WESTCHESTER, Ill - Returning to the classroom after a three-month break signals that summer is drawing to a close. For children and teens, the end of summer also means an end to the long daylight hours that allows them to stay out later, as well as the long lazy mornings of "sleeping in". The American Academy of Sleep Medicine (AASM) advises children and teens that sleep habits adopted over the summer will need to be changed when school starts in order to ensure proper sleep.
Daniel G. Glaze, MD, of Texas Children's Hospital in Houston, a pediatric sleep expert and a member of the AASM board of directors, notes that, just as one wouldn't start a trip with a half-full tank of gas, children and teens need to obtain a proper amount of sleep during the night to complete the school day successfully.
"Many children, and especially teens, alter their sleep-wake schedules and maintain a later bedtime," says Dr. Glaze. "This works for the summer until the start of the school year. They then need to advance their bedtime to meet early school start times. It is difficult to advance your bedtime and, once a schedule has been established, it may take days or weeks to develop a new schedule. It can't be done overnight. Not unexpectedly, for the first weeks of school, many children and teens do not obtain a proper amount of sleep."
William Kohler, MD, of the Florida Sleep Institute in Spring Hill, and a pediatric sleep expert, says that children and teens need more sleep than adults, and their circadian rhythm is easily disrupted. Because an adequate quantity and quality of sleep is necessary for optimal learning, Dr. Kohler encourages parents to enforce appropriate bedtime hours and a healthy sleep environment to ensure at least nine to 10 hours of quality sleep, depending on the age of the student.
"A student's performance in the classroom is dictated by the amount of sleep he or she gets the night before," says Dr. Kohler. "A child or teen who regularly gets enough sleep will have improved academic performance, a positive attitude towards their education, and be able to better interact socially with their peers and teachers. Students can also remember better what they learned if they get a good night's sleep after learning the task."
Sleep deprivation, on the other hand, increases the incidence of academic failure, depression and behavioral problems, says Dr. Kohler, adding that studies have shown that inadequate and disruptive sleep can lead to problems with behavior and mood along with difficulty with cognition.
Ralph Downey III, PhD, chief of sleep medicine at the Sleep Disorders Center at Loma Linda University (LLU) Medical Center in California, an associate professor of medicine, pediatrics and neurology at LLU, an associate professor of psychology at the University of California at Riverside, and a pediatric sleep expert, notes that the body clock that signals the teen's brain to prep for sleep occurs later in the evening than when they were younger. Now, says Dr. Downey, they must prep for the school bell at the same time.
"This means that there is a big adjustment ahead for teens," says Downey. Now, they will be getting up at 6 or 7 a.m. for school, rather than 10 a.m. for breakfast. That is the same as if the body had to adjust from sleeping and waking in Los Angeles to sleeping and waking in New York. That is a three-day adjustment for the most itinerant traveler. To the teen and the family, it is a battleground where biology meets the harsh new reality of school bells. To adjust, follow a rule that seems to help many: 'When in Rome, do as the Romans do.' That means, start a week ahead preparing for school by modifying all of your behavior to the expected start school time and the new bedtime."
Dr. Downey suggests that if teens adjust their bedtimes by about an hour each day, it should be easier.
"It will help you see your old friends through a clear mind, rather than a sleepy fog," adds Dr. Downey.
Several studies that outline the adverse effects of poor sleep among children and teens with regards to their academic performance were presented at SLEEP 2007, the 21st Annual Meeting of the Associated Professional Sleep Societies, this past June:
- Students with symptoms of sleep disorders are more likely to receive poor grades in classes such as math, reading and writing than peers without symptoms of sleep disorders.
- The brain responses of those children who don't get enough sleep can accurately predict the impact sleep loss has on their ability to pay attention during the course of a day.
- Research examining the impact of sleep in school-age children suggests that even mild sleep loss produces marked deficits in their cognitive development and functioning. Sleep restriction can alter children's initial stages of speech perception, which could contribute to disruptions in cognitive and linguistic functioning - skills necessary for reading and language development and comprehension.
- Teenagers who stay up late on school nights and make up for it by sleeping late on weekends are more likely to perform poorly in the classroom. This is because, on weekends, they are waking up at a time that is later than their internal body clock expects. The fact that their clock must get used to a new routine may affect their ability to be awake early for school at the beginning of the week when they revert back to their old routine.
- Aggressive behavior and bullying, common among schoolchildren, are likely to have multiple causes, one of which may be an undiagnosed sleep-related breathing disorder.
- Over the past decade, children have been going to bed later and sleeping less. This can be attributed, in part, to a lack of awareness in the community concerning sleep need in children and how the amount of sleep a child should get each night is dependent on one's age. The Sleep-Side Rule is found to be an effective classroom tool that improves children's understanding of the relationship between age and sleep need.
The AASM offers the following tips for children and teens on how to get a good night's sleep:
- Follow a consistent bedtime routine.
- Establish a relaxing setting at bedtime.
- Get a full night's sleep every night.
- Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
- Do not stay up all hours of the night to "cram" for an exam, do homework, etc. If after-school activities are proving to be too time-consuming, consider cutting back on these activities.
- Do not go to bed hungry, but don't eat a big meal before bedtime either.
- Avoid any rigorous exercise within six hours of your bedtime.
- Make your bedroom quiet, dark and a little bit cool. Also, keep computers and TVs out of the bedroom.
- Get up at the same time every morning.
Parents who suspect that their child might be suffering from a sleep disorder are encouraged to consult with their child's pediatrician or a sleep specialist.
AASM is a professional membership organization dedicated to the advancement of sleep medicine and sleep-related research.