March 18: World Sleep Day
Sleep expert: Schools should start at 9 to give kids more hours of sleep A good night’s rest is essential to their physical and cognitive growth By Aaron Gifford
N
eurologist Antonio Culebras has studied sleep for more than 40 years now. The more he learns about the process, the more mysterious it becomes. Culebras knows what happens when we are in a deep slumber, what can happen if we don’t get enough rest and what can be done to help people sleep better. And yet, he and other experts who have shared their discoveries around the globe still cannot answer that one fundamental question. Why do we sleep? “We still don’t know why,” said Culebras, consultant for the Community General Hospital Sleep Center in Syracuse and a professor of neurology at Upstate Medical University. “The closest we can come to an answer is just to say to be fully awake the following day, you have to sleep. That’s it.” As Culebras and other sleep scientists continue searching for that answer, they want to share what they’ve learned in the field so far and promote the importance of a good night’s rest through the upcoming World Sleep Day event on March 18. Culebras, one of the event’s founding fathers and its co-chairman, announced that the 2011 theme focuses on children — “Sleep Well, Grow Healthy.” The World Association of Sleep Medicine (WASM) established the event in 2009, employing the motto “Sleep Well, Live Fully Awake.” Last year’s slogan was “Sleep Well and Be Healthy.” The celebration actually takes place online, launched from a computer server in China. On the day of the event, The World Sleep Day website (www.worldsleepday.org/World_ Sleep_Day/Welcome.html) will have information, stories and videos that educate viewers about the importance of sleep. Children, Culebras said, need between nine and 12 hours of sleep per night, depending on their age. A good night’s rest is essential to their physical and cognitive growth and development. He cited lab tests that focused on hormone growth during sleep and determined that rats that were deprived of sleep did not fully grow. He also noted a recent long-term study in China that focused on quality of sleep. That study found that infants who used the most moisture-absorbing diapers went on to perform much better in school than children who did not use the higher-quality diapers. “Sleep is a must,” he said. “It’s like eating. We spend one-third of our life sleeping. It’s critical to being healthy.” Although some of the commandments sound obvious (see side story), Culebras said many people that he has treated over the years were not aware of them. He also said experts in the United States, Japan, China and Spain are finding that, despite public informa-
tion campaigns on the importance of a good night’s rest, many children are still sleep-deprived. This is a common problem in households where both parents work long hours and have to get their children up early to go to a day care center before school starts. Culebras also thinks that school simply starts too early in the morning. “If they’re getting up to catch a bus at 7 a.m. or 7:30 a.m. that goes against their biology” he said. “Kids are sleep deprived because of it, and it’s an emerging epidemic around the world. School should start later in the morning, maybe 9 a.m., and just run later into the day, say 4 or 4:30 p.m.” Sound sleeping habits learned at an early age can carry into adulthood, Culebras added. At the nationally accredited Community General Sleep Center, he treats patients with insomnia, narcolepsy and sleep apnea, a disorder where the patient’s uneven breathing affects their ability to go into a deep sleep. Culebras works alongside a team of subspecialists that includes pediatric neurologists and ear, nose and throat specialists. Culebras, of Manlius, maintains that, despite his busy schedule as a physician, he usually gets eight hours
of sleep a night, “except sometimes when I’m on call and I have to go in.” A native of Spain, Culebras began his sleep research at Boston University in 1970. Back then, sleep apnea was unknown and insomnia was viewed as a psychological problem, not a neurological one. “This area of medicine has advanced so much since then,” said Culebras, who has also worked at the Syracuse Veterans Administration hospital. “With sleeping patients we can look at what centers of the brain are still lit up and active during the night.” Culebras finds that often, someone who is severely sleep-deprived shows the same type of physical behavior as an intoxicated person, including clumsiness, lack of coordination and slurred speech. While lack of sleep is an immediate danger for drivers, over the course of time it also affects your memory, judgment, and other functions of the brain and body. “There are cases where someone had convulsions, or the inability to think straight,” he said. “Lack of sleep is not like cancer where it can kill you in three months, but it can catch up with you over time and decrease the quality of your life.”
■ 10 Sleep Commandments for Children 1. Go to the bed around the same time every night. 2. Avoid overstimulation during the hour before bedtime. This would include television, video games or other electronic devices. 3. Make the child’s bedroom conducive to sleeping. The room should be fairly dark, and not too hot or cold. 4. Encourage your child to sleep independently. “They need to know how to fall asleep when you are not in the room with them,” said Antonio Culebras, consultant for the Community General Hospital Sleep Center in Syracuse and a professor of neurology at Upstate Medical University. “Otherwise, they may never develop good sleeping habits.” 5. Avoid bright lights close to bed time, but expose them to the brightest lights possible at wake-up time. “The brighter the better,” Culebras said. “There’s a function between the retina and the brain that orchestrates rhythms for sleeping and waking up. The bright light increases your chances of being fully awake during the day.” 6. Keep televisions and other electronic devices out of the child’s bedroom. 7. Maintain a regular daily schedule for sleeping, eating, exercising and other activities. “We have to be consistent day to day,” Culebras said. “Otherwise, your brain and body become confused, and you can get sick easier.” 8. Have an age-appropriate nap schedule. Culebras said children 5 and older typically don’t need a daytime nap. 9. Get plenty of exercise. Those who get sleepy around mid-day can simply activate their body’s natural circadian rhythms by getting up and moving around. As your heart pumps faster you will feel more awake. 10. Avoid cola, chocolate and other products with caffeine as often as possible, and never consume them past noon.
■ 10 Sleep Commandments for Adults
Dr. Antonio Culebras, consultant for the Community General Hospital Sleep Center in Syracuse and a professor of neurology at Upstate Medical University. March 2011 •
1. Fix a bedtime and an awakening time. 2. If you are in the habit of taking siestas do not exceed 45 minutes of daytime sleep. 3. Avoid excessive alcohol ingestion 4 hours before bedtime and do not smoke. 4. Avoid caffeine 6 hours before bedtime. This includes coffee, tea and many sodas, as well as chocolate. 5. Avoid heavy, spicy, or sugary foods 4 hours before bedtime. A light snack before bed is acceptable. 6. Exercise regularly, but not right before bed. 7. Use comfortable bedding. 8. Find a comfortable temperature setting for sleeping and keep the room well ventilated. 9. Block out all distracting noise and eliminate as much light as possible. 10. Reserve the bed for sleep and sex. Don’t use the bed as an office, workroom or recreation room. IN GOOD HEALTH – CNY’s Healthcare Newspaper
•
Page 11