College Students: Getting Enough Sleep is Vital to Academic Success 0
Research is increasingly showing that more and more students are not getting enough sleep, which can have a negative impact on their grades. Among the reasons for these changes in sleeping patterns are increased part-time working hours, pulling all-nighters to finish a paper or cram for an exam, and watching television at bedtime. According to the American Academy of Sleep Medicine (AASM), the best way to maximize performance on final exams is to both study and get a good night of sleep.
Lawrence Epstein, MD, medical director of Sleep HealthCenters in Brighton, Mass., an instructor of medicine at Harvard Medical School, a past president of the AASM and a member of the AASM board of directors, says that sleep deprivation effects not only whether a student can stay awake in class but how they perform as well.
“Recent studies have shown that adequate sleep is essential to feeling awake and alert, maintaining good health and working at peak performance,” says Dr. Epstein. “After two weeks of sleeping six hours or less a night, students feel as bad and perform as poorly as someone who has gone without sleep for 48 hours. New research also highlights the importance of sleep in learning and memory. Students getting adequate amounts of sleep performed better on memory and motor tasks than did students deprived of sleep.”
Clete A. Kushida, MD, PhD, associate professor in the department of psychiatry and behavioral sciences at Stanford University Medical Center, an attending physician at the Stanford Sleep Disorders Clinic, director of the Stanford University Center for Human Sleep Research and a member of the AASM board of directors, notes that the degree of daytime alertness is arguably the most sensitive measure as to how much sleep is necessary for the specific individual.
“If the individual is routinely tired or sleepy during the daytime, odds are that he or she is not getting enough sleep,” says Dr. Kushida. “To take it one step further, there are two primary factors that affect the degree of daytime alertness: sleep quantity and sleep quality. For the student-age population, sleep quantity and quality issues are both important. However, key factors affecting sleep quality, such as the major sleep disorders (e.g., obstructive sleep apnea and restless legs syndrome), are less prevalent in this age group compared to middle-aged or older individuals.”
Dr. Kushida adds that the importance of obtaining adequate sleep in the student-age population cannot be overemphasized.
“There are data that sleep loss leads to learning and memory impairment, as well as decreased attention and vigilance,” says Dr. Kushida. “In the student-age population, studies have found that factors such as self-reported shortened sleep time, erratic sleep/wake schedules, late bed and rise times, and poor sleep quality have been found to be negatively associated with school performance for adolescents from middle school through college. Thus, there is ample evidence to indicate that the lack of adequate nighttime sleep can lead to disturbances in brain function, which in turn, can lead to poor academic performance.”
Other recent studies outline the adverse effects of poor sleep among students with regards to their success in school:
- Sleepiness and poor sleep quality are prevalent among university students, affecting their academic performance and daytime functioning.
- Students with symptoms of sleep disorders are more likely to receive poor grades in classes such as math, reading and writing than peers without symptoms of sleep disorders.
- College students with insomnia have significantly more mental health problems than college students without insomnia.
- College students with medical-related majors are more likely to have poorer quality of sleep in comparison to those with a humanities major.
- College students who pull “all-nighters” are more likely to have a lower GPA.
- Students who stay up late on school nights and make up for it by sleeping late on weekends are more likely to perform poorly in the classroom. This is because, on weekends, they are waking up at a time that is later than their internal body clock expects. The fact that their clock must get used to a new routine may affect their ability to be awake early for school at the beginning of the week when they revert back to their old routine.
The following tips are provided by the AASM to help students get the most out of their sleep:
Go to bed early
Students should go to bed early enough to have the opportunity for a full night of sleep. Adults need about seven to eight hours of sleep each night.
Get out of bed
If you have trouble falling asleep, get out of bed and do something relaxing until you feel sleepy.
Stay out of bed
Don’t study, read, watch TV or talk on the phone in bed. Only use your bed for sleep.
If you take a nap, then keep it brief. Nap for less than an hour and before 3 p.m.
Wake up on the weekend
It is best to go to bed and wake up at the same times on the weekend as you do during the schoolweek. If you missed out on a lot of sleep during the week, then you can try to catch up on the weekend. But sleeping in later on Saturdays and Sundays will make it very hard for you to wake up for classes on Monday morning.
Avoid caffeine in the afternoon and at night. It stays in your system for hours and can make it hard for you to fall asleep.
Adjust the lights
Dim the lights in the evening and at night so your body knows it will soon be time to sleep. Let in the sunlight in the morning to boost your alertness.
Take some time to “wind down” before going to bed. Get away from the computer, turn off the TV and the cell phone, and relax quietly for 15 to 30 minutes.
Eat a little
Never eat a large meal right before bedtime. Enjoy a healthy snack or light dessert so you don’t go to bed hungry.
