SLEEP AND COLLEGE LIFE Waverly Green, III, MD Teresa Green, MD WestCare Sleep Disorders Center: Harris Regional Hospital Sylva, NC Overview • Why Sleep is Important • Consequences of Sleep Deprivation • Recognizing Sleep Disorders • Tips for Good Sleep Sleep is Vitally Important... • • • • • Growth and physical development Learning & memory consolidation Cognitive & physical performance Mood and emotional stability Health maintenance and prevention of disease Sleep Needs Vary Over the Life Cycle Newborns/ Infants 0 - 2 months 2 - 12 months 10.5-18 hours 14-15 hours Toddlers/ Children 12 - 18 months 18 months - 3 yrs. 3 - 5 yrs. 5 - 12 yrs. 13-15 hours 12-14 hours 11-13 hours 10-11 hours Adolescents/ On Average Young Adults 9 hours Adults/Older Persons 7-9 hours On Average Yet… College Students are Chronically Sleep Deprived • Average significantly less sleep (6-7 hours). A 2hr sleep debt each night! • Most experience excessive daytime sleepiness on a regular basis (50-70%) • Report twice as many sleep problems as the general population Why? • The obvious: – Academic workload • The less obvious: – Social activities, extracurricular activities, and jobs – Computer / internet / TV / cell phones – Excessive caffeine use, alcohol and/or recreational drugs – Delayed sleep phase and irregular sleep wake schedules Social pressures Class start times / delayed sleep phase Substance abuse Academic workloads Slee p Time Genetic predisposition Computer, Internet, TV, Cell phones Delayed Sleep Phase Sleep Schedule In order to get to classes on time, many students must wake early and shorten their sleep time. QUESTION: • What do the following disasters have in common? • Three Mile Island • Chernobyl • Exxon Valdez • Space Shuttle Challenger QUESTION: • What do the following disasters have in common? • • • • Three Mile Island Chernobyl Exxon Valdez Space Shuttle Challenger • All are attributed in some degree to the poor judgment of sleep deprived workers. Effects of Sleep Deprivation 1. Impaired alertness/excessive daytime sleepiness • Alertness is impaired after: 3 hrs of sleep for 1 night 5 hrs for 2 nights However, although the individual’s subjective sleepiness levels out, cognitive and performance impairment does not: * We are not always aware of the severity of our impairment * Effects of Sleep Deprivation 2. Impaired performance (cognitive and motor) • • • • Impaired short-term memory Decreased reaction time and judgment Increased number of errors Impaired information processing All of which can lead to lower academic performance… Effects of Sleep Deprivation Would you ever take an test drunk?…… • 18 hours awake produces performance impairment = 0.05% Blood alcohol level (BAL) • 24 hours awake = 0.10% BAL. • Chronic sleep restriction of 4-6 hrs for 2 weeks also results in performance deficits = 0.08% BAL • On 4 hours sleep, 1 beer can have the impact of a sixpack. Sleep and College Performance • Study at St Lawrence Univ. “All nighters” correlated with lower GPAs • Study at Stanford Univ. Academic and athletic performance in basketball players improved with lengthening of sleep time • Study in South Korea Staying up late associated with poorer academic performance Effects of Sleep Deprivation 3. Health Problems • • • • • Mood disturbances – depression, irritability, and anxiety Weight gain Insulin resistance leading to diabetes Impaired immunity Increased cardiovascular problems – hypertension, stroke, heart attack The Consequences of Sleep Deprivation on the Highway Sleepiness and Driving • 15-20% of all MVA’s felt to be sleep related. • DOT estimates 100,000 MVA’s per year direct result of driver sleepiness/drowsiness. • 1500 fatalities / 71,000 injuries per year. • Excessive sleepiness 2nd leading cause of car accidents, and a major cause of truck accidents in the US. • The peak age for fall-asleep driving accidents is 20. • Drivers under 30 account for 2/3 of all drowsydriving crashes. Drowsy Driving Recognizing The Warning Signs • Trouble focusing, keeping your eyes open or your head up • Daydreaming; wandering/disconnected thoughts • Yawning or rubbing your eyes repeatedly • Drifting from your lane, tailgating, & missing signs or exits • Feeling restless & irritable Drowsy Driving Countermeasures While Driving • Stop driving • Pull off the road at a safe place and take a short nap • Let a passenger take over the driving • Consume caffeine (best combined with a nap) • Don’t rely on “drowsy driving devices” • Be aware of shoulder rumble strips Watch for Sleep Disorders 1. Insomnia • • • • Affects up to 40% of college students Involves difficulty falling asleep or staying asleep, associated with daytime impairment Can be a normal reaction to short term stress When chronic can lead to long-term problems Watch for Sleep Disorders 2. Obstructive Sleep Apnea • • • • Airway closure during sleep, that leads to partial or complete pauses in breathing. This leads to drop in oxygen levels, rise in carbon dioxide levels, and eventually arousal from sleep Symptoms: snoring, pauses in breathing, gasping, frequent awakenings restless sleep, and daytime sleepiness Risk factors: obesity, male gender, small upper airway family history, neuromuscular disease Watch for Sleep Disorders 3. • • • • Restless Legs Syndrome Unpleasant, tingling, painful or restless feeling in the legs occurring primarily in in the evening. Worsened by rest/inactivity and relieved by movement. Can be associated with legs movements during sleep. Can be associated with sleep disruption and daytime sleepiness. Watch for Sleep Disorders 4. Narcolepsy • • • • Severe excessive daytime sleepiness and uncontrollable “sleep attacks”, sleep paralysis, and hallucinations at the onset of sleep May be associated with sudden episodes of muscle weakness triggered by emotional situations 1/2000 people and often diagnosed late due to subtlety of symptoms Can be very disabling, but is treatable with medications When Should You Get Help? • Trouble getting to sleep or waking up frequently during the night for several weeks • Excessive daytime sleepiness (falling asleep at inappropriate times despite adequate sleep) • Sudden attacks of sleep or muscle weakness (especially associated with emotional situations) • Loud snoring or witnessed episodes of not breathing during sleep Healthy Sleep Tips • Maintain a regular sleep schedule, even on weekends. • Allow for relaxing activities during the hour before sleep • Create a sleep friendly environment: • Go to bed only when sleepy and get out of bed if unable to fall asleep. • Exercise daily, but not too close to bedtime • Avoid caffeine, nicotine, and alcohol, especially in the late afternoon and evening • Avoid naps, particularly in the late afternoon or evening Make Sleep a Priority!