• No results found

An Unrecoverable Sleep Deficit : A literary analysis of Adolescents’ sleep loss and the consequences of sleep deficit regarding academic performance

N/A
N/A
Protected

Academic year: 2021

Share "An Unrecoverable Sleep Deficit : A literary analysis of Adolescents’ sleep loss and the consequences of sleep deficit regarding academic performance"

Copied!
27
0
0

Loading.... (view fulltext now)

Full text

(1)

Linköpings universitet | Institutionen för IFM Examensarbete, grundläggande nivå, 15 hp | Lärarprogrammet Vårteminen 2020 | LIU-GY-L-G—20/191--SE

An Unrecoverable Sleep Deficit

A literary analysis of Adolescents’ sleep loss and

the consequences of sleep deficit regarding

academic performance

Hugo Åhs

Tutor: Matthias Laska Examinator: Thomas Östholm

(2)

2 Institutionen för IFM 581 83 LINKÖPING 16/01 - 2020 Språk Rapporttyp ISRN-nummer: Svenska/Swedish

X Engelska/English Examensarbete grundläggande nivå

LIU-GY-L-G—20/191--SE

Title An Unrecoverable Sleep Deficit Författare Hugo Åhs

Abstract:

There is a noticeable difference in the debate regarding adolescents’ sleep patterns between the biological clock and society’s clock when we talk about adolescents. Sleep scientists or somnologists, are alarming as more evidence reach the surface that young people are not getting the recommended sleep that is required to perform academically well. Not only are there direct connections between sleep deficit and academic performance, but sleep deficit also takes a critical toll upon their physical and mental health. The problem is that adolescents’ circadian cycle is postponed with a few hours compared to children and adults. This results in a major sleep deficit when adolescents must adjust to societal rhythms and habits – a clock they are not

programmed biologically to follow. Adolescents must attend to school in the early morning, when in reality their needs point to that school times in fact should start around 10:00. Society’s view has traditionally been that teenagers are lazy but in fact evidence does prove that it may not be the case. The following essay will therefore serve as an informative update to what has been stated by somnologists and raise awareness regarding adolescents and what happens when they are exposed to a chronic sleep deficit put on them by society.

Keywords: Adolescence, circadian cycle, education, school performance, school start times. NREM, REM, Sleep deficit, Chronotype

(3)

3

Innehållsföreckning

2. Introduction ... 4

2.1 Adolescents’ Circadian cycle ... 4

2.1.1 Students Well Being ... 4

2.2 Purpose and Thesis statement ... 5

3. Background ... 5

3.1 Somnology – The beginning ... 5

3.2 Somnology – Common Terms and Expressions ... 5

3.3 Somnology – How do we fall asleep? ... 6

4. Method ... 8

4.1 Search method ... 8

4.2 Research selection ... 8

4.3 Demarcation ... 9

5. Results ... 10

5.1 Sleep Research and Studies in Correlation to Academic Performance ... 10

5.2 Brain Developing During Adolescence ... 12

5.3 The Effects of Sleep in Correlation to School Performance ... 13

5.4 Insufficient sleep, a Determinant on Young Academic Brains ... 14

5.5 A Delay in Adolescents’ Circadian cycle ... 16

5.6 Adolescents’ Education Suffers from Sleep Deficit ... 17

6. Discussion ... 20

6.1 Sleep, the Brain and Academic Performance ... 20

6.2 School Start Times in Practice ... 21

6.3 Chronotypes ... 22

6.4 Sleep Quality, Sleep Duration and Sleepiness, Which One Is It? ... 22

6.5 Conclusion ... 23

6.6 For Future Research ... 24

(4)

4

2. Introduction

2.1 Adolescents’ Circadian cycle

There is a well-established natural shift in the circadian cycle, adolescents’ bodies natural mechanism for falling asleep and waking up (Paul. Kelley, Steven W. Lockley, Jonathan. Kelley & Mariah D.R. Evans, 1: 2017). Adolescents wake and sleep pattern are later compared to grown-ups/young children and thus come with a few problems (Kelley et al. 2017, 2). One of these problems is the mismatch between adolescent biological circadian cycle and the conventional practice of starting school early, which consequently becomes a systematic reduction in the amount of sleep teenagers receive and leads to chronic sleep deficiency (Paul. Kelley, Steven W. Lockley, Russell G. Foster & Jonathan. Kelley 2015, 211) (Judith Owens, Darrel Drobnich, Allison Baylor and Daniel Lewin 2014, 183). Chronic sleep deficiency or just sleep deficiency leads to increased health risks and have a substantial amount of evidence tied with it. (Kelley et al. 2017, 2). Albeit, there are multiple studies and ways to treat sleep deficiency in itself, one glaring problem arise when

somnologists examine sleep deficiency for adolescents which is that school start times are too early if we have the circadian-cycle shift in mind (Kelley et al. 2017, 2). The common school start times in Sweden is around 09.00 8-9am in the morning, and in UK it is 08.00-09.00am (Kelley et al. 2017, 2). What is also interesting is that there are no exact laws as to when school starts should start, and this is relative common across various European countries (Kelley et al. 2017, 3). Practically speaking it is up to the leadership at the school to determine when that day should start (SFS, 2018:1303).

2.1.1 Students Well Being

So, the facts are that today’s youth might actually suffer from sleep deficiency (or maybe even chronic) and if we would in fact scratch the surface and examine various problems that today’s youth suffer such as mental illness, we do see that there is a correlation between sleep deficiency and increasing mental illness in today’s adolescents (Kelley et al. 2017, 2).