Those who believe they have a sleep disorder should consult with their primary care physician or a sleep specialist.
From: American Academy of Sleep Medicine
Which Country Gets the Most Sleep? 0
Sleep Apnea and COPD: What You Should Know 0
This blog post was written by Xavier Soler, MD, PhD, Assistant Professor of Medicine, Pulmonary and Critical Care Division, University of California San Diego
Chronic obstructive pulmonary disease (COPD) is very common leading to frequent physician visits and hospitalizations and become the 3rd leading cause of death in the U.S. COPD is the only major disease among the top 10 that continues to increase. Because of the long pre-clinical period, signs and symptoms of COPD develop predominantly in older adults.
Sleep-related disorders are most prevalent in adults and are associated with increased mortality and morbidity from obesity, cardiovascular diseases, diabetes, and depression, resulting in reduced quality of life (QOL) and increased health care costs. Patients with severe COPD commonly exhibit abnormal sleep like insomnia contributing to chronic fatigue, daytime sleepiness. Additionally, medications used to treat COPD, such albuterol or prednisone may affect sleep quality. A nocturnal reduction of nocturnal oxygen levels commonly seen in patients with COPD can have profound effects and contribute to long-term sequelae, producing arrhythmias, myocardial stress, and, possibly, lower survival.
Sleep apnea (OSA) is a chronic medical condition where the affected person repeatedly stops or nearly stops breathing during sleep. These episodes last 10 seconds or more and cause oxygen levels in the blood to drop leading to important health consequences. Usually it is caused by obstruction of the upper airway, resulting in obstructive sleep apnea. However, it may be caused also by a failure of the brain to initiate a breath, called central sleep apnea. OSA is very common, especially in older adults, occurring in up to 70% of men and 56% of women. Patients with untreated OSA have more automobile accidents and suffer from more family and social discord. Other important risk factors associated with OSA include smoking and alcohol. The symptoms of obstructive sleep apnea include loud snoring and/or abnormal pattern of snoring with pauses and gasps. Other symptoms include excessive daytime sleepiness, memory changes, depression, erectile dysfunction and irritability. OSA occurs in about 10 to 15% of patients with COPD, a condition referred to as the “overlap syndrome”. Although the prevalence of OSA is similar in patients with COPD as in the general population, individuals with both conditions without CPAP treatment have an increased risk of death and more hospitalizations from acute exacerbations.
Effective available treatments for OSA include continuous nasal airway pressure devices (e.g., CPAP); a mask is worn over the nose during sleep while compressed air is gently forced through the nose to keep the airway open. Different patients need different mask sizes and different pressure levels for optimal treatment results.
Oxygen therapy is used for low nocturnal oxygen levels and, medications such as non-benzodiazepines and behavioral therapy are current treatments for insomnia. Another type of treatment for obstructive sleep apnea is surgery to correct obstructions in the airways. The most common surgery is called UPPP, for uvulopalatopharngyoplasty. This surgery removes tissue from the rear of the mouth and top of the throat. The tissues removed include parts of the uvula (the flap of tissue that hangs down at the back of the mouth), the soft palate, and the pharynx. Tonsils and adenoids are usually removed in this operation. Surgical interventions are sometimes considered but are rarely successful. Another approach to treating OSA involves the use of oral appliances intended to improve breathing either by holding the tongue in place or by pushing the lower jaw forward during sleep to increase the air volume in the upper airway. In treating insomnia in COPD, benzodiazepines such diazepam should be avoided. However, newer compounds, such as zolpidem, may be safer in less severe COPD. Melatonin agonists can also be used. Cognitive behavior therapy is still considered the primary first-line treatment for insomnia, but has not yet been studied in COPD.
Exercise has been demonstrated to improve sleep in epidemiological studies. In a prospective study of 86 patients with chronic lung diseases referred to the UCSD pulmonary rehabilitation program (PR), we demonstrated a significant improvement in sleep quality after pulmonary rehabilitation measured with the Pittsburgh Sleep Quality Index (PSQI), a well-validated measure of overall sleep quality. Further studies to better characterize sleep-related disorders among COPD are under way.
In conclusion, sleep is poor in COPD patients and sleep disorders such OSA have profound effects on this population. Prediction of the patients diagnosed with COPD who are at risk for sleep difficulty but crucial because their clinical implications. Therefore, increased public awareness about this serious condition is of paramount importance. Clinicians should include sleep evaluation in patients diagnosed of COPD asking about daytime sleepiness, snoring, pauses while sleeping and insomnia symptoms, referring to the specialist when necessary to address treatment options of comorbid sleep disturbances, which may provide significant long-term benefit for such patients.