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Glasgow Physician: Americans Need Better Understanding of Health, Academic Impacts of Lack of Sleep

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As researchers learn more about the human brain and body, we’re starting to understand more about the importance of sleep. For many in the health field, getting enough sleep ranks alongside diet and exercise in terms of importance.

For Dr. Phillip Bale, increasing the understanding of the importance of sleep is crucial to improving health, as well as the academic performance of children. Bale is a Family Physician from Glasgow where he serves as the Medical Director and Founder of the Bale Center for Prevention of Heart Attack, Stroke & Diabetes. He spoke to WKU Public Radio about his concerns over the quantity and quality of sleep the average American is getting—especially young Americans.
WKU Public Radio: What do we know about how much sleep teens in the U.S. are getting, versus how much sleep they need to function at a high level?

Dr. Bale: “Well, there really is some good data on that. The Kaiser Family Foundation has studied it extensively, and their statistics would indicate that the average American teenager today is getting about six hours and fifteen minutes of sleep. Brain research, on the other hand, is telling us that for optimal learning and daytime performance adolescents require about nine hours and fifteen minutes of sleep.”

“Sleep deprivation is cumulative, and it’s not hard to connect the dots to see how that may be a real factor in the under-performance of many of our educational institutions and our schoolchildren today.”

So if a teenager is only getting five or six hours of sleep—and in many cases much less than that—when they should be getting over nine, what are the real life consequences on the health and performance level of that individual?

“People who get less than five hours of sleep a night, even for one night, have about three times the risk of getting a cold or infection. The information leading to our understanding of the immune system tells us that sleep deprivation is very detrimental to our immune system, which can then even lead to certain cancers.”

“Behavioral problems are another major aspect of sleep deprivation. There’s an area of the brain called the amygdala, and sleep deprivation activates the amygdala, which has to do with anger, and maybe even bullying.”

Credit WKU
Dr. Phillip W. Bale is a Family Physician from Glasgow, KY where he serves as the Medical Director and Founder of Bale Center for Prevention of Heart Attack, Stroke & Diabetes.

“There are lots of data also linking sleep deprivation to obesity and diabetes, both in children and adults…cardiovascular disease, because sleep deprivation is associated with an increase in certain hormones in our body that are not good for our vascular system.”

“And the list goes on. As more research is done, the picture becomes clearer and clearer that sleep is necessary, and we should learn to value it more.”

Given what we know about the overall importance of sleep and how much sleep the average teen is actually getting, should we be starting school as early as we do in the U.S.? Most schools start around 8 a.m.—many even earlier than that. Should school start later in the day?

“Sleep requirements are different for different ages, and it’s not really just teenagers—it’s adolescents, which most people would define as being between 12 and maybe 22 or 23. So we’re talking about middle school, high school, and higher education students. Their brains are different, and they have about a three hour phase shift in melatonin production. Melatonin is the hormone that often signals to our body that we’re ready to go to sleep, and makes us sleepy.”

“So, as adults, that typically occurs between 9:00, 9:30, 10:00 at night. But for adolescents, their brains are different, and they don’t get sleepy until midnight or maybe 1 a.m.”

“So they actually have a physiological handicap, if you will, in a system where school may start at 7:30 or a quarter till 8. There’s quite a lot of data from different areas of the country that demonstrate that school districts that have delayed starting times have shown not only greater academic achievement, but less behavioral problems, better attendance, and improved retention rates.”

When it comes to the different levels of sleep, those of us who are non-experts often use terms like “light sleep” or “deep sleep”. I understand that one of the consequences of not getting enough overall sleep is that it prohibits the ability to get enough of the deep sleep cycle known as R.E.M. sleep.

“Yes, and this is a critical thing to understand, because typically you go through 90 minute cycles of sleep during the night. Toward the end of that 90 minute sleep cycle, you enter R.E.M sleep, which is the phase 4 ‘deep sleep’. Brain research today shows this is when a lot of learning and memory occurs.”

“The brain, during sleep, is very active—in fact, as active, and maybe even more active, than it is in the waking state. The other very interesting that is that the periods of R.E.M. sleep get longer and longer throughout the night, so you have your longest period of R.E.M. sleep typically between seven and eight hours. So if you’re sleeping less than seven hours, you’re cheating yourself of the longest period of R.E.M. sleep, which is when a lot of converting short-term memory into long-term memory, what we call consolidation of memory, occurs.”

What role does modern technology play in possibly inhibiting people—especially teenagers—from getting a good night’s sleep? I’m especially thinking about teens getting in bed and texting their friends, watching TV, etc.

“In my work with the local school district, I was not surprised when asking an auditorium full of children how many of them have TVs in their bedroom, and almost all of their hands went up. I asked them how many found themselves texting their friends at 11:00 at night, and almost all of their hands went up."

"So we have to educate parents, and we have to educate the students, that TVs in the bedroom are not conducive to good sleep patterns, and cell phones for adolescents probably ought to be checked in. But remember, the parents are probably going to bed and going to sleep (before the children) do."

"Some honest discussions need to occur, and at the heart of that needs to be both the health matters and the educational achievement matters, because it impairs both.”

Here are a few additional audio excerpts from Dr. Bale's conversation with WKU Public Radio:

PBATHL.mp3
Dr. Bale describes how sleep deprivation can impact athletes.
PBNAPS.mp3
What does research say about the effectiveness of napping?

PBFMRI.mp3
On the role functional MRIs are playing as researchers learn more about how sleep impacts our brains and bodies

Kevin is the News Director at WKU Public Radio. He has been with the station since 1999, and was previously the Assistant News Director, and also served as local host of Morning Edition.
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