tag:theconversation.com,2011:/global/topics/melatonin-15404/articlesMelatonin – The Conversation2024-03-04T13:36:47Ztag:theconversation.com,2011:article/2245972024-03-04T13:36:47Z2024-03-04T13:36:47ZCould the days of ‘springing forward’ be numbered? A neurologist and sleep expert explains the downside to that borrowed hour of daylight<figure><img src="https://images.theconversation.com/files/579007/original/file-20240229-24-zwzuqp.jpg?ixlib=rb-1.1.0&rect=16%2C8%2C5557%2C3648&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">While that 'extra' hour of sunlight in the evenings can be exhilarating, it comes with significant health trade-offs.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/daylight-saving-time-notepad-with-text-spring-royalty-free-image/1365468815?phrase=daylight+saving+time&adppopup=true">Anna Blazhuk/Moment via Getty Images</a></span></figcaption></figure><p>As people in the U.S. prepare to set their clocks ahead one hour on Sunday, March 10, 2024, I find myself bracing for the annual ritual of <a href="https://www.inquirer.com/news/standard-time-daylight-saving-time-clock-change-sleep-20201031.html">media stories</a> about <a href="https://qz.com/1114163/daylight-saving-time-dst-is-incredibly-disruptive-heres-how-to-reset/">the disruptions to daily routines</a> <a href="https://doi.org/10.5664/jcsm.8780">caused by switching from standard time</a> to daylight saving time. </p>
<p>About one-third of Americans say they don’t look forward to these twice-yearly time changes. And nearly two-thirds <a href="https://today.yougov.com/topics/politics/articles-reports/2021/11/04/daylight-saving-time-americans-want-stay-permanent">would like to eliminate them completely</a>, compared with 17% who aren’t sure and 21% who would <a href="https://docs.cdn.yougov.com/etwjvohrxx/Daylight_Saving_Time_Toplines_Crosstabs.pdf">like to keep moving their clocks back and forth</a>. </p>
<p>But the effects go beyond simple inconvenience. Researchers are discovering that “springing ahead” each March is connected with serious negative health effects, including an uptick in <a href="https://doi.org/10.3390/jcm8030404">heart attacks</a> and <a href="https://doi.org/10.5664/jcsm.4938">teen sleep deprivation</a>. In contrast, the fall transition back to standard time is not associated with these health effects, as my co-authors and I explained in a <a href="https://doi.org/10.1001/jamaneurol.2019.3780">2020 commentary</a>.</p>
<p>I’ve studied the pros and cons of these twice-annual rituals for more than five years as a <a href="https://scholar.google.com/citations?user=ZddlKEoAAAAJ&hl=en">professor of neurology and pediatrics</a> and the director of Vanderbilt University Medical Center’s sleep division. It’s become clear to me and many of my colleagues that the transition to daylight saving time each spring affects health immediately after the clock change and also for the nearly eight months that <a href="https://www.cnn.com/2022/11/06/health/permanent-daylight-savings-health-harms-wellness/index.html#">Americans remain on daylight saving time</a>.</p>
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<figcaption><span class="caption">Washington is one of the states where legislators are pushing for permanent standard time.</span></figcaption>
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<h2>Why our bodies are thrown off by DST</h2>
<p>Americans are split on whether they <a href="https://today.yougov.com/topics/politics/articles-reports/2021/11/04/daylight-saving-time-americans-want-stay-permanent">prefer permanent daylight saving time</a> or <a href="https://apnorc.org/projects/dislike-for-changing-the-clocks-persists/">permanent standard time</a>. But a <a href="https://savestandardtime.com/current/">growing number of states</a> are supporting permanent standard time. </p>
<p>However, the two time shifts – jolting as they may be – are not equal. Standard time most closely approximates natural light, with the sun directly overhead at or near noon. In contrast, during daylight saving time from March until November, the clock change causes natural light to be present one hour later in the morning and one hour later in the evening according to clock time.</p>
<p>Morning light is essential for helping to set the body’s natural rhythms: It <a href="https://doi.org/10.1038/s41598-018-36791-5">wakes us up and improves alertness</a>. Morning light also boosts mood – light boxes simulating natural light are prescribed for morning use <a href="https://doi.org/10.1001/archpsyc.55.10.890">to treat seasonal affective disorder</a>.</p>
<p>Although the exact reasons why light activates us and benefits our mood are not yet known, this may be due to light’s effects on <a href="https://doi.org/10.1080/10253890.2020.1741543">increasing levels of cortisol</a>, a hormone that <a href="https://doi.org/10.1038/s41574-019-0228-0">modulates the stress response</a>, or the effect of <a href="https://doi.org/10.1038/s41598-018-36791-5">light on the amygdala</a>, a part of the brain involved in emotions.</p>
<p>Adolescents also may be <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">chronically sleep-deprived due to school</a>, sports and social activities. For instance, many <a href="https://nces.ed.gov/pubs2020/2020006/index.asp">children start school around 8 a.m.</a> or earlier, which means that during daylight saving time they get up and travel to school in pitch darkness.</p>
<p>The body of evidence makes a good case for adopting permanent standard time nationwide, as I testified at a <a href="https://democrats-energycommerce.house.gov/committee-activity/hearings/rescheduled-hearing-on-changing-times-revisiting-spring-forward-fall">March 2022 Congressional hearing</a> and argued in a <a href="https://doi.org/10.1093/sleep/zsac236">recent position statement</a> for the Sleep Research Society. The American Medical Association recently <a href="https://www.ama-assn.org/press-center/press-releases/ama-calls-permanent-standard-time">called for permanent standard time</a>. And in late 2022, <a href="https://www.timeanddate.com/news/time/mexico-abolishes-dst-2022.html#">Mexico adopted permanent standard time</a>, citing benefits to <a href="https://thehill.com/policy/international/3708301-mexicos-senate-votes-to-end-daylight-saving-time-for-most-of-the-country/">health, productivity and energy savings</a>. </p>
<figure class="align-center ">
<img alt="An illustration of two clocks depicting Daylight Savings Time changes: Fall backward, and spring forward." src="https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
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<span class="caption">In 2024, clocks spring forward one hour at 2 a.m. on Sunday, March 10. They fall back at 2 a.m. on Sunday, Nov. 3.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/daylight-saving-time-fall-backward-and-royalty-free-illustration/1356689682?adppopup=true">iam2mai/iStock via Getty Images Plus</a></span>
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<p>The biggest advantage of daylight saving time is that it provides an extra hour of light in the late afternoon or evening, depending on time of year, for sports, shopping or eating outside. However, exposure to light later into the evening for almost eight months during daylight saving time comes at a price. This extended evening light delays the brain’s release of melatonin, the hormone that promotes drowsiness, which in turn interferes with sleep and <a href="https://doi.org/10.1093/sleep/zsac236">causes us to sleep less overall</a>.</p>
<p>Because puberty also causes <a href="https://www.neurologylive.com/view/teenage-circadian-rhythm">melatonin to be released later at night</a>, meaning that teenagers have a delay in the natural signal that helps them fall asleep, adolescents are <a href="https://dx.doi.org/10.5664/jcsm.4938">particularly susceptible to sleep problems</a> from the extended evening light. This shift in melatonin during puberty lasts into our 20s.</p>
<h2>The ‘western edge’ effect</h2>
<p>Geography can also make a difference in how daylight saving time affects people. One study showed that people living on the western edge of a time zone, who get light later in the morning and later in the evening, <a href="https://doi.org/10.1016/j.jhealeco.2019.03.007">got less sleep</a> than their counterparts on the eastern edge of a time zone. </p>
<p>This study found that western-edge residents had higher rates of obesity, diabetes, heart disease and <a href="https://theconversation.com/breast-cancer-risk-higher-in-western-parts-of-time-zones-is-electric-light-to-blame-85803">breast cancer</a>, as well as lower per capita income and higher health care costs. Other research has found that <a href="https://doi.org/10.1158/1055-9965.EPI-16-1029">rates of certain other cancers are higher</a> on the western edge of a time zone. </p>
<p>Scientists believe that these health problems may result from a combination of <a href="https://doi.org/10.3389/fphys.2019.00944">chronic sleep deprivation and “circadian misalignment</a>.” Circadian misalignment refers to a mismatch in timing between our biological rhythms and the outside world. In other words, the timing of daily work, school or sleep routines is based on the clock, rather than on the sun’s rise and set. </p>
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<iframe width="440" height="260" src="https://www.youtube.com/embed/84aWtseb2-4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">This video takes a deeper dive – all the way back to 1895 – into the history of daylight saving time.</span></figcaption>
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<h2>A brief history of daylight saving time</h2>
