Who Needs Sleep?

The importance of Sleep and Communicating it to College

Students

Henry L. Johns, BS, RPSGT, CRT, CPFT Kansas Association of Sleep Professionals

Conflict of Interest DisclosuresSpeaker:

1. I do not have any potential conflicts of interest to disclose, OR

2. I wish to disclose the following potential conflicts of interest:

Type of Potential Conflict Details of Potential Conflict

Grant/Research Support none

Consultant none

Speakers’ Bureaus none

Financial support none

Other

3. The material presented in this lecture has no relationship with any of these potential conflicts, OR

4. This talk presents material that is related to one or more of these potential conflicts, and the following objective references are provided as support for this lecture:

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Participants will:

1.Identify challenges in cross generational communications2. Gain insight on the Physiological Mechanisms of normal sleep3. increase understanding of social, technological and intuitional distractions that limit sleep4. Review sleep disorders most likely to affect college students5. Assess strategies to improve overall sleep health

“I’ll Sleep When I’m Dead”Warren Zevon 1947-2003

• Sleep has always been poorly understood– Why do we sleep– How much sleep does a person need

• Societal norms and stresses dictate sleep– Peer pressure– Time sensitive tasks– Watching the clock

What is sleep

• Sleep is a physical and mental resting state in which a person becomes relatively inactive and unaware of the environment. In essence, sleep is a partial detachment from the world, where most external stimuli are blocked from the senses.

Why do we sleep?

• This is a question that has baffled scientists for centuries

• We have to sleep because it is essential to maintaining normal levels of cognitive skills such as speech, memory, innovative and flexible thinking.

• In other words, sleep plays a significant role in brain development.

Sleep needs vary over the life cycle.

Newborns/Infants0 - 2 months:2 - 12 months:

10.5-18 hours14-15 hours

Toddlers/Children

12 mo - 18 mo:18 mo - 3 years:3 - 5 years:5 - 12 years:

13-15 hours12-14 hours11-13 hours10-11 hours

Adolescents On Average: 9.25 hours

Adults/Older Persons

On Average: 7-9 hours

Sleep in History• Greek god of sleep, Hypnos,

was a prominent figure in early literature

• Dionysius of Heracleia, 338 BC, was notorious for his appetite, suffered from apnea or narcolepsy, prompting his doctors to prick his flesh with needles whenever he fell asleep.

Sleep in Mythology• German mythology. Ondine

was very beautiful and immortal.

• fell in love - Sir Lawrence - and were married.

• "My every waking breath shall be my pledge of love and faithfulness to you."

• Caught cheating• "You swore faithfulness to

me with every waking breath, and I accepted your oath. As long as you are awake, you shall have your breath, but should you ever fall asleep……..

Sleep in Literature

• Sleeping Beauty by Charles Perrault, 1696

• Sleep could be seen as refreshing

• Sleep could also be freighting

• Sleep was unavoidable

Normal Sleep Distribution In A Typical Night

Circadian Biological Clock• The internal

mechanism that regulates when we feel sleepy and when we feel alert

• Resides in the

brain and is affected by light and dark

Retino-hypothalamic tract

Suprachiasmatic nuclei

Hypothalamus

Delayed Sleep Phase Syndrome

• Seen in all ages• Difficulty falling asleep at

expected bedtime• Late (but consistent)

sleep onset time• Difficult to awaken at

desired time• Normal sleep on delayed

schedule

Treatment includes

1. Phase Advance2. Sleep Deprivation with

Phase Advance3. Chronotherapy4. Melatonin5. Phototherapy

Delayed Sleep Phase

In order to get to school on time, many teens & young adults must wake before 6:30 am and shorten their sleep time.

Awareness of a Problem

“In college, you can only do two of three things: have a social life, do well academically and sleep,” said Neil Bhattacharya, a freshman majoring in biology and health policy and management.

Miruna Barnoschi · Daily Trojan Posted April 13, 2010

Aaron Rover | Daily Trojan2010

Circadian Rhythm Disorders

• Delayed Sleep Phase Syndrome• Irregular Sleep-Wake Cycle• Advanced Sleep Phase Syndrome• Jet Lag• Shift work Syndrome

Chronically Sleep Deprived

• need 8 ½ –9 ½ hours of sleep

• 85% get less than the minimum requirement

• often have poor sleep habits and irregular sleep patterns – trying to make up for sleep on weekends

• regularly experience daytime sleepiness

Consequences of Sleep Deprivation

• Cognitive, social and behavioral performance become impaired.

• Poor school/work performance and lower grades

• Tardiness and absence from school/work• Difficulty remaining alert and paying attention• Reduced ability to concentrate, problem-

solve, remember and have a positive attitude

Sleep Deprivation (cont.)

• Irritability and impaired moods • Problems controlling emotions and getting

along with others• Greater risk for hyperactivity, depression and

possibly violence and substance abuse• At risk for injuries and drowsy driving

accidents• Overall, daytime sleepiness reduces enjoyment

and quality of life.

