USA TODAY Collegiate Case Study: The Truth About Sleep: Myths, Realities, Needs

8/14/2019 USA TODAY Collegiate Case Study: The Truth About Sleep: Myths, Realities, Needs

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The Truth about Sleep:Myths, Realities and Needs

How much sleep do you need? The answer is simple: It depends. On you,that is.

But the picture is becoming clearer every year about what happens whenthere is not enough. Sleep researchers are putting together a daunting pic-ture o what happens to us mentally, physically and emotionally when wecheat ourselves o this basic need.

This case study explores some o the realities and e ects o sleep deprivationand provides tips or understanding your own sleep needs and how to keepyoursel in top per ormance mode. Your uture depends on it!

Lack o sleep sendsemotions o deep end 1-2

Sleep deprivation might leadto Alzheimers disease 5

Sleep habits a ect weight,study fnds 4

Extended sleep may give

athletes a boost 4

Drowsy drivers: A wake-upcall 2-3

Additional Resources 10-11

Reprinted with permission. All rights reserved.

By Sharon JaysonUSA TODAY

You might have guessed it, but nowresearchers have real proo : Sleepdeprivation causes our emotions togo haywire.

Thats according to the rst neu-rological probe into the emotionalbrain without sleep. It was carriedout by researchers at the Universityo Cali ornia-Berkeley and HarvardMedical School.

Most people think that whenyoure sleep-deprived, what hap-pens to the brain is that it becomes

sleepy and less active, says Mat-thew Walker, assistant pro essoro psychology at Berkeley and aormer Harvard sleep researcher.But Walker says the imaging studypublished in todays issue o Cur-rent Biology ound that the brainsemotional centers become 60%

more reactive.

The study also suggests that lack o sleep elevates activity in the emo-tional centers o the brain mostclosely associated with psychiatricdisorders such as depression.

Walkers team studied 26 peopleages 18 to 30 who were divided into

Cover Story

Lack o sleep sendsemotions o deep end

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Late nights could catch up with you 6-7

Regular bedtime boosts chanceor success in school 8-9


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Reprinted with permission. All rights reserved. Page 2

As seen in USA TODAY LIFE Section, Tuesday, October 23, 2007 Page 2D

two groups. The sleep-deprived group was awake 35

hours; the other group slept normally.Using the brain scans, the researchers showed par-ticipants a series o images, rom neutral to increas-ingly negative and disturbing. The responses o bothgroups showed up as hot spots, but the sleep-deprivedevoked stronger responses because the pre rontalarea o the brain that normally sends out inhibitingsignals wasnt able to keep emotions in check.

Though the thinking has been that psychiatric disor-ders cause poor sleep, Walker says now hes not sosure because those he studied didnt have psychiatricconditions, yet they exhibited emotional brain reac-

tions similar to psychiatric conditions.

Mary Carskadon, a pro essor o psychiatry and humanbehavior at Brown University who has studied ado-lescents and sleep deprivation, says the new study iscompatible with her ndings. She is particularly con-cerned about what it means or adolescents, who areo ten sleep-deprived and who are being diagnosedwith depression in increasing numbers.

What we dont know is whether early sleep depriva-tion then projects out to things like major depressivedisorder or bipolar illness and whether were reallysetting up our kids or these major problems as theygrow up, she says.

As seen in USA TODAY NEWS Section, Thursday, April 2, 2009 Page 3A

Drowsy drivers: A wake-up callSleep deprivation carries risks similar to drunken drivings

By Larry CopelandUSA TODAY

Lionel Edwards used to nod o while driving. Foryears, hed get behind the wheel and a ter ve to 10minutes nd himsel dozing.

I was so exhausted because I wasnt getting theproper sleep, he says. It was really, really bad, espe-cially at night.

Two years ago, Edwards, 39, was driving to his

Pottstown, Pa., home a ter working a night shi t. Heell asleep, waking to the rantic honking o a wom-an whose car he was orcing o the road. She wasalready on the shoulder, Edwards says, adding thathe pulled over just in time or the woman to avoidcrashing into a ditch. I told my wi e, and she was re-ally upset. She said I had to (get help).