<p><a href="https://blogs.loc.gov/teachers/2017/03/world-war-i-and-daylight-savings-time/">Congress instituted year-round daylight saving time</a> during World War I and World War II, and <a href="https://www.mercurynews.com/2016/10/30/the-year-daylight-saving-time-went-too-far/">once again during the energy crisis</a> of the early 1970s. But the popularity of year-round daylight saving time fell from 79% to 42% after it went into effect in January 1974, largely due to <a href="https://www.washingtonian.com/2022/03/15/the-us-tried-permanent-daylight-saving-time-in-the-70s-people-hated-it/">safety concerns about children going to school in the dark</a>. </p>
<p>The idea at that time was that having extra light later into the afternoon would save energy by decreasing the need for electric lighting. This idea has since been <a href="https://doi.org/10.1016/j.jebo.2014.03.012">proved largely inaccurate</a>, as heating needs may increase in the morning in the winter, while air conditioning needs can also increase in the late afternoon in the summer.</p>
<p>After World War II, designating the start and end dates for daylight saving time fell to state governments. Because this created many railroad scheduling and safety problems, however, Congress passed the <a href="https://www.transportation.gov/regulations/time-act#">Uniform Time Act in 1966</a>. This law set the nationwide dates of daylight saving time from the last Sunday in April until the last Sunday in October. In 2007, <a href="https://www.bts.gov/geospatial/daylight-savings-time">Congress amended the act</a> to expand the period in which daylight saving time is in effect from the second Sunday in March to the first Sunday in November – dates that remain in effect today.</p>
<p>But the Uniform Time Act does allow states and territories to opt out of daylight saving time. Arizona and Hawaii are on permanent standard time, along with Puerto Rico, the U.S. Virgin Islands, Northern Mariana Islands, Guam and American Samoa. </p>
<h2>A shifting landscape</h2>
<p>As of March 2024, <a href="https://savestandardtime.com/current/">17 states have passed laws</a> to adopt year-round daylight saving time. But federal law requires that they need to wait for Congress, and in some cases also neighboring states, to act. More than two dozen states <a href="https://www.sleepfoundation.org/sleep-news/latest-updates-daylight-saving-time-legislation-change#what-is-the-status-of-state-level">introduced legislation related to the clock change in 2023</a>, but no laws were passed. </p>
<p>Meanwhile, proposed legislation and resolutions for <a href="https://savestandardtime.com/current/">permanent standard time have increased</a> from 15% in 2021 to 37% in 2024. </p>
<p>In March 2022, the U.S. Senate <a href="https://www.congress.gov/bill/117th-congress/senate-bill/623">passed the Sunshine Protection Act </a> in a bid to <a href="https://www.reuters.com/world/us/us-senate-approves-bill-that-would-make-daylight-savings-time-permanent-2023-2022-03-15/">make daylight saving time permanent</a>. But the House did not move forward with this legislation. Florida Sen. Marco Rubio <a href="https://thehill.com/homenews/nexstar_media_wire/3880009-bill-to-make-daylight-saving-time-permanent-reintroduced-in-congress/">reintroduced the bill</a> on March 1, 2023, but <a href="https://www.congress.gov/bill/118th-congress/senate-bill/582/all-info#">this bill has not progressed</a>. </p>
<p>The spike in activity among states seeking to break from these twice-yearly changes reflects how more people are recognizing the downsides of this practice. Now, it’s in the hands of legislators to decide whether to end the time shift altogether and to either choose a full year of having clocks more aligned with the sun or to artificially extend the day for more than half the year, for better or for worse.</p>
<p><em>This is an updated version of an article <a href="https://theconversation.com/why-daylight-saving-time-is-unhealthy-a-neurologist-explains-175427">originally published on March 10, 2022</a>.</em></p><img src="https://counter.theconversation.com/content/224597/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Beth Ann Malow is the Sleep Research Society representative to the Coalition for Permanent Standard TIme. </span></em></p>Americans have long been divided over adopting permanent standard versus permanent daylight saving time. But support for permanent standard time grew dramatically between 2021 and 2024.Beth Ann Malow, Professor of Neurology and Pediatrics, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2221512024-01-31T04:58:36Z2024-01-31T04:58:36ZTurns out the viral ‘Sleepy Girl Mocktail’ is backed by science. Should you try it?<figure><img src="https://images.theconversation.com/files/572103/original/file-20240130-21-f4mjgk.jpg?ixlib=rb-1.1.0&rect=44%2C8%2C5946%2C3979&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/trendy-sleepy-girl-mocktail-popular-cherry-2311807805">Shutterstock</a></span></figcaption></figure><p>Many of us wish we could get a better night’s sleep. Wouldn’t it be great if it was as easy as a mocktail before bed? </p>
<p>That’s what the latest viral trend might have us believe. The “Sleepy Girl Mocktail” is a mix of tart cherry juice, powdered magnesium supplement and soda water. TikTok videos featuring the concoction have garnered hundreds of thousands of views. But, what does the science say? Do these ingredients actually help us sleep?</p>
<p><div data-react-class="TiktokEmbed" data-react-props="{"url":"https://www.tiktok.com/@taaylorvictoriaa/video/7317809719945661742?is_from_webapp=1\u0026sender_device=pc\u0026web_id=7239513980711093761"}"></div></p>
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Read more:
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<h2>Tart cherry juice</h2>
<p>There is <a href="https://www.mdpi.com/2072-6643/12/4/936">research</a> to show including tart cherry juice in your diet improves overall sleep. <a href="https://ift.onlinelibrary.wiley.com/doi/full/10.1111/1750-3841.14952">Clinical trials</a> show tart cherry juice increases sleep quality and quantity, as well as a lessening insomnia symptoms (compared to a placebo). This could be due to the <a href="https://link.springer.com/article/10.1007/s13668-021-00362-4">presence of melatonin</a>, a sleep-promoting hormone, in cherries. </p>
<p>Tart cherry varieties such as Jerte Valley or Montmorency have the highest concentration of melatonin (approximately 1.35 micrograms of melatonin per 100g of <a href="https://www.liebertpub.com/doi/full/10.1089/jmf.2009.0096">cherry juice</a>). Over the counter melatonin supplements can range from 0.5 milligram to over 100 milligrams, with research suggesting those beginning to take melatonin start with a dose of 0.5–2 milligrams to <a href="https://onlinelibrary.wiley.com/doi/pdf/10.1111/jpi.12782">see an improvement in sleep</a>. </p>
<p>Melatonin naturally occurs in our bodies. Our body clock promotes the release of melatonin in the evening to help us sleep, specifically in the two hours before our natural bedtime. </p>
<p>If we want to increase our melatonin intake with external sources, such as cherries, then we should be timing our intake with our natural increase in melatonin. Supplementing melatonin <a href="https://www.frontiersin.org/articles/10.3389/fneur.2010.00137/full">too close to bed</a> will mean we may not get the sleep-promoting benefits in time to get off to sleep easily. Taking melatonin too late may even harm our long-term sleep health by sending the message to our body clock to delay the release of melatonin until later in the evening. </p>
<h2>Magnesium – but how much?</h2>
<p>Magnesium also works to promote melatonin, and magnesium supplements <a href="https://www.mdpi.com/2072-6643/12/4/936">have been shown to improve sleep outcomes</a>. </p>
<p>However, results vary depending on the amount of magnesium people take. And we don’t yet have the answers on the <a href="https://link.springer.com/article/10.1007/s12011-022-03162-1">best dose of magnesium for sleep benefits</a>. </p>
<p>We do know magnesium plays a vital role in energy production and bone development, making it an important <a href="https://downloads.hindawi.com/journals/ije/2018/9041694.pdf">daily nutrient for our diets</a>. Foods <a href="https://bibliotekanauki.pl/articles/877044.pdf">rich in magnesium</a> include wheat cereal or bread, almonds, cashews, pumpkin seeds, spinach, artichokes, green beans, soy milk and dark chocolate.</p>
<p><div data-react-class="TiktokEmbed" data-react-props="{"url":"https://www.tiktok.com/@courtneyscicluna/video/7327962156488477953"}"></div></p>
<h2>Bubbly water</h2>
<p>Soda water serves as the base of the drink, rather than a pathway to better sleep. And bubbly water may make the mix <a href="https://theconversation.com/dont-like-drinking-plain-water-10-healthy-ideas-for-staying-hydrated-this-summer-191859">more palatable</a>. It is important to keep in mind that drinking fluids close to bedtime can be disruptive to our sleep as it might lead to waking during the night to urinate. </p>
<p>Healthy sleep recommendations include avoiding water intake in the <a href="https://link.springer.com/article/10.1007/s10865-006-9047-6">two hours before bed</a>. Having carbonated beverages too close to bed can also trigger digestive symptoms such as <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2036.2010.04232.x">bloating, gassiness and reflux during the night</a>. </p>
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Read more:
<a href="https://theconversation.com/dont-like-drinking-plain-water-10-healthy-ideas-for-staying-hydrated-this-summer-191859">Don’t like drinking plain water? 10 healthy ideas for staying hydrated this summer</a>
