Tag Archives: Sleep

University of St. Thomas study: Sleep problems equal to marijuana use and drinking in predicting poor academic performance in college

4 Jun

Moi has posted quite a bit about the effect of sleep deprivation on children and teens. A study of older men published in the Journal Sleep details the effect of sleep deprivation on older men. The bottom line is that no matter one’s age, in order to fully function, people need adequate rest. See, Study: Poor sleep quality can lead to cognitive problems in older men https://drwilda.com/2014/04/02/study-poor-sleep-quality-can-lead-to-cognitive-problems-in-older-men/

Sarah Klein reported in the Huffington Post article, Sleep Problems Equal To Binge Drinking, Marijuana Use In Predicting Poor Academic Performance:

While the temptations to stay up late are many, a small new study suggests a very good reason for college students to hit the hay. Those who are poor sleepers are more likely to get worse grades and to withdraw from a course, according to a new study. In fact, the effects of poor sleep were about as strong as binge drinking and marijuana use on a student’s academic performance.
The researchers analyzed data from over 43,000 students included in the spring 2009 American College Health Association’s National College Health Assessment (NCHA). After controlling for potentially confounding factors that might predict how a college student fares academically, like clinical depression, feelings of isolation or chronic health problems, the researchers found that getting poor sleep was a strong predictor of problems at school.
While few students are likely to have a clinical sleep disorder, Roxanne Prichard, Ph.D., associate professor of psychology at the University of St. Thomas in St. Paul, Minnesota tells The Huffington Post, about 60 percent say they have some kind of problem sleeping. But for all the effort colleges put into anti-drinking and de-stressing campaigns, little time or money is spent to promote better sleep — and doing so could help both students and the colleges themselves, she says…. http://www.huffingtonpost.com/2014/06/03/sleep-drinking-marijuana_n_5433148.html?utm_hp_ref=education&ir=Education

Citation:

Poor sleep equal to binge drinking, marijuana use in predicting academic problems

Date: June 2, 2014
Source: American Academy of Sleep Medicine
Summary:
College students who are poor sleepers are much more likely to earn worse grades and withdraw from a course than healthy sleeping peers, new research shows. Results show that sleep timing and maintenance problems in college students are a strong predictor of academic problems. The study also found that sleep problems have about the same impact on grade point average (GPA) as binge drinking and marijuana use.
See, Poor sleep equal to binge drinking, marijuana use in predicting academic problems http://www.sciencedaily.com/releases/2014/06/140602102011.htm

Here is the press release from the American Academy of Sleep Medicine:

FOR IMMEDIATE RELEASE
American Academy of Sleep Medicine
Sunday, June 1, 2014

CONTACT: Lynn Celmer, 630-737-9700, ext. 9364, lcelmer@aasmnet.org

Poor sleep equal to binge drinking, marijuana use in predicting academic problems
DARIEN, IL – A new study shows that college students who are poor sleepers are much more likely to earn worse grades and withdraw from a course than healthy sleeping peers.
Results show that sleep timing and maintenance problems in college students are a strong predictor of academic problems even after controlling for other factors that contribute to academic success, such as clinical depression, feeling isolated, and diagnosis with a learning disability or chronic health issue. The study also found that sleep problems have about the same impact on grade point average (GPA) as binge drinking and marijuana use. Its negative impact on academic success is more pronounced for freshmen. Among first-year students, poor sleep— but not binge drinking, marijuana use or learning disabilities diagnosis—independently predicted dropping or withdrawing from a course. Results were adjusted for potentially confounding factors such as race, gender, work hours, chronic illness, and psychiatric problems such as anxiety.
“Well-rested students perform better academically and are healthier physically and psychologically,” said investigators Roxanne Prichard, PhD, associate professor of psychology and Monica Hartmann, professor of economics at the University of St. Thomas in St. Paul, Minnesota.
The research abstract was published recently in an online supplement of the journal Sleep and will be presented Tuesday, June 3, in Minneapolis, Minnesota, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies LLC.
Data from the Spring 2009 American College Health Association National College Health Assessment (NCHA) were analyzed to evaluate factors that predict undergraduate academic problems including dropping a course, earning a lower course grade and having a lower cumulative GPA. Responses from over 43,000 participants were included in the analysis.
According to Prichard, student health information about the importance of sleep is lacking on most university campuses.
“Sleep problems are not systematically addressed in the same way that substance abuse problems are,” she said. “For colleges and universities, addressing sleep problems early in a student’s academic career can have a major economic benefit through increased retention.”
For a copy of the abstract, “What Is The Cost Of Poor Sleep For College Students? Calculating The Contribution to Academic Failures Using A Large National Sample,” or to arrange an interview with Roxanne Prichard or an AASM spokesperson, please contact AASM Communications Coordinator Lynn Celmer at 630-737-9700, ext. 9364, or lcelmer@aasmnet.org.
Established in 1975, the American Academy of Sleep Medicine (AASM) improves sleep health and promotes high quality patient centered care through advocacy, education, strategic research, and practice standards. With about 9,000 members, the AASM is the largest professional membership society for physicians, scientists and other health care providers dedicated to sleep medicine. For more information, visit http://www.aasmnet.org.

According to the Centers for Disease Control (CDC), insufficient sleep is a public health epidemic.

In the article, Insufficient Sleep Is a Public Health Epidemic, the CDC reports:

How Much Sleep Do We Need? And How Much Sleep Are We Getting?
How much sleep we need varies between individuals but generally changes as we age. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need 9-105 hours, and adults need 7-8 hours. According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night.4
Sleep Hygiene Tips
The promotion of good sleep habits and regular sleep is known as sleep hygiene. The following sleep hygiene tips can be used to improve sleep.
• Go to bed at the same time each night and rise at the same time each morning.
• Avoid large meals before bedtime.
• Avoid caffeine and alcohol close to bedtime.
• Avoid nicotine.
(Sleep Hygiene Tips adapted from the National Sleep Foundation ) http://www.cdc.gov/features/dssleep/

More Americans of all ages need to begin getting a good night’s sleep.

Resources:

National Sleep Foundation’s Teens and Sleep
http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems
http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success
http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:

Another study: Sleep problems can lead to behavior problems in children https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

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Harvard Study: Television impairs kid’s sleep patterns

21 Apr

Moi wrote in Study: Blue light may affect the sleep habits of students:
The goal of this society should be to raise healthy and happy children who will grow into concerned and involved adults who care about their fellow citizens and environment. In order to accomplish this goal, all children must receive a good basic education and in order to achieve that goal, children must arrive at school, ready to learn. One of the mantras of this blog is there should not be a one size fits all approach to education and that there should be a variety of options to achieve the goal of a good basic education for all children.
The University of Illinois Extension has some good advice for helping children with study habits. In Study Habits and Homework he University of Illinois recommends:

Parents can certainly play a major role in providing the encouragement, environment, and materials necessary for successful studying to take place.
Some general things adults can do, include:
Establish a routine for meals, bedtime and study/homework
Provide books, supplies, and a special place for studying
Encourage the child to “ready” himself for studying (refocus attention and relax)
Offer to study with the child periodically (call out spelling words or do flash cards) http://urbanext.illinois.edu/succeed/habits.cfm

Some folks claim they need as few as four hours of sleep. For most folks, that is not healthy and it definitely isn’t healthy for children.