Moreover, there should be a performance decline from an academic point of view (Kelley et al. 2017, 2). In fact, adolescents that are qualified from high school in Sweden is in decline (Skolverket, 2019), and while it is likely there are a lot of other contributing factors to why

(5)

5

that is, somnologists wonder if today’s youth get the necessary amount of sleep they require, and if they have the right pre-conditions to achieve high results during their academic carriers.

2.2 Purpose and Thesis statement

The purpose of this thesis is to examine research from various somnologists and see whether there is a connection between adolescents and their academic performance with regards to early school starts. Therefore, the aim of this thesis is to examine how insufficient sleep affect student’s academic performance during adolescence.

3. Background

3.1 Somnology – The beginning

To be able to understand the many processes that occurs while we sleep, and of course sleep itself, scientists invented the term somnology, which means the scientific study of sleep. It started off by just examining brain activity during sleep (1937), but it has branched out into different directions, such as study the brainwaves during different sleep phases, treat various sleep disorders but also into chronobiology, which is the field in biology that examines organisms biological rhythms (Shepard, J. W., Jr, Buysse, D. J., Chesson, A. L., Jr, Dement, W. C., Goldberg, R., Guilleminault, C., Harris, C. D., Iber, C., Mignot, E., Mitler, M. M., Moore, K. E., Phillips, B. A., Quan, S. F., Rosenberg, R. S., Roth, T., Schmidt, H. S., Silber, M. H., Walsh, J. K., & White, D. P., 2005, 1). Furthermore, Somnology could be regarded as a young scientific branch since discovery of the different sleep stages (see Somnology – Common Terms and Expressions) was made in 1953 and could be regarded as the milestone that would pave the way for the upcoming research funding’s later in 1960, when

somnologists made a breakthrough in understanding the disease narcolepsy, which is a disease that had been known for over a century. (Shepard et al. 2005, 1) Somnology has later flourished as increasing research organizations have been formed (Shepard et al. 2005, 7).

3.2 Somnology – Common Terms and Expressions

Sleep is something that all humans have in common and need in order to complete our daily lives, but sleep is a complicated process and somnologists still do not fully understand what

(6)

6

transpires in our brain when we fall asleep. One of the things somnologists do know is that sleep is composed out of different stages (National sleep Foundation, 2020). Non-rapid eye movement (NREM) and Rapid eye movement (REM) are the two major factors and what this thesis will be based upon. NREM enter four different stages;

• Stage one: Lightest sleep stage. One might experience falling or sleep twitches. • Stage two: Heart rate slows, muscles contract and relax, and your body temperature

decreases while the brain prepares to enter deep sleep.

• Stage three and four is the deep phases where the brain waves slow down, and it becomes more difficult to wake up.

• After phase 4 we enter REM and our heart rate, breathing and eye movement become more active meanwhile the brain process things that you have learned throughout the day, form memories and boost hormones such as serotonin. The process all through NREM to REM sleep is considered one cycle. (National sleep foundation, 2020) Moreover, people and especially adolescents need eight to ten hours of sleep per night (Kelley et al. 2017, 2), which translates to about five complete cycles in order for the brain to fully recover after a whole day’s activities (National sleep foundation, 2020)

3.3 Somnology – How do we fall asleep?

The brain receives input signals from a hormone called melatonin that is accumulated over time from our photoreceptors that absorbs light (National sleep foundation, 2020). A specific part in the brain reacts to the melatonin levels which is called master circadian pacemaker. The master circadian pacemaker is located in the suprachiasmatic nuclei (SCN) which is located in the hypothalamus. (Kelley, Paul & Lockley, Steven & Foster, Russell & Kelley, Jonathan., 2015, 211)

(7)

7

Fig 1 The optic nerve is in direct contact with the SCN which contains that Master circadian pacemaker. The master circadian pacemaker is what controls the melatonin levels in our body and determines whether we should go to sleep or not depending on the amount accumulated.

As the day progresses the amount of melatonin accumulated reaches a threshold which makes us eventually fall asleep. The SCN receives information from the photoreceptors (see fig 1) which are in line with the optic chiasm (Kelley et al. 2015, 211). The SCN co-ordinates with the entire circadian network which includes alertness, performance, hormones, core body temperature, metabolism (Kelley et al. 2015, 211). Once the necessary levels of the hormone melatonin are reached, we fall asleep and that is when we enter NREM sleep stage 1 and the cycle is completed when REM sleep goes back to NREM stage 1. The estimated time that these cycle takes is about 90minutes according to the Sleepfoundation (2020)

(8)

8

4. Method

4.1 Search method

This thesis will base its result from doing a qualitative literature analysis. Since research within somnology is still young compared to other scientific branches, I expected not to find enough gathered data that would be enough to do a quantitative data analysis. To my surprise there was quite bit of quantitative data, but nothing that expanded for over a couple of years, and not nearly enough that I felt comfortable to do a quantitative research analysis. Therefore, I was pleased to conduct a qualitative literature review analysis, in which I compared different research around adolescents and their sleeping pattern. I choose the keywords Sleep deficit; teen*; Adolescence; Academic performance; school performance when I searched after articles. The database that was chosen was Web of Science which I find comfortable to use and targets articles that is peer-reviewed in science that might not be widespread, furthermore, I chose to select only peer-reviewed articles to get more reliable research. A final note on my search method is that occasionally I used the ancestry method, often when a researcher named someone else’s research repeatedly in their own article.