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<h2>Bottoms up?</h2>
<p>Overall, there is evidence to support trying out the Sleepy Girl Mocktail to see if it improves sleep, however there are some key things to remember: </p>
<ul>
<li><p><strong>timing</strong>: to get the benefits of this drink, avoid having it too close to bed. Aim to have it two hours before your usual bedtime and avoid fluids after this time </p></li>
<li><p><strong>consistency</strong>: no drink is going to be an immediate cure for poor sleep. However, this recipe could help promote sleep if used strategically (at the right time) and consistently as part of a balanced diet. It may also introduce a calming evening routine that helps your brain relax and signals it’s time for bed </p></li>
<li><p><strong>maximum magnesium</strong>: be mindful of the amount of magnesium you are consuming. While there are many health benefits to magnesium, the recommended daily maximum amounts are 420mg for adult males and 320mg for adult females. Exceeding the maximum can lead to low blood pressure, respiratory distress, stomach problems, muscle weakness and mood problems </p></li>
<li><p><strong>sugar</strong>: in some of the TikTok recipes sugar (as flavoured sodas, syrups or lollies) is added to the drink. While this may help hide the taste of the tart cherry juice, the consumption of sugar too close to bed may make it <a href="https://academic.oup.com/advances/article-abstract/7/5/938/4616727">more difficult to get to sleep</a>. And sugar in the evening raises blood sugar levels at a time when our body is not primed to be processing sugar. Long term, this can increase our <a href="https://www.nature.com/articles/s41387-020-0109-6">risk of diabetes</a> </p></li>
<li><p><strong>sleep environment</strong>: follow good sleep hygiene practices including keeping a consistent bedtime and wake time, a wind-down routine before bed, avoiding electronic device use like phones or laptops in bed, and avoiding bright light in the evening. Bright light works to suppress our melatonin levels in the evening and make us more alert. </p></li>
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Read more:
<a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">Nope, coffee won't give you extra energy. It'll just borrow a bit that you'll pay for later</a>
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<h2>What about other drinks?</h2>
<p>Other common evening beverages include herbal tisanes or teas, hot chocolate, or warm milk.</p>
<p>Milk can be especially beneficial for sleep, as it contains the amino acid tryptophan, which can <a href="https://link.springer.com/article/10.1007/s13197-020-04236-5">promote melatonin production</a>. Again, it is important to also consider the timing of these drinks and to avoid any caffeine in tea and too much chocolate too close to bedtime, as this can make us more alert rather than sleepy. </p>
<p>Getting enough sleep is <a href="https://theconversation.com/how-dangerous-is-insomnia-how-fear-of-what-its-doing-to-your-body-can-wreck-your-sleep-212248">crucial to our health and wellbeing</a>. If you have tried multiple strategies to improve your sleep and things are not getting better, it may be time to seek professional advice, such as from a GP. </p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/reel/CzpbcaGMZCP/?utm_source=ig_web_copy_link","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
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Read more:
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<p><em>Correction: the approximate amount of melatonin in cherries has been updated due to a calculation error.</em></p><img src="https://counter.theconversation.com/content/222151/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Charlotte Gupta does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Unlike many viral wellbeing trends, this one may have some science to back it. But don’t drink too much too close to bedtime.Charlotte Gupta, Postdoctoral research fellow, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2199552024-01-17T13:37:48Z2024-01-17T13:37:48ZWhat’s the best diet for healthy sleep? A nutritional epidemiologist explains what food choices will help you get more restful z’s<figure><img src="https://images.theconversation.com/files/569476/original/file-20240116-23-j8753f.jpg?ixlib=rb-1.1.0&rect=12%2C0%2C2105%2C1409&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">A balanced diet is one key factor in getting a restful night's sleep. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/freshly-woken-up-young-woman-enjoying-the-morning-royalty-free-image/1413633179?phrase=person+sleeping&searchscope=image%2Cfilm&adppopup=true">SimpleImages/Moment via Getty Images</a></span></figcaption></figure><p>You probably already know that how you eat before bed affects your sleep. Maybe you’ve found yourself still lying awake at 2 a.m. after enjoying a cup of coffee with dessert. But did you know that your eating choices throughout the day may also affect your sleep at night? </p>
<p>In fact, more and more evidence shows that <a href="https://doi.org/10.3390/nu12092830">overall dietary patterns</a> can <a href="https://doi.org/10.3390/nu14142998">affect sleep quality and contribute to insomnia</a>.</p>
<p>I am a <a href="https://sph.umich.edu/faculty-profiles/jansen-erica.html">nutritional epidemiologist</a>, and I’m <a href="https://scholar.google.com/citations?user=NwgRhPYAAAAJ&hl=en">trained to look at diets at the population level</a> and how they affect health. </p>
<p>In the U.S., a large percentage of the population suffers from <a href="https://www.gallup.com/analytics/390536/sleep-in-america-2022.aspx">poor sleep quality</a> and sleep disorders like <a href="https://www.nhlbi.nih.gov/health/insomnia#">insomnia</a> and <a href="https://www.ncbi.nlm.nih.gov/books/NBK459252/#">obstructive sleep apnea</a>, a condition in which the upper airway becomes blocked and breathing stops during sleep. At the same time, most Americans eat far too much <a href="https://fns-prod.azureedge.us/sites/default/files/media/file/AverageHealthyEatingIndex-2020ScoresfortheUSPopulation.pdf">fatty and processed food, too little fiber and too few fruits and vegetables</a>. </p>
<p>Although it is difficult to determine whether these two trends are causally linked to one another, more and more <a href="https://doi.org/10.1146%2Fannurev-nutr-120420-021719">research points to linkages between sleep and diet</a> and offers hints at the biological underpinnings of these relationships.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Overhead view of colorful foods with high dietary fiber content arranged side by side on a countertop." src="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=337&fit=crop&dpr=1 600w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=337&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=337&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=424&fit=crop&dpr=1 754w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=424&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/569475/original/file-20240116-23-bh5k9m.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=424&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Most Americans consume far too little fiber and too few fresh fruits and vegetables.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/group-of-food-with-high-content-of-dietary-fiber-royalty-free-image/1457889029?phrase=high+fiber+diet&searchscope=image%2Cfilm&adppopup=true">fcafotodigital/E+ via Getty Images</a></span>
</figcaption>
</figure>
<h2>How diet and sleep quality can be intertwined</h2>
<p>My colleagues and I wanted to get a deeper understanding of the possible link between sleep and diet in Americans who are 18 and older. So we analyzed whether people who follow <a href="https://health.gov/our-work/nutrition-physical-activity/dietary-guidelines">the government’s Dietary Guidelines for Americans</a> get more hours of sleep.</p>
<p>Using a nationally representative dataset of surveys collected from 2011 to 2016, we found that people who did not adhere to dietary recommendations such as consuming enough servings of fruits, vegetables, legumes and whole grains <a href="https://doi.org/10.1016/j.appet.2020.104748">had shorter sleep duration</a>.</p>
<p>In a separate study, we followed more than 1,000 young adults ages 21 to 30 who were enrolled in a web-based dietary intervention study designed to help them increase their daily servings of fruits and vegetables. We found that those who increased their fruit and vegetable consumption over a three-month period reported better sleep quality and <a href="https://doi.org/10.1016/j.sleh.2021.02.005">reductions in insomnia symptoms</a>. </p>
<p>Research conducted outside the U.S. by my group and others also shows that healthier overall dietary patterns are associated with better sleep quality and fewer insomnia symptoms. These include the <a href="https://doi.org/10.3390/nu12092830">Mediterranean diet</a> – a diet rich in plant foods, olive oil and seafood, and low in red meat and added sugar – and <a href="https://doi.org/10.3390/nu15020419">anti-inflammatory diets</a>. These are <a href="https://doi.org/10.1016/j.appet.2021.105881">similar to the Mediterranean diet</a> but include additional emphasis on <a href="https://doi.org/10.1093/sleep/zsy158">certain components in the diet</a> like <a href="https://doi.org/10.3390%2Fmolecules25225243">flavonoids</a>, a group of compounds found in plants, which are shown to lower inflammatory biomakers in the blood.</p>
<h2>Parsing the foods and nutrients</h2>
