Bradley Hospital

About: Bradley Hospital is a healthcare organization based out in East Providence, Rhode Island, United States. It is known for research contribution in the topics: Bipolar disorder & Mental health. The organization has 261 authors who have published 265 publications receiving 10477 citations.

Adolescent Sleep Patterns, Circadian Timing, and Sleepiness at a Transition to Early School Days

Abstract: Study Objectives: This study examined effects on adolescent sleep patterns, sleepiness, and circadian phase of a school transition requiring an earlier start. Design and Setting: Adolescents were evaluated in 9th and 10th grades; school start time in 9th grade was 0825 and in 10th grade was 0720. Assessments at each point included 2 weeks of actigraphy and sleep diaries at home, followed by a 22-hour laboratory evaluation, including evening saliva samples every 30 minutes in dim light for determination of dim-light salivary melatonin onset phase (DLSMO), overnight sleep monitoring, and multiple sleep latency test (MSLT). Participants: Twenty-five females and 15 males, ages 14 to 16.2 were enrolled; 32 completed the study in 9th grade and 26 completed in 10th grade. Interventions: Participants kept their own schedules, except that laboratory nights were scheduled based upon school-night sleep pattems. Measurements and Results: According to actigraphy, students woke earlier on school days in 10th than in 9th grade, but they did not go to sleep earlier and they slept less. DLSMO phase was later in 10th grade (mean = 2102) than 9th grade (mean = 2024). Sleep latency on MSLT overall was shorter in 10th (mean = 8.5 minutes) than in 9th (mean = 11. 4 minutes), particularly on the first test of the moming at 0830 (5.1 vs 10.9 minutes). Two REM episodes on MSLT occurred in 16% of participants in 10th grade; one REM episode occurred in 48%. When those with REM sleep on one or both morning MSLTs (n=11) were compared to those without morning REM, significant differences included shorter sleep latency on the first test, less slow wave sleep the night before, and later DLSMO phase in those who had morning REM. Conclusions: Early start time was associated with significant sleep deprivation and daytime sleepiness. The occurrence of REM sleep on MSLT indicates that clinicians should exercise caution in interpreting MSLT REM sleep in adolescents evaluated on their usual schedules. Psychosocial influences and changes in bioregulatory systems controlling sleep may limit teenagers' capacities to make adequate adjustments to an early school schedule.

Patterns of sleep and sleepiness in adolescents.

Abstract: Most studies of adolescent sleep habits show a pattern of decreasing total sleep time, a tendency to delay the timing of sleep, and an increased level of daytime sleepiness. Laboratory tests have shown that adolescents do not have a decreased need for sleep but probably need more sleep than prepubertally. A number of factors affect the development of adolescent sleep patterns. Puberty itself imposes a burden of increased daytime sleepiness with no change in nocturnal sleep. Parental involvement in setting bedtimes wanes, though they become increasingly involved in waking teenagers in the mornings. Curfews and school schedules also affect adolescent sleep patterns, seen most commonly as imposing earlier rise times as the school day begins earlier during the adolescent years. Part-time employment has a significant impact on the sleep patterns of teenagers: those who work more than 20 h each week sleep less, go to bed later, are more sleepy, and drink more caffeine and alcohol. Development of circadian rhythms may also play a role in the phase delay teenagers commonly experience. The primary conclusion is that many adolescents do not get enough sleep. The consequences of the chronic pattern of insufficient sleep are daytime sleepiness, vulnerability to catastrophic accidents, mood and behavior problems, increased vulnerability to drugs and alcohol, and development of major disorders of the sleep/wake cycle. Educational programs hold the promise of improving teenagers' sleep patterns through informing youngsters, parents, and pediatricians about proper sleep hygiene and the risks of poor sleep habits.

Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep

Abstract: Sleep deprivation among adolescents is epidemic. We argue that this sleep deprivation is due in part to pubertal changes in the homeostatic and circadian regulation of sleep. These changes promote a delayed sleep phase that is exacerbated by evening light exposure and incompatible with aspects of modern society, notably early school start times. In this review of human and animal literature, we demonstrate that delayed sleep phase during puberty is likely a common phenomenon in mammals, not specific to human adolescents, and we provide insight into the mechanisms underlying this phenomenon.