How important is Sleep?

Across Generations• Millennials (or Gen Y or

Z): born 1981–2000, • Generation X-ers: born

1965–1980• Boomers: born 1946–

1964• Traditionalists: born

1922–1945

Identity

• How do you Identify yourself?

• What is your generation?

• Where do you see yourself ?

What is a Millennial?• highly educated, self-confident,

technologically savvy and ambitious• use social media and text on their cell phones• have been plugged into technology since they

were babies• are a safe generation• have the most educated mothers of any prior

generation• true multi-taskers

7 Traits, by Strauss and Howe

• Special• Sheltered• Confident• Team Oriented• Achieving• Pressured• Conventional

Special

• Embraced by their parents • Entitled• Indulged• Narcissistic• Easily distracted, multi taskers• Identity does not come from being whatever;

rather being a whatever, is a job

Sheltered

• Buckled up• Helmets on• Padded playgrounds• Reminded of deadlines by Parents• May expect extra help or resources• Expect Authority figures to treat everyone

fairly

Confident

• Content• Optimistic• Self assured

Team Oriented

• Used to working in teams

• Task groups

Achieving• Long range plan• Millennials

motivated by achievement and affiliation

• versus Generation X motivated by Power

Pressured• To excel• To Study hard• Avoid personal risks• College stress

epidemic

Conventional

• Strong attachments to family

• Family Unity is important

• Are likely to adopt their parents beliefs and attitudes

At Risk

• 1997 NIH identified adolescents and young adults (ages 12 to 25 years) as a high risk group for problem sleepiness

• NTSB reports, drowsiness or fatigue cause 100,000 traffic crashes each year

• Drivers age 25 or under are involved in more than half of fall-asleep crashes

The Kansas Department of Transportation reports that in 2007 over 800 accidents on

Kansas roads, involved sleepy drivers.

Over 80 known sleep disorders (International Classification of Sleep Disorders, 2nd Edition

American Academy of Sleep Medicine, 2005)

• Insomnias (33%)• Sleep related breathing disorders (1.4-40%)• Hypersomnias (0.3-16%)• Circadian rhythm sleep disorders• Parasomnia • Sleep related movement disorders• Isolated symptoms, normal variants• Other sleep disorders

Did you know?

Insomnia affects nearly twice as many women

than men

Insomnia

• Insomnia is more frequent in women across all age groups

• Insomnia is more common in the unmarried, divorced or separated; and elderly; and those under stress

• Often occurs during the menstrual cycle, pregnancy, post-partum, menopause and post menopausal phases

Narcolepsy…

• Typically begins in the teens and early twenties, but can occur as early as age 5 or after age 40

• The symptoms may worsen over the first few years and then persist for life

• Half of all patients report that symptoms interfere with job, marriage, or social life

Associated Features…

• Hypnagogic hallucinations

• Sleep paralysis

• Cataplexy

Selling the Message

• Don't dumb down your message

• flexible content• giving them meaningful

content that they want to share

• established early that content has value

Sleep Hygiene Tips

1. Establish a Regular Routine2. Get an Adequate Amount of Sleep Every

Night3. Go to Bed When You Are Sleepy4. Develop Sleep Rituals Before Going to Bed5. Avoid Stress and Worries at Bedtime6. Use Your Bed for Sleeping and Sex Only

Sleep Hygiene Tips, cont.

7. Avoid Heavy Meals Late in the Evening8. Reduce Your Intake of Caffeine and Nicotine9. Avoid Alcohol 4-6 Hours Before Bedtime10.Exercise regularly11.Don't nap for more than 30 minutes or after

3 p.m12.Keep it Dark and Cool13.Use Sleeping Aids Conservatively

Summing Up

• Clear rules, Expectations & Consequences

• Deadlines & Pace• What is flexible?• Role model

Thank you

• Howe, Neil; Strauss, William; (2000) Millennials Rising: The Next Great Generation

• Lee-Chiong , T. (2013)Fundamentals of Sleep Technology, second edition, Lippincott

• Keriger, M; Dement, W. (2012) Principles and Practice of Sleep Medicine, Elsevier Saunders

• Lowry,Megan; Dean, Kayla; Manders, Keith (2010) The Link Between Sleep Quantity and Academic Performance for the College Student, Department of Psychology, University of Minnesota, Minneapolis, Minnesota, www.psych.umn.edu/sentience/files/Lowry_2010.pdf

• Harrison, Whitney L. (2010) The Effects of Sleep Deprivation on the Body.. Southern Utah University. Abstract english2010information.pbworks.com

• http://www.leadershipmanagement.com.au/leadership-and-management-articles/seven-tips-to-effective-cross-generational-communication/

• Chiang, Yu-Chih, "The effects of sleep on performance of undergraduate students working in the hospitality industry as compared to those who are not working in the industry" (2013). Graduate Theses and Dissertations. Paper 13060.