<p>Within overall healthy diet patterns, there are numerous individual foods and nutrients that may be linked to quality of sleep, with varying degrees of evidence. </p>
<p>For example, studies have linked consumption of <a href="https://doi.org/10.5664/jcsm.3714">fatty fish</a>, <a href="https://doi.org/10.1016/j.advnut.2023.01.004">dairy</a>, <a href="https://doi.org/10.3389/fnut.2023.1079609">kiwi fruit</a>, <a href="https://doi.org/10.1097/mjt.0000000000000584">tart cherries</a> and <a href="https://doi.org/10.3390/nu15245115">other berries</a> such as strawberries and blueberries with better sleep. One of the common pathways through which these foods may affect sleep is by <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">providing melatonin</a>, an important modulator of sleep and wake cycles in the brain.</p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/Z7mNwDrr53c?wmode=transparent&start=82" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Walnuts and almonds, as well as fruits like kiwis and bananas, provide natural sources of melatonin.</span></figcaption>
</figure>
<p><a href="https://theconversation.com/fiber-is-your-bodys-natural-guide-to-weight-management-rather-than-cutting-carbs-out-of-your-diet-eat-them-in-their-original-fiber-packaging-instead-205159">Fiber-rich foods</a> like beans and oatmeal and certain protein sources – especially those that are high in the amino acid tryptophan, such as poultry – are also associated with <a href="https://doi.org/10.1016/j.jand.2022.01.007">higher-quality sleep</a>. Individual nutrients that may be beneficial include <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703169/">magnesium</a>, <a href="https://doi.org/10.1016/j.tjnut.2023.11.030">vitamin D</a>, <a href="https://doi.org/10.1016/j.tjnut.2023.11.030">iron</a>, <a href="https://doi.org/10.1093/jn/nxz286">omega-3 fatty acids</a> and <a href="https://doi.org/10.1016/j.tjnut.2023.11.012">manganese</a>. Some foods like salmon are sources of multiple nutrients. </p>
<h2>Untangling the complexity</h2>
<p>One important caveat with a lot of the research on individual foods, as well as diet patterns, is that most studies cannot easily disentangle the direction of the relationships.</p>
<p>In other words, it’s hard to know whether the association is a result of diet affecting sleep, or sleep affecting diet. The reality is that it is likely a cyclical relationship, where a healthy diet promotes good sleep quality, which in turn helps to <a href="https://doi.org/10.1146/annurev-nutr-120420-021719">reinforce good dietary habits</a>. </p>
<p>With observational studies, there are also possible confounding factors, such as age and economic status, that may have important correlations with both sleep and diet.</p>
<h2>Foods to avoid for sleep health</h2>
<p>Aiming for higher intake of sleep-promoting foods isn’t necessarily enough to get better sleep. It’s also important to avoid certain foods that could be bad for sleep. Here are some of the main culprits:</p>
<ul>
<li><p>Saturated fats, such as that in burgers and fries and processed foods, could <a href="https://doi.org/10.5664/jcsm.5384">lead to less slow-wave sleep</a>, which is <a href="https://pubmed.ncbi.nlm.nih.gov/19998869/">considered the most restorative sleep</a>. </p></li>
<li><p>Refined carbohydrates, such as those in white bread and pasta, are metabolized quickly. If you eat these foods for dinner, they can result in <a href="https://doi.org/10.3389/fpubh.2022.931781">waking up from hunger</a>. </p></li>
<li><p><a href="https://doi.org/10.1016/j.alcohol.2014.07.019">Alcohol disrupts sleep quality</a>. Although the sedative effects of alcohol can initially make it easier to fall asleep, it disrupts sleep patterns by shortening the amount of <a href="https://www.webmd.com/sleep-disorders/sleep-101">REM, or rapid eye movement</a>, sleep in the first part of the night and leads to more night awakenings.</p></li>
<li><p>Caffeine consumed even six hours before bed can <a href="https://doi.org/10.5664/jcsm.3170">make it difficult to fall asleep</a> because it blocks the hormone adenosine, which promotes sleepiness. </p></li>
<li><p>The consistent overconsumption of calories can lead to weight gain, one of the <a href="https://doi.org/10.1016/j.smrv.2023.101838">strongest predictors of obstructive sleep apnea</a>. Having excess weight is a factor because it can put additional pressure on the diaphragm and lungs, and can also lead to a narrower airway if fat accumulates around the neck and throat.</p></li>
</ul>
<p>Interestingly, our group has recently shown that toxicants in food or food packaging, <a href="https://doi.org/10.1186/s12889-021-12014-x">like pesticides</a>, <a href="https://doi.org/10.1016/j.envres.2020.110216">mercury</a> and <a href="https://doi.org/10.1007/s11356-023-26833-5">phthalates</a> – chemicals used to manufacture plastics – can affect sleep. Since toxicants can be found in both healthy and unhealthy foods, this research suggests that some foods can contain a mix of components that are both beneficial and harmful for sleep.</p>
<h2>Timing of meals and gender considerations</h2>
<p>The timing and consistency of eating, known as “chrononutrition” in the sleep research field, also very likely help to explain associations between healthy diets and good sleep. </p>
<p>In the U.S., eating at conventional meal times as opposed to random snacking <a href="https://doi.org/10.1017/S136898001000296X">has been associated with better sleep</a>. In addition, late-night eating is typically associated with unhealthier food intake – such as processed snacks – and could <a href="https://doi.org/10.1017/s0007114521003597">cause more fragmented sleep</a>.</p>
<p>A final and very interesting piece of this puzzle is that associations between diet and sleep often differ by gender. For example, it appears that the associations between healthy diet patterns and insomnia symptoms <a href="https://doi.org/10.1016/j.sleh.2021.02.005">could be stronger among women</a>. One reason for this could be gender differences in sleep. In particular, <a href="https://doi.org/10.3389%2Ffpsyt.2020.577429">women are more likely than men to suffer from insomnia</a>.</p>
<h2>Keys to a good night’s sleep</h2>
<p>Overall, there is not one magic food or drink that will improve your sleep. It’s better to focus on overall healthy dietary patterns throughout the day, with a higher proportion of calories consumed earlier in the day. </p>
<p>And, in addition to avoiding caffeine, alcohol and heavy meals in the two to three hours before bed, the last few hours of the day should include other <a href="https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/">good sleep hygiene practices</a>. </p>
<p>These include disengaging from technology, reducing light exposure and creating a comfortable and relaxing environment for sleep. Moreover, allowing enough time to sleep and maintaining a consistent bedtime and wake time is essential.</p><img src="https://counter.theconversation.com/content/219955/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Erica Jansen receives funding from the National Heart Lung Blood Institute (NHBLI) through a K01 award (K01HL151673). </span></em></p>A growing body of research is finding a robust link between diet and sleep quality. But it’s not just the usual suspects like caffeine and alcohol that can get in the way of restful sleep.Erica Jansen, Assistant Professor of Nutritional Sciences, University of MichiganLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2129642023-10-25T19:09:58Z2023-10-25T19:09:58ZHow can I get some sleep? Which treatments actually work?<figure><img src="https://images.theconversation.com/files/549731/original/file-20230922-15-vh7iga.jpg?ixlib=rb-1.1.0&rect=4%2C0%2C994%2C666&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-surrounded-by-different-pills-on-2132651521">Shutterstock</a></span></figcaption></figure><p><em>This article is the next in The Conversation’s six-part series on insomnia, which charts the rise of insomnia during industrialisation to sleep apps today. Read other articles in the series <a href="https://theconversation.com/au/topics/insomnia-series-144018">here</a>.</em></p>
<hr>
<p>Do you have difficulty falling asleep? Do you stay awake for a long time at night? Do these sleep problems make you feel fatigued, strung-out, or exhausted during the day? Has this been happening for months?</p>
<p>If so, you’re not alone. About <a href="https://www.sleephealthfoundation.org.au/special-sleep-reports/chronic-insomnia-disorder-in-australia">12-15%</a> of Australian adults have chronic insomnia.</p>
<p>You might have tried breathing exercises, calming music, white noise, going to bed in a dark and quiet bedroom, eating different foods in the evening, maintaining a regular sleep pattern, or reducing caffeine. But after three to four weeks of what seems like progress, your insomnia returns. What next?</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/a-short-history-of-insomnia-and-how-we-became-obsessed-with-sleep-211729">A short history of insomnia and how we became obsessed with sleep</a>
</strong>
</em>
</p>
<hr>
<h2>What not to do</h2>
<p>These probably won’t help:</p>
<ul>
<li><p><strong>spending more time in bed</strong> often results in more time spent <em>awake</em> in bed, which can make <a href="https://theconversation.com/how-do-i-stop-my-mind-racing-and-get-some-sleep-207904">insomnia patterns worse</a></p></li>
<li><p><strong>drinking coffee and taking naps</strong> might help get you through the day. But <a href="https://theconversation.com/nope-coffee-wont-give-you-extra-energy-itll-just-borrow-a-bit-that-youll-pay-for-later-197897">caffeine</a> stays in the system for many hours, and can disrupt our sleep if you drink too much of it, especially after about 2pm. If naps last for more than 30 minutes, or occur after about 4pm, this can reduce your “sleep debt”, and can make it <a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">more difficult</a> to fall asleep in the evening</p></li>
