Question of the Week

March 5, 2007


For years, many of us in the United States have dutifully changed our clocks one hour ahead and lost an hour of sleep on the first Sunday in April. This year, 2007, we will be making the change to Daylight Saving Time (DST) on the second Sunday of March (the 11th).

Not everyone will lose this hour of sleep. For those in some states, DST is not observed. For those of us who know that it is coming, there are ways to prepare.

"* To prepare for the return to Daylight Saving Time, try to sleep more than usual a few nights prior to and immediately following the time change. You can also take a nap in the afternoon on Sunday if you need it, but not within a few hours of your regular bedtime. Napping too close to bedtime can disrupt nighttime sleep. * Gradually advance your sleep schedule by going to sleep and waking up 15 to 20 minutes earlier each day for 3 to 4 consecutive days prior to the start of Daylight Savings Time.
* Create a sleep-conducive environment that is dark, quiet, comfortable and cool.
* Establish a regular bedtime and wake time schedule
* Try a relaxing routine, like soaking in hot water (a hot tub or bath) before bedtime.
* Exercise regularly. It is best to complete your workout at least a few hours before bedtime.
* Avoid caffeine, nicotine and alcohol close to bedtime, as they can disrupt sleep."
National Sleep Foundation

Several of the above suggestions will help refresh those who are suffering from lack of sleep throughout the year. The time change brings sleep loss and sleep deprivation to our attention, but for many they are unfortunately a way of life.

"The National Sleep Foundation (NSF) is the organizer and sponsor of National Sleep Awareness Week � (NSAW), an annual public education, information and awareness campaign.� Now in its tenth year, this nationwide effort is the cornerstone for multiple initiatives designed to make sleep consciousness a part of every person's lifestyle.� This year's theme is 'Sleep: As Important as Diet and Exercise (Only Easier!).' Each year, the timing of the campaign coincides with the return to Daylight Saving Time, when clocks 'spring forward' at 2:00 a.m. on the second Sunday in March -- a time when most Americans choose to lose an hour of sleep!� The 2007 campaign runs from March 5th -- 11th, 2007." National Sleep Foundation

"Sleep: As Important as Diet and Exercise (Only Easier!)" Not only does sleep (or lack there of) affect our overall health, just as diet and exercise do, but the amount of sleep that we get can also affect how we view and process the food that is in our diets.

"Researchers at the University of Chicago have found that partial sleep deprivation alters the circulating levels of the hormones that regulate hunger, causing an increase in appetite and a preference for calorie-dense, high-carbohydrate foods. The study, published in the 7 Dec. 2004 issue of the Annals of Internal Medicine, provides a mechanism linking sleep loss to the epidemic of obesity. Research subjects who slept only four hours a night for two nights had an 18 percent decrease in leptin, a hormone that tells the brain there is no need for more food, and a 28 percent increase in ghrelin, a hormone that triggers hunger. The study volunteers, all healthy young men, reported a 24 percent increase in appetite, with a surge in desire for sweets, such as candy and cookies, salty foods such as chips and nuts, and starchy foods such as bread and pasta. ... 'It provides biochemical evidence connecting the trend toward chronic sleep curtailment to obesity and its consequences, including metabolic syndrome and diabetes.'"

Just as sleep and diet are interconnected, so are sleep and exercise.

"For some time now, it has been common knowledge that exercise is good for one's physical health. It has only been in recent years, however, that it has become commonplace to read in magazines and health newsletters that exercise can also be of value in promoting sound mental health. ... Another area associated with positive mental health is the relationship between exercise and restful sleep. ... [F]indings support the compensatory position in that trained subjects and those engaging in an acute bout of exercise went to sleep more quickly, slept longer, and had a more restful sleep than untrained subjects or subjects who did not exercise. There were moderating variables influencing these results. Exercise had the biggest impact on sleep when: (a) the individuals were female, low fit, or older; (b) the exercise was longer in duration; and (c) the exercise was completed earlier in the day (Kubitz et al., 1996)."

While exercising during the day can be benefit some in their attempts to get a better night's sleep and be more well rested overall, it is not always the answer.