Drowsy driving is one o the most vexing problemsinvolving tra c sa ety. It is a actor in more than

100,000 crashes, resulting in 1,550 deaths and 40,000injuries annually, according to the National HighwayTra c Sa ety Administration. Thats probably a con-servative estimate, says Je Michael, the NHTSAsassociate administrator or research and program de-velopment.

Darrel Drobnich, chie program o cer o the Nation-al Sleep Foundation, puts the numbers much higher:71,000 injuries and more than 5,500 deaths a year.Its a huge problem thats largely gone unreportedbecause we dont have good, hard police data, he

says.

An obstacle or police is that there is no test ordrowsy driving like the Breathalyzer an o cer cangive a motorist suspected o drunken driving.

A new battle

Some sleep experts and state legislators say the na-tions progress against drowsy driving is about where


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As seen in USA TODAY NEWS Section, Thursday, April 2, 2009 Page 3A

the campaign against drunken driving was 30 yearsago. That was be ore Mothers Against Drunk Driv-ing (MADD), be ore any stigma in getting behind thewheel a ter drinking, be ore every state adopted asingle standard or driving while intoxicated.

Years ago, we didnt think anything o getting in acar a ter having a ew drinks, says Carol Ash, medi-cal director o a sleep program at Somerset Medi-cal Center in Somerville, N.J. Sleep deprivation hasthe same impact. Your judgment becomes impaired,whether you realize it or not. Were starting to un-derstand that drowsy driving is the same as driving

intoxicated.

According to Ash and other researchers, a personwho drives a ter 18 consecutive hours without sleepper orms at the same level as a person with a blood-alcohol concentration o .08% the legal standardor drunken driving in all 50 states and the Districto Columbia.

About 250,000 drivers all asleep at the wheel daily,says Charles Czeisler, director o the Division o SleepMedicine at Harvard Medical School and chie o theDivision o Sleep Medicine at Brigham and WomensHospital in Boston. Theres an epidemic o drowsydriving crashes, particularly among young drivers,he says.

In a national poll released last month by the NationalSleep Foundation, 54% o adult drivers said they haddriven while drowsy during the past year; 28% saidthey had actually allen asleep while driving.

A widespread malady

About 40 million-50 million Americans su er romsleep disorders, but like Edwards was, about 85% o them are undiagnosed. Yet they account or only asmall percentage o drowsy drivers, who are morelikely to be young people and night-shi t workers,Czeisler and other experts say.

Legislators in some states spurred by the deathso constituents by drowsy drivers are trying toaddress the issue. New Jersey is the only state thatcriminalizes drowsy driving in a atal crash by classi-ying it as recklessness under its vehicular homicidestatute. No state has a law dealing with non- atalsleep-related crashes.

The problem has been that people dont take it allthat seriously, says Massachusetts state Sen. Rich-ard Moore, a Democrat. He has been pursuing sti erpenalties since 2002, when a constituent was killedby a driver who had allen asleep and later admit-

ted he had been up all night playing video games,he says. The penalty was a slap on the wrist, sus-pension o his drivers license or a couple years andprobation. Grate ul or sound sleep

Edwards, now a night security counselor at a youthcenter, was working the overnight shi t at the Wal-Mart in Boyertown, Pa., in 2007. He had just le twork when he had the near-accident that changedhis li e.

A ter his narrow escape and at the insistence o hiswi e, Jamesha, he went to University Services SleepDiagnostic and Treatment Centers in Pottstown. Helearned he has obstructive sleep apnea, a disorder inwhich a persons sleep is repeatedly interrupted asmuscles in the throat ail to keep the airway open.Edwards was tted with a mask that ts over thenose and mouth and blows air into the airway tokeep it open during sleep. He sleeps soundly nowand says hes thank ul he didnt kill anyone: Yes, oh

my God, yes.He was lucky: The greatest predictor that youre go-ing to have a sleep-related crash, Czeisler says, isyou just had a near-miss.


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As seen in USA TODAY SPORTS Section, Tuesday, July 14, 2009 Page 13B

Extended sleep may give athletes a boostBy Erin ThompsonUSA TODAY

Stan ord University researchers have an idea thatmay be something to sleep on.