<li><p><strong>drinking alcohol</strong> might help you fall asleep quicker, but <a href="https://journals.sagepub.com/doi/10.1300/J465v26n01_01">can cause</a> more frequent awakenings, change how long you sleep, change the time spent in different “stages” of sleep, and reduce the overall quality of sleep. Therefore, it is not recommended as a sleep aid.</p></li>
</ul>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-do-i-fall-asleep-on-the-sofa-but-am-wide-awake-when-i-get-to-bed-208371">Why do I fall asleep on the sofa but am wide awake when I get to bed?</a>
</strong>
</em>
</p>
<hr>
<h2>What to do next?</h2>
<p>If your symptoms have lasted more than one or two months, it is likely your insomnia requires targeted treatments that focus on sleep patterns and behaviours.</p>
<p>So, the next stage is a type of non-drug therapy known as cognitive behavioural therapy for insomnia (or <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti">CBTi</a> for short). This is a four to eight week treatment that’s been shown to be <a href="https://doi.org/10.1016/j.smrv.2022.101687">more effective</a> than sleeping pills. </p>
<p>It involves education about sleep, and offers psychological and behavioural treatments that address the underlying causes of long-term insomnia.</p>
<p>You can do this one-on-one, in a small group with health professionals trained in CBTi, or via self-guided <a href="https://www.sleepprimarycareresources.org.au/insomnia/cbti/referral-to-digital-cbti-programs">online programs</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Counsellor or psychologist putting hand on shoulder of woman in group therapy" src="https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/550533/original/file-20230927-23-490yxo.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">You can do this therapy in a group, one-on-one or online.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/men-women-sitting-circle-during-group-1316330951">Shutterstock</a></span>
</figcaption>
</figure>
<p>Some GPs are trained to offer CBTi, but it’s more usual for specialist <a href="https://psychology.org.au/find-a-psychologist">sleep psychologists</a> to offer it. Your GP can refer you to one. There are some Medicare rebates to subsidise the cost of treatment. But many psychologists will also charge a gap fee above the Medicare subsidy, making access to CBTi a challenge for some. </p>
<p><a href="https://doi.org/10.12703%2Fr%2F11-4">About 70-80%</a> of people with insomnia sleep better after CBTi, with improvements lasting <a href="https://doi.org/10.1016/j.smrv.2019.08.002">at least a year</a>.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/what-makes-a-good-psychologist-or-psychiatrist-and-how-do-you-find-one-you-like-120981">What makes a good psychologist or psychiatrist and how do you find one you like?</a>
</strong>
</em>
</p>
<hr>
<h2>What if that doesn’t work?</h2>
<p>If CBTi doesn’t work for you, your GP might be able to refer you to a specialist sleep doctor to see if other sleep disorders, such as <a href="https://doi.org/10.1016/j.smrv.2016.04.004">obstructive sleep apnoea</a>, are contributing to your insomnia. </p>
<p>It can also be important to manage any mental health problems such as <a href="https://doi.org/10.5694/mja2.51200">depression and anxiety</a>, as well as physical symptoms such as pain that can also disrupt sleep. </p>
<p>Some lifestyle and work factors, such as shift-work, might also require management by a specialist sleep doctor.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/counting-the-wrong-sheep-why-trouble-sleeping-is-about-more-than-just-individual-lifestyles-and-habits-210695">Counting the wrong sheep: why trouble sleeping is about more than just individual lifestyles and habits</a>
</strong>
</em>
</p>
<hr>
<h2>What about sleeping pills?</h2>
<p>Sleeping pills are <a href="https://www.sleepprimarycareresources.org.au/insomnia/pharmacological-therapy">not the recommended</a> first-line way to manage insomnia. However, they do have a role in providing short-term, rapid relief from insomnia symptoms or when CBTi is not accessible or successful.</p>
<p>Traditionally, medications such as benzodiazepines (for example, temazepam) and benzodiazepine receptor agonists (for example, zolpidem) have been used to help people sleep.</p>
<p>However, these can have <a href="https://doi.org/10.1136/bmj.38623.768588.47">side-effects</a> including a risk of falls, being impaired the next day, as well as tolerance and dependence. </p>
<p>Melatonin – either prescribed or available from pharmacies for people aged 55 and over – is also often used to manage insomnia. But the <a href="https://doi.org/10.1016/j.smrv.2022.101692">evidence suggests</a> it has limited benefits.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/some-reasons-why-you-should-avoid-sleeping-pills-10054">Some reasons why you should avoid sleeping pills </a>
</strong>
</em>
</p>
<hr>
<h2>Are there new treatments? How about medicinal cannabis?</h2>
<p>Two newer drugs, known as “orexin receptor antagonists”, are available in Australia (suvorexant and lemborexant).</p>
<p>These block the wake-promoting pathways in the brain. <a href="https://doi.org/10.4088/PCC.22nr03385">Early data suggests</a> they are effective in improving sleep, and have lower risk of potential side-effects, tolerance and dependence compared with earlier medicines.</p>
<p>However, we don’t know if they work or are safe over the long term.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Dropper bottles of medicinal cannabis oil" src="https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/552457/original/file-20231006-29-t56795.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Medicinal cannabis may be one option in the future. But trials so far have been mixed.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/macro-detail-dropper-cbd-oil-cannabis-725041309">Shutterstock</a></span>
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<p><a href="https://doi.org/10.1093/sleep/zsab149">Medicinal cannabis</a> <a href="https://doi.org/10.1111/jsr.13793">has only in recent years</a> <a href="https://doi.org/10.1093/sleepadvances/zpac029.048">been studied</a> as a treatment for <a href="https://doi.org/10.1093/sleepadvances/zpac029.005">insomnia</a>.</p>
<p>In an Australian survey, <a href="https://doi.org/10.2147/nss.s390583">more than half</a> of people using medicinal cannabis said they used it to treat insomnia. There are reports of <a href="https://doi.org/10.1371/journal.pone.0272241">significant benefit</a>. </p>
<p>But of the four most robust studies so far, <a href="https://doi.org/10.1093/sleep/zsab149">only one</a> (led by one of us, Jen Walsh) has demonstrated an improvement in insomnia after two weeks of treatment.</p>
<p>So we need to learn more about which cannabinoids – for example, delta-9-tetrahydrocannabinol, cannabidiol or cannabinol – and which doses may be beneficial. We also need to learn who can benefit most, and whether these are safe and effective over the long term.</p>
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Read more:
<a href="https://theconversation.com/1-in-10-women-with-endometriosis-report-using-cannabis-to-ease-their-pain-126516">1 in 10 women with endometriosis report using cannabis to ease their pain</a>
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<h2>What now?</h2>
<p>If you’ve had trouble sleeping for a short time (under about a month) and nothing you try is working, there may be underlying reasons for your insomnia, which when treated, can provide some relief. Your GP can help identify and manage these.</p>
<p>Your GP can also help you access other treatments if your insomnia is more long term. This may involve non-drug therapies and/or referral to other services or doctors.</p>
<hr>
<p><em>For more information about insomnia and how it’s treated, see the Sleep Health Foundation’s <a href="https://www.sleephealthfoundation.org.au/sleep-disorders/insomnia-2">online resource</a>.</em></p><img src="https://counter.theconversation.com/content/212964/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Alexander Sweetman is a Senior Program Manager at the Australasian Sleep Association, the peak sleep health scientific and advocacy body in Australia and New Zealand, and has academic status at Flinders University. Dr Sweetman reports previous research funding and/or consultancy work for; the National Health and Medical Research Council, The Hospital Research Foundation, Flinders University, Flinders Foundation, ResMed, Philips, Cerebra, Re-Time, and Australian Doctor.</span></em></p><p class="fine-print"><em><span>Jen Walsh is affiliated with the Centre for Sleep Science at The University of Western Australia and the West Australian Sleep Disorders Research Institute at Sir Charles Gairdner Hospital. She is a director of the Australian Sleep Association (ASA), and a member of the Australia and New Zealand Sleep Science Association (ANZSSA) and Sleep Health Foundation (SHF).
Jen Walsh has received research funding (past) from the NHMRC, Sir Charles Gairdner Hospital research advisory committee, Australia and New Zealand College of Anaesthetists (ANZCA), Oventus Pty Ltd, Nyxoah Pty Ltd, Zelira Therapeutics Ltd and Incannex Healthcare Ltd. She is currently receiving research funding from CHC Helicopter Australia and Chevron Australia Pty Ltd. She also receives consultancy fees from Invicta Medical and Melius Consulting.
