My regular readers are probably aware that the topic of adolescent sleep and the issue of starting times of schools are some of my favourite subjects for a variety of reasons: I am a chronobiologist, I am an extreme “owl” (hence the name of this blog), I am a parent of developing extreme “owls”, I have a particular distaste for Puritanical equation of sleep with laziness which always raises its ugly head in discussions of adolescent sleep, and much of my own research is somewhat related to this topic (see the bottom of this post for Related Posts).
So, I was particularly pleased when Jessica of the excellent Bee Policy blog informed me of the recent publication of a book devoted entirely to this topic. Snooze…or Lose! by Helen Emsellem was published by National Academies and Jessica managed to get me an Advanced Reading Copy to review.
You can also read the book online (or buy the PDF). Much more information on the topic can be found on the book webpage, on the National Slep Foundation website, on Dr.Emsellem’s homepage and the Start Later for Excellence in Education Proposal (S.L.E.E.P.) website. I strongly encourage you to look around those webpages.
Her daughter Elyssa wrote one of the chapters in the book and is promoting the book and the information relevant to teenagers at the place where teenagers are most likely to see it – on MySpace (you see – it’s not just music bands who caught onto this trick – serious information can be promoted at MySpace as well).
The main audience for this book are teenagers themselves and their parents – I think in this order although officially the order is reversed. Secondarily, the audience are teachers, administrators and officials in charge of school policy. Who this book is not targeted to are scientists and book reviewers because there are no End Notes!
On the other hand, what I got is an Advanced Reading Copy so the actual book may have end notes for all I know. I detected only a couple of typos, a reference to “see page X” in place of “see page 122″, and a reference to Process S as a “clock” (p.15) which it is not – Process C is a clock, Process S is an hourglass timer and mixing the two metaphors is confusing (but metaphors are tricky anyway). I am assuming that those errors were fixed in the real edition of the book.
Anyway, considering that the main audience are teens, their parents and teachers (i.e., laypeople), the book is admirably clear and readable. The book starts out with presenting the problem – the chronic sleep deprivation of adolescents in modern society – and provides ample evidence that this is indeed a wide-spread problem. It continues with a simple primer on physiology of sleep and circadian rhythms, followed by a review of the current knowledge of the negative consequences of chronic sleep deprivation: from susceptibility to diseases, through psychological and behavioral problems, to problems of physical and mental performance.
A whole chapter – the one I found most interesting – is devoted to the role of sleep in various kinds of memory and the negative effects of sleep deprivation on learning – both declarative and episodic memory, as well as kinesthetic memory needed for athletic performance and safe driving. This is where I missed the end notes the most.
Throughout the book, Dr.Emsellem makes statements of fact about sleep that are obviously derived from research. I’d like to see the references to that research so I can evaluate for myself how strong each such statement is. Although my specialty is chronobiology (physiology, development, reproduction, behavior, ecology and evolution) of birds, and secondarily that of mammals, reptiles, invertebrates and microorganisms (I could never quite get excited about clocks in fish, fungi and plants, or molecular aspects of circadian rhythms, or medical aspects of human rhythms), I am quite familiar with the literature on sleep, including in humans.
Thus, I know that the statements in the book reflect scientific consensus but that the meaning of “consensus” is quite elastic. In some cases, it means “there is a mountain of evidence for this statement and no evidence against it, so it is highly unlikely that this will change any time soon”. In other cases it means “there are a few studies suggesting this, but they are not perfect and there are some studies with differing results, and this can stand for now but is likely to me modified or completely overturned by future research”.
Having end notes would help the expert reader see how weak or strong each one of these findings is, and would also be suggestive to lay readers that the statements in the book are supported by actual research and are not just the author’s invention as seen in so many self-help books. End notes and references add to the believability of the text even if one does not bother to check the papers out.