Sarah D. Sparks reported in the Education Week article, ‘Blue Light’ May Impair Students’ Sleep, Studies Say:

Schools may soon face an unintended consequence of more flexible technology and more energy-efficient buildings: sleepier students.
That’s because evidence is mounting that use of artificial light from energy-efficient lamps and computer and mobile-electronics screens later and later in the day can lead to significant sleep problems for adults and, particularly, children….
http://www.edweek.org/ew/articles/2013/12/11/14sleep_ep.h33.html?tkn=XYNFw7hK%2F8TdYrgvqxBY6H%2FjAT%2FMKwiy%2FAaU&cmp=clp-edweek

Technology may be interrupting children’s sleep patterns.
https://drwilda.com/tag/blue-light-may-impair-students-sleep-studies-say/

Tara Haelle reported in the Yahoo news post, More TV, Less Sleep for Kids:

A recent study found that children tended to get slightly less sleep with the more TV they watched. The most dramatic drop in daily sleep time, however, was linked to having a TV in the bedroom for minority children.
The authors suggested that reducing TV time and/or removing televisions from children’s bedrooms might help their sleep time.
The study, led by Elizabeth Cespedes, of the Obesity Prevention Program at Harvard Medical School, looked at the possible impact of television of children’s sleep.
The researchers collected daily average TV viewing information and sleep time from the parents of 1,864 children, starting at 6 months old and then once a year through age 7.
The researchers also gathered information on which children had a TV in their bedroom when they were aged 4 through 7.
Then the researchers analyzed the interaction of television viewing and sleep along with the children’s age, sex, race/ethnicity, income and mothers’ education level.
The group of children were diverse, including 35 percent who were racial/ethnic minorities and 37 percent who had family incomes of at least $70,000.
The children went from getting an average 12.2 hours of sleep each day at age 6 months old to an average of 9.8 hours a day at age 7.
During the same time span, the amount of TV the children watched increased from 0.9 hours a day to 1.6 hours a day.
About 17 percent of the children had a TV in their bedrooms when they were 4 years old, which increased to 23 percent by the time the children were 7 years old.
In comparing TV viewing time with sleep, the researchers found that each additional hour per day of watching TV was linked to seven fewer minutes of sleep each day.
Having a TV in children’s room also appeared to influence how much sleep the children got, but only for racial/ethnic minority children.
Among racial and ethnic minorities, children got an average 31 fewer minutes of sleep each day if they had a TV in their bedrooms than if they didn’t have a TV.
Among white, non-Hispanic children, however, a TV in the bedroom was only linked to eight fewer minutes of sleep each day, but this finding could have been the result of chance.
“Our study supports a negative influence of TV viewing and bedroom TV on children’s sleep,” the researchers wrote.
“TV viewing and the presence of a bedroom TV track over time,” they added. “Thus, modest decreases in sleep duration could form lasting habits leading to substantial sleep deficits as children age.”
The researchers suggested that making changes related to children’s TV viewing could have a positive impact on their sleep time.
http://health.yahoo.net/articles/parenting/more-tv-less-sleep-kids

Citation:

• Article
Television Viewing, Bedroom Television, and Sleep Duration From Infancy to Mid-Childhood
Authors
1. Elizabeth M. Cespedes, SMa,b,
2. Matthew W. Gillman, MD, SMa,b,
3. Ken Kleinman, ScDa,
4. Sheryl L. Rifas-Shiman, MPHa,
5. Susan Redline, MD, MPHc, and
6. Elsie M. Taveras, MD, MPHb,d
1. aObesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts;
2. bDepartment of Nutrition, Harvard School of Public Health, Boston, Massachusetts;
3. cBrigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts; and
4. dDivision of General Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children, Boston, Massachusetts
Abstract
BACKGROUND: Television and insufficient sleep are associated with poor mental and physical health. This study assessed associations of TV viewing and bedroom TV with sleep duration from infancy to midchildhood.
METHOD: We studied 1864 children in Project Viva. Parents reported children’s average daily TV viewing and sleep (at 6 months and annually from 1–7 years) and the presence of a bedroom TV (annually 4–7 years). We used mixed effects models to assess associations of TV exposures with contemporaneous sleep, adjusting for child age, gender, race/ethnicity, maternal education, and income.
RESULTS: Six hundred forty-three children (35%) were racial/ethnic minorities; 37% of households had incomes ≤ $70 000. From 6 months to 7 years, mean (SD) sleep duration decreased from 12.2 (2.0) hours to 9.8 (0.9) hours per day; TV viewing increased from 0.9 (1.2) hours to 1.6 (1.0) hours per day. At 4 years, 17% had a bedroom TV, rising to 23% at 7 years. Each 1 hour per day increase in lifetime TV viewing was associated with 7 minutes per day (95% confidence interval [CI]: 4 to 10) shorter sleep. The association of bedroom TV varied by race/ethnicity; bedroom TV was associated with 31 minutes per day shorter sleep (95% CI: 16 to 45) among racial/ethnic minority children, but not among white, non-Hispanic children (8 fewer minutes per day [95% CI: −19 to 2]).
CONCLUSIONS: More TV viewing, and, among racial/ethnic minority children, the presence of a bedroom TV, were associated with shorter sleep from infancy to midchildhood.
Key Words:
• television
• sleep duration
• sleep hygiene
• childhood
• Accepted February 11, 2014.
• Copyright © 2014 by the American Academy of Pediatrics
1. Published online April 14, 2014

(doi: 10.1542/peds.2013-3998)
1. » AbstractFree
2. Full Text (PDF)Free

Education is a partnership between the student, parent(s) or guardian(s), teachers(s), and school. The students must arrive at school ready to learn and that includes being rested. Parent(s) and guardian(s) must ensure their child is properly nourished and rested as well as providing a home environment which is conducive to learning. Teachers must have strong subject matter knowledge and strong pedagogic skills. Schools must enforce discipline and provide safe places to learn. For more information on preparing your child for high school, see the U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Resources:

National Sleep Foundation’s Teens and Sleep http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts
http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America
http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn
http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success
http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:
Another study: Sleep problems can lead to behavior problems in children
https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/

Tags: , , , , , , , , , , , , , , , , , , , , , , ,

Study: Poor sleep quality can lead to cognitive problems in older men

2 Apr

Moi has posted quite a bit about the effect of sleep deprivation on children and teens. A study of older men published in the Journal Sleep details the effect of sleep deprivation on older men. The bottom line is that no matter one’s age, in order to fully function, people need adequate rest.

Science Daily reported in the article, Poor sleep quality linked to cognitive decline in older men:

A new study of older men found a link between poor sleep quality and the development of cognitive decline over three to four years. Results show that higher levels of fragmented sleep and lower sleep efficiency were associated with a 40 to 50 percent increase in the odds of clinically significant decline in executive function, which was similar in magnitude to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.
“It was the quality of sleep that predicted future cognitive decline in this study, not the quantity,” said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute (CPMCRI) in San Francisco, Calif. “With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline.”
The study involved 2,822 community-dwelling older men at six clinical centers in the U.S. Participants had a mean age of 76 years. The study is published in the April 1 issue of the journal Sleep.
“This study provides an important reminder that healthy sleep involves both the quantity and quality of sleep,” said American Academy of Sleep Medicine President Dr. M. Safwan Badr. “As one of the pillars of a healthy lifestyle, sleep is essential for optimal cognitive functioning.”
The population-based, longitudinal study was conducted by a research team led by Dr. Katie Stone, senior scientist at CPMCRI in San Francisco, Calif. Institutions represented by study collaborators include the University of California, San Francisco; University of California, San Diego; Harvard Medical School; University of Minnesota; and several Veterans Affairs medical centers….
http://www.sciencedaily.com/releases/2014/03/140331170557.htm

Citation:

VOLUME 37, ISSUE 04

ASSOCIATION OF SLEEP QUALITY WITH SUBSEQUENT COGNITIVE DECLINE IN OLDER MEN
Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study
http://dx.doi.org/10.5665/sleep.3562
Terri Blackwell, MA1; Kristine Yaffe, MD2; Alison Laffan, PhD1; Sonia Ancoli-Israel, PhD3; Susan Redline, MD, MPH4; Kristine E. Ensrud, MD, MPH5; Yeonsu Song, PhD1; Katie L. Stone, PhD1
1Research Institute, California Pacific Medical Center, San Francisco, CA; 2Departments of Psychiatry, Neurology, and Epidemiology, University of California, San Francisco, San Francisco VA Medical Center, San Francisco, CA; 3Department of Psychiatry and Medicine, University of California, San Diego, La Jolla, CA and the Veterans Affairs San Diego Center of Excellence for Stress and Mental Health, San Diego, CA; 4Departments of Medicine, Brigham and Women’s Hospital and Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA; 5Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, MN; Department of Medicine and Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
Study Objectives:
To examine associations of objectively and subjectively measured sleep with subsequent cognitive decline.
Design:
A population-based longitudinal study.
Setting:
Six centers in the United States.
Participants:
Participants were 2,822 cognitively intact community-dwelling older men (mean age 76.0 ± 5.3 y) followed over 3.4 ± 0.5 y.
Interventions:
None.
Measurements and Results:
Objectively measured sleep predictors from wrist actigraphy: total sleep time (TST), sleep efficiency (SE), wake after sleep onset (WASO), number of long wake episodes (LWEP). Self-reported sleep predictors: sleep quality (Pittsburgh Sleep Quality Index [PSQI]), daytime sleepiness (Epworth Sleepiness Scale [ESS]), TST. Clinically significant cognitive decline: five-point decline on the Modified Mini-Mental State examination (3MS), change score for the Trails B test time in the worse decile. Associations of sleep predictors and cognitive decline were examined with logistic regression and linear mixed models. After multivariable adjustment, higher levels of WASO and LWEP and lower SE were associated with an 1.4 to 1.5-fold increase in odds of clinically significant decline (odds ratio 95% confidence interval) Trails B test: SE < 70% versus SE ≥ 70%: 1.53 (1.07, 2.18); WASO ≥ 90 min versus WASO < 90 min: 1.47 (1.09, 1.98); eight or more LWEP versus fewer than eight: 1.38 (1.02, 1.86). 3MS: eight or more LWEP versus fewer than eight: 1.36 (1.09, 1.71), with modest relationships to linear change in cognition over time. PSQI was related to decline in Trails B performance (3 sec/y per standard deviation increase).
Conclusions:
Among older community-dwelling men, reduced sleep efficiency, greater nighttime wakefulness, greater number of long wake episodes, and poor self-reported sleep quality were associated with subsequent cognitive decline.
Citation:
Blackwell T; Yaffe K; Laffan A; Ancoli-Israel S; Redline S; Ensrud KE; Song Y; Stone KL. Associations of objectively and subjectively measured sleep quality with subsequent cognitive decline in older community-dwelling men: the MrOS sleep study. SLEEP 2014;37(4):655-663.