Jen Walsh was the first author of a medicinal cannabis trial mentioned in this article.</span></em></p><p class="fine-print"><em><span>Nicole Grivell is involved in the Australasian Sleep Association as a co-chair of the Primary Care Council and as a member of the Conference Committee.
She currently has PhD funding from Flinders University and an NHMRC-funded Partnership Grant. She has previously received PhD funding from the Flinders Foundation in the form of a Nick Antic Sleep Research PhD Scholarship. </span></em></p>You’ve tried everything to get some sleep, but nothing’s working. Here’s what not to do, and what works.Alexander Sweetman, Research Fellow, College of Medicine and Public Health, Flinders UniversityJen Walsh, Director of the Centre for Sleep Science, The University of Western AustraliaNicole Grivell, Research Coordinator and final year PhD Candidate at FHMRI Sleep Health, Flinders UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2118212023-08-31T03:41:34Z2023-08-31T03:41:34ZHow can I get better sleep on long-haul flights?<figure><img src="https://images.theconversation.com/files/545666/original/file-20230831-16733-lxnmp2.jpg?ixlib=rb-1.1.0&rect=784%2C95%2C1212%2C901&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/vladivostok-russia-september-08-2013-passengers-312891566">Shutterstock</a></span></figcaption></figure><p>For most of us, the prospect of a long-haul flight is exciting, mixed with a few nerves. We’re off somewhere different – perhaps a holiday, maybe to catch up with friends or family. Even work can be more interesting when you’re in a new location.</p>
<p>Of course, you want to arrive fully rested and ready to go. But by its very definition, a long-haul flight involves travelling for a long period of time, often more than 12 hours. If you’re on a flight from New York to Singapore, it can be close to 19 hours.</p>
<p>All that time you’re confined in a seat that’s <em>supposed</em> to recline but feels like it hardly moves, while the seat in front seems to recline ten times lower than yours.</p>
<p>So, what can you do to get a a decent rest?</p>
<h2>Accept the situation</h2>
<p>The first tip for sleep in this setting is to relax your expectations a little.</p>
<p>Humans are just not well designed to sleep in an almost upright position. Unless you’re lucky to fly in a class with a lie-flat seat, you’re very unlikely to step off a long-haul flight having had a solid eight hours of sleep.</p>
<p>Research by colleagues and myself <a href="https://academic.oup.com/sleep/article/36/1/109/2656896">has shown</a> pilots – who get a bunk to sleep in during their in-flight rest breaks – have light and fragmented sleep. Despite not having great quality sleep, you can be assured <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/jsr.12071?casa_token=S_3bRlU31x8AAAAA:BDeXhWwlMUXfDvtz59M0eSRGfXiK2jm45Tsr5uzMM02t3hktXfEEzU9OjSdGwbVZ_YuCIoUvnpDaKO0">our research</a> <a href="https://www.ingentaconnect.com/content/asma/asem/2014/00000085/00000012/art00007">also shows</a> pilots remain very good at their job throughout a long-haul flight. This, <a href="https://www.tandfonline.com/doi/full/10.3109/07420528.2012.719957?casa_token=zoFj2qt5RPMAAAAA%3ANeXdd1ALMMv9zxRJF3GhpoCS3u3eT8Q_kmNqFpsWh7oz1dLyVJgDpU3vo547iGotvX5d9CCiTfi62g">plus findings</a> from <a href="https://www.sciencedirect.com/science/article/abs/pii/B9780444537027000099">many other lab-based studies</a>, tells us that even a short amount of light sleep has benefits.</p>
<p>So, even if you can’t get your usual eight hours during the flight, <em>any</em> sleep you do get will help you feel and function better at your destination.</p>
<p>Also, we’re not great at judging how much sleep we’ve had, particularly if our sleep is light and broken. So you’re likely to have slept more than you think.</p>
<h2>Time your sleep and drinks</h2>
<p>The timing of your flight, and consumption of alcohol and caffeine will directly impact your ability to sleep on an aircraft.</p>
<p>Assuming you’re adjusted to the time zone the flight departs from, daytime flights will make sleep on board much harder, whereas nighttime flights make sleep easier.</p>
<p>All humans have a circadian (24-hour) time-keeping system, which programs us for sleep at night and wakefulness during the day. Sleeping (or waking) against this biological time-keeping system poses significant challenges.</p>
<p>We do have a natural decrease of alertness in the middle of the afternoon, which makes this a good time to try for sleep on a daytime flight. On nighttime flights it will be easier to sleep once the dinner service is finished, otherwise you will be battling noise, light and the movement of people around you.</p>
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Read more:
<a href="https://theconversation.com/explainer-can-you-pay-off-your-sleep-debt-11618">Explainer: can you pay off your 'sleep debt'?</a>
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<p>As a stimulant, caffeine helps us stay alert. Even if you’re a regular coffee drinker and can fall asleep after drinking caffeine, your sleep will be lighter and <a href="https://doi.org/10.1016/j.smrv.2016.01.006">you’ll be more easily woken</a>.</p>
<p>On the other hand, alcohol makes us feel sleepy, but it interferes with our brains’ ability to have REM sleep (also known as dreaming sleep). Although you may fall asleep more easily after consuming alcohol, your sleep will be more disturbed once your body metabolises the alcohol and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5821259/">attempts to catch up</a> on the REM sleep it’s missed out on.</p>
<h2>What about taking melatonin or other drugs?</h2>
<p>Some people find taking a sleeping tablet or melatonin can help on a plane. This is a very personal choice.</p>
<p>Before taking sleeping medication or melatonin you should see your doctor, and only take what’s prescribed for you. Many sleeping medications <a href="https://www.ingentaconnect.com/content/ben/cnsnddt/2023/00000022/00000002/art00006">do not allow perfectly normal sleep to occur</a> and can make you feel <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3657033">groggy and drowsy</a> after waking.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/i-cant-sleep-what-drugs-can-i-safely-take-102343">I can't sleep. What drugs can I (safely) take?</a>
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<p>Importantly, melatonin is a hormone our brains use to tell us it’s nighttime. Melatonin can assist with sleep, but depending on when and how much you take, it can also shift your circadian clock. This could shift you further away from being aligned with the destination time zone.</p>
<p>Taking melatonin in your biological afternoon and evening will shift your circadian time-keeping system east (or earlier) and taking it toward the end of your biological night and in your biological morning will shift the circadian time-keeping system west (or later). It gets complicated very quickly!</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A woman with long hair folded over on an airplane" src="https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/545470/original/file-20230830-23-xaf21i.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Our muscles naturally relax when we’re asleep, making it difficult to keep the head supported.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/nanjing-china-june-19-2018-people-1130883641">Shutterstock</a></span>
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<h2>Prepare your clothes and accessories</h2>
<p>Be prepared so you can create the best possible sleep situation within the constraints of an aircraft seat.</p>
<p>Wear comfy layers, so you can take things off if you get too hot or put things on when you cool down, and hang on to that blanket instead of losing it under your seat.</p>
<p>Light and noise disturb sleep, so pack eye shades and earplugs (or a noise cancelling headset) to block these out. Practice with eye shades and earplugs at home, as it can take a few sleeps to get used to them.</p>
<p>A normal and necessary part of the falling asleep process is relaxation, including our neck muscles. When sitting up, this means our heavy heads will no longer be well supported, resulting in that horrible head-dropping experience most of us have had. Try supporting your head with a neck pillow or, if you have a window seat, against the aircraft wall. (Unless you know the person in the next seat well, they are probably not a good option to prop you up.)</p>
<h2>Don’t try to force it</h2>
<p>Finally, if you wake up and are struggling to go back to sleep, don’t fight it. </p>
<p>Take advantage of the in-flight entertainment. This is one of the few times sleep scientists will tell you it’s okay to turn on the technology – watch a movie, binge-watch a TV series, or if you prefer, listen to music or read a good book.</p>
<p>When you feel sleepy, you can try going back to sleep, but don’t get stressed or worried about getting enough sleep. Our brains are very good at sleeping – trust that your body will catch you up when it can.</p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/jetlag-hits-differently-depending-on-your-travel-direction-here-are-6-tips-to-get-over-it-196730">Jetlag hits differently depending on your travel direction. Here are 6 tips to get over it</a>