4.2 Research selection

I read which ever article that was peer-reviewed and that I felt stayed on the topic about teenagers and their academic performance that involved their sleeping patterns. During my selection process I wanted to stay rather close to the topic and therefore upon writing the result selection I realized that I did not have enough background material in order for the reader to understand the result material, therefore I went back and searched for somnology; sleep; NREM; REM; Why do we sleep. For this part I also used google and choose an established sleep organization, National sleep foundation, as a part of my background research. This particular sleep organization was referred to by name in Shepard and

colleagues’ article “History of the development of sleep medicine in the United States” (2005, 9) and therefore I felt that its credibility was good enough to rely on. When I looked for information about the Swedish school system, I searched on Skolverket as it is a credible source in Sweden since it is managing authority and transparent with its research and information about Swedish schools.

(9)

9

4.3 Demarcation

Because there is a difference in which researchers define adolescence I had to sort out a lot of texts in which involved pre-teens and also late teenagers, in order for the thesis to have a more coherent age group. The selected age group is therefore between 13 and 18 when referring to adolescents. Moreover, since I found it hard to find somnology research based in Sweden I branched out and selected schools in which have relatively identical school systems and cultural parables.

(10)

10

5. Results

5.1 Sleep Research and Studies in Correlation to Academic Performance

Dewald, F, J, Meijer M, A, Oort, J, F, Kerkhof, A, G, Bögels, M, S. (2010) state, that earlier research indicates a correlation between poor sleep and poor academic performance, however, the research according to her lacks systematic reviews and therefore conducted an analysis evaluating empirical evidence (Dewald et al. 2010, 179). They therefore performed a meta-analysis analyzing different studies focusing on sleep in correlation to academic performance in order to discover consistencies in what appears as inconsistent data. They ended up

examine 26 different studies, that seemingly have different methodological differences and tries to make a conclusion based on the data, in order to make the studies more reliable (Dewald et al. 2010, 179). They categories different ways one measure sleep research in regards to academic performance and then draws the following conclusion:

• Social economic factors were incoherently reported and therefore excluded. • IQ was incoherently reported and therefore excluded.

• Age and gender were coherently reported and therefore included. • Self-reports, parent reports and teacher reports on sleep was subjective. • Grades from schools and standardized tests were deemed as objective.

• Some studies reported on sleep quality, whereas some studies reported on sleep duration and finally some studies were examining sleepiness.

By coding and calculating these different values and cross examine the 26 different studies they came up with a summarization of the data they gathered. Sleep quality affects academic performance more than sleep duration but that both affects academic performance if one receives less sleep than the recommended amount, whereas sleepiness affected school performance the most (Dewald et al. 2010, 182). From these results they identified that there might be three subcategories in which sleep affects academic performance; sleep duration, sleep quality and sleepiness (Dewald et al. 2010, 183). They conclude that research between the three domains, sleep quality, sleep duration and sleepiness, is in fact in line with previous made research that separate the three, when talking about school performance (Dewald et al. 2010, 183). When they discussed to how these three differentiate they found that sleep quality is more a more subjective feeling (feeling rested) and therefore might be influenced by other

(11)

11

factors, such as a stronger relationship with school performance (Dewald et al. 2010, 184), whereas sleep duration is a more objective measurement. Individuals require different amount of sleep duration in order to feel rested and therefore some individuals suffer from a more chronic sleep reduction as their sleep quotas might never be fulfilled (Dewald et al. 2010, 183). Individuals could therefore suffer from a sleep reduction that they can not control and leaves them more vulnerable to sleep reduction’s consequences compared to individuals who fulfill their sleep amount quotas (Dewald et al. 2010, 183). Furthermore, sleepiness affected school performance the most, which Dewald and colleagues interpreted as it being in line what other research find between neurobehavioral functioning and negative academic performance (Dewald et al. 2010, 183).

Lastly, Dewald and colleagues call to be more thorough when one examines sleep in

correlation to academic performance. As now sleepiness, sleep quality and duration might be influenced by various other factors that do indeed affect the data gathered (Dewald et al. 2010, 184). Such factors might be Social economic status (SES), general life style,

communities and sleep environment (Dewald et al. 2010, 184). In order to move forward one must regard the measurements and their reliability as well, they call to continue mixing subjective measurements and objective measurements as it gives different results on, for example, sleep quality’s interaction with academic performance (Dewald et al. 2010, 186). Comparing the data gained from subjective respectively objective data will generate more results to base more theories going forward (Dewald et al. 2010, 186).

An additional text that I reviewed was “Understanding adolescents' sleep patterns and school performance: a critical appraisal” - by Amy R. Wolfson and Mary A. Carskadon (2003). They aimed their report based on studies which was based upon survey data from students on sleep habits and academic performance collected from middle school, high school and first-year college. The results of compared with each other strongly suggests that there is correlation between sleep duration, sleep quality, sleep schedule and poor academic performance (Wolfson & Carskadon 2003, 502). However, Wolfson & Carskadon also point out the fact that the most researches done up to this point are poorly executed and strongly argues the point that in the future one would try to avoid relying on self-reports from adolescents due to the fact that they are mostly subjective (Wolfson & Carskadon 2003, 492, 502). They advise that one should use a multi-measured approach, which would provide a more comprehensive and reliable assessment going forward (Wolfson & Carskadon 2003, 502). Furthermore, they

(12)

12

also emphasize that assessing sleep “along with a variety of other variables that influence school performance [...] would provide a more thorough understanding” (Wolfson &

Carskadon 2003, 502). It is important to get a clear picture of sleep patterns and moderate the determinates that impact sleep and on a broader scale the academic performance(Wolfson & Carskadon 2003, 503).