Here is the press release from the American Academy of Sleep Medicine:

Poor sleep quality linked to cognitive decline in older men
American Academy of Sleep Medicine
Monday, March 31, 2014
FOR IMMEDIATE RELEASE
CONTACT: Lynn Celmer, 630-737-9700, ext. 9364, lcelmer@aasmnet.org
DARIEN, IL – A new study of older men found a link between poor sleep quality and the development of cognitive decline over three to four years.
Results show that higher levels of fragmented sleep and lower sleep efficiency were associated with a 40 to 50 percent increase in the odds of clinically significant decline in executive function, which was similar in magnitude to the effect of a five-year increase in age. In contrast, sleep duration was not related to subsequent cognitive decline.
“It was the quality of sleep that predicted future cognitive decline in this study, not the quantity,” said lead author Terri Blackwell, MA, senior statistician at the California Pacific Medical Center Research Institute (CPMCRI) in San Francisco, Calif. “With the rate of cognitive impairment increasing and the high prevalence of sleep problems in the elderly, it is important to determine prospective associations with sleep and cognitive decline.”
The study involved 2,822 community-dwelling older men at six clinical centers in the U.S. Participants had a mean age of 76 years. The study is published in the April 1 issue of the journal Sleep.
“This study provides an important reminder that healthy sleep involves both the quantity and quality of sleep,” said American Academy of Sleep Medicine President Dr. M. Safwan Badr. “As one of the pillars of a healthy lifestyle, sleep is essential for optimal cognitive functioning.”
The population-based, longitudinal study was conducted by a research team led by Dr. Katie Stone, senior scientist at CPMCRI in San Francisco, Calif. Institutions represented by study collaborators include the University of California, San Francisco; University of California, San Diego; Harvard Medical School; University of Minnesota; and several Veterans Affairs medical centers.
An average of five nights of objective sleep data were collected from each participant using a wrist actigraph. Cognitive function assessment included evaluation of attention and executive function using the Trails B test. According to the authors, executive function is the ability for planning or decision making, error correction or trouble shooting, and abstract thinking. Results were adjusted for potential confounding factors such as depressive symptoms, comorbidities and medication use.
The underlying mechanisms relating disturbed sleep to cognitive decline remain unknown, the authors noted. They added that additional research is needed to determine if these associations hold after a longer follow-up period.
Funding was provided by the National Heart, Lung, and Blood Institute (NHLBI) for the Outcomes of Sleep Disorders in Men Study, an ancillary study of the parent Osteoporotic Fractures in Men (MrOS) Study, which was supported by the National Institutes of Health (NIH).
To request a copy of the study,“Associations of Objectively and Subjectively Measured Sleep Quality with Subsequent Cognitive Decline in Older Community-Dwelling Men: The MrOS Sleep Study,” or to arrange an interview with the study author or an AASM spokesperson, please contact Communications Coordinator Lynn Celmer at 630-737-9700, ext. 9364, or lcelmer@aasmnet.org.
The monthly, peer-reviewed, scientific journal Sleep is published online by the Associated Professional Sleep Societies LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society. The AASM is a professional membership society that improves sleep health and promotes high quality patient centered care through advocacy, education, strategic research, and practice standards (www.aasmnet.org). A searchable directory of AASM accredited sleep centers is available at http://www.sleepeducation.com.

According to the Centers for Disease Control (CDC), insufficient sleep is a public health epidemic.

In the article, Insufficient Sleep Is a Public Health Epidemic, the CDC reports:

How Much Sleep Do We Need? And How Much Sleep Are We Getting?
How much sleep we need varies between individuals but generally changes as we age. The National Institutes of Health suggests that school-age children need at least 10 hours of sleep daily, teens need 9-105 hours, and adults need 7-8 hours. According to data from the National Health Interview Survey, nearly 30% of adults reported an average of ≤6 hours of sleep per day in 2005-2007.3 In 2009, only 31% of high school students reported getting at least 8 hours of sleep on an average school night.4
Sleep Hygiene Tips
The promotion of good sleep habits and regular sleep is known as sleep hygiene. The following sleep hygiene tips can be used to improve sleep.
• Go to bed at the same time each night and rise at the same time each morning.
• Avoid large meals before bedtime.
• Avoid caffeine and alcohol close to bedtime.
• Avoid nicotine.
(Sleep Hygiene Tips adapted from the National Sleep Foundation ) http://www.cdc.gov/features/dssleep/

More Americans of all ages need to begin getting a good night’s sleep.

Resources:

National Sleep Foundation’s Teens and Sleep http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts
http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America
http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn
http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:

Another study: Sleep problems can lead to behavior problems in children
https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Tags: , , , , , , ,

Study: Blue light may affect the sleep habits of students

13 Dec

The goal of this society should be to raise healthy and happy children who will grow into concerned and involved adults who care about their fellow citizens and environment. In order to accomplish this goal, all children must receive a good basic education and in order to achieve that goal, children must arrive at school, ready to learn. One of the mantras of this blog is there should not be a one size fits all approach to education and that there should be a variety of options to achieve the goal of a good basic education for all children.

The University of Illinois Extension has some good advice for helping children with study habits. In Study Habits and Homework he University of Illinois recommends:

Parents can certainly play a major role in providing the encouragement, environment, and materials necessary for successful studying to take place.
Some general things adults can do, include:
Establish a routine for meals, bedtime and study/homework
Provide books, supplies, and a special place for studying
Encourage the child to “ready” himself for studying (refocus attention and relax)
Offer to study with the child periodically (call out spelling words or do flash cards) http://urbanext.illinois.edu/succeed/habits.cfm

Some folks claim they need as few as four hours of sleep. For most folks, that is not healthy and it definitely isn’t healthy for children.

Sarah D. Sparks reported in the Education Week article, ‘Blue Light’ May Impair Students’ Sleep, Studies Say:

