Part V
Global Impacts



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Snooze…Or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits Part V Global Impacts

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Snooze…Or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits 14 Sleep Deprivation Around the World Though the 24/7 culture of much of the United States certainly contributes to adolescent sleep problems, American teenagers aren’t the only kids who suffer the effects of sleep deprivation. Teenagers across the globe find their natural circadian rhythms out of sync with the people and places around them and find it difficult to get the quality and quantity of sleep they need to be their best. Just as U.S. researchers are studying adolescent sleep issues in order to improve teen health, performance, and well-being, researchers in most developed societies are delving into teen sleep patterns and problems in their own countries. What are the results? Many studies have shown that sleep deprivation and the effects associated with it are common to adolescents no matter what their nationality. Differences appear to arise only from cultural, socioeconomic, and environmental factors. One characteristic that teens in many countries have in common is their night-owl behavior. Researchers Miriam Andrade and L. Menna-Barreto found that 14- to 16-year-old Brazilian teens went to sleep later on the weekends than 12- and 13-year-olds and that once adolescents reached puberty their sleep onset time became more delayed. Studies in Australia, Japan, Italy, Finland, and Israel have reported similar results.

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Snooze…Or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits A High School Student in England Reports … “My school, in London, starts at 8:30, but I have to get up at about 6:30 to get ready and to have enough time to take public transportation. I never feel like I really wake up until after my first double-period class is over at 9:45. When I stay up late on the weekends, which I usually do, I have a really hard time falling asleep on Sunday night and getting up Monday morning. On the weekends I can stay up till 3:00 a.m. and sleep till noon or 1:00.” Many students in all the studies also reported increased daytime sleepiness. Just as in the United States, high schools in other countries start early in the morning—in Brazil they begin between 7:00 and 7:30 and in Israel at 8:00—leaving night owls exhausted as well as at risk for health and behavior consequences. According to researcher Amy Wolfson, teenagers in developed countries average a little over seven hours of sleep on school nights—a far cry from the eight and a half to nine and a half hours they should be getting. What effects does this sleep deficit have on teens internationally? In China, a study of 1,538 adolescents revealed that regular nightly sleep of less than seven hours was significantly associated with increased behavior problems. In Italy, a study by Flavia Giannotti of 14-to 20-year-olds showed a correlation between increased daytime sleepiness, increased vulnerability to accidents, increased use of stimulants and tobacco, sleep problems, and anxiety. A survey of 1,457 Korean students revealed a progressive decrease in total sleep time from grades 5 to 12 of three hours on weeknights and one hour on weekends. Tenth graders averaged 6.02 hours of sleep on weeknights and twelfth graders just 4.86 hours. The study showed evidence of major detriments to functionality with symptoms of daytime sleepiness, depressed mood, and problem sleep-wake behavior. Stress, just as it is in the United States, also is linked to sleep deprivation in other parts of the world. Israeli researcher Avi Sadeh has found that sleep is quite sensitive to emotions, expectations, and anxi-

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Snooze…Or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits A High School Student in Singapore Reports … “My high school starts at 7:20 a.m. It’s so hard waking up in the morning. In first period class, which is reading, my friends and I all doze off while we’re pretending to read.” eties and that the fatigue and sleepiness that result from sleep deprivation can actually become sources of stress themselves, creating a vicious cycle. In a study of the effects of trauma and stress from separation and loss, war and disasters, and child abuse on children’s and adolescents’ sleep patterns, he found that a 16-year-old girl was able to fall asleep easily only on the nights her older sister was home from military duty. When her sister was there, the two young women talked until they fell asleep. When her sister was away, the teenager took 40 minutes to fall asleep and then woke very early and couldn’t get back to sleep. Her separation stress, and the related sleep difficulties, were helped by using relaxation techniques and leaving the radio on, set to shut off automatically later, as she went to bed. IT’S A FACT In a nationwide survey of close to 108,000 junior and senior high students in Japan, a significant relationship between short sleep duration and smoking was discovered. The study showed that 45 percent of daily smokers and 39 percent of occasional smokers slept less than six hours a night. A Variety of Sleep Disturbances What kinds of sleep difficulties do teenagers experience globally? As the above example points out, stress and anxiety often are associated with trouble falling asleep and trouble maintaining sleep. But all of the sleep disturbances American adolescents experience are seen in every developed nation. For example, a study by J. Vignau et al., reported in the Journal of Adolescent Health, found that more than 40 percent of