5.2 Brain Developing During Adolescence

If we are to examine sleep’s effect on learning, and in broader terms, academic performance I examined: “Sleep’s effects on cognition and learning in adolescence” by Carskadon. Mary A, 2011. Carskadon brings up the various effects that occur to students lacking a sufficient

amount of sleep (around eight-nine hours) and states that the academic performance suffers by lack of sleep in different ways (Carskadon 2011, 137). By comparing a well slept brain and a poorly slept brain, somnologists could determine through various test, such as functional imaging and EEG assessment (A test used to find problems related to electrical activity of the brain), that the brain indeed could processes and store learned information better when we receive the correct amount of required sleep, compared to a poorly slept brain (less than eight hours) (Carskadon 2011, 137). Furthermore, sleep research has earlier been dismissed due to difficulty by poor neurophysiological measurement techniques, (Carskadon 2011, 138) but thanks to technological advancement in said area, such as improved experimental designs, more advanced conceptualization of types of learning and tasks to measure them, there is now more substantial evidence that indeed confirms that sleep plays a significant role in memory formation for adults. (Carskadon 2011, 138)

To summarize, adolescents are less likely to receive and maintain information when we sleep poorly, but also adolescents are less expected to save the information we have obtained. The reason for this has to do with the fact that adolescents probably do not provide the brain with the necessary time to process the information and store it properly, according to Carskadon (137F).

Moreover, Carskadon unfolds one reason to why there is a circadian cycle change between adolescence and adults. Brain scans show changes in adolescence’s sleep behavior compared to adults and, in particular, slow-wave sleep (SWS) stages and slow-wave activity (SWA), which occurs in stage 3 of NREM (Carskadon 2011, 138). Alas, the brain wave scans show a 40% decrease in SWS and SWA between early aged adolescents and adults (Carskadon 2011,

(13)

13

138). She follows up with that the brain structure, particularly synaptic density and brain circuitry shows a similar alteration across this interval (early adolescents into adults) (Carskadon, 2011, 138). It is however unclear if the changes in sleep is an “integral to CNS function (Central nerve system) […] or the CNS reorganization of adolescence” (Carskadon 2011, 138). There is a key difference between children and young adults as Carskadon pointed out earlier, and by examining subjects in early adolescence rather than adults, which is more difficult, we can follow adolescents’ sleep cycle and examine how sleep waves contribute to an improving memory stabilization.

5.3 The Effects of Sleep in Correlation to School Performance

Carskadon brings up several points that children undergoing adolescence require a lot of sleep (eight-nine hours/night) since the brain develops quite rapidly and their bodies change

(Carskadon 2011, 147). Furthermore, it is important during the development phase in children and teenagers’ life that they get the proper sleep that they require to prevent negative effects from their development (Carskadon 2011, 147). Moreover, she says academic performance is compromised due to the lack of sleep and early school weekdays, which becomes problematic for adolescents in regard to their school performance:

“Evidence has accumulated that adolescents’ educational outcomes suffer with sleep thus compromised and that adolescents attending schools that have changed to later first-bell times manifest improvements in a number of important areas (Owens et al.., 2010; Wahlstrom, 2002), including certain measures of academic performance and mood.“(Carskadon 2011, 142)

Furthermore, Pestana, L., Duarte, J., Coutinho, E.C., Nelas, P., Chaves, C.M., & Amaral, O (2016) wrote an analysis about Portuguese teens and their sleeping habits to identify a direct link between sleep and academic performance. The academic performance in this text were separated in different categories; “Study methods”, “reading skills”, “study environment”, “study planning” and “motivation for study”. The questioners answer a scale between one-five (one=bad, one-five=good) on all these different subtopics in which they would also answer whether they had bad or good sleeping habits. The results confirmed that in every category,

(14)

14

students who slept more than eight hours performed and experienced better results compared to students who slept less than eight hours. The results show, as Pestana et al. express, “Teenagers who sleep more than 8 hours a day have better overall school performance and, in all dimensions, […], which leads us to infer that school performance is affected by the duration of sleep during the week “(Pestana et al. 2016, 240)

5.4 Insufficient sleep, a Determinant on Young Academic Brains

Carskadon addresses that the reduction of sleep during school nights is a major concern. Carskadon asked in 2006 1602 adolescents about their sleeping patterns and asked them to compared school nights with non-school nights. It was clear from the results (see figure 2) that students in fact receive less sleep than the recommended eight-hour threshold.

Figure 2 shows the difference between the amount of sleep during non-school nights and school nights. She links her earlier findings with the concerns about sleep deficit:

“Short school night-sleep also negatively affect school performance (Wolfson and Carskadon, 2003). As reviewed by Kopasz et al. (2010), several experimental studies in school-age youngsters show that insufficient sleep interferes with memory encoding and working memory; however, no data exist to indicate whether sleep reduction affects the efficiency of sleep-dependent memory consolidation.” (Carskadon 2011, 141).

(15)

15

Carskadon states in other words that there is indeed evidence that insufficient sleep will affect our memory coding and our working memory, which are critical for young adolescents’’ learning abilities (Carskadon 2011, 141). Furthermore, she adds that if it turns out that sleep indeed does play a role in memory consolidation for a developing brain then it is critical that this information reach the surface (Carskadon 2011, 141). She also states in the quote that there is not enough research to how sleep support cognitive matters such as the efficiency of sleep-dependent memory consolidation (Neurological process involving the conversion of learned information into long-term memory)(Carskadon 2011, 141). Her answer to why there is not enough research on the direct connection between sleep and cognitive matters is due to the different measurements somnologists have to take into the equation, in order to figure out exactly how sleep reduction contributes to academic school performance. Not only do

somnologists have to factor in school performance, which by itself can be divide into subcategories such as grades and score tests, but also these following examples: the socioeconomic status (SES) of the child’s family, school size, number of hours the teen is spent studying, teacher salary, child’s developmental status, test anxiety, self-image (Carskadon 2011, 142).

