A danger sign for parents and schools: Poor sleepers
Monday, May 14, 2018
If this describes your daughter, she’s probably a good sleeper.
"She is happy, inquisitive, and focused. She quickly and correctly detects social clues, shows a good sense of humor, masters the curriculum, works to do what’s right, and feels optimistic about most things. In fact, she’s always looking on the bright side of things, maybe a little too much."
But if this describes her, she’s probably a poor sleeper.
"She’s cranky, despondent, and moody. Often, she’s easily distracted, forgets to follow through, struggles with learning, looks bleary-eyed, walks around in a fog, and accidentally trips or bangs into things. To her, everything’s a catastrophe. A small pimple is an unmitigated crisis. It would be miraculous if she slept even six hours."
The Positive Influence of Quality Sleep
In his 2017 book, "Why We Sleep," Dr. Matthew Walker, professor of neuroscience and psychology at the University of California, Berkeley, clearly summarized much of the neuroscience of sleep, including the dramatically different effects of quality sleep and poor sleep. Among other consequences, he explained how quality may lessen emotional distress and strengthen cognition, learning and memory, and problem-solving.
Lessens Emotional Distress
Recent research has found that "REM sleep performed the elegant trick of divorcing the bitter emotional rind from the information-rich fruit [of emotionally upsetting experiences]. We can therefore learn and usefully recall salient life events without being crippled by the emotional baggage that those painful experiences originally carried ... You can accurately relive the memory, but you do not regurgitate the same visceral reaction."
"One longitudinal study tracked more than 5,000 Japanese schoolchildren and discovered that those individuals who were sleeping longer obtained better grades across the board. Controlled sleep laboratory studies in smaller samples show that children with longer total sleep times develop superior IQ, with brighter children having consistently slept forty to fifty minutes more than those who went on to develop a lower IQ. Examinations of identical twins further impress how powerful sleep is as a factor that can alter genetic determinism."
Strengthens Learning and Memory
"Within the brain, sleep enriches a diversity of functions, including our ability to learn, memorize, and make logical decisions and choices ... A tired, under-slept brain is little more than a leaky memory sieve, in no state to receive, absorb, or efficiently retain an education ... Sleep has proven itself time and again as a memory aid: both before learning, to prepare your brain for initially making new memories, and after learning, to cement those memories and prevent forgetting."
"In ways your waking brain would never attempt, the sleeping brain fuses together disparate sets of knowledge that foster impressive problem-solving abilities ... REM sleep and the act of dreaming have another distinct benefit: intelligent information processing that inspires creativity and promotes problem solving."
The Negative Influence of Poor Quality Sleep
The consequences of poor sleep aren’t neutral; they’re destructive. As Dr. Penelope A. Lewis of the University of Manchester’s Sleep and Memory Lab discussed in her 2013 book, "The Secret World of Sleep," sleep deprivation, such as regularly sleeping for six hours, has many downsides. Here’s a smattering.
"Many brain areas are down-regulated when we are sleep deprived, and this means our senses are dulled, we lose creativity and lateral thinking, and our moral compass and decision-making abilities are altered. Sleep deprivation also disrupts new learning and leads to general low mood."
"Sleep deprivation impairs learning ... The hippocampus, the part of the brain that is critical for learning new information, is markedly less active when you learn something after a night of sleep deprivation than when you learn the same information after a normal night of sleep."
"Tiredness can also lead us to see the world through a negative filter. We are more likely to perceive perfectly neutral facial expressions as negative, and we are less able to appreciate humor."
"Sleep deprivation leads to an increase in the stress hormone cortisol, a small drop in body temperature and immune response."
Adding to Dr. Lewis’ comments about impaired health, the National Institutes of Health (NIH) asserted that a "growing evidence shows that a chronic lack of sleep increases … [the] risk of obesity, diabetes, cardiovascular disease, and infections."
Likely, the conclusions of Drs. Walker and Lewis affect people to different degrees. After two nights of only six hours sleep, Wilson’s ability to learn new materials may decline by 10 percent, while Edwin’s declines by 20 percent and Larry’s by 30 percent.
After two straight nights of quality, restful sleep, the intensively upsetting emotions that Luz originally felt about her painful experiences may have lost most of their piercing power, while Sheila’s lost only a sliver, and Mary Ellen’s none. These differences don’t negate the importance of quality sleep. As Drs. Walker and Matthew’s work has shown, it’s important; it’s critical.
Though Drs. Walker and Lewis’ work doesn’t emphasize struggling learners and other special education learners (however, Dr. Walker makes important comments about ADHD), there’s no set of compelling reasons to think that our general knowledge of sleep doesn’t apply to them.
