FRIDAY FLYER-Issue 183

What is the greatest neglect of humanity?

And what do these birds have to do with it?

In my humble opinion, the greatest neglect to humanity is sleep deprivation. I cast my mind back to being a child and my teenage years. I don’t recall having any concerns about sleep, then again I don’t recall having concerts for much of anything! Maybe this is something only old or aging people concern themselves with but regardless of one's age, it’s an essential part of life.

Sleep over the course of humanity has evolved with a mixture of philosophy and scientific research. It is possible that sleep is highly derived from other primates. It makes logical sense that tribal hunters would have slept in shifts and this might go some way to help unpack the complex evolution of sleep.

In a modern world, it could be difficult to relate to the past, especially with the evolution of technology and the ease that exists with food, energy and home comforts. With the benefits of technology, come new, evolutionary pressures, pressures that break the rhythm and routine we require for healthy productive sleep. The evolution of technology and human ingenuity is truly remarkable but it is staggering to learn that humans are the only species to deprive themselves of sleep and never for personal gain. This doesn’t make us sound very clever now, does it!

Origins and evolution of sleep

While Aristotle and many other Greek philosophers are noted for referencing sleep and dreams, some believed we slept because our blood needed to be warm. Of course, we know this not to be anatomically true, as for best sleep our bodies need to drop as much as 2 degrees Celsius in core temperature. To encourage this process an ideal room temperature for sleep should be 16 to 19 degrees Celsius (60 to 67 degrees Fahrenheit). As the myth of sleep continued throughout the ages, historian Robert Ekrich extensively studied sleep and in his book, ‘at day’s close: night in times past’, he purported many examples of biphasic sleep, sleeping in two segments. This was often referred to as a first and second sleep. It is reported that throughout the 14^th and 15^th century the gap between sleep, the waking as it became known, was a period used for reading, praying, studying or even attending to livestock, depending on your social status. 

Throughout the 17^th century segmented sleep began to diminish. Paris became the first city in the world to introduce artificially light to streets, with Amsterdam and London following. The evening became more accessible and perhaps even a more fashionable time to socialise. The concept of ‘a working day’ also discouraged a biphasic sleep mode. With the growth of the industrial revolution and Edison’s light bulb, sleep became inconvenient. After all, you could not make money, socialize or simply get things done! In a review of sleep deprivation of adolescents and young people, it was considered that several factors could be at play (NAHIC, 2014). This included, hormonal development not being in sync with school times, frenetic after school schedules, leisure activities, light exposure, an increase in lifestyle activities, as well as social and cultural trends. It might also have something to do with teenagers moving from a more dependent child to being a more independent adult, with this comes pressure.

“Sleep is the intermediate state between wakefulness and death, wakefulness being regarded as the active state of all animals and intellectual functions and death as that of their total suspension" Macnish, (2012). Robert Macnish was an early 19^th century Scottish surgeon, physician, philosopher and writer. His early writings suggested that sleep was a negative to a person’s time. Electricity, artificial light and the punishing industrial revolution working hours, depriving a generation of sleep. At the time an attitude of, sleep is for wimps was becoming evident and this is most certainly evident throughout the youth of many today.  Fortunately advances in Science have allowed us to measure this cost and the 20^th century was certainly a breakthrough era. With Science and technology working side by side, Hans Berger in the 1920’s discovered electrical activity (electroencephalograms, EEG) in the human brain. Berger showed a distinction between brain waves at rest, versus those carrying out an intellectual task. There continued to be a wealth of discoveries from many notable scientists, citing key features, such as, REM, sleep and dreams to melatonin synthesis and the naming of sleep stages.

But what does this mean for me as a student, I’m young and invincible!

For many years I have attended and presented in school assemblies. It never ceases to amaze me how many students I witness nodding off. In general, students appear to be regularly tired and sleepy. Adolescent research on sleep - wake cycles, reports 60% of adolescents are sleepy mainly from 8am to 10am and again from 2pm to 4pm. While such findings could be more associated with older adolescents, perhaps this can be linked back to more dramatic hormonal and social changes? Or is it simply the case that some students are preoccupied with electronics and do not maintain a consistent sleep schedule? Nonetheless, such tiredness and potentially irregular patterns raise a number of questions.

What are people’s perceptions of sleep and are they different at certain periods in life?

Are children of school age aware of the importance of sleep but worry little as life has only just begun?

Many scientists have suggested children are very aware of how important sleep is. They are aware it deteriorates your mental state and when you do not get enough sleep you get groggy. So, this begs the question, why are there so many reports of adolescents being sleep deprived? In 2010 the Journal of Adolescent Health, reported that a mere 8% of high school students got enough sleep. The results should not have come as a surprise given the reports from the 2006 National Sleep Foundation, examined adolescents and young adults. In this 60% reported poor quality sleep. Academic stress was associated with disturbed sleep.