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Snooze…Or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits SLEEP THERAPY IN RUSSIA In a program of lectures and workshops given in Russia, poor urban areas were shown to use a holistic approach to treating the growing problems of adolescent depression, high school dropout rates, and drug and alcohol abuse. Children and adolescents received massages and warm baths, acupuncture, various herbs, and rest during the day at sleep therapy clinics. the French high school students surveyed had at least one of the problems being studied: difficulty falling asleep, difficulty staying asleep, needing more sleep, waking up too early, or chronically taking sleeping pills. Another study, comparing the health of U.S. teenagers with teenagers in other countries, discovered similar sleep problems. The study, entitled the International Health Behavior in School-Aged Children Study, published as U.S. Teens in Our World by the U.S. Department of Health and Human Resources, asked 11-, 13-, and 15-year-olds in 29 countries a number of questions relating to their health. Two of those questions asked the students if they had trouble sleeping at least once a week and if they felt tired four or more times a week when they went to school. While U.S. boys ranked first in trouble sleeping and U.S. girls ranked second after France, both had rates similar to those of boys and girls in Canada, Wales, and Israel. About 40 percent of U.S. students said they felt tired in the mornings before school, boys slightly more than girls, but students in Norway and Finland ranked first and second, respectively, in that category. SNOOZE NEWS According to an article in the Japan Times, a global survey on sleep habits by market research firm A. C. Nielsen found that 41 percent of Japanese people get six or less hours of sleep a night, making Japan the most sleep-deprived country on earth. Another study, of self-reported sleep problems among adolescents in Japan carried out by T. Ohida, showed a range of sleep difficulties among junior and senior high school students throughout the country. Between 15 and 39 percent of the students who participated had problems initiating sleep, slept less than six hours, or were excessively sleepy during the day during the previous month. The study concluded that

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Snooze…Or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits sleep problems were common among Japanese adolescents. It also stated that being female, a student in senior high school, and having an unhealthy lifestyle, which included stress, smoking, and drinking alcohol, were risk factors for those problems. The study also concluded that there was a need for health education aimed at solving Japanese adolescents’ sleep problems. Cultural, Socioeconomic, and Environmental Differences Affecting Sleep Though it’s true that sleep deprivation and sleep disturbances are the bane of teenagers everywhere, different factors do contribute to the problems. For example, researchers who looked at data for a World Health Organization study of health behaviors, reported by Tynjala et al., found that teenagers slept longer in countries in which parents seemed to be stricter. A study of ethnocultural differences in the sleep complaints of adolescents in nine ethnocultural groups, performed by R. E. Roberts et al. and reported in the Journal of Nervous and Mental Disease, found that Chinese American teens had a significantly lower risk for insomnia than Anglo teens and that Mexican American teens had an increased risk compared to Anglos. African, Mexican, and Central American adolescents had an increased risk for hypersomnia, a condition in which a person sleeps excessively, and no group was at a lower risk for hypersomnia than the Anglo kids. The study suggested that minority status may affect the risk for sleep problems. In Japan, which you’ve already read is a very sleep-deprived nation, hours in front of the TV as well as business pressures and social norms appear to be factors in people’s lack of sleep. Many workers who put in long hours because of downsizing and restructuring often work well into the evening, then go out with colleagues for drinks, and then watch several hours of TV before heading for bed. A recent Eurodata TV Worldwide study reported that Japanese people average more than five hours a day watching television, more than people in any other country. Here in the United States, an ongoing study at the University of Maryland may eventually provide data that could be applied worldwide. The study is examining the relationship between adolescent

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Snooze…Or Lose!: 10 “No-War” Ways to Improve Your Teen’s Sleep Habits sleep-wake habits and daytime sleepiness as they relate to school engagement and academic performance in teens from varying racial and economic backgrounds in urban vs. suburban settings. Summing It Up Just what does this look at sleep around the globe tell us about worldwide sleep deprivation? From the data that’s been gathered, it appears that adolescents in every developed country have the same problems with sleep that teens in the United States do, and that they’re just as negatively affected by the resulting sleep deprivation. That’s an alarming fact for both our teens and our world. Teens’ lives are compromised now by the small amount of sleep they get and may be even more damaged as these adolescents reach maturity and start taking their places in the global community. And that state of affairs will keep our nations and our world from advancing to the greatest degree possible. The effects of sleep deprivation on today’s teens—all 1.2 billion+ of them—may have significant and wide-ranging consequences in every corner of the world for years to come. But taking the problem seriously now, and supporting efforts both locally and internationally to help teens get the sleep they need, will go a long way toward making teens’ lives better today and all our lives brighter in the future.