I not enough sleep is bad, they wondered, could ex-tended sleep be good?

They had a hunch that getting more than the usualamount would improve athletic per ormance andmood -- a theory they say has not been explored byexercise physiologists.

The researchers asked ve members o Stan ordswomens tennis team to be their guinea pigs. A terollowing a normal sleeping pattern or a ew weeks,the students, ages 18 to 21, were asked to sleep lon-ger; the goal was 10 hours a night.

The study was conducted during their regular tennisseason; athletic per ormance and mood were mea-sured a ter every practice session.

Cheri Mah, a researcher at the Stan ord Sleep Disor-ders Clinic and Research Laboratory and lead authoro the study, acknowledged that the athletes didntalways hit the 10-hour mark. But they noticed a di -erence even i sleep was extended by a hal -hour,she says: The athletes sprinting drills were aster,their hitting was more accurate and deeper, and theirmood improved.

The study was part o a research abstract presentedin Seattle last month at the annual meeting o the As-sociated Pro essional Sleep Societies.

Frank Wyatt, president o the American Society o Exercise Physiologists, says the study is too small tobe de nitive. But natural hormones are released intothe brain during sleep that aid in the physical recov-ery process, he says.

Serotonin and growth hormone are both releasedinto the body while you sleep, he says, These en-hance your mood and acilitate tissue repair, respec-tively. So i you get extra sleep, youre going to have abetter mood and have enhanced recovery.

Sleep habits a ect weight, study fndsPeople who sleep ewer than six hours a night or more thannine are more likely to be obese, according to a governmentstudy out Wednesday that is one o the largest to show a linkbetween irregular sleep and obesity. The study also linked light

sleepers to higher smoking rates, less physical activity and more alcohol use. The research addsweight to a stream o studies that have ound obesity and other health problems in those whodont get proper sleep, says Ron Kramer, a Colorado physician and a spokesman or the AmericanAcademy o Sleep Medicine. The data is all coming together that short sleepers and long sleep-ers dont do so well, Kramer said. The study is based on door-to-door surveys o 87,000 U.S.adults by the National Center or Health Statistics, part o the Centers or Disease Controland Prevention.

By Michelle HealeyUSA TODAYThursday, September 24, 2009


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As seen in the Gannett News Service on Thursday, September 24, 2009

Sleep deprivation might lead to Alzheimers diseaseBy RANDY DOTINGAGannett News Service

I youre middle-aged, you might want to try a littleharder to get a good nights sleep, now that new re-search suggests the right amount o slumber mightkeep Alzheimers disease at bay.

The research was conducted in mice and is prelimi-

nary, and it may not apply to humans. Still, the pos-sible link between sleep deprivation and Alzheimersraises the prospect o possible treatments that targetrelated pathways in the brain, explained study au-thor Dr. David M. Holtzman, chairman o neurologyat Washington University School o Medicine in St.Louis.

This might be a way to delay or prevent the diseaseby doing something in middle li e rather than wait-ing until something goes wrong, Holtzman said.

The Alzheimers Association estimates that as manyas 5.3 million people in the United States have thedisease, which is the countrys seventh-leading causeo death. Alzheimers disease is incurable, and al-though some treatments are available, they only re-lieve symptoms. In some cases, those symptoms in-clude sleep problems.

Holtzman and his colleagues were not initially look-ing at sleep, but instead wanted to better understandhow a protein clogs the brains o people with Al-zheimers. Its not clear how these clogs, known asplaques, and structures called tangles cause symp-toms. But experts think it may have something to dowith their disruption o how neurons communicatewith each other.

The researchers developed a way to monitor thelevels o the protein by the hour in both humans

through a continual measurement o their spinal fuidvia a catheter and mice. Their ndings are reportedonline Sept. 24 in Science.

The researchers discovered that the level o the pro-tein went up during waking hours and ell duringsleep. Holtzman said that its levels may be related tobrain activity, which is higher during waking hours.

In mice, the researchers ound that sleep deprivationboosted the levels o the protein, which builds up inplaques.

