Transcription:
Preparing Childen and Teens for Their Back-to-School Sleep Routine

Melanie Cole (Host): You may not realize it, but a good night's sleep is essential for a child's growth and development and certainly, for our teens. Many studies have shown that poor sleep quality in children is associated with many different issues — attentional, learning, memory, weight — so many things.

My guest today is Dr. Anita Bhola. She's a Sleep Specialist and Medical Director of Edythe Kurz Center for Sleep Medicine at Montefiore Nyack Hospital. Dr. Bhola, I'm so glad to have you with us today. As a mother of two teens, I know how important sleep is. What is the relationship between kids' sleep, school performance, and attendance?

Dr. Anita Bhola (Guest): Sure. Melanie, thanks for having me on today. Most teens do need about — who are about 11 to 17 years of age — do need about 8 ½ to 9 ½ hours of sleep per night in order to be alert, productive, healthy, and happy. Younger kids could need up to 10 hours. The problem is that when kids head back to school, especially after a long summer holiday, they get used to staying up late and sleeping in late. It's a condition called Social Jet Lag. We all face it as mothers. This can lead to difficulties transitioning back to their normal pattern for waking up for school as well as — even for college, as our body clocks are now used to a delayed bedtime.

It's especially true for adolescents because they are probably the most sleep-deprived of all age groups. As we know, their schedules are packed with homework, all kinds of academic demands, they have so many extracurricular activities going on. What's also important is that these kids also go through a biological change in their sleep during puberty where their bedtime is just naturally delayed. Most adolescents have delayed sleep times. They become night owls. When you combine this with early school start time — which is what is prevalent, especially here on the East Coast — you end up with a very sleep-deprived kid. This is not just true for school kids, but also for kids that return back to college after spending a long summer at home or elsewhere.

What happens with this insufficient sleep is that not only are the kids' memory and concentration impaired, but their academic performance can suffer. Even though a kid may put in an all-nighter, and they think, "Oh, you know what? I'm going to stay up to 2 in the morning, and I'll do great because I studied all night long." Well, guess what, that's not true because, on that morning math test, you are just so sleep-deprived that you're not going to be able to do well.

We also know that insufficient sleep — kids who are sleep-deprived will have a harder time getting up in the morning. I have an 18-year-old kid that's so hard to wake him up in the morning and often misses his school bus. There's tardiness. There's poor attendance.

What is most scary about the insufficient sleep is that we know from studies I now that there are higher rates of mental health issues in kids that are sleep-deprived, especially in the form of impulsive behavior, anxiety, and depression. We know a lot of kids suffer from anxiety and depression. Kids often will use stimulants such as caffeine or even prescription medications, sometimes when they need to stay awake for a test. What's really scary is that studies I have shown that there's a higher prevalence of addiction and substance abuse. There is also a higher incidence of drowsy, driving-related crashes. We know from studies that teenagers are a very vulnerable group when it comes to accident-related deaths. Drowsy driving in teenagers is a huge, big issue. The insufficient sleep in teenagers, according to the CDC, is a huge public health issue.

Host: Well, it certainly is. It is scary to think that our teens are driving around on such little sleep and that they're not able to really function adequately. How early in the summer do we start trying — because these kids want to sleep all day in the summer, Dr. Bhola — how early do we try to start getting them ready for that back to school routine where they have to be up, and get the bus, and have breakfast, and get ready for a good day at school and learning?

Dr. Bhola: Right. Melanie, I couldn't really give you the answer to that because kids are going to do what kids are going to do and sleep in. I would say that they do need a sleep tuneup that should really begin at least a couple of weeks before school or college starts. Understand that their internal body clock that's housed in our brains — you can't just fool it from let's say sleeping in until noon one day to having to wake up at 6:30 in the morning for the school bus. It doesn't work that way. You're going to end up with severe sleepiness on your first day back in school or college.

Begin early. Begin at least a couple of weeks early. As a parent, you need to work with your child to return them to that school-appropriate sleep schedule. I know college students have the ability to choose their classes even later in the day, but they should really start working on regularizing their sleep schedule.

Every night, set an incrementally earlier bedtime. It could even just be 15 minutes earlier. For about a week or so, advance your bedtime by 15 minutes to half an hour earlier. Every morning, get out of bed 15 minutes or half an hour earlier as well until you reach that desired bedtime and rise time, which is school-appropriate. That will make sure that when your school actually starts, they'll wake up with the amount of sleep that they need for their age group. Sometimes kids will go to camp, and in camp, they have to wake up early. That's actually a great thing where somebody else is doing the job for you.

Also, it's important to establish a relaxing bedtime routine. Start off with a quiet time. Allow your child to unwind. For younger kids, relaxing activities before bedtime could be a bath or a bedtime story. For older kids, it could be just putting their electronics away or reading. When you actually establish a back to school sleep schedule, make sure that the kid sticks with it and doesn't use the weekends to catch up on sleep. That is really, really key.