Moreover, there have been made few attempts to disentangle these different factors from one and another but currently somnologists can not simply state, right now, with scientific proof that there is a direct connection between insufficient sleep and cognitive matters, even though research strongly suggest that is the case (Carkadon 2011, 142).

Furthermore, Dewald et al. conducted a Meta-analysis (2010) which draws the conclusion that children and adolescents require an average sleep time of approximately nine hours/night. However, their results reveal that 45% of the study participants slept less than eight

hours/night (Dewald et al. 2010, 179). Dewald et al. also bring up the fact, as well as Kelley et al. (2017), that this is caused by different factors such as puberty, circadian-cycle,

homeostatic changes, as well as social factors, such as “early school start times and social pressure combined with academic workload” (Dewald et al. 2010, 180), which leads to later bedtimes but early mornings.

Dewald et al also mention that there is empirical evidence that: “demonstrates an association between sleep and consolidation of cognitive performance, which is required for executive functioning including abstract reasoning, goal directed behavior and creative processing” (Dewald et al. 2010, 183) which all of the mentioned above is critical to perform well from an academic point of view. Furthermore, Dewald and colleagues provide an explanation that

(16)

16

when the brain gets disturbed it reduces the necessary overnight brain activity that is needed for neurocognitive functioning, which means complex tasks requiring, abstract thinking, creativity, integration, and planning (Dewald et al. 2010, 180). In addition, these examples are involved in the prefrontal cortex of the brain, which is known to be sensitive to sleep (Dewald et al. 2010, 187). In summary, Dewald states that because of this evidence it can be suggested that insufficient or low-quality sleep during early adolescence impacts the executive function of the prefrontal cortex and “consequently the decline of learning abilities and school

performance” (Dewald et al. 2010, 180).

Moreover, Kelley et al. states that sleep is a highly complex state arising from the interaction between multiple brain region, neurotransmitter pathways and hormones (Kelley et al. 2015, 212). Furthermore, they are all involved in the generation of sleep, which makes sleep very vulnerable to disruption, and as a result small changes in the brain during development can have a critical impact upon sleep, thus, abnormal sleep will in turn take a great toll on or health (Kelley et al. 2015, 212). As a result – small changes in the brain during adolescent development can have a critical impact upon sleep. Thus, abnormal sleep will in turn take a great toll on health. Kelle and colleagues’ study aligns with the previous statement as he concludes that early school hours makes adolescents vulnerable and extradited to dangers of unrecoverable sleep, which and lead to a number of health risks (Kelley et al. 2015, 212) and as a result – small changes in the brain during adolescent development can have critical impact upon sleep. Thus, abnormal sleep will in turn take a great toll on health. Kelley and colleauges’ study align with the previous statement as they conclude that early school hours makes adolescents vulnerable and extradited to the dangers of unrecoverable sleep, which can lead to a number of health risks (Kelley et al. 2015, 212)

5.5 A Delay in Adolescents’ Circadian cycle

Kelley and colleagues state multiple times in their research that there is in fact two different types of time when we discuss adults and adolescents, the social time and the biological time (2015, 210, 211). Social time is referred to the social timetable which means up in the

morning by seven, lunch by 12 and dinner at six whereas the biological time is measured by the developmental changes in the body and the effects that comes with it on our internal biological clock (Kelley et al. 2015, 210) In addition, Kelley et al further points out that the failure to adjust the educational timetables leads to a systematic, chronic, and unrecoverable

(17)

17

sleep deficit and that the impact of early school times on adolescents is not understood by most educators (Kelley et al., 2015:211) Moreover, the common belief that adolescents are tired, irritable, and uncooperative because they stay up late or experiencing difficulties to wake up in the morning because they are lazy is wrong (Kelley et al. 2015, 211). Adolescents are simply victims of a systematic error, which continues to negatively affect them (Kelley et al. 2015, 211). Moreover Kelley et al. point out that the sleep-wake cycle is an interplay between the SCN (Stem Cell Network) pacemaker and a homeostatic sleep cycle, which allow us to go to sleep (Kelley et al. 2015, 212). They interact as opposites to each other, to ensure that we stay asleep and we stay awake. Kelley suggests that this interaction generates

something he calls a “wake maintenance zone” (WMZ) (Kelley et al. 2015, 212). He points out that this is a major factor to why some adolescents experience difficulties during evenings as the homeostatic drive for sleepiness is not able to counteract the circadian drive for

alertness, resulting in numerous hours where it is difficult to fall asleep (Kelley et al. 2015, 213). Furthermore the homeostatic regulation of sleep also alters the build-up of sleep which in turn makes the sleep pressure become a lot slower compared with adults, meaning that it takes longer time to reach the critical threshold required to initiate sleep, thus, contributing to a later sleep time. The WMZ is the reason why we cannot simply choose to sleep earlier than normal, as the brain is still promoting wakefulness at that time (Kelley et al. 2015,

212).Lastly, he adds that this is the major reason to why teens are tired during education start times and that it impacts their cognition, emotional and physical health, but also that

insufficient sleep is linked with impaired immune response, metabolic disorders, diabetes, hypertension, anxiety, depression and obesity. (Kelley, 213, 2015),

5.6 Adolescents’ Education Suffers from Sleep Deficit

Judith Owens et al. (182F, 2014) and Paul Kelly et al. (214, 2015) find in their studies that adolescents show poor communication, decreased concentration and cognitive

performance(Owens 182), increased risk taking and changes in mood pattern, especially depression (Kelley, 2015) which they both agreed upon was not surprising since older teenagers show the largest difference in sleep between free days and work days, combined with a need to sleep for a longer duration than adults (Kelley 214). Moreover, Kelly and Owens state brings up other studies that have shown that short sleep duration has a negative impact on adolescents learning and academic performance based on both grade performance but also on long-term memory encoding (which Carskadon mentions on page 7).