I a person is awake or a long time, levels o the pro-tein might build up, Holtzman said. This could play arole in middle age because Alzheimers disease be-gins to clog the brain several years be ore symptomsbecome apparent.

Dr. Nikolaos Scarmeas, an associate pro essor o neu-rology at Columbia University Medical Center in New

York City, said the ndings are very impressive, ex-tremely valid and use ul.

Researchers have linked sleep problems and Al-zheimers disease be ore, he said, but rom the per-spective o the sleep problems being a symptom o the illness and a result o aging. The idea that sleepdeprivation might cause Alzheimers deserves moreattention, Scarmeas said.

Holtzman said that uture research should investigatehow processes in the brain can be manipulated withdrugs so that people get more sleep and less brainclogging.

For now, though, his advice is short and simple: Getenough sleep in middle age.


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As seen in USA TODAY LIFE Section, Monday, November 26, 2007 Page 9D

Late nights could catch up with youBy Kathleen FackelmannUSA TODAY

Youve got a long list o e-mails to return, bills to payand, oh, yeah, you dont want to miss the latest epi-sode o The O ce.

By the time you crawl into bed, its nearly midnight.The alarm goes o at 6 the next morning, and bin-go! Youve just joined the legions o Americans whoare bleary-eyed and fat-out tired most days o theweek.

For years, sleep researchers have been preaching thedangers o lost sleep: People who are atigued cantpay attention to routine tasks, have trouble learningand are prone to a laundry list o health problems,rom depression to high blood pressure.

New research suggests an added risk to losing sleepday a ter day: Humans and animals that have chronicsleep deprivation might reach a point at which thevery ability to catch up on lost sleep is damaged, sayspro essor Fred Turek, a sleep researcher at North-western University in Evanston, Ill.

His research on sleep patterns in rats appeared thissummer in the Proceedings o the National Academyo Sciences. That, together with ndings rom a hu-man study, suggests people who lose sleep night a ternight might not recover the alertness they need to

per orm well during the day.

So ar the studies dont tell researchers whether thedamage is permanent. But they do suggest that peo-ple who go to work atigued day a ter day might per-orm consistently at a subpar level.

They may say, Hey, Im doing ne. I dont need moresleep, even as their per ormance on memory and at-tention tests goes down, Turek says.

People who lose sleep because o a single all-nightertypically make up or it by boosting the amount o deep sleep they get the next night, says study co-au-thor Aaron Laposky, also rom Northwestern. Deepsleep is thought to restore alertness and helps keepmemory and other brain unctions in top orm.

People also make up or the occasional bout o insom-nia by sleeping in on weekends, Laposky says.

But is that capacity lost when sleep deprivation be-comes a act o li e?

At Northwestern, researchers kept lab rats awake or20 hours and then let them sleep or our hours. A terthe rst night, the rats recovered; when they wereallowed to sleep, the rats ell into a deep sleep morerequently than they did when well-rested.

But a ter three nights o sleep deprivation, the ratsailed to show an increase in deep sleep. And at theend o the ve-day study, the animals were givena chance to sleep in, but the rats recovered almostnone o the lost sleep.

The ability to compensate or lost sleep is itsel lost,which is damaging mentally and physically, Tureksays.

Sleep expert David Dinges says people seem to re-spond to a chronic lack o sleep the same way.

Dinges, a researcher at the University o PennsylvaniaSchool o Medicine in Philadelphia, and his colleaguesstudied 48 healthy people. Some got eight hours o sleep a night while others stayed up, losing rom twoto our hours o sleep a night.

By the end o two weeks, the people who had lostsleep at night said they no longer elt tired during theday. But test scores revealed a di erent story, accord-

Researchers suspect that once sleep is lost, it may be gone orever


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As seen in USA TODAY LIFE Section, Monday, November 26, 2007 Page 9D

ing to the 2003 study published in the journal Sleep.

The sleep-deprived group had trouble paying atten-tion, had slower reaction times and developed im-pairments in memory, Dinges says.