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<img src="https://counter.theconversation.com/content/211821/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Leigh Signal, or the research team she is a member of, have received funding from Boeing Commercial Airplanes, Royal Society of New Zealand, South African Airways, Air New Zealand, Delta Air Lines, Civil Aviation Authority of Singapore and the United States Air Force Office of Scientific Research.</span></em></p>A sleep scientist explains how to maximise your chances of getting decent rest while trapped on a plane.Leigh Signal, Professor in Fatigue Management and Sleep Health/Associate Dean, Research, Massey UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2044362023-08-25T12:27:42Z2023-08-25T12:27:42ZScreen time is contributing to chronic sleep deprivation in tweens and teens – a pediatric sleep expert explains how critical sleep is to kids’ mental health<figure><img src="https://images.theconversation.com/files/544646/original/file-20230824-2188-dbvyvh.jpg?ixlib=rb-1.1.0&rect=45%2C36%2C5961%2C3971&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">When teens can’t sleep, they often scroll online well into the night, which only exacerbates the problem.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/teenager-sending-email-from-smart-phone-in-her-bed-royalty-free-image/537460890?phrase=teens+screens&adppopup=true">ljubaphoto/E+ via Getty Images</a></span></figcaption></figure><p>With the start of a new school year comes the inevitable battle to get kids back into a healthy bedtime routine. In many cases, this likely means resetting boundaries on screen use, especially late in the evenings. But imposing and enforcing those rules can be easier said than done.</p>
<p>A growing body of research is finding strong <a href="https://doi.org/10.1016/j.smrv.2020.101414">links between sleep, mental health and screen time</a> in teens and tweens – the term for pre-adolescent children around the ages of 10 to 12. Amid an <a href="https://www.cdc.gov/mmwr/volumes/72/wr/mm7219a1.htm">unprecedented mental health crisis</a> in which some <a href="https://www.cdc.gov/healthyyouth/mental-health/index.htm">42% of adolescents</a> in the U.S. are suffering from mental health issues, teens are also <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">getting too little sleep</a>. </p>
<p>And it is a vicious cycle: Both a lack of sleep and the heightened activity involved in the consumption of social media and video games before bedtime can exacerbate or even trigger anxiety and depression that warrant intervention.</p>
<p>I am the lead physician of the sleep center at Seattle Children’s Hospital, where I <a href="https://www.seattlechildrens.org/directory/maida-lynn-chen/">study various pediatric sleep disorders</a>. Our team of physicians and providers routinely observe firsthand the negative effects of excessive screen time, and particularly social media, both of which affect not only sleep, but also the <a href="https://doi.org/10.1016/C2017-0-04667-0">physical and mental health</a> of our patients. </p>
<h2>Relationship between mental health and poor sleep</h2>
<p>Research has long shown a clear relationship between mental health and sleep: Poor sleep can lead to poor mental health and vice versa. People with <a href="https://doi.org/10.1016%2Fj.chc.2020.09.003">depression and anxiety commonly have</a> <a href="https://www.nhlbi.nih.gov/health/insomnia">insomnia</a>, a condition in which people have trouble falling or staying asleep, or both, or getting refreshing sleep. That ongoing sleep deprivation further worsens the very depression and anxiety that caused the insomnia in the first place. </p>
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<figcaption><span class="caption">A teen’s health, growth and emotional stability are linked to the quality and quantity of sleep.</span></figcaption>
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<p>What’s more, insomnia and poor-quality sleep may also <a href="https://doi.org/10.1016%2Fj.chc.2020.09.003">blunt the benefits of therapy and medication</a>. At its worst, chronic sleep deprivation increases the risk of suicide. One study found that <a href="https://doi.org/10.1007/s10964-014-0170-3">just one hour less sleep</a> during the week was associated with “significantly greater odds of feeling hopeless, seriously considering suicide, suicide attempts and substance use.” </p>
<p>And what do young people do when lying in bed awake, frustrated and unable to sleep? You guessed it – far too often, <a href="https://doi.org/10.1016/j.envint.2018.11.069">they get on their smart devices</a>. </p>
<p>Studies across the world in over 120,000 youth ages 6 to 18 who engage in any sort of social media have repeatedly shown <a href="https://doi.org/10.1001%2Fjamapediatrics.2016.2341">worsened quality and decreased quantity of sleep</a>. This is happening across the globe, not just in the U.S. </p>
<h2>The strong pull of screens and social media</h2>
<p>Although social media has some benefits, I believe research makes it clear that there are significantly <a href="https://doi.org/10.1503%2Fcmaj.190434">more downsides to social media consumption</a> than upsides. </p>
<p>For one, scrolling social media requires being awake, and hence, displaces sleep.</p>
<p>Second, the <a href="https://doi.org/10.1111/bjop.12351">light emitted from most hand-held devices</a>, even with a night filter, a blue light filter or both, is enough to decrease <a href="https://www.hopkinsmedicine.org/health/wellness-and-prevention/melatonin-for-sleep-does-it-work">levels of melatonin</a>, the primary hormone that signals the onset of sleep. </p>
<p>When melatonin release is inhibited by staring at a lit device near bedtime, <a href="https://doi.org/10.1073%2Fpnas.1418490112">falling asleep becomes more challenging</a>. For some people, melatonin supplements can help with inducing sleep. However, supplements cannot overcome the highly stimulating powers of internet content and light. </p>
<p>Third, and perhaps most problematic, is the content that young people are consuming. Taking in fast-paced imagery like that found on TikTok or video games <a href="https://doi.org/10.1111/j.1365-2869.2012.01060.x">before bedtime is disruptive</a> because the brain and body are highly stimulated by these exposures, and require time to settle back into a state that is conducive to sleep. </p>
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<figcaption><span class="caption">Teens are often ‘night owls,’ which adds to sleep deprivation.</span></figcaption>
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<p>But it’s not just the speed of the imagery flitting by. Media content can disrupt both nondream and dream sleep. Have you ever fallen asleep watching a disturbing thriller or a horror movie and had scenes from that movie <a href="https://www.courierpostonline.com/story/life/2019/02/06/perchance-dream-how-binge-watching-social-media-affect-your-dreams-sleep/2796568002/#">enter your dreams</a>? And it’s not just dreams that are affected – the brain also <a href="https://doi.org/10.5935%2F1984-0063.20180046">may not sustain deep nondream sleep</a> since it is still processing those fast-paced images. These intrusions in your sleep can be very disruptive to overall quality and quantity of sleep. </p>
<p>Worst of all, social media can contribute to FOMO – short for the fear of missing out. This can occur when a teen becomes enmeshed with an influencer or role model through posts, reels and stories, all of which are cultivated to reflect unrealistic perfection, not reality.</p>
<p>In addition, research has found a clear link between <a href="https://theconversation.com/mounting-research-documents-the-harmful-effects-of-social-media-use-on-mental-health-including-body-image-and-development-of-eating-disorders-206170">social media consumption and poor body image</a> in kids and teens, as well as overall <a href="https://doi.org/10.1016/j.smrv.2020.101414">worse mental health and worsened sleep problems</a>. </p>
<p>These issues are troubling enough that in May 2023, <a href="https://www.hhs.gov/about/news/2023/05/23/surgeon-general-issues-new-advisory-about-effects-social-media-use-has-youth-mental-health.html">the surgeon general issued a statement</a> <a href="https://www.nytimes.com/2023/05/23/health/surgeon-general-social-media-mental-health.html">warning of the dangers of social media</a> and encouraging caregivers, teachers and policymakers to work together to create a safer online environment. </p>
<h2>A state of chronic sleep deprivation</h2>
<p>Making <a href="https://theconversation.com/how-much-sleep-do-you-really-need-156819">sleep a high priority</a> is a cornerstone of overall health and mental health, and it is also key to staying alert and attentive during the school day.</p>
<p>Multiple <a href="https://publications.aap.org/aapnews/news/6630/AAP-endorses-new-recommendations-on-sleep-times">professional medical</a> and <a href="https://www.thensf.org/how-many-hours-of-sleep-do-you-really-need/">scientific organizations</a> have recommended that teens sleep eight to 10 hours per night. But only 1 in 5 high schoolers <a href="https://edition.cnn.com/2022/06/07/health/teen-sleep-deprivation-wellness/index.html">come close to that</a>. </p>
<p>Some of this is due to <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">school start times</a> that don’t align with the natural rhythms of most teens, so they don’t fall asleep early enough on weekdays. </p>
<p>Teens who don’t get enough sleep <a href="https://doi.org/10.1016/j.pcl.2011.03.002">may suffer from weak academic performance</a>, a lack of organizational skills and mediocre decision-making. Teens don’t have fully formed frontal lobes, the part of the brain that controls impulse and judgment. Sleep deprivation <a href="https://doi.org/10.1016/j.dcn.2018.03.012">further impairs those behaviors</a>. This, in turn, may lead to poor decisions regarding <a href="https://doi.org/10.1111%2Facer.12618">drug and alcohol use</a>, <a href="https://www.cdc.gov/mmwr/volumes/67/wr/mm6703a1.htm">driving under the influence</a>, <a href="https://doi.org/10.1037%2Fhea0000753">sexual promiscuity</a>, fighting or the <a href="https://doi.org/10.1111/josh.12044">use of weapons</a>, and more. And these behaviors can start <a href="https://doi.org/10.1093/sleep/zsw004">in middle school</a>, if not earlier.</p>
