21 (Academic Improvements)

•• J J ClinClin Sleep Med. 2008;4(6):533Sleep Med. 2008;4(6):533––535 / NASSP Bull. 535 / NASSP Bull.

2002;286(633):32002;286(633):3––21 (Motor Vehicle Crashes)21 (Motor Vehicle Crashes)

5-5-15 Burning More Than the Midnight Oil - Sleep ... · 5/1/2015 6 Sleep Deprivation Academics •...

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