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Circadian Rhythms and School Start Times CTSS Conference, November 14, 2009

Outline. Sleep Requirements at different stages of lifeCircadian Rhythms at different stages of lifeConsequences of sleep lossTypical school schedules in AmericaHow these factors coincide (or not)Obstacles and considerations regarding school times. Objectives. Understand the circadian rhythms and sleep requirements of all age groupsUnderstand the issues surrounding school time scheduling and how this may or may not coincide with the sleep requirementsUnderstand the consequences of sleep l29813

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Circadian Rhythms and School Start Times CTSS Conference, November 14, 2009

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    1. Circadian Rhythms and School Start Times CTSS Conference, November 14, 2009 Debra Ann Pollack, MD Board Certified in Neurology and Sleep Medicine

    2. Outline Sleep Requirements at different stages of life Circadian Rhythms at different stages of life Consequences of sleep loss Typical school schedules in America How these factors coincide (or not) Obstacles and considerations regarding school times

    3. Objectives Understand the circadian rhythms and sleep requirements of all age groups Understand the issues surrounding school time scheduling and how this may or may not coincide with the sleep requirements Understand the consequences of sleep loss in children Become aware of what can be done to improve this situation

    4. Definition-CIRCADIAN RHYTHM Circa = About Dian = Day The body’s natural cycling of a variety of functions over the course of the 24-hour day. Actually 24.9 hours, but that’s a whole topic unto itself. Includes sleep-wake, hormones, temperature and others. Circadian rhythms can be influenced by external factors (zeitgebers): light/dark, clocks, activities, aromas, etc. The human body’s timekeeper is the suprachiasmatic nucleus (SCN) of the hypothalamus.

    5. Pre-school Sleep requirement approximately 12-14 hours per 24-hour period: 10-12 hour night Daytime nap (or two) Timing “advanced” (early) night (e.g. 7pm-7am) and midday nap

    6. Elementary School Sleep requirement approximately 11-12 hours, all at night Need to nap generally ends by age 5-6 Timing still “advanced” (early to bed, early to rise)

    7. Middle School Sleep requirement approximately 9-11 hours, all at night Timing of sleep starts to become “delayed” (later)

    8. High School Sleep requirement approximately 9-11 hours Circadian rhythm distinctly delayed (late to bed, late to rise)

    9. Adult Sleep requirement 7-8 hours Circadian timing of sleep period generally becomes more moderate during the 20’s---bedtime approximately 10pm-midnight, rise time approximately 6-8am. Generally no naps

    10. Consequences of Sleep Loss Sleepiness during day Sleeping in school Dozing while driving—high incidence of MVA’s in teenagers driving TO school Napping after school (which only delays bedtime further) “Catch-up” sleep on weekends Weight gain

    11. Consequences of Sleep Loss, cont. Inattention/poor concentration (if not overt sleepiness) Poor school performance Irritability Mood disorders, anxiety Substance abuse (to stay awake during day and to promote sleep at night) Impaired immune function

    12. Typical School Schedules in America Elementary Schools generally start late (e.g. 9am) and end late (e.g. after 3pm). After bus ride, many children don’t arrive home until 4pm or later! High Schools generally start early (e.g. 7:30am) and end early (e.g. before 2pm). Morning bus routes often begin before 6:30am!

    13. Some factors influencing school schedules HIGH SCHOOL SPORTS! HIGH SCHOOL SPORTS! HIGH SCHOOL SPORTS! After-school jobs (high-schoolers) Child care (older siblings watching younger siblings after school) One factor against current norm-care of young kids in am

    14. Some corrective measures Before-school care for young children Parents driving high schoolers to school Rotating class schedules Lights at sports fields/stadiums CHANGE THE MIND SET! CHANGE THE SCHOOL SCHEDULES!

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