(18)

18

Additionally, Kelley’s graph (see Table figure 2) demonstrates further that the difference between in work/education schedules and biological time, and that the sleep deficit at different ages, (p 214) which is slowly reverted in early adulthood but also that there is a radical decline of sleep duration (p 214) from the beginning of puberty.

Figure 3

Kelley’s graphs show that there is a significant difference between work/education days and free days, as well as the difference between the ages and the amount of sleep adolescents are drastically decreasing.

To prevent sleep deprivation Kelley et al. (2015) suggest that biological clock in adolescents must synchronize school start times. Global studies show that older teenagers biological wake up time is about 08:00 and therefore the school should start around 10:00-10:30 (Kelley et al 2017, 2).

Lastly, Paul Kelly et al. (2017) examined the idea of delaying school starts for students, in order to assess if giving adolescents more time to sleep and thus increase their sleep duration and thereby improve their school performance. The research was based on an experiment carried out in a school in UK which had poor results compared to the national benchmark, which served as a control group and something to compare the results to (Kelley et al. 2017, 4). Kelley and colleagues’ goal were to see if they postponed the school starting time by a certain amount would there be any changes to both attendance and grades. Firstly, Kelley et

(19)

19

al. mentions that they faced some resistance from external local educational administrators, which was a phenomenon noted in other studies (Kelley et al. 2017, 4). However, parents were supportive and after some discussions the school accepted to try this method out. The data gathering was going on for 3 years and they also used a control group from the school itself by collecting data before the experiment was carried out, which they refer to as year 0. At year 3 the school board was switched out and the new school board canceled the

experiment and returned to the old school starting time, which Kelly et al. actually saw as something positive in terms of data gathering, as they could compare the data gathered during year 1 and 2 and see if there would be any changes in year 3(the year it returned to the old school starting times).

The school starting time before the experiment was 8:50 and the school agreed to postpone the school starting time to 10:10. (Kelley et al., 2: 2017) The change included moving transport to and from the school, Family arrangements, school clubs and activities. The age group were targeted towards 13 to 16-year old. The data gathered showed during the second year that illness decreased with 50%, but for third year, when it was reverted, illness rose with 30%. (Kelley et al. 2017, 7).

Kelley et al. refer to a national benchmark number in which schools gain certain points by how students perform on national tests and these are then compared nation-wide and the school thereby get a score that they can compare other schools to. The academic performance rose Sharpley between year 0 and year 1. Academically successful students shot up by 19 percentage points but Kelley et al. states the following:

“The heart of the field experiment is the comparison of year 2 and year 0. Here again there is extensive evidence for the positive impact of the 10a.m start on student success. Student success in year 2 is 52% compared to the 34% for year 0” (Kelley et al, 7, 2017)

A 20% score increase after 2 years is by Kelley and colleagues’ definition a huge

improvement. In year 3 the school suffered a deficit by 9 percentage points. Kelley et al. follow up in their discussion that using a fixed time for all students would disadvantage one or more chronotypes (A chronotype is the behavioral manifestation of underlying circadian rhythms, other words would be a person’s chronotype is their individual sleeping pattern during a 24-hour period) but evening chronotypes in particular if starts were early. Kelley restates that even though 10:00 in fact is beneficial it does not address the wider variation of wake times in different chronotypes. (Kelley et al., 8: 2017)

(20)

20

6. Discussion

6.1 Sleep, the Brain and Academic Performance

Sleep research have had a major impact in how we have viewed and approached sleep the last decades. As stated by Shepard (2005) there have been major breakthroughs in how sleep research developed and made progress in various scientific areas, but most notable is the discovery of sleep cycles and what happens when we do not get the right amount of sleep. When the connection between narcolepsy and disturbed sleep cycles where made, one could not shy away from the importance that we do need to meet the necessary requirement of sleep in order to function and develop properly (Shepard et al. 2005, 7).

Because of advancements in somnology (Carskadon et al. 2011, 137), we can better understand how the brain works regarding sleep and we better understand why it is critical that adolescence meet the required amount of sleep in order to perform well in school. Nevertheless, there is a significant amount of evidence that points towards that adolescents need their recommended sleep hours, and that there is a sleep loss over time occurring during school periods (Kelly et al. 2015, 214). Moreover, Students report that they are more alert, more active and can retrieve information more easily when they meet the said requirement of sleep (Pestana et al. 2016, 240). If we examine the results from Kelley and colleagues’ experiment in 2017(6, 7), it shows both illness reduction but also a great improvement in academic performance. In addition, Carskadon and Owens states, that adolescents perform better when they meet the sleep requirement, which it further adds to the fact that students do perform better when they get the right amount of sleep, and suffer dire consequences when they do receive insufficient sleep over a period of time. Moreover, Amy and Carskadon make the case (2003, 502), just as Pestana et al. (2016, 239) that whenever a student lack a good amount of sleep (8-9/hours) it is reflected upon their academic performance. In contrast, Insufficient sleep becomes a determinant to the brain with evidence such as problems with concentration, long term memory, working memory, alertness and learning abilities, which affects school performance. In addition, adolescents are more likely to suffer from physical health issues and mental issues which also impact their academic performance negatively (Carskadon 2011, 142). As Kelley and colleagues also demonstrated in their experiment there was a notable academic performance loss when the system reverted back to the 8.50am school starting hours as well as an illness increase with 30% (Kelley et al. 2017, 7). To summarize,

(21)

21

the brain is not capable to perform without sufficient sleep at the level that is required and therefore the academic performance is suffering (Kelley et al. 2017, 1).

