Sleepless in Bethesda - the Sequel

I last wrote about the topic of sleep, or lack thereof, two and half years ago. Three classes have graduated since then, new research has expanded our understanding of the negative effects of sleep deprivation on adolescents, and a greater School-wide emphasis on wellness all serve to make it time to address the topic again. Lest we think this isn't an issue, let me quote from an American Academy of Pediatrics 2014 report: "chronic sleep loss and associated sleepiness and daytime impairments in adolescence . . . a serious threat to the academic success, health and safety of our nation's youth and an important public health issue."[i]

Let's begin by describing what's happening as far as sleep is concerned. Maria Konnikova in a July New Yorker article reports that in the last fifty years, we've gone from approximately eight and a half hours of sleep on work nights to under seven. Children have experienced similar declines, having lost about 100 minutes of sleep between the early twentieth and early twenty-first centuries. As adults, we should get eight hours a night.[ii] Adolescents need nine and a half hours. However, very few teenagers actually sleep that much – only about 20%, according to the National Sleep Foundation. Almost half get fewer than eight hours nightly on school nights.[iii]

In both adults and young people, lack of sleep creates a host of problems including mood disorders from simple irritability to anxiety and depression, obesity which in turn can lead to diabetes, impaired cognitive functioning, and more car accidents. Sleep deprivation has also been associated with substance abuse, low self-esteem, and may even be misdiagnosed as ADHD. Some of these findings are just common sense: if you don't get enough sleep, you're more likely to fall asleep behind the wheel and have an accident. If you've ever pulled an all-nighter, you know how hungry you get and how you crave fats and carbohydrates, cravings caused by a metabolic process that affects all sleep deprived individuals. One study found that for every lost hour of sleep, adolescents' likelihood of being obese increased 80%. Plus, the particular "metabolic perturbations" resulting from lack of sleep increased the likelihood of developing type 2 diabetes in young people.[iv]

Certainly, I notice that when I'm really tired, I'm more irritable, less patient, and have a much shorter temper. In general, with less sleep, we all have less impulse control. Lack of sleep can also cause more serious psychological issues, including depression and anxiety. Research shows that depression and anxiety cause lack of sleep and that lack of sleep can also promote these conditions in children and adolescents. In addition, "sleeping less than 8 hours at night seems to be associated with an almost threefold increased risk of suicide attempts."[v]

Perhaps you're saying, these sleep deprivation effects don't apply to my daughter (or me). You also probably don't believe that lack of sleep affects your cognitive functioning because, in fact, research shows that we are remarkably unaware of those affects. Whether we notice it or not, lack of sleep significantly affects our cognitive abilities. Adults sleeping for only six hours a night for twelve nights straight behave both mentally and physically as though they had not slept at all in twenty-four hours. Moreover, not sleeping for twenty-four hours produces the same impairment as a blood alcohol level of 0.1, or well in the range of legally drunk.[vi] Imagine the impact on adolescents who should be getting 90 minutes more sleep.

To demonstrate how sleep deprivation might play out in problem solving, two German scientists taught a group of people a fairly difficult math problem. However, there was another easier solution, a fact almost no one noticed initially. Eight hours later, the scientists retested their subjects. Half of them had been allowed to sleep during that time, the other half had to stay awake. Sixty percent of the group who slept figured out the simpler solution versus only 24%, or less than half, of the subjects who didn't sleep.[vii] In addition to making us sharper thinkers, a lot of processing happens while we sleep. In particular, research shows that sleep plays a significant role in embedding information in our memories. Problem solving and memory obviously represent two key components for academic success; sleep is essential for both.

Several weeks ago, a group of us had the opportunity to hear the results of a sleep study conducted by Roberta Longpré, the former Head of Student Services at Branksome Hall, a girls school in Toronto, at a conference entitled "Deepening Girls' Social and Emotional Intelligence" sponsored by the Center for Research on Girls at the Laurel School in Cleveland. Longpré surveyed Branksome Hall tenth through twelfth grade students during a mid-week advisory on how much sleep they had gotten the night before, how many hours they had spent on homework, and whether after 8 p.m. they had texted, emailed, or been on Facebook or YouTube (this was in 2010 so no Instragram or Snapchat yet). The previous night had been a typical night without any special events. They then tracked the information they collected against the students' next report cards.

First, they found, not surprisingly, that their students weren't sleeping close to the 9.5 recommended hours. The plurality, 43.64%, had slept 5-6 hours (the survey was multiple choice with 3-4, 5-6, 7-8, or 8+ hours as the choices for sleep) with another 38.49% sleeping 7-8 hours. All in all, 94.16% of their students suffered from sleep deprivation. The more interesting, and possibly surprising, discoveries came when they compared hours of sleep and hours of homework to grades. The data showed that the girls who slept 7-8 hours had the highest GPA's; the girls who slept the least had the lowest GPA's. Taking the whole sample, girls who did 3-4 hours of homework also had the highest GPA's (the multiple choices were: 1-2, 2-3, 3-4, or 4+ hours of homework). When they broke out the data by grade, some interesting trends appeared. In 11^th and 12^th grades, the girls who slept 7-8 hours and did 2-3 hours of homework had the highest GPA's; by contrast 10^th graders who got 8+ hours of sleep and did 3-4 hours of homework had the highest GPA's. Among all grades, the lowest GPA's belonged to 10^th graders doing more than four hours of homework and sleeping only 3-4 hours. This data suggests that sacrificing sleep for extra hours of homework yields no benefit; indeed, such habits negatively impact grades. It also may suggest that as students get older, the best students get more efficient at doing their homework. In terms of technology use, only a tiny percentage, .06%, did not use technology after 8:00 p.m. However, those students did have the highest GPA's and slept the most. There did seem to be some correlation between technology use and hours of sleep, but, unless one engaged in no technology use, technology did not seem to have an impact on academic performance.

Longpré observes "Our school found this to be the most important correlation in the study, suggesting that a balance of sleep, homework and recreational technology use could lead to higher levels of academic success."[viii] Longpré's study supports other research which has repeatedly found a direct correlation between more sleep and higher grades. This is counterintuitive to our girls. They think more time invested will lead to higher grades and the easiest way to find more time is to sleep less. I asked Longpré how their students who were working longer hours explained the extra time they seemed to be spending; she answered that the students were making the work look nice.

Interestingly, research indicates that girls tend to get less sleep than boys. While no one seems to understand the exact cause of this discrepancy, a variety of factors may contribute to it. Girls experience puberty earlier than boys and some sleep disruption may result from hormones. Depression afflicts girls more than boys and we've already seen the relationship between sleep and depression. Stress also impacts sleep, particularly falling asleep, and lack of sleep can also cause or exacerbate stress. Girls tend to report more stress than boys, especially stress related to social relationships, so stress could offer another factor.[ix]

This means we need to be all the more attuned to our daughters' sleep behavior. We need to educate them about just how important sleep is while disabusing them of the misguided notion that shortchanging sleep in favor of doing homework will benefit them. As Maria Konnicova observes, "We lose more by skimping on rest than we can ever gain back by adding a few hours to our days. We are less productive, less insightful, less happy, more likely to get sick."[x] In Holton's Upper School, we talk a lot about the importance of sleep with the girls. However, in an environment where girls sometimes wear their lack of sleep as a badge of honor, we still have work to do. That work will be more effective if we partner with parents to encourage good sleep hygiene.

Next week, we'll talk about sleep hygiene. In the meantime, if you feel your daughter is spending too much time on her homework talk to her about how you and she can raise that issue with her teachers during conferences next week. I can promise you that her teachers want to help her be efficient and get enough sleep.