The book then turns to variety of factors, both biological and social, that conspire to deprive our teens of sleep, both from the perspective of a sleep researcher and from the perspective of teenagers. Little snippets of teenagers’ thoughts on the topic are included throughout the book and add an important perspective as well as make the book more fun to read. Otherwise, the “case studies”, the bane of so many psychology books, are kept to the minimum, discussed very briefly, and used wisely..
In the next section, Dr.Emsellem turns to solutions. First, she present several tests of sleep deprivation that readers can administer themselves in order to self-diagnose the problem. She then describes ten different strategies that parents and teens can work on together in order to solve the problem of sleep deprivation and all the concomittant negative effects (and Alyssa adds her own chapter on the teen perspective on how those can work). If that does not work, she describes additional methods that a sleep doctor may prescribe to help solve the problem. There is also a short chapter describing a couple of other sleep disorders, e.g., sleep apnea, that also contribute to sleep deprivation in affected individuals.
The last portion of the book addresses the social aspects of sleep deprivation and changes that parents and teens can make in their homes, as well as broader community, towards solving the problem. For adults, being a role model for the child is important and this requires paying attention to one’s own sleep hygiene.
The very last portion is really the raison d’etre of the book – how to make one’s community change the school starting times. The author presents a couple of examples of school districts in which such change was enacted, the strategies parents used to force such changes and the incredible positive results of such changes. The whole book is really designed to provide information to parents and teens who are working on changing their local attitudes toward school starting times.
The schools used to start about 9am for most of the century (and before). Then, due to the pressure from business and economic (read “busing”) woes of school districts, the school starting times started creeping earlier and earlier starting back in 1970s until they reach the horirbly early times seen today in many places, requiring kids to get up as early as 5am in order to catch the school bus on time. As a result, high schoolers (and to some extent middle schoolers and college students) sleep through the first two periods in school, feel weak and groggy all day long, more eaily succumb to diseases, have trouble learning and performing well in school and the athletic field, and are in too bad mood to be pleasant at home – this is not the natural state of things as much as the stereotype of the “grouchy teen” is prevalent in the society, it is mainly due to sleep deprivation and the biggest factor causing sleep deprivation are early school starting times.
In places in which enlightened and progressive school boards succumbed to the wishes of parents and students, i.e., in places in which parents and students used smart diplomatic tactics to engender such change, the positive results are astounding. The grades went up. The test scores went up. The students are happy. The parents are happy. The teachers are happy. The coaches are happy because their teams are winning all the state championships. There is a decrease in tardiness and absences. There is a decrease in sick days and even in numbers of diagnoses of ADD and depression in teens. There is a drop in teen crime. There is a drop in car accidents involving teens (by 15% in one place!). The whole county feels upbeat about it!
While the book makes me – a scientist – thirsty for end notes and references, it does remarkably well what it was designed to do – arm the parent and kids with knowledge needed to make a positive change in their communities – a change that is neccessary in order to raise new generations to be healthy and successful, something we owe to our children.
We should do this no matter how much it costs, but the experiences from places in which the changes were made, contrary to doom-sayers, is that there was no additional cost to this at all. The changes were implemented slowly and with everyone involved pitching in their opinion and their expertise until the best possible system was arrived at, adapted to the local community situation. No new buses were needed to be rented. No unexpected new costs appeared. And having a safe, happy community saved money elsewhere (e.g., accidents and crime rate decline). And it worked wonderfully everywhere.
So, get the book and let your child read it, you read it, give a copy to other people in your community: the teachers, the school principal, the pediatrician, the child psychologist, the school board members, the superintendent of education and the governor. This is something that is easy to do, there are no good reasons against it and the health and the future of our kids is at stake. It is something worth fighting for and this book is your first weapon.
Sleep Schedules in Adolescents
ClockNews – Adolescent Sleep
More on sleep in adolescents
When Should Schools Start in the morning?
All Politics Is Local
Adolescent Sleep Schedule
Everything You Always Wanted To Know About Sleep (But Were Too Afraid To Ask)
Nicotine and Depression