Schools may soon face an unintended consequence of more flexible technology and more energy-efficient buildings: sleepier students.
That’s because evidence is mounting that use of artificial light from energy-efficient lamps and computer and mobile-electronics screens later and later in the day can lead to significant sleep problems for adults and, particularly, children.
While lights and electronic devices that mimic daylight can improve students’ attention and alertness if used during normal daytime hours, Dr. Charles A. Czeisler, a professor of sleep medicine at Harvard Medical School, has found exposure in the late afternoon and evening can disrupt sleep cycles as much as six to eight hours—the same amount of “jet lag” caused by a flight from New York City to Honolulu.
“Technology has disconnected us from the natural 24-hour day,” Dr. Czeisler said in a keynote lecture at the Society for Neuroscience meeting held here last month.
That could lead to headaches for school districts across the country that are rolling out take-home electronic devices in an effort to boost student achievement.
Two connected systems determine how people of all ages sleep. The first is pretty straightforward: The longer it’s been since you’ve slept, the sleepier you get. The second system, called the circadian cycle, is more complex and can easily come into conflict with a person’s basic sleep drive.
Human brains regulate circadian sleep through exposure to short-wavelength “blue” light, which makes up the bulk of bright daylight. Short-wavelength light increases cortisol in the brain, which regulates alertness. As blue light during the day fades to the longer-wavelength, redder light of dusk, the brain’s timekeeper, the hypothalamus, suppresses cortisol and releases the sleep-promoting chemical melatonin.
One study released this month in the Journal of Cognitive Neuroscience showed that even those who are functionally blind become more alert and have increased brain activity in response to blue light, suggesting it can have effects even when it can’t be seen.
‘Biologically Potent’
In several studies, Dr. Czeisler has found that light-emitting diodes, or LEDS, which contain a large proportion of blue light, are more “biologically potent”—twice as effective at resetting the brain’s circadian clock as incandescent light. College students exposed to even brief periods of blue light late in the day showed delayed release in melatonin and up to a two-hour delay in sleep time.
Losing Shut-Eye
As students move through school, the gap between the amount of sleep they get on school nights and the amount they get on weekend nights tends to grow.
Blue light is becoming ubiquitous in any device that uses LEDS—including tablet and laptop computers, energy-efficient lamps, and some televisions. The Arlington, Va.-based National Sleep Foundation found this year that more than half of Americans use a computer, laptop, or tablet device in the hour before sleep every night or nearly every night. More than seven in 10 also have televisions in their bedrooms.
In real life, that can create an unhealthy cycle: Students exposed to blue light late in the day feel less sleepy and continue to do homework or play online until very late, exposing themselves to more light and making it harder to feel sleepy, even as their need for sleep grows. In the past 50 years, Americans’ average sleep time has dropped from 8.5 hours a day to only 6.9 hours, Harvard’s Dr. Czeisler said. An analysis of nearly 700,000 school-age children in 20 countries found that they slept on average 75 minutes less a night in 2008 than in 1905, with American children’s sleep shrinking more rapidly than for those in most other countries…..
http://www.edweek.org/ew/articles/2013/12/11/14sleep_ep.h33.html?tkn=XYNFw7hK%2F8TdYrgvqxBY6H%2FjAT%2FMKwiy%2FAaU&cmp=clp-edweek

Citation:

December 2013, Vol. 25, No. 12, Pages 2072-2085
Posted Online October 30, 2013.
(doi:10.1162/jocn_a_00450)
© 2013 Massachusetts Institute of Technology
Blue Light Stimulates Cognitive Brain Activity in Visually Blind Individuals
Gilles Vandewalle1,2*,**, Olivier Collignon3,4*,†, Joseph T. Hull5,6, Véronique Daneault1,2, Geneviève Albouy1, Franco Lepore3, Christophe Phillips7, Julien Doyon1, Charles A. Czeisler5,6, Marie Dumont2, Steven W. Lockley5,6††, and Julie Carrier1,2††
1University of Montréal Geriatric Institute, Québec, Canada
2Hôpital du Sacré-Cœur de Montréal, Québec, Canada
3Université de Montréal, Québec, Canada
4Centre de Recherches CHU Sainte-Justine, Montréal, Québec, Canada
5Brigham and Women’s Hospital, Boston, MA
6Harvard Medical School, Boston, MA
7University of Liège, Belgium
*These authors contributed equally to this work.
**Present address: Cyclotron Research Centre, University of Liège, Belgium.
†Present address: Centre for Mind/Brain Science, University of Trento, Italy.
††These authors are joint senior authors on this work.
Light regulates multiple non-image-forming (or nonvisual) circadian, neuroendocrine, and neurobehavioral functions, via outputs from intrinsically photosensitive retinal ganglion cells (ipRGCs). Exposure to light directly enhances alertness and performance, so light is an important regulator of wakefulness and cognition. The roles of rods, cones, and ipRGCs in the impact of light on cognitive brain functions remain unclear, however. A small percentage of blind individuals retain non-image-forming photoreception and offer a unique opportunity to investigate light impacts in the absence of conscious vision, presumably through ipRGCs. Here, we show that three such patients were able to choose nonrandomly about the presence of light despite their complete lack of sight. Furthermore, 2 sec of blue light modified EEG activity when administered simultaneously to auditory stimulations. fMRI further showed that, during an auditory working memory task, less than a minute of blue light triggered the recruitment of supplemental prefrontal and thalamic brain regions involved in alertness and cognition regulation as well as key areas of the default mode network. These results, which have to be considered as a proof of concept, show that non-image-forming photoreception triggers some awareness for light and can have a more rapid impact on human cognition than previously understood, if brain processing is actively engaged. Furthermore, light stimulates higher cognitive brain activity, independently of vision, and engages supplemental brain areas to perform an ongoing cognitive process. To our knowledge, our results constitute the first indication that ipRGC signaling may rapidly affect fundamental cerebral organization, so that it could potentially participate to the regulation of numerous aspects of human brain function.
Cited by
Vivien Bromundt, Sylvia Frey, Jonas Odermatt, Christian Cajochen. (2013) Extraocular light via the ear canal does not acutely affect human circadian physiology, alertness and psychomotor vigilance performance. Chronobiology International1-6
Online publication date: 13-Nov-2013.
http://www.mitpressjournals.org/doi/abs/10.1162/jocn_a_00450

Education is a partnership between the student, parent(s) or guardian(s), teachers(s), and school. The students must arrive at school ready to learn and that includes being rested. Parent(s) and guardian(s) must ensure their child is properly nourished and rested as well as providing a home environment which is conducive to learning. Teachers must have strong subject matter knowledge and strong pedagogic skills. Schools must enforce discipline and provide safe places to learn. For more information on preparing your child for high school, see the U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Resources:

National Sleep Foundation’s Teens and Sleep
http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

Teen Health’s Common Sleep Problems
http://kidshealth.org/teen/your_body/take_care/sleep.html

CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts
http://www.cbsnews.com/2100-500165_162-6052150.html

Psychology Today’s Sleepless in America http://www.psychologytoday.com/blog/sleepless-in-america

National Association of State Board’s of Education Fit, Healthy and Ready to Learn http://eric.ed.gov/?id=ED465734

U.S. Department of Education’s Tools for Success
http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:

Another study: Sleep problems can lead to behavior problems in children https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps Does school start too early? https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

Where information leads to Hope. © Dr. Wilda.com

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Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
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Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

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University of California at Berkeley Study: Staying up late hurts teen’s academic achievement

17 Nov

Moi wrote in Teens need sleep: The UK’s Daily Mail reported that not only does lack of sleep result in kids not being ready to learn, but may be an explanation for some mental illnesses. In Online Night Owls ‘Risk Mental Illness’: Sleepless Nights Blamed For Rise in Teen Depression the Daily Mail reports:

Young people who become sleep deprived by using the internet into the small hours are much more likely to become mentally ill in later life, research shows.
Lack of sleep may help explain the puzzling increase in mental illness among young people in recent decades, according to an extensive study.
And regularly staying up late to surf the internet and chat on social networking sites could be one reason young people are sleeping less, according to the research.
The study of about 20,000 young people aged between 17 and 24 found that those who slept fewer than five hours a night were three times more likely than normal sleepers to become psychologically distressed in the next year.
Each hour of sleep lost was linked to a 14 per cent increased risk of distress, according to the results, published in the journal Sleep.
Professor Nicholas Glozier, who led the research, said: ‘Sleep disturbance and in particular insomnia is a predictor of later development of depression and possibly anxiety.’
Less sleep was also associated with longer-term mental health problems – which were the focus of the professor’s study.
A lot of mental ill-health comes and goes, he said. ‘It’s the ones who don’t get better that we are particularly interested in.’ http://www.dailymail.co.uk/health/article-1308182/Online-night-owls-risk-mental-illness-Sleepless-nights-blamed-rise-teen-depression.html

It is important that children get enough sleep.