The ability to end o sleep might have evolved tohelp animals and humans survive a natural disaster.People orced to evacuate during a re or hurricaneo ten lose sleep or a short period, but theyre morelikely to make it through a crisis alive, Turek says. The trouble is humans have built a society that runsround the clock, Turek says. Cellphones, laptops and

other electronic devices make it easy to stay con-nected at all hours. All-night TV and an extendedworkday also can rob sleep, says James Walsh, execu-tive director o sleep medicine at St. Lukes Hospitalin St. Louis.

Surveys now show that most people in the USA getless than seven hours o sleep a night, about an hourless than the average sleep time 40 years ago.

No one really knows the ull e ect o the steady ero-sion o sleep time. Only a study that keeps track o

lots o sleepy humans or a long time would answer

that question, Turek says.But even i the damage can be reversed, theres plen-ty o scienti c evidence suggesting that sleep loss isbad or your health.

For example, atigue might play a role in obesity. Andtheres no question that sleep loss plays a role in atal-ities on the highway. The National Sleep Foundationsays drowsy driving is the likely cause o more than100,000 car crashes each year in the USA.

For that reason alone, Dinges and other experts rec-ommend getting seven to eight hours o sleep onmost nights. Losing just an hour night a ter night canlead to oggy thinking and slow reaction times.

The de cits can become severe, Dinges says.

People who put o bedtime to get more done mightnd its wiser to make their sleep a priority. You needto make sure sleep time is protected, he says.

Dont lose that snooze

The American Academy o Sleep Medicine, the National Sleep Foundation and other sleep experts o erthese tips on getting a good nights sleep:

Do not stay up late to talk on the phone or surf the Internet. Keep computers and TVs out of the bedroom. Stick with a regular bedtime.

Avoid food or drinks with caffeine, especially at night. Such stimulants can keep you awake. Dont stay up all night to cram for a big work project or to nish homework if youre in school. Avoid vigorous exercise within a few hours of bedtime.


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Late nights could catch up with youBy Darla CarterGannett News Service

Pencils. Check.

Paper. Check.

Folders. Check.

A sleep schedule?

I that last item is missing rom your childs back-to-school list, then its time to write it in, some expertssay.

Children and teens not only need plenty o sleep,but a consistent sleep schedule that includes a regu-lar bedtime, says Sarah Honaker o the University o Louisvilles Pediatric Sleep Medicine Center.

I think it really improves the quality o li e or thechild and (may improve) the childs mood ... and cer-tainly that has important implications or ... the well-being o the amily in general, says Honaker, a psy-chologist.

Past surveys by the National Sleep Foundation, a non-pro t organization that educates the public on sleepand sleep disorders, have ound that children o tendont get enough sleep.

Parents should be concerned about that because i

children are sleep-deprived, theyre not going togive their best e ort, says Ron Kron, clinical man-ager o the Sleep Disorders Center at Floyd MemorialHospital in New Albany, Ind.

Sleep allows the body to restore and re resh itsel ,says Kron, a registered respiratory therapist. I youdont get enough sleep ... youre going to be tired anddrowsy through the day.

Also, Honaker notes, We know that sleep depriva-tion can impair learning; it impairs mood, physicalhealth.

The National Sleep Foundation recommends 9 to 11hours o sleep a night or children 5 through 12 whoattend school, and 8.5 to 9.5 hours a night or adoles-cents.

Estimates among experts vary. Elementary-age chil-dren and young intermediate-age children probablyneed 10 hours o (nightly) sleep, and then the adoles-cents need at least nine, but thats sort o a beginningpoint, says Dr. Vincent McCarthy, a physician andassociate pro essor with the University o Louisvillessleep center.

Ease back into schedule To ensure that youths get enough sleep, parentsshouldnt wait until the last minute to get them backon a school-year sleep schedule, Honaker says.

Its important to return to the schedule graduallybecause i you ask a child whos been going to sleepat 10 or 11 all summer all o a sudden to all asleep at8, then chances are theyre not going to be able to allasleep at that earlier time, Honaker says.

She suggests having the children go to bed earlier andearlier each night until they reach the target bedtimethat you want them to stick with during the school

year.Having a regular bedtime is important, even or teens,who have unique challenges, she says.