In contrast, many compelling reasons suggest we should affirmatively and systematically act to ensure that all children routinely experience a good night’s sleep, one that rejuvenates and energies them, that bodes well for improving their concentration, focus, learning, memory, mood, emotional well-being, and physical health. By failing to systematically do so, many children will suffer.
For well over three decades, I’ve analyzed countless reading, learning disability, and school psychology evaluations. Not one of these probed deeply for sleep problems or suggested follow-up sleep studies. Neither did my reports.
Why? Much of the valuable research on sleep has just started seeping into the world of education. Before this, the vast majority of reading specialists, school psychologists, learning consultants, and their professors never gained more than superficial, “passing” knowledge of children’s voluntary or involuntary sleep problems. It’s time to rectify the situation.
What You Can Do
In supportive ways, you can try to ensure that your child follows the well-established, highly effective tenets of sleep hygiene. The National Institute of Health (NIH), an outstanding federal agency grounded in research, offers a bevy of practical tips for improving the duration and quality of sleep. Here are three.
- Stick to a sleep schedule. [Have your child] go to bed and wake up at the same time each day.
- Have a good sleeping environment. Get rid of anything in your [child’s] bedroom that might distract [her] from sleep, such as noises, bright lights, an uncomfortable bed, or warm temperatures.
- Have the right sunlight exposure. Daylight is key to regulating daily sleep patterns. [Encourage your child] to get outside in natural sunlight for at least 30 minutes each day. If possible, have her wake up with the sun or use very bright lights in the morning.
If the NIH’s recommendations produce little improvement, consider having your child evaluated by a Sleep Specialist certified by the American Board of Sleep Medicine (ABSM). If the problem’s not medical, but behavioral, such as insistently using a tablet late into the night, you might institute a behavioral program aimed at improving your child’s sleep habits.
In this instance, you may need to work with a behavioral psychologist who’s highly skilled in improving sleep habits. ABSM certification is a strong indicator of knowledge.
You can politely ask your child’s teachers and support staff about his daily alertness and energy. Does he yawn often? Does he start drifting off to sleep? Does his attention wax and wane? Does he often rest his head on a desk or table? Does he frequently complain about sleep or say he’s “tired”? Does he get moody or restless at certain times of the day? Does his alertness and energy interfere with is learning? And so on.
You can politely and formally request that the school have a physician who specializes in sleep disorders evaluate your child. Because of the Individuals with Disabilities Education Act (IDEA), federal law may support such a request.
Specifically, IDEA’s evaluation regulations require schools to ensure that trained and knowledgeable professionals evaluate the student in all areas of suspected disability (see 20 USC § 1414(b)(3)(B)). Conceivably, “all areas” includes sleep if you have good reason and documentation to think your child’s problems are caused or amplified by sleep issues. To my knowledge, however, federal courts have not ruled on this matter.
What Schools Can Do
School evaluation team members can interview you and your child's teachers to roughly estimate the likelihood that your child has sleep problems that are blocking is progress.
Schools can educate all remedial and special education personnel about the importance of sleep, the problems that poor sleep creates, the benefits of quality sleep, and appropriate steps they should take if they suspect that poor sleep is undermining a student’s development.
Schools can conduct an annual series of parent workshops on Building Lifelong Sleep Habits. They can also create podcasts and webinars that match the needs of the local area.
Schools can contract for sleep studies by physicians who are Board-Certified Sleep Specialists. Similarly, they can contract with psychologists who specialize in helping children and youth overcome poor sleep habits.
Schools can schedule the day’s first class to start at 9 a.m., especially in high schools. (This can help to prevent problems caused by the mismatch between school schedules and the circadian clocks of children and youth. Though changing schedules sounds easy, it’s not.)
What Must be Kept in Mind
Education’s overarching goal is to prepare students for successful lives. Thus, it’s important to look well into the future, when today’s children are adults. Much of the knowledge and many of the habits they develop today will either undermine or strengthen their adult lives, academically, socially, emotionally, physically, vocationally, recreationally, and medically.
Will helping children substitute good sleep habits and practices for poor ones make a difference? In a word, "Yes." As Dr. William Kohler, medical director of the Florida Sleep Institute, noted:
"If we don't get adequate sleep, our mood is going to be more depressed, we're not going to be as sharp cognitively, our thinking is not going to be as alert. And with lack of sleep, there are long-term potential consequences and changes in our health: Our immune system is not going to function as well if we do not get adequate sleep, and we're going to have a tendency to put on weight. There are some fascinating studies that they've done with children where they follow children for a number of years, and ones with short sleep times were more likely to become obese than children who had adequate sleep."
"There are various sleep problems that have significant health morbidity associated with them, like sleep apnea ... stroke, high blood pressure, irritability, depression, elevated cholesterol and elevated blood sugar.”
My view: Let’s not wait. Let’s help kids now.
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