The Child Mind Institute USA, considers biology, screen time and unreasonable expectations to be key factors associated with sleep deprivation. It could also be suggested exams, jobs and technology keeps teens up at night. Most students report the need to study as a justified reason for sleep deprivation but is studying late in the early hours of the morning productive? Are there too many distractions? Would the same students study if smart phones, laptops and/or computers were not available? Time is constant and 3 hours in daylight is still 3 hours in darkness. When preparing for an exam, it’s obvious that poor or insufficient sleep, if even due to study, is not the best way to prepare for an early morning exam.

That said, we would do well to remember that school schedules have changed little since the industrial revolution. Children of all ages are taught at the same times of day, regardless of their age or chronotype. Perhaps what we provide in terms of educational timing is antiquated for the more curious, social, hormonal and increasingly nocturnal teenage mind. Do schools place students at a disadvantage because biological rhythms are out of sync with lesson times?

Interestingly not all demographics share such stresses and sleep deprivation. Those living in rural areas can be amongst the exceptions. A study conducted in rural Brazil was undertaken on thousands of teenagers. The study highlighted positive results for effective sleep, with many students sleeping for more than 9 hours on school nights. The obvious analysis of this suggests rural areas are less affected by artificial light and are certainly less technologically connected. 

Cognitive function

With looming exams on the horizon, what about students' academic performance? What part can sleep play? When hoping to convince students that sleep is important it makes sense to highlight the associated dangers but also the most pertinent benefits. Issues relating to all-cause mortality but benefits such as positive mood and better cognitive functioning, thus better school performance should go some way towards evoking sensible responses.

A large South Korean study of 206,719 adults found that there was a negative relationship between sleep quality & duration and cognitive function. The findings were classified as subjective but the study also found that the presence of poor sleep correlated with depressive symptoms, stress and health-related behaviours, such as smoking and drinking. The same poor behaviours and habits, such as smoking and drinking alcohol were also evident in a study conducted. Students reported an increase in stress levels, lower grade attainment and difficulty in socializing with others.

In contrast to a good night's sleep, studies have shown that despite serious health and academic implications, many justify staying awake at night to accomplish their goals. A further 120,000 males and females were surveyed, also in Asia and results showed that those who had short sleeps or poor sleep tended to consume more fast foods, sugary drinks, instant noodles and confectioneries while reducing their fruit, vegetables and milk intake. Both poor sleep hygiene and the consumption of poor food choices can quickly become a habitual cause for concern. The fact remains that the effects of sleep are far reaching. Short term effects are often triggers for more devastating long-term consequences and for children and adolescents the loss of sleep can and does affect cognitive function, academic outcome and is aligned to stress, poor decision making and behavioral problems.  

So what are the recommendations, how much sleep should I get?

Before reading the recommendations, all based on science, ask yourself how many hours of sleep do you get?

A key feature of sleep hygiene is consistency, daily routines and healthy habits. However, what is sleep hygiene? Sleep hygiene can be viewed as a set of practices that helps promote good and effective sleeping. Inhibitors are features that can disrupt sleep. Two key inhibitors of sleep are caffeine/alcohol and artificial light/electronics.

1. Do you drink caffeinated drinks within 3 hours of bed (soda, tea, coffee, energy drinks)
2. Do you surf the net and/or use my phone one hour or less before going to bed?

All these can be inhibitors and while I can hear the masses screaming,  I sleep fine! You may sleep but you can not, without scientific input, measure the quality of sleep.

A common and fundamental inhibitor that did provide worrying, yet predictable results is that of electronic/screen time. The use of social media 30 minutes before bedtime is associated with disturbed sleep, this remains a fact! Playing video games could stimulate teenagers’ minds before going to sleep. Both of these causes an increased sleep latency and limits the quality of sleep teenagers obtain. Lack of sufficient and quality sleep was negatively associated with academic performance. As I suggested earlier, my experiences and observations have led me to conclude that students do not always use electronic devices effectively, especially later in the evening. There are simply too many distractions. Students will have excessive amounts of different social media platforms alerting regularly. It takes a strong will and desire to resist such temptations. The key must be to develop a set of rules, outlining your healthy habits. If you are wondering, do you sleep well and do you have healthy habits? Ask yourself these two questions;

Do you  feel alert and awake throughout the day while in lessons?

Do you ever nap during the day?

If you are not sold on the idea that sleep is important enough to introduce healthy habits, then consider the table below.

We need to understand the power of sleep and the devastating implications that lack of sleep can have. Failing Oxygen, it is arguably the most important aspect of our lives. Sleep is a topic we must pay attention to, it’s a basic human need and one that allows you to flourish.

Mr Dan Long, Head of Boarding