Vicki Abeles, director of the documentary “Race to Nowhere,”and Abigail A. Baird, associate professor of psychology at Vassar College in Poughkeepsie, NY. Baird’s primary area of research focuses on the neurophysiology of adolescence are reporting in the Washington Post about the effect of sleep deprivation on teens. Abeles and Baird write in the article, Sleep deprivation and teens: ‘Walking zombies’:

Over the past several years we’ve created national guidelines for eating and exercise, shouldn’t we do the same for sleep?
We can also make changes in our schools, like advocating for later high school start times. An adolescent’s brain works on a different circadian rhythm than that of adults — theirs thrives with later wake-up times. After the start time at a high school in Edina, Minnesota, was changed from 7:25 a.m. to 8:30 a.m., verbal SAT scores for the top 10 percent of students increased by several hundred points. The increase could not be attributed to any variable other than later start times.
Schools should also adopt block schedules and bring back study halls, both of which reduce the number of classes students must prepare for each day and give them more in-school time to complete academic assignments rather than requiring them to put in a grueling “second shift” after school.
So as Daylight Savings Time kicks in and we lose our annual hour of sleep, let’s make a pledge to help our children get the sleep they need to be happy, healthy, and successful in school and in their lives.http://www.washingtonpost.com/blogs/answer-sheet/post/sleep-deprivation-and-teens-walking-zombies/2012/03/10/gIQAr0QP3R_blog.html

The National Sleep Foundation (Sleep Foundation) has some great information about teens and sleep. http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep
https://drwilda.com/2012/03/11/teens-need-sleep/

Huffington Post reported in the article, Teens Who Stay Up Late Could Face Academic, Emotional Problems Later On:

Teens who stay up late on school nights — whether it be due to homework, chatting online with friends or late sports practices — may experience more academic andemotional problems than their peers who are earlier to bed, a new study suggests.
Researchers from the University of California, Berkeley, found that teens who went to bed later than 11:30 p.m. on school nights and 1:30 a.m. in the summer had lower GPAs than teens who got to bed earlier. They were also more susceptible to emotional problems.
“This very important study adds to the already clear evidence that youth who are night owls are at greater risk for adverse outcomes,” study researcher Allison Harvey, a psychologist at UC Berkeley, said in a statement. “Helping teens go to bed earlier may be an important pathway for reducing risk.”
The Journal of Adolescent Health study included 2,700 teens in grades 7 to 12 who were part of the National Longitudinal Study of Adolescent Health. Researchers analyzed their sleep habits and circadian patterns. About 30 percent of the teens said they went to bed later than 11:30 p.m. on school nights and 1:30 a.m. in the summer.
An association was found between going to bed later and getting less sleep (though this association was not found in the summertime, and sleep duration was not associated with changes in educational and emotional outcomes later on). The researchers also found an association between going to bed late during the school year and having worse educational outcomes, as well as higher emotional distress, after six to eight years. Late summertime bedtimes were not linked with academic outcomes, but were linked to higher emotional distress.
“These findings underscore the significance of evaluating and monitoring bedtime in adolescents and the importance of intervention strategies that target bedtimes in an effort to reduce associated functional impairments, and improve academic and emotional outcomes,” the researchers wrote in the study.
The findings add to past research also suggesting an association between late nights and poorer academic performance among teens. One study, presented at the SLEEP meeting in 2007, showed that teens who stay up late during the week and then oversleep on the weekends do worse in school…
http://www.huffingtonpost.com/2013/11/14/teens-stay-up-late-academic-emotional-problems_n_4256298.html?utm_hp_ref=education&ir=Education

Citation:

The Effects of Bedtime and Sleep Duration on Academic and Emotional Outcomes in a Nationally Representative Sample of Adolescents
Lauren D. Asarnow, M.A., Eleanor McGlinchey, Ph.D., Allison G. Harvey, Ph.D.email address
Received 16 April 2013; accepted 9 September 2013. published online 11 November 2013.
Corrected Proof
Abstract Full Text PDF Images References
Abstract
Purpose
The overall aim of this study was to clarify and better characterize the sleep/circadian patterns of adolescents in a nationally representative sample.
Methods
We used three waves of data from the National Longitudinal Study of Adolescent Health to assess sleep/circadian patterns of 2,700 adolescents in grades seven through 12.
Results
Late school year bedtime was associated with shorter total sleep time cross-sectionally, whereas late summertime bedtime was not. Moreover, late school year bedtime was not associated with late summertime bedtime cross-sectionally. Late school year bedtime in Wave I (1994–1995) was associated with worse educational outcomes and emotional distress 6–8 years later. In addition, late summertime bedtime in Wave II (1996) was associated with more emotional distress at Wave III (2001–2002). Short total sleep time was not associated longitudinally with changes in emotional and academic functioning. Across Waves I and II, more than three quarters of adolescents who went to sleep at 11:15 a.m. or later during the school year or 1:30 a.m. or later during the summer reported sleeping fewer than the recommended 9 hours.
Conclusions
These findings underscore the significance of evaluating and monitoring bedtime in adolescents and the importance of intervention strategies that target bedtimes in an effort to reduce associated functional impairments, and improve academic and emotional outcomes.
Keywords: Eveningness, Sleep, Adolescents, Academic outcomes, Emotional outcomes
Disclaimer: The opinions presented in this article reflect those of the authors and do not necessarily reflect those of the granting agencies.
Funding Sources: This project was supported by a Lisa M. Capps Fellowship and a National Science Foundation Graduate Research Fellowship award to L.D.A., a National Institute of Child Health and Human DevelopmentRuth L. Kirschstein National Research Service Award Predoctoral FellowshipF31-HD058411 awarded to E.L.M., and grant 1R01HD071065-01A1 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development awarded to A.G.H. This research used data from Add Health, a program project designed by J. Richard Udry, Peter S. Bearman, and Kathleen Mullan Harris, and funded by Grant P01-HD31921 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, with cooperative funding from 17 other agencies. This research used data from the Adolescent Health and Academic Achievement study, which was funded by Grant R01 HD040428-02 (PI: Chandra Muller) from the National Institute of Child Health and Human Development, and Grant REC-0126167 (PI: Chandra Muller and Co-PI: Pedro Reyes) from the National Science Foundation. This research was also supported by Grant 5 R24 HD042849, Population Research Center, awarded to the Population Research Center at the University of Texas at Austin by the Eunice Kennedy Shriver National Institute of Health and Child Development. No direct support was received from Grant P01-HD31921 for this analysis.
PII: S1054-139X(13)00486-2
doi:10.1016/j.jadohealth.2013.09.004
© 2013 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Here is the press release from UC Berkeley:

Teen night owls likely to perform worse academically, emotionally
By Yasmin Anwar, Media Relations | November 10, 2013
BERKELEY —
Teenagers who go to bed late during the school year are more prone to academic and emotional difficulties in the long run, compared to their earlier-to-bed counterparts, according to a new study from UC Berkeley.
Berkeley researchers analyzed longitudinal data from a nationally representative cohort of 2,700 U.S. adolescents of whom 30 percent reported bedtimes later than 11:30 p.m. on school days and 1:30 a.m. in the summer in their middle and high school years.
By the time they graduated from high school, the school-year night owls had lower GPA scores, and were more vulnerable to emotional problems than teens with earlier bedtimes, according to the study published online Nov.10 in the Journal of Adolescent Health.
The results present a compelling argument in favor of later middle and high school start times in the face of intense academic, social and technological pressures, researchers said.
“Academic pressures, busy after-school schedules, and the desire to finally have free time at the end of the day to connect with friends on the phone or online make this problem even more challenging,” said Lauren Asarnow, lead author of the study and a graduate student in UC Berkeley’s Golden Bear Sleep and Mood Research Clinic.
On a positive note, she said the findings underscore how a healthy sleep cycle promotes the academic and emotional success of adolescents.
“The good news is that sleep behavior is highly modifiable with the right support,” said Asarnow, citing UC Berkeley’s Teen Sleep Study, a treatment program designed to reset the biological clocks of adolescents who have trouble going to sleep and waking up.
This latest UC Berkeley study used data from the National Longitudinal Study of Adolescent Health, which has tracked the influences and behaviors of adolescents since 1994. Focusing on three time periods – the onset of puberty, a year later and young adulthood – UC Berkeley researchers compared how the sleep habits of 2,700 teenagers aged 13-18 impacted their academic, social and emotional development. They looked at participants’ school transcripts and other education and health data.
While going to bed late in the summer did not appear to impact their academic achievement, including grades, researchers did find a correlation between later summer bedtimes and emotional problems in young adulthood.
Surveys show that many teenagers do not get the recommended nine hours sleep a night, and report having trouble staying awake at school. The human circadian rhythm, which regulates physiological and metabolic functions, typically shifts to a later sleep cycle at the onset of puberty. UC Berkeley researchers theorize that an “evening circadian preference” in adolescence is a confluence of biological factors, as well as parental monitoring, academic and social pressures and the use of electronic gadgetry.
Late-night texting and the use of other electronic gadgetry can disrupt sleep patterns (iStockphoto)
For example, bright lights associated with laptops, smartphones and other electronic devices have been found to suppress melatonin, a hormone that helps regulate the sleep cycle. UC Berkeley’s Teen Sleep Study uses dim lighting and limits technology before bedtime, among other interventions, to help reverse this night-owl tendency.
‘This very important study adds to the already clear evidence that youth who are night owls are at greater risk for adverse outcomes,” said UC Berkeley psychologist Allison Harvey, senior author of the paper. “Helping teens go to bed earlier may be an important pathway for reducing risk. This will not be an easy process. But here at Berkeley, our sleep coaches draw from the science of motivation, habit formation and sleep to help teens achieve earlier bedtimes.”
Categories: Education, Health & medicine, News, Press Release, Science, Social science
Tags: academic performance, adolescent health, sleep, teen health, teenagers, teens