Teenagers tend to eel tired later and want to sleeplater, and thats a biological tendency.

However, because o typical school times, they haveto wake up early, they get sleep-deprived during the

As seen in the Gannett News Service on Thursday, August 14, 2008


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week and then they do sort-o catch-up sleep on theweekends or (take) a ter-school naps, she says.

Honaker pre ers that children not be allowed to sleep-in more than 30 to 60 minutes on weekends.

Sleeping in longer than an hour can really causeproblems with their sleep schedule, keeping themrom being sleepy at bedtime, Honaker says.

The same goes or naps, which Honaker discouragesexcept under special circumstances, such as sick-

ness.

Kron doesnt oppose naps as long as they dont keepthe child rom sticking to his or her bedtime.

To help kids sleep, encourage them to relax be orebed and to minimize light, even the glow rom elec-tronics. Such light can be pretty power ul, and itsends a cue to the system that its time to be awake,Honaker says.

In act, the bedroom should be electronics- ree, i possible, she says. This will help remove the tempta-tion to use them close to bedtime, allow parents tomonitor use more closely and create an associationbetween the bedroom and sleep.

The bedroom should be used basically to sleep,Kron agrees. No television, no computers, no games.When its time to go to bed, its time to go to bed.

As seen in the Gannett News Service on Thursday, August 14, 2008


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Discussion Questionsu Re er back to the articles on lack o sleep, drowsy drivers and the possible boost to athletes rom extra

sleep. Create a list o the mental, physical and emotional consequences o poor sleep. Add consequencesrom your own personal experiences.

u Shortened sleep time has been linked to health impairments as indicated in the ar ticles on weight changeand Alzheimers links. In group or individual study, determine what you think are the top 5 causes o short-ened/restricted sleep or you. What are the underlying reasons or each cause (e.g. culture, personal choice,need-based)? How can one realistically prevent shortened sleep?

u Some research suggests that sleep-deprived drivers can be as dangerous as drunk drivers. Should there bea law similar to a DUI or sleepy drivers? Create a mock debate or this proposed law. Be sure to considerhow you will determine sleepiness, the guidelines or punishment (e.g. i adults need less sleep than teen-agers are adults allowed to be sleepier than teenagers without ne?), and the implications or uture laws.Use other evidence to support or reject the proposed law.

u People with short sleep (6 hours or less) or too much sleep (9 or more hours) are more likely to be obesethan those sleeping about 8 hours a night. Given this evidence, a hypothetical sleep diet appears whichclaims that the average sleep deprived and overweight American can now sleep themselves thin! Write a2-minute paper describing why you would or would not believe this diet could work. (Hint: Which do youbelieve happens rst: Sleep changes or obesity?)

u Good sleep habits and hygiene may be just as important as diet and exercise or a healthy body and mind.Individually or in groups, increase sleep hygiene awareness by creating a small skit, poster, brochure, orcommercial promoting healthy sleep habits.

Future Implications

u Your sleep/wake cycle is tightly linked to your bodys circadian rhythm. Your circadian rhythm includesdaily fuctuations in many things rom gene expression to behavior (e.g. stress hormone levels, body tem-perature). O ten it is di cult or scientists to determine what is due to altering circadian rhythms and whatis due to altering sleep. How can we use our understanding o circadian rhythms to prevent sleep depriva-tion?

u Dr. Van Cauter ound that healthy young adults undergoing sleep restriction or 1 week developed symp-toms o metabolic syndrome. How is sleep linked to metabolism? How is sleep linked to other health prob-lems (e.g. depression)?

u New research suggests that people may not be able to catch up on lost sleep when chronically sleep re-stricted. How do we determine an individuals limit to sleep restriction and what are the consequences o permanently losing sleep?

u How can we maximize the quality and bene t o the sleep we are getting when we are able to get it?

u What other variables a ect sleep? Do men and women respond di erently to sleep challenges? How mightdrugs (e.g. prescriptions, ca eine), light exposure, exercise, eeding patterns, and stress positively or nega-tively a ect sleep?


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USA TODAY Collegiate Case Study: The Truth About Sleep: Myths, Realities, Needs