Burning the candle at both ends: Why we can’t overlook the importance of sleep

In September Apple released the latest upgrade to its iPhone and iPad software – IOS 12. As usual, they made a hullabaloo over its new features and updated apps aimed at changing your life. This time, they also emphasised their attempts at keeping the smartphone out of your life.

At part of their Bedtime app, used to help the user get their quota of sleep, they added the Do Not Disturb feature. Now, during the night, the phone will not beep with messages or notifications and will not light up.

All of the tech companies are responding to criticism of the impact that smartphones are having on their users, particularly their young users. One area is of particular concern, that smartphones are depriving teenagers and college students of sleep. And sleep, as the research is increasingly showing, is a vital part of human life.

Physical and mental health

Writing for RTE’s online Brainstorm website Dr Samantha Dockray from the School of Applied Psychology in UCC says that insufficient sleep and consequent daytime sleepiness contributes to a number of physical and mental health issues. She cites estimates that less than half of adolescents are getting a healthy quota of sleep.

This won’t surprise most people, especially parents and teachers, as there has been much commentary over the years as to the impact of first TV, then PCs and on to games consoles and now smartphones, which are now combinations of all the others.

But that vague feeling that overstimulation and lack of rest wasn’t good for young people is being replaced by science and research showing a wide spectrum of problems associated with chronic sleep deprivation which robs the young of the ability to concentrate, to learn, to relax and to recharge.

Dr Dockray says that the links between sleep, wellbeing and disease are still not clear but academic performance declines. “It increases the risk of emotional instability, anxiety, childhood depression and learning difficulties. In general, teens who don’t get enough sleep have poorer overall wellbeing.”

Established patterns

Once a poor pattern of sleep has been established it can be hard to reset. In a study published in the journal ‘Nature and Science of Sleep’ a research study showed that 70 per cent of college students reported that they were getting less than the recommended eight hours sleep.

The study identified the lack of ‘Sleep Hygiene’ as a major factor. Sleep Hygiene is all the habits and practices associated with preparation for sleep and the time spent asleep. The major component of good sleep hygiene is having a consistent sleep pattern and the avoidance of caffeine and alcohol before sleep.

The box on the right shows the various pieces of advice that experts give to people experiencing sleep disorders, and now being proffered to a broader swathe of the population. Most of these points could have been given 50 years ago but one area of sleep hygiene in particular applies to more recent times.

A hard day’s night

The blue light emitted from smartphone screens, games monitors and PCs interrupts the production of melatonin, which is the hormone that controls the sleep-wake cycle of the circadian rhythm.

The circadian rhythm is the 24 hour cycle that humans, and all other living creatures, evolved with over millions of years. It is internal to us but it can be modified by external influences such as light and temperature. With the onset of the industrial revolution and latterly the coming of the electric light, humans have been messing with their circadian rhythms and now it looks as if evolution is catching up with us.

The science tells us that there are clear patterns of brain wave activity, hormone production, cell regeneration and other biological activities linked to the daily circadian cycle. The question is: what are the consequences of sleep patterns outside a normal circadian rhythm?

Dr Dockray at UCC writes that: “While people manage to get through the next day following a night of poor sleep, they have more anxiety, more anger, poorer impulse control and experience changes in how they interact with others. They are also somewhat less able to think rationally.”

“Insufficient and poor sleep in adolescence directly affects academic performance. The less sleep the teen has, the more likely they are to be stressed and the greater the number of health risks we can see in their bodies, including blood pressure, cholesterol and weight.”

Not just a bad mood

Grumpiness is a feature of people who get a bad night’s sleep. But the ongoing seriousness of the problem is now being given numbers. In the study in Nature and Science of Sleep there is a terse, stark statement: depression and sleep are interrelated. One of the most important features of depression is disturbed sleep. In college the study reported that 15 per cent of students suffer depression and 11 per cent have suicidal ideation.

The hours of sleep missed is called sleep debt. In a study of female college students a sleep debt of 2 hours per night or a bedtime after 2am was associated with greater depressive symptoms. There was also evidence produced to show that improving sleep patterns improved reported depression.

How to change the patterns

The research into the consequences of sleep deprivation goes on but the negative outcomes are in little doubt. Interest is now moving on to what to do about the problem.

The launch of the first initiative to tackle sleep problems in young people was held in March 2018. The Sleep Programme was published by an inter-agency group in Wicklow including Crosscare and the HSE. The booklet, described as a toolkit, was developed by a team of professionals who noted that sleep deprivation was a key factor affecting school attendance, school retention and concentration levels when attending school.

The Sleep Programme is a practical tool which aims to address poor sleep habits among young people. It is recommended for young people aged 12-14 as an education and prevention programme and provides teachers and youth workers with the tools to support young adults improve or maintain their sleep routine.

The programme sets out ways to prevent sleep becoming a problem. It addresses areas like stress, diet, physical activity, drug and alcohol use in young people and encourages changes to poor sleep hygiene. It provides practical information for young people, which they can then implement in their day-to-day lives.

The project was funded by the National Youth Council of Ireland (NYCI) and Ailish O’Neill, NYCI National Youth Health Programme Manager, said: “Sleep deprivation is a growing issue for so many young people. It’s high time it became part of the national conversation and this toolkit is a great first step towards framing that discussion in terms of positive sleeping habits.”

Young people feeling better

The sleep problem is part of broader issues of wellbeing for young people. There is a growing realisation that many of the problems are interconnected. There is evidence that some young people have been using alcohol or cannabis to help them sleep which only reinforces a cycle of overstimulation, stress, exhaustion and underachievement. Sleep is going to a key part of how well the education system can serve young people.

Tips to establish healthy sleep habits (for everyone)

>  Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
>  Set a bedtime that is early enough for you to get at least 7 hours of sleep.
>  Don’t go to bed unless you are sleepy.
>  If you don’t fall asleep after 20 minutes, get out of bed.
>  Establish a relaxing bedtime routine.
>  Use your bed only for sleep and sex.
>  Make your bedroom quiet and relaxing.
>  Keep the room at a comfortable, cool temperature.
>  Limit exposure to bright light in the evenings.
>  Turn off electronic devices at least 30 minutes before bedtime.
>  Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
>  Exercise regularly and maintain a healthy diet.
>  Avoid consuming caffeine in the late afternoon or evening.
>  Avoid consuming alcohol before bedtime.
>  Reduce your fluid intake before bedtime.
Source: American Academy of Sleep Medicine