Education is a partnership between the student, parent(s) or guardian(s), teachers(s), and school. The students must arrive at school ready to learn and that includes being rested. Parent(s) and guardian(s) must ensure their child is properly nourished and rested as well as providing a home environment which is conducive to learning. Teachers must have strong subject matter knowledge and strong pedagogic skills. Schools must enforce discipline and provide safe places to learn. For more information on preparing your child for high school, see the U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Resources
1. National Sleep Foundation’s Teens and Sleep
http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

2. Teen Health’s Common Sleep Problems http://kidshealth.org/teen/your_body/take_care/sleep.html

3. CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts http://www.cbsnews.com/2100-500165_162-6052150.html

4. Psychology Today’s Sleepless in America http://www.psychologytoday.com/blog/sleepless-in-america

5. National Association of State Board’s of Education Fit, Healthy and Ready to Learn
http://eric.ed.gov/?id=ED465734

6. U.S. Department of Education’s Tools for Success http://www2.ed.gov/parents/academic/help/tools-for-success/index.html

Related:

Another study: Sleep problems can lead to behavior problems in children
https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices https://drwilda.com/2013/06/21/stony-brook-medicine-study-teens-need-sleep-to-function-properly-and-make-healthy-food-choices/

University of Massachusetts Amherst study: Preschoolers need naps
Does school start too early?
https://drwilda.com/tag/too-little-sleep-raises-obesity-risk-in-children/

Where Information Leads to Hope © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:

COMMENTS FROM AN OLD FART©
http://drwildaoldfart.wordpress.com/

Dr. Wilda Reviews ©
http://drwildareviews.wordpress.com/

Dr. Wilda ©
https://drwilda.com/

Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , ,

University of Massachusetts Amherst study: Preschoolers need naps

15 Oct

Some folks claim they need as few as four hours of sleep. For most folks, less sleep is not healthy and it definitely isn’t healthy for children.
At least one study links obesity in children to lack of sleep. Reuters reported in Too Little Sleep Raises Obesity Risk In Children:

Children aged four and under who get less than 10 hours of sleep a night are nearly twice as likely to be overweight or obese five years later, according to a U.S. study.
Researchers from the University of California and University of Washington in Seattle looked at the relationship between sleep and weight in 1,930 children aged 0 to 13 years old who took part in a survey in 1997 and again five years later in 2002.
For children who were four years old or younger at the time of the first survey, sleeping for less than 10 hours a night was associated with nearly a twofold increased risk of being overweight or obese at the second survey.
For older children, sleep time at the first survey was not associated with weight status at the second survey but current short sleep time was associated with increased odds of a shift from normal weight to overweight status or from overweight or obese status at follow up. Dr. Janice F. Bell from the University of Washington said this study suggested that early childhood could be a “critical window” when nighttime sleep helps determine a child’s future weight status. According to the National Sleep Foundation, toddlers aged one to three years old should sleep for 12 to 14 hours a night; preschoolers, aged 3 to 5 years old, should sleep 11 to 13 hours, and 5- to 10-year-olds should get 10 to 11 hours. Teens should get 8.5 to 9.25 hours of sleep nightly.
Several studies have linked short sleep to excess weight in children and teens, Bell and fellow researcher Dr. Frederick Zimmerman from the University of California noted in their report.
But many of these studies have been cross-sectional, meaning they looked at a single point in time, which makes it difficult to determine whether not getting adequate sleep caused a child to become obese, or vice versa.
These findings, said the researchers, suggest there is a critical time period prior to age five when adequate nightly sleep may be important in terms of a healthy weight later on. http://www.reuters.com/article/2010/09/09/us-sleep-children-idUSTRE6880CP20100909

Children need proper nutrition and sleep not only to be healthy and happy, but to be ready to learn.

Dr. Michael J. Breus, Clinical Psychologist; Board Certified Sleep Specialist reported in the article, Naps During School? For Preschoolers, Yes:

Researchers at the University of Massachusetts Amherst investigated how naps influence memory and learning in young children. They found that a regular habit of midday naps increased memory and cognitive skills among preschool children — a boost that their study showed was not replicated by overnight sleep in the absence of a daytime nap. Researchers studied more than 40 preschoolers in six different classrooms. They conducted two different experiments — one centered on a learning and memory game taught to children and the other involved observing brain activity among young children during their naps usingpolysomnography.
In the learning exercise, children were shown a grouping of pictures and then had to recall the placement of individual pictures within the group. All the children learned the game at the same time in the morning. Researchers then split the children into two groups. One group took naps lasting an average of 75 minutes and the other group stayed awake. Researchers had the all the children perform the same exercise they’d learned in the morning after some had napped and others had not. Researchers also tested the children on the memory exercise the next day, to evaluate how a night of sleep might influence the children’s recall. They found that daytime naps were associated with significantly greater memory recall:
• The children, when tested on the same day they learned the exercise, all performed roughly the same whether they had napped or not.
• When tested the following day, children who had napped after learning the game the day before were able to remember significantly more of the picture locations than those who had not napped.
• The children who performed best on the memory test were those for whom daytime naps were a regular, consistent habit.
In the second experiment, researchers observed brain activity of a different group of preschool children while they were napping. They found an increase in the density of sleep spindles — bursts of electrical activity in the brain that are believed to play a significant role in memory consolidation, the process by which the brain takes newly acquired information and converts it to longer-term memory. Researchers were able to associate the increase in sleep spindle density they observed among the napping preschoolers to improvements in the children’s memory skills.
These study results provide some important and potentially significant new insight into the purpose and importance of naps in young children. The function of naps among preschool age children has not been well studied. Parents may know well from experience the mood and behavioral consequences of a missed nap, but science doesn’t actually yet know very much about the biological purpose that naps serve for children this age. A recent study by researchers at the University of Colorado Boulder investigated the effects of naps on emotional and cognitive responses in children ages 2 to 3, and found that inconsistent napping was associated with diminished emotional and cognitive behavior. Missing a single nap led to an increase in children’s expression of anxiety and negative emotions, while also diminishing the expression of positive feelings of joy and excitement. Missed naps also were associated with greater difficulty in problem solving among these young children….
http://www.huffingtonpost.com/dr-michael-j-breus/importance-of-nap-time_b_4064936.html?utm_hp_ref=@education123

Citation:

> Early Edition > Laura Kurdziel
Sleep spindles in midday naps enhance learning in preschool children
Laura Kurdziela, Kasey Duclosb,c, and Rebecca M. C. Spencera,b,1
Author Affiliations
A Neuroscience and Behavior Program, b Department of Psychology, and c Commonwealth Honors College, University of Massachusetts Amherst, Amherst, MA 01002
Edited by Terrence J. Sejnowski, Salk Institute for Biological Studies, La Jolla, CA, and approved August 19, 2013 (received for review April 5, 2013)
Significance
Lacking scientific understanding of the function of naps in early childhood, policy makers may curtail preschool classroom nap opportunities due to increasing curriculum demands. Here we show evidence that classroom naps support learning in preschool children by enhancing memories acquired earlier in the day as compared with equivalent intervals spent awake.
Abstract
Despite the fact that midday naps are characteristic of early childhood, very little is understood about the structure and function of these sleep bouts. Given that sleep benefits memory in young adults, it is possible that naps serve a similar function for young children. However, children transition from biphasic to monophasic sleep patterns in early childhood, eliminating the nap from their daily sleep schedule. As such, naps may contain mostly light sleep stages and serve little function for learning and memory during this transitional age. Lacking scientific understanding of the function of naps in early childhood, policy makers may eliminate preschool classroom nap opportunities due to increasing curriculum demands. Here we show evidence that classroom naps support learning in preschool children by enhancing memories acquired earlier in the day compared with equivalent intervals spent awake. This nap benefit is greatest for children who nap habitually, regardless of age. Performance losses when nap-deprived are not recovered during subsequent overnight sleep. Physiological recordings of naps support a role of sleep spindles in memory performance. These results suggest that distributed sleep is critical in early learning; when short-term memory stores are limited, memory consolidation must take place frequently.
Development education
Footnotes
↵1To whom correspondence should be addressed. E-mail: rspencer@psych.umass.edu. Author contributions: R.M.C.S. designed research; L.K., K.D., and R.M.C.S. performed research; L.K., K.D., and R.M.C.S. analyzed data; and L.K. and R.M.C.S. wrote the paper.
The authors declare no conflict of interest.
This article is a PNAS Direct Submission.
Freely available online through the PNAS open access option.
http://www.pnas.org/content/early/2013/09/18/1306418110

Our goal as a society should be:

A Healthy Child In A Healthy Family Who Attends A Healthy School In A Healthy Neighborhood. ©

Related:

Another study: Sleep problems can lead to behavior problems in children
https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

Albert Einstein School of Medicine study: Abnormal breathing during sleep can lead to behavior problems in children https://drwilda.com/2012/03/25/albert-einstein-school-of-medicine-study-abnormal-breathing-during-sleep-can-lead-to-behavior-problems-in-children/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

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Stony Brook Medicine study: Teens need sleep to function properly and make healthy food choices

21 Jun

 

The goal of this society should be to raise healthy and happy children who will grow into concerned and involved adults who care about their fellow citizens and environment. In order to accomplish this goal, all children must receive a good basic education and in order to achieve that goal, children must arrive at school, ready to learn. One of the mantras of this blog is there should not be a one size fits all approach to education and that there should be a variety of options to achieve the goal of a good basic education for all children.