So why do adolescents suffer from insufficient sleep? Dewald and colleagues claims it to be the circadian shift as one major factor to why teenagers do experience insufficient sleep (Dewald et al. 2010, 180). Albeit one night with less sleep is not a major problem, it does however become a problem when it occurs for several days (Kelley et al. 2015, 213). With less sleep than the recommended eight to nine hours for several weeks and even years does indeed become a severe problem that adolescents face (Kelley et al. 2015, 211).

The research that is brought up in this thesis all recommended strongly to postpone school starting hours to better match adolescents circadian-cycle and thereby give adolescents the preconditions and necessary amount of sleep. The counter argument toward this change was not really stated in Kelley and colleagues’ article (2017) but in vague terms it was stated that they faced opposition from external local educational administrators (Kelley et al. 2017, 4). One can only speculate that it would have to do with various changes that would come with the experiment that was proposed. Kelley et al. (2015) do however mention that society views teenagers as lazy and that they maybe do not take sleep seriously (Kelley et al. 2015, 211). This is probably something many people usually tend to do, including myself. Nevertheless, if we are to take these scientific evidences seriously one can understand why teenagers do express their mood swings, are irritable and are up late in evenings. If the majority of

adolescence do in fact shift their circadian cycle and is not receiving the necessary amount of sleep for years it would not surprise if it resulted in these mood shifts that we see, and it would explain why they oversleep during weekends (see table figure 2).

6.2 School Start Times in Practice

Since school start times are not regulated by any laws or other political influences, it would in theory be possible to change school start times if Swedish principals decides to. However, there will be inconveniences to do so. It would require an overall change in a lot of external parties’ involvement to change their schedule. From experience a lot of teenagers rely on their parents to co-ride with their parents to school as the latter is traveling to work. Schools would have to in the initial change make sure that any inconveniences would be covered by other transportation means. Even if the parents where supportive in Kelley and colleagues’ report

(22)

22

(Kelley et al. 2017, 4) it is not certain that every single family in Sweden would be as supportive. One would have to explain to why the change occurs thoroughly and take it into consideration if you live far out at the countryside or in urban city. Urban cities tend to have a more accessible public transportation network compared to the Swedish countryside which would require the regions in the countryside to invest in public transport. If Swedish schools would postpone starting times to benefit adolescents sleep it is important that this will not be a luxury benefit that only urban cities can afford and that schools in the country side get the initial financial support they would supposedly need.

6.3 Chronotypes

Firstly, and notably there are adolescents that do have different chronotypes as it is individualistic. However, there seems to be a minority that benefits from today’s school starting times and as Kelley and Colleagues state, evening chronotypes are suffering from the current school starting times the most (Kelley et al. 2017, 8). Morning chronotypes would in fact be able to still partake in education without any real downsize and could study choose to study in the morning if they wish to do so. Lastly, it is beneficial to try include as many chronotypes as possible and since morning chronotypes would still get their sleep without suffering from any major inconvenience, delaying school start times would seem to be the best option as of now.

6.4 Sleep Quality, Sleep Duration and Sleepiness, Which One Is It?

Somnologists have made several reports that sleep in fact do affect academic performance. Those students who report that they sleep well will in most cases state that they feel that their academic performance is good, in contrast those who report that they sleep poor will report that their academic performance is worse than those who perform good (Dewald et al. 2010, 180). However, Wolfson & Carskadon (2003) and Dewald et al. (2010) both acknowledge that there is a difference in how students report on and experience sleep, as well as there is an incoherence from somnologists when they research how sleep affects student performance (Wolfson & Carskadon 2003, 502; Dewald et al. 2010, 186). Somnologists need to be more informed and thorough when they ask students specific questions regarding sleep and be more clear with what they are researching. As of now there is three subcategories that are being looked at, sleep quality, sleep duration and sleepiness (Dewald et al. 2010, 186). These subcategories may be referred too, and also be influenced in different manner. For example,

(23)

23

sleep quality is something that is rather subjective and sleep duration is a more objective standpoint, one needs to make sure that they are asking questions that are relevant for what they research. One can not expect to draw conclusions on sleep quality sole based on questions that are seemingly asking how long the sleep duration was, and vice versa. Furthermore, Dewald and colleagues (2010). expressed concern that there are a lot of other factors that influence sleep duration and quality (Dewald et al. 2010, 184). Future research need to factor in these variables, such as socioeconomic status (SES) of the child’s family school size, number of hours the teen is spent studying, teacher salary, child’s developmental status, test anxiety, self-image (Carskadon 211, 142) in order to eliminate the possibility of interference from other sources. Kelley et al. (2017) conducted a long-term experiment which was very thorough and rather transparent with what the surrounding communities expressed, as well as results from a long period of time. However, one could ask though if it was merely the sleep duration that improved or if sleep quality improved as well, and if there were any other key factors or variables that played its part for the experiment to be such a success story as it turned out to be.

In summary, sleep research in the past has had somewhat incoherent research in the past, and if one is to conduct future experiment they need to be sure in what they exclude from their reports and what they include in their reports. It is important that researchers make sure that they do understand that the method they use is either subjective or objective and that variables such as communities, parents, teachers, social economic status, age, gender and so on make a difference when future researchers continue investigate sleep in regards to academic

performance.