Host: All important points, Dr. Bhola. Now, I want to go back to when you talked about bedtime routine because these kids sit on their phone, and then they lay in bed with their laptops — and of course, screen time is all different now because part of their homework is on the computer. A lot of it — most of it, in fact. What do we tell them about sitting there on their phones? Usually, Dr. Bhola, they have those phones next to them so that they're buzzing all night. Give us a little sleep hygiene. How — as a sleep specialist that you are — how can we get them to stop doing some of those white light-blue light — all of that stuff that goes on before they go to bed?

Dr. Bhola: Right. You're absolutely right. Anybody who has walked into their kids' rooms in the middle of the night is well aware that electronics — computer screens are on, phones are buzzing. I walk into my kid's room at 2 in the morning sometimes because I'll see the light on, and there are notifications coming through. It's horrible. Not only is the noise distracting, but these devices also emit, as you mentioned, blue light. Blue light emitted from all of these electronic devices such as computer screens, televisions, smartphones, iPads, and what have you.

This blue light prevents the secretion of melatonin. Melatonin is a hormone that is secreted by the Pineal gland in our brain. It is the hormone that is responsible for inducing sleep. It's paradoxical that people who can't sleep will actually go and buy melatonin and take melatonin as a sleeping pill available over the counter when actually, your own brain is secreting melatonin at night. All you need to do is shut these devices off.

This blue light, by preventing the secretion of melatonin, delays the kid's bedtime even further. Now you've got a kid who can't even go to sleep, plus the noise, the notifications, et cetera, et cetera from all of their phones buzzing. They need to really start using these blue light blocking filters that are available for screens. There are blue light blocking glasses available. There are even amber colored light bulbs that are available. It's really, really important to use these. It's important in this age of social media an internet addiction that you, as a parent, have this very nasty, but important task to initiate a digital curfew for the entire family. It's very hard to do, but you need to set an example yourself, and you need to set a time when you and your kids will turn all for the night, you'll put your phones on the silent mode.

As far as homework on the computers, well, as I mentioned, these blue light blocking filters will be helpful. But again, doing your homework earlier would also be a good idea.

Host: Yeah, that certainly is a great idea and one that I work with my children all of the time trying to get them to do. Dr. Bhola, your best advice — you've given us so much great advice today — about the importance of teen sleep and quality sleep for our teens, getting them up, getting them ready. Wrap it up for us, what you would like us to know about teens, and sleep, and getting them into that good bedtime routine.

Dr. Bhola: Right. Melanie, I would say that the most important thing is that kids need to be educated on bedtime routines. They need to be part of the education process. They need to be your partners in this. You shouldn't really have to enforce these rules because the kid will sneak in that phone when you've turned your back. You need to educate them on how important it is for their well-being, for their not only mental and physical well-being, but also for their academic performance to stick with these bedtime rules. If you have to impose a digital curfew for electronics, then you need to.

But also, educate your kids on eating well and exercising regularly. They should not be eating a heavy meal close to bedtime because this may prevent them from falling asleep. Exercising daily would be a wonderful idea, but not close to bedtime as exercising close to bedtime can heat up the core body temperature, and it's not conducive to good sleep. Exercise sometime in the evening. Kids should avoid caffeine. They should be aware of the fact that sodas contain caffeine — most sodas, so they should read the label. They should really stop drinking caffeinated beverages in the afternoon, evening, or at night time. Caffeine can have a long half-life, and can hang around in the body for long, and can interrupt the kid's natural sleep patterns, making it difficult for them to fall asleep. Avoid anything with caffeine in it.

Also, if you're a parent of a high school kid, you may consider advocating for delaying the school start times. There are studies, such as in Minneapolis where school start times have been delayed until 8:30 am, and studies showed that there was less rates of depression, less rates of obesity, the grades improved, attendance was better, there was less tardiness, and there were less car accidents. The American Academy of Pediatrics has been recommending and pushing for middle- and high-school times to be delayed — that they delay their classes. Where I live, in New York, in some of the schools, they have started actually — they were successful in implementing this. I think that's a great thing.

And then, most importantly, be a good role model for your kids. Set a good example yourself. You need to have a good, regular sleep cycle and maintain a home that promotes happy healthy sleep.

Host: Great information. Great advice, Dr. Bhola. Thank you so much for coming on and sharing your expertise with us today. That wraps up this episode of our Health Talk Podcast. For more information, or to schedule a consultation appointment, please call (845) 348-2209 or head on over to our website at MontefioreNyack.org/TeenSleep to get connected with one of our providers. If you found this Podcast as helpful as I did, please share on your social media with your friends, and family, and teens, and be sure to check out the entire Podcast library for topics of interest to you. I'm Melanie Cole.