The University of Illinois Extension has some good advice for helping children with study habits. In Study Habits and Homework he University of Illinois recommends:

 

Parents can certainly play a major role in providing the encouragement, environment, and materials necessary for successful studying to take place.

Some general things adults can do, include:

  • Establish a routine for meals, bedtime and study/homework

  • Provide books, supplies, and a special place for studying

  • Encourage the child to “ready” himself for studying (refocus attention and relax)

  • Offer to study with the child periodically (call out spelling words or do flash cards)

 

Some folks claim they need as few as four hours of sleep. For most folks that is not healthy and it definitely isn’t healthy for children.

 

One study linked obesity in children to lack of sleep. Reuters reported in Too Little Sleep Raises Obesity Risk In Children

 

Children aged four and under who get less than 10 hours of sleep a night are nearly twice as likely to be overweight or obese five years later, according to a U.S. study.

 

Researchers from the University of California and University of Washington in Seattle looked at the relationship between sleep and weight in 1,930 children aged 0 to 13 years old who took part in a survey in 1997 and again five years later in 2002.

For children who were four years old or younger at the time of the first survey, sleeping for less than 10 hours a night was associated with nearly a twofold increased risk of being overweight or obese at the second survey.

For older children, sleep time at the first survey was not associated with weight status at the second survey but current short sleep time was associated with increased odds of a shift from normal weight to overweight status or from overweight or obese status at follow up. Dr. Janice F. Bell from the University of Washington said this study suggested that early childhood could be a “critical window” when nighttime sleep helps determine a child’s future weight status. According to the National Sleep Foundation, toddlers aged one to three years old should sleep for 12 to 14 hours a night; preschoolers, aged 3 to 5 years old, should sleep 11 to 13 hours, and 5- to 10-year-olds should get 10 to 11 hours. Teens should get 8.5 to 9.25 hours of sleep nightly.

Several studies have linked short sleep to excess weight in children and teens, Bell and fellow researcher Dr. Frederick Zimmerman from the University of California noted in their report.

But many of these studies have been cross-sectional, meaning they looked at a single point in time, which makes it difficult to determine whether not getting adequate sleep caused a child to become obese, or vice versa.

These findings, said the researchers, suggest there is a critical time period prior to age five when adequate nightly sleep may be important in terms of a healthy weight later on.

 

Children need proper nutrition and sleep not only to be healthy and happy, but to be ready to learn.

 

Science Daily reported about teens need for sleep in the article, Study Reveals Link Between Sleep Deprivation in Teens and Poor Dietary Choices:

 

 

Well-rested teenagers tend to make more healthful food choices than their sleep-deprived peers, according to a study led by Lauren Hale, PhD, Associate Professor of Preventive Medicine at Stony Brook University School of Medicine. The finding, presented at SLEEP 2013, the annual meeting of the Associated Professional Sleep Societies, may be key to understanding the link between sleep and obesity….

 

The study, which was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, examined the association between sleep duration and food choices in a national representative sample of 13,284 teenagers in the second wave of the National Longitudinal Study of Adolescent Health. The data were collected in 1996 when the interview subjects had a mean age of 16 years.

 

The authors found that those teens who reported sleeping fewer than seven hours per night — 18 percent of respondents — were more likely to consume fast food two or more times per week and less likely to eat healthful food such as fruits and vegetables. The results took into account factors such as age, gender, race and ethnicity, socioeconomic status, physical activity and family structure, and found that short sleep duration had an independent effect on both healthy and unhealthy food choices.

 

The respondents fell into one of three categories: short sleepers, who received fewer than seven hours per night; mid-range sleepers, who had seven to eight hours per night; and recommended sleepers, who received more than eight hours per night. The American Academy of Pediatrics currently recommends that adolescents get between nine and 10 hours of sleep per night. http://www.sciencedaily.com/releases/2013/06/130620162746.htm#.UcN9_iGkjBA.email

 

Here is the press release from Stony Brook Medicine:

 

 

Research based on data from interviews with 13,284 adolescents nationwide

 

STONY BROOK, NY, June 20, 2013 – Well-rested teenagers tend to make more healthful food choices than their sleep-deprived peers, according to a study led by Lauren Hale, PhD, Associate Professor of Preventive Medicine at Stony Brook University School of Medicine. The finding, presented at SLEEP 2013, the annual meeting of the Associated Professional Sleep Societies, may be key to understanding the link between sleep and obesity. 

 

“Not only do sleepy teens on average eat more food that’s bad for them, they also eat less food that is good for them,” said Dr. Hale, speaking about the study results. “While we already know that sleep duration is associated with a range of health consequences, this study speaks to some of the mechanisms, i.e., nutrition and decision making, through which health outcomes are affected.” 

 

The study, which was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, examined the association between sleep duration and food choices in a national representative sample of 13,284 teenagers in the second wave of the National Longitudinal Study of Adolescent Health. The data were collected in 1996 when the interview subjects had a mean age of 16 years. 

 

The authors found that those teens who reported sleeping fewer than seven hours per night — 18 percent of respondents — were more likely to consume fast food two or more times per week and less likely to eat healthful food such as fruits and vegetables. The results took into account factors such as age, gender, race and ethnicity, socioeconomic status, physical activity and family structure, and found that short sleep duration had an independent effect on both healthy and unhealthy food choices. 

 

The respondents fell into one of three categories: short sleepers, who received fewer than seven hours per night; mid-range sleepers, who had seven to eight hours per night; and recommended sleepers, who received more than eight hours per night. The American Academy of Pediatrics currently recommends that adolescents get between nine and 10 hours of sleep per night. 

 

“We are interested in the association between sleep duration and food choices in teenagers because adolescence is a critical developmental period between childhood and adulthood,” said the first author of the study, Allison Kruger, MPH, a community health worker at Stony Brook University Hospital. “Teenagers have a fair amount of control over their food and sleep, and the habits they form in adolescence can strongly impact their habits as adults.” 

 

The research team — which included co-authors Eric N. Reither, PhD, Utah State University; Patrick Krueger, PhD, University of Colorado at Denver; and Paul E. Peppard, PhD, University of Wisconsin-Madison — concluded that addressing sleep deficiency may be a novel and effective way to improve obesity prevention and health promotion interventions. 

 

Dr. Hale said that one of the next steps in the research will be to explore whether the association between sleep duration and food choices is causal. 

 

“If we determine that there is a causal link between chronic sleep and poor dietary choices, then we need to start thinking about how to more actively incorporate sleep hygiene education into obesity prevention and health promotion interventions,” she said. 

 

Citation:

 

 

Stony Brook Medicine (2013, June 20). Sleep deprivation in teens linked to poor dietary choices. ScienceDaily. Retrieved June 21, 2013, from http://www.sciencedaily.com­ /releases/2013/06/130620162746.htm#.UcN9_iGkjBA.email

 

 

Lauran Neergaard, AP medical writer wrote about a teen sleep study which was reprinted at Boston.Com. In Study: Lack of Early Light Upsets Teen Clock

 

 

Sit by the window in school? Lack of the right light each morning to reset the body’s natural sleep clock might play a role in teenagers’ out-of-whack sleep, a small but provocative school experiment suggests.