6.5 Conclusion

Insufficient sleep affects the brain as it is not getting the enough time to recharge throughout the night. The brain needs about 5 completed NRES-RES cycles to fully recharge and

function properly (Sleepfoundation 2020). Because the reduced sleep amount which naturally occur because of the delayed circadian-cycle, adolescents consequently experience a net loss of sleep that goes on for years. These consequences affect their school performance in various ways such as lacking concentration, the brain having problems storing information both short term and long term, as well as learning abilities along with various mental and physical health problems. In order to combat insufficient sleep several somnologists propose to postpone

(24)

24

school starting hours both for the sake of adolescents’ health but also to increase their

academic performance. In addition, the schools should look after children’s best interest, and therefore I do want to ask principals and politicians in Sweden to question whether it is worth keeping the old starting times for the sake of convenience, or if it would better increase adolescents quality of life to postpone school starting times.

6.6 For Future Research

It would be interesting to conduct a similar research that Kelley et al. (2017) but in Sweden. Swedish culture is rather similar to UK since both are western countries, but there are differences. Swedish teens are not getting the same amount of sun hours as most no-Nordic countries do, and therefore it should be a difference in how Swedish people’s circadian cycle works. Swedish teens do express similar characteristics, lazy, irritable and moody and I have not identified anything that would argue the point that Swedish adolescents would not see an improvement from postponing sleep in order to get sufficient sleep, and by extent, improve academically.

Finally, it would be beneficial to continue to detangle the various factors that might influence sleep’s role on academic performance, such as social economic status, parents’ involvement, sleep environment, self-image, developmental status, number of hours the teen is spent studying (Carskadon 2011, 142). In order to better distinguish exactly how insufficient sleep affects school performance, and in order to better understand how to prevent teenagers from experiencing insufficient sleep it would be good to produce more scientific, transparent data on adolescents sleep pattern.

(25)

25

7. References

Carskadon, M.A, (2011) Chapter 8 - Sleep’s effects on cognition and learning in adolescence, Editor(s): Hans P.A. Van Dongen, Gerard A. Kerkhof, Progress in Brain Research, Elsevier, Volume 190.

Dewald, F, J., Meijer M, A., Oort, J, F., Kerkhof, A, G., Bögels, M, S. (2010). The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review, Sleep. Medicine Reviews, Volume 14.

Kelley, P., Foster, R. G & Kelley. J (2015) Synchronizing education to adolescent biology: ‘let teens sleep, start school later’, Learning, Media and Technology, 40:2, 210-226.

Kelley, P., Lockley S, W., Kelley, J. & Evans D.R.M (2017). Is 8:30 a.m. Still Too Early to Start School? A 10:00 a.m. School Start Time Improves Health and Performance of Students Aged 13–16. Frontiers in Human Neuroscienc, Volume 11.

Owens, Judith & Drobnich, Darrel & Baylor, Allison & Lewin, Daniel. (2014). School Start Time Change: An In-Depth Examination of School Districts in the United States. Mind, Brain, and Education. 8.

Pestana, L., Duarte, J., Coutinho, E.C., Nelas, P., Chaves, C.M., & Amaral, O. (2016). Sleep and academic performance of Portuguese Teenagers.

Shepard, J. W., Jr, Buysse, D. J., Chesson, A. L., Jr, Dement, W. C., Goldberg, R.,

Guilleminault, C., Harris, C. D., Iber, C., Mignot, E., Mitler, M. M., Moore, K. E., Phillips, B. A., Quan, S. F., Rosenberg, R. S., Roth, T., Schmidt, H. S., Silber, M. H., Walsh, J. K., & White, D. P. (2005). History of the development of sleep medicine in the United

States. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 1(1), 61–82.

(26)

26

https://www.skolverket.se/download/18.7f0610616b709c26f72acd/1569409696488/pdf4771. pdf

Sleepfoundation (2020) What Happens When You Sleep? Hämtat 2020-09-04

https://www.sleepfoundation.org/articles/what-happens-when-you-sleep

SFS SFS, 2018:1303 Skollag. Stockholm: Utbildningsdepartementet.

https://www.riksdagen.se/sv/dokument-lagar/dokument/svensk-forfattningssamling/skollag-2010800_sfs-2010-800

Wolfson, A. R., & Carskadon, M. A. (2003). Understanding adolescents' sleep patterns and school performance: A critical appraisal. Sleep Medicine Reviews, 7, 491–506.

(27)

References

Related documents

The results show that a significant portion of adolescents (age 12-16) sleep too little and this is worrisome because poor sleep was associated to worse school atten- dance and

The aim of this dissertation was to contribute to each of these goals; Study I investigated the longitudinal association between sleep prob- lems, defined as symptoms of insomnia,

0% 5% 10% 15% 20% 25% 30% 35% 40% Difficulty initiating sleep Difficulty maintaining sleep Early morning awakening Excessive daytime sleepiness Insomnia symptoms Snoring

The aim of this literature review is to objectively compile and analyse if there is an effect, of early daytime outdoor exercise in natural light environments, on sleep quantity

Innehållet i detta kapitel utgörs av teorier som vi anser vara relevanta för belysandet av vårt syfte, vilket är att med hjälp av två fallföretag, NCC och Skanska, identifiera

Lastly, we identify individuals with 12 or more years of education (D = 1 if 12 or more years of education), which corresponds to university level education. People in this group

The sleepiness related risk factors (short habitual sleep time, use of hypnotics high ESS score) and annual driving distance identified to associate with MVA history in

Additionally, we aimed to identify specific risk factors linked to a history of MVA in these patients and toassess the prevalence of such factors in a large European sleep apnea