"Being tired is not the same as being fatigued or exhausted, and the difference matters, according to a researcher from Canada who has spent years investigating fatigue in various populations. ... People who are tired, Olson explained, still have a fair bit of energy but are apt to feel forgetful and impatient and experience muscle weakness following work, which is often alleviated by rest. People who are fatigued, on the other hand, experience difficulty concentrating, anxiety, a gradual decrease in stamina, difficulty sleeping, and increased sensitivity to light. They also may skip social engagements once viewed as important to them. People who suffer from exhaustion, Olson has observed, report frank confusion that resembles delirium, emotional numbness, sudden loss of energy, difficulty in staying awake as well as in sleeping and complete social withdrawal. Failure to recognize the difference between tiredness, fatigue and exhaustion could lead to inappropriate approaches to combat the problem, which could make matters worse. For example, Olson has some evidence that while exercise may relieve tiredness, it may decrease the ability to adapt in people who are suffering from fatigue or exhaustion."

Most teens feel tired at some point. Knowing that these feelings may be more than "tired" -- and may be caused by more than a basic lack of sleep -- can help when determining how to solve the problem in the most effective manner.

That said, for many, the problem is simply lack of sleep.

"Most teens need about 8 1/2 to more than 9 hours of sleep each night. The right amount of sleep is essential for anyone who wants to do well on a test or play sports without tripping over their feet. Unfortunately, though, many teens don't get enough sleep. ... [S]tudies show that during the teen years, the body's circadian rhythm (sort of like an internal biological clock) is reset, telling a person to fall asleep later and wake up later. Unlike kids and adults, whose bodies tell them to go to sleep and wake up earlier, most teens' bodies tell them go to sleep late at night and sleep into the late morning. This change in the circadian rhythm seems to be due to the fact that the brain hormone melatonin is produced later at night for teens than it is for kids and adults. This can make it harder for teens to fall asleep early. These changes in the body's circadian rhythm coincide with a time when we're busier than ever."

While determining the cause may be simple (lack of sleep as a result of time constraints, early school days, and busy schedules), determining the solution may be more difficult. In the mean time, sleep deprivation is not something to be taken lightly.

"In adolescents, who are biologically driven to sleep longer and later than adults do, the effects of insufficient sleep are likely to be even more dramatic--so much so that some sleep experts contend that the nation's early high-school start times, increasingly common, are tantamount to abuse. ... There can be little question that sleep deprivation has negative effects on adolescents. According to the National Highway Traffic Safety Administration, for example, drowsiness and fatigue cause more than 100,000 traffic accidents each year--and young drivers are at the wheel in more than half of these crashes. Insufficient sleep has also been shown to cause difficulties in school, including disciplinary problems, sleepiness in class and poor concentration."

For teachers, there are teacher's guides available to help you talk with your students about the topic of sleep. The following are created by "The Nemours Foundation/KidsHealth. Reproduction permitted for individual classroom use.":

For teachers working with students grades 9 - 12: "How did your students sleep last night? It's more important than you might think. Sleep affects not only how much energy we have but also our abilities to learn, be creative, and play sports. The following discussion questions and activities will help your students understand sleep and get their ZZZs."

For teachers working with students grades 6 - 8: "Sleep gives the body a rest, but your students may not be getting enough to reap the benefits! The following discussion questions and activities will help your students learn the value of a good night's sleep and explore ways to remedy some common sleep problems."

Questions of the Week:
How often do you wake well rested -- having had enough sleep the night before? How often do you go through your day tired and sleep deprived? How does having enough sleep affect how you function the next day? How does not having enough sleep affect your day? If you are always tired, how can you know what aspects of your day would be different if you had more sleep? What lifestyle and/ or time management changes could you make to help you get a better night's sleep on a more regular basis? How can you determine if you are suffering from fatigue or exhaustion, and how might you handle things differently if that is the case?

Please email me with any ideas or suggestions. Due to increasing amounts of SPAM sent to this account, please include "QOW" in the subject line when sending me email.

I look forward to reading what you have to say.

Health Community Coordinator
Access Excellence @ the National Health Museum

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