 

Specialists say too few teens get the recommended nine hours of shut-eye a night. They’re often unable to fall asleep until late and struggle to awaken for early classes. Sleep patterns start changing in adolescence for numerous reasons, including hormonal changes and more school, work and social demands….

 

From waking until school ended, 11 students donned special orange goggles that block short-wavelength “blue light,” but not other wavelengths necessary for proper vision. Blocking that light for five days upset the students’ internal body clocks – delaying by half an hour their evening surge of a hormone called melatonin that helps induce sleep, Rensselaer Polytechnic Institute researchers reported Tuesday.

 

Teens who trudge to the bus stop before dawn or spend their days in mostly windowless schools probably suffer the same effect, as daylight is the best source of those short-wavelength rays, said lead researcher Mariana Figueiro of Rensselaer’s Lighting Research Center in Troy, N.Y.

 

“If you have this morning light, that is a benefit to the teenagers,” Figueiro said.

 

If children do not receive the appropriate amount of sleep, they will not be ready to learn when they arrive at school.

 

Why Do Teens Need Sleep?

 

The National Sleep Foundation has a Teens and Sleep Fact Sheet:

 

Sleep is vital to your well-being, as important as the air you breathe, the water you drink and the food you eat. It can even help you to eat better and manage the stress of being a teen.

 

  • Biological sleep patterns shift toward later times for both sleeping and waking during adolescence — meaning it is natural to not be able to fall asleep before 11:00 pm.

  • Teens need about 9 1/4 hours of sleep each night to function best (for some, 8 1/2 hours is enough). Most teens do not get enough sleep — one study found that only 15% reported sleeping 8 1/2 hours on school nights.

  • Teens tend to have irregular sleep patterns across the week — they typically stay up late and sleep in late on the weekends, which can affect their biological clocks and hurt the quality of their sleep.

  • Many teens suffer from treatable sleep disorders, such as narcolepsy, insomnia, restless legs syndrome or sleep apnea.

 

CONSEQUENCES:

 

Not getting enough sleep or having sleep difficulties can:

 

  • Limit your ability to learn, listen, concentrate and solve problems. You may even forget important information like names, numbers, your homework or a date with a special person in your life;

  • Make you more prone to pimples. Lack of sleep can contribute to acne and other skin problems;

  • Lead to aggressive or inappropriate behavior such as yelling at your friends or being impatient with your teachers or family members;

  • Cause you to eat too much or eat unhealthy foods like sweets and fried foods that lead to weight gain;

  • Heighten the effects of alcohol and possibly increase use of caffeine and nicotine; and

  • Contribute to illness, not using equipment safely or driving drowsy.

 

Parents should be alert to signs of sleep deprivation in their children.

 

How Can You Help Your Teen Get Enough Sleep?

 

The National Sleep Foundation has the following suggestions for improving sleep

 

Make sleep a priority. Review Teen Time in this toolkit and keep the Teen Sleep Diary. Decide what you need to change to get enough sleep to stay healthy, happy, and smart!

 

  • Naps can help pick you up and make you work more efficiently, if you plan them right. Naps that are too long or too close to bedtime can interfere with your regular sleep.

  • Make your room a sleep haven. Keep it cool, quiet and dark. If you need to, get eyeshades or blackout curtains. Let in bright light in the morning to signal your body to wake up.

  • No pills, vitamins or drinks can replace good sleep. Consuming caffeine close to bedtime can hurt your sleep, so avoid coffee, tea, soda/pop and chocolate late in the day so you can get to sleep at night. Nicotine and alcohol will also interfere with your sleep.

  • When you are sleep deprived, you are as impaired as driving with a blood alcohol content of .08%, which is illegal for drivers in many states. Drowsy driving causes over 100,000 crashes each year. Recognize sleep deprivation and call someone else for a ride. Only sleep can save you!

  • Establish a bed and wake-time and stick to it, coming as close as you can on the weekends. A consistent sleep schedule will help you feel less tired since it allows your body to get in sync with its natural patterns. You will find that it’s easier to fall asleep at bedtime with this type of routine.

  • Don’t eat, drink, or exercise within a few hours of your bedtime. Don’t leave your homework for the last minute. Try to avoid the TV, computer and telephone in the hour before you go to bed. Stick to quiet, calm activities, and you’ll fall asleep much more easily!

  • If you do the same things every night before you go to sleep, you teach your body the signals that it’s time for bed. Try taking a bath or shower (this will leave you extra time in the morning), or reading a book.

  • Try keeping a diary or to-do lists. If you jot notes down before you go to sleep, you’ll be less likely to stay awake worrying or stressing.

  • When you hear your friends talking about their all-nighters, tell them how good you feel after getting enough sleep.

  • Most teens experience changes in their sleep schedules. Their internal body clocks can cause them to fall asleep and wake up later. You can’t change this, but you can participate in interactive activities and classes to help counteract your sleepiness. Make sure your activities at night are calming to counteract your already heightened alertness.

 

If teens need about 9 1/4 hours of sleep to do their best and naturally go to sleep around 11:00 pm, one way to get more sleep is to start school later.     http://www.sleepfoundation.org/article/sleep-topics/teens-and-sleep

 

These suggestions point to establishing a regular routine for your teen and setting a time for all activities to cease each evening.

 

Education is a partnership between the student, parent(s) or guardian(s), teachers(s), and school. The students must arrive at school ready to learn and that includes being rested. Parent(s) and guardian(s) must ensure their child is properly nourished and rested as well as providing a home environment which is conducive to learning. Teachers must have strong subject matter knowledge and strong pedagogic skills. Schools must enforce discipline and provide safe places to learn. For more information on preparing your child for high school, see the U.S. Department of Education’s Tools for Success

 

Resources

 

  1. National Sleep Foundation’s Teens and Sleep
  2. Teen Health’s Common Sleep Problems
  3. CBS Morning News’ Sleep Deprived Kids and Their Disturbing Thoughts
  4. Psychology Today’s Sleepless in America
  5. National Association of State Board’s of Education Fit, Healthy and Ready to Learn
  6. U.S. Department of Education’s Tools for Success

 

Related:

 

Another study: Sleep problems can lead to behavior problems in children                                                                                 https://drwilda.com/2013/03/30/another-study-sleep-problems-can-lead-to-behavior-problems-in-children/

 

 

Where Information Leads to Hope ©     Dr. Wilda.com

 

Dr. Wilda says this about that ©

 

Blogs by Dr. Wilda:

 

COMMENTS FROM AN OLD FART©                           http://drwildaoldfart.wordpress.com/

 

Dr. Wilda Reviews ©                                                http://drwildareviews.wordpress.com/

 

Dr. Wilda ©                                                                             https://drwilda.com/

 

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The 04/23/13 Joy Jar

22 Apr

 

It helps to have a glide path toward sleep. A cup of tea and soothing music, the kind of relaxation music moi likes many refer to as ‘background music.’ It is smoothing and helps one’s mind rest. Today’s deposit into the ‘Joy Jar is soothing bedtime music.

“Music is a moral law. It gives soul to the universe, wings to the mind, flight to the imagination, and charm and gaiety to life and to everything.”

Plato

“Music produces a kind of pleasure which human nature cannot do without”

Confucius

“Music takes us out of the actual and whispers to us dim secrets that startle our wonder as to who we are, and for what, whence, and whereto.”

Ralph Waldo Emerson

What I dream of is an art of balance, of purity and serenity devoid of troubling or depressing subject matter – a soothing, calming influence on the mind, rather like a good armchair which provides relaxation from physical fatigue.
Henri Matisse

“Music washes away from the soul the dust of everyday life.”

Berthold Auerbach

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The 02/08/13 Joy Jar

7 Feb

Do you ever think what one welcomes after a long tiring week? A pillow and a good night’s rest. A time when one doesn’t have to turn on the trusty alarm clock and one can sleep until you wake-up. The pillow becomes an ally and friend. Today’s deposit into the ‘Joy Jar’ is the pillow.

 

Fatigue is the best pillow.
Benjamin Franklin

No one realizes how beautiful it is to travel until he comes home and rests his head on his old, familiar pillow.
Lin Yutang

“What pillow can one have like a good conscience?”
John Steinbeck, Tortilla Flat

 

Comfy jammies, cozy bed, big soft pillow for your head. Worry not, the world can wait take your time and recuperate.

Unknown

 

I put a piece of paper under my pillow, and when I could not sleep I wrote in the dark.
Henry David Thoreau

 

Let gratitude be the pillow upon which you kneel to say your nightly prayer. And let faith be the bridge you build to overcome evil and welcome good.

Maya Angelou

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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