<p>In addition, sleep deprivation is directly linked with <a href="https://doi.org/10.1161%2FCIRCULATIONAHA.108.766410">high blood pressure</a>, <a href="https://www.sleepfoundation.org/sleep-deprivation/how-sleep-deprivation-affects-your-heart">heart attacks</a> and the <a href="https://www.sleepfoundation.org/physical-health/lack-of-sleep-and-diabetes">development of diabetes</a> in adulthood. Lack of adequate sleep is also linked with <a href="https://doi.org/10.2147%2FAHMT.S219594">childhood and adolescent obesity</a>. Undesired weight gain occurs with sleep deprivation though a series of complex mechanisms, including <a href="https://www.sleepfoundation.org/physical-health/obesity-and-sleep">shifts in metabolism</a>, a more <a href="https://doi.org/10.1186%2Fs12966-016-0428-0">sedentary lifestyle and poor dietary</a> choices. </p>
<h2>A way forward</h2>
<p>So what can be done to pry teens and tweens away from their screens? Keeping goals realistic is key, and sometimes it is helpful to start by focusing on just one goal.</p>
<p>Parents need to prioritize sleep for the entire household and model good screen time habits. Caregivers too often <a href="https://www.pewresearch.org/internet/2018/08/22/how-teens-and-parents-navigate-screen-time-and-device-distractions/">send mixed messages</a> around screen time use, given their own bad habits.</p>
<p>Ultimately, parents and caregivers need to recognize the warning signs of <a href="https://parentingscience.com/signs-of-sleep-deprivation/">sleep deprivation</a> and <a href="https://www.stanfordchildrens.org/en/topic/default?id=overview-of-mood-disorders-in-children-and-adolescents-90-P01634">progressive mood</a> and <a href="https://www.aacap.org/AACAP/Families_and_Youth/Resource_Centers/Anxiety_Disorder_Resource_Center/Your_Adolescent_Anxiety_and_Avoidant_Disorders.aspx">anxiety disorders</a>. Seek professional help for disordered sleep, troubled mental health or both, keeping in mind that finding <a href="https://theconversation.com/as-the-mental-health-crisis-in-children-and-teens-worsens-the-dire-shortage-of-mental-health-providers-is-preventing-young-people-from-getting-the-help-they-need-207476">mental health professionals can take time</a>. </p>
<p>When it comes to digital media, the American Academy of Pediatrics recommends avoiding screens for <a href="https://publications.aap.org/pediatrics/article/138/5/e20162592/60321/Media-Use-in-School-Aged-Children-and-Adolescents">at least an hour before going to bed</a> and not sleeping with devices in the bedroom. </p>
<p>For older kids who have homework to do online, avoiding screen use right before bedtime can feel next to impossible. What’s more, this rule tends to lead to <a href="https://www.parents.com/parenting/better-parenting/teenagers/teen-talk/how-strict-parents-can-actually-make-their-teens-more-rebellious/">covert use of electronic devices</a>.</p>
<p>So if one hour before bedtime is too stringent, then start by avoiding media for even 15 or 30 minutes prior to going to sleep. Or if some media is needed as a compromise, try watching something passive, like TV, rather than engaging in social media apps like Snapchat. </p>
<p>Remember that not everything has to be done all at once – incremental changes can make a big difference over time.</p><img src="https://counter.theconversation.com/content/204436/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Maida Lynn Chen does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Exposure to screens before bedtime can contribute to chronic sleep deprivation, which raises the risk for anxiety, depression and even suicidal thoughts.Maida Lynn Chen, Professor of Pediatrics, School of Medicine, University of WashingtonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/2028952023-04-05T13:37:48Z2023-04-05T13:37:48ZMelatonin use may reduce self-harm in young people, research shows<figure><img src="https://images.theconversation.com/files/518789/original/file-20230331-26-oz0lfg.jpg?ixlib=rb-1.1.0&rect=9%2C0%2C6330%2C4220&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/full-length-stressed-young-teenage-child-1971215000">fizkes/Shutterstock</a></span></figcaption></figure><p>Melatonin is a naturally occurring hormone that regulates the <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">sleep-wake cycle</a>. It’s also often used as a medication for people who have difficulty sleeping. Since there are known links between <a href="https://www.sciencedirect.com/science/article/abs/pii/S0163834318300380">sleep problems, depression, and self-harm</a>, we were interested in exploring whether treating sleep problems with melatonin would lead to fewer instances of self-harm. </p>
<p>Our findings, <a href="https://acamh.onlinelibrary.wiley.com/doi/10.1111/jcpp.13785">recently published</a> in the Journal of Child Psychology and Psychiatry, suggest that melatonin could have this effect in young people.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/melatonin-should-i-take-it-to-help-me-sleep-179053">Melatonin: should I take it to help me sleep?</a>
</strong>
</em>
</p>
<hr>
<p>Melatonin is the most common sleep medication recommended for children and adolescents <a href="https://www.lakemedelsverket.se/sv/behandling-och-forskrivning/behandlingsrekommendationer/sok-behandlingsrekommendationer/behandling-av-somnstorningar-hos-barn-och-ungdomar--kunskapsdokument">in Sweden</a>. It’s safer than many other types of medications used for sleep problems, with <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419450/pdf/12967_2019_Article_1835.pdf">low risks</a> of serious side-effects, overdose, or dependence.</p>
<p>Using data from Sweden, we identified more than 25,000 children and adolescents, aged six to 18, who started using melatonin between 2006 and 2013. During this time, melatonin was available in Sweden only by prescription, which enabled us to capture all melatonin use.</p>
<p>We looked at the rates of accidental and intentional injuries in the year before and after starting to use melatonin. We also examined whether the young people in our study had any psychiatric diagnoses.</p>
<p>Observational studies usually compare two different groups of people, such as melatonin users and non-users. However, these groups may differ in other ways which can cloud interpretation of the results, such as in their genetics, family environment and psychiatric diagnoses. To account for the influence of factors unique to each person, we used a study design which compares each person to themselves when they are taking or not taking melatonin.</p>
<h2>A strong link</h2>
<p>We observed that accidental injuries, such as falls or transport accidents, occurred at fairly similar rates before and after starting melatonin. Intentional self-harm and poisoning, however, increased shortly before melatonin was prescribed and decreased by about half in the months following the initiation of treatment.</p>
<p>The increase in self-harm prior to beginning to take melatonin may be related to the symptoms that led to the doctor visit in which the medicine was prescribed. Girls were approximately five times more likely to harm themselves compared with boys, so the reduction following melatonin use was more dramatic for girls.</p>
<p>About 87% of the young people starting melatonin treatment also had a psychiatric diagnosis. The most common one was ADHD, followed by anxiety, depression and autism spectrum disorders. The reduction in self-harm and poisoning was particularly evident among adolescent girls with depression or anxiety disorders.</p>
<p>To check whether the use of other medications might have affected our findings, we repeated the analyses excluding antidepressant users. The same pattern of results emerged. This suggests that melatonin might be responsible for the reduced self-harm rates, but we cannot exclude the possibility that psychotherapy or the use of psychiatric medications other than antidepressants may have influenced the findings.</p>
<figure class="align-center ">
<img alt="A young woman asleep in bed." src="https://images.theconversation.com/files/519005/original/file-20230403-24-an9a8q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/519005/original/file-20230403-24-an9a8q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/519005/original/file-20230403-24-an9a8q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/519005/original/file-20230403-24-an9a8q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/519005/original/file-20230403-24-an9a8q.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/519005/original/file-20230403-24-an9a8q.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/519005/original/file-20230403-24-an9a8q.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">There are known links between sleep problems and mental health.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-woman-sleep-bed-2204059989">F8 studio/Shutterstock</a></span>
</figcaption>
</figure>
<h2>Why melatonin?</h2>
<p>There are a few reasons melatonin might have this effect. The primary reason is likely to be that people make better decisions <a href="https://psycnet.apa.org/record/2000-02426-006">when they are well rested</a>. Treating the sleep problems that often accompany anxiety and depression may lead people to have fewer thoughts about harming themselves or to choose not to act on these thoughts when they occur. </p>
<p>Research has also shown that melatonin <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7012243/pdf/jpr-13-331.pdf">modifies how people feel pain</a>, potentially making people who take it less sensitive to pain. They may be less likely to hurt themselves intentionally if this is the case.</p>
<p>Finally, melatonin may represent just one aspect of the care that young people receive when they’re experiencing sleep and other problems. In addition to psychotherapy and other medications, increased monitoring from parents and doctors may also play a role in the behavioural changes we observed.</p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/melatonins-role-in-protecting-the-heart-the-evidence-so-far-179387">Melatonin's role in protecting the heart – the evidence so far</a>
</strong>
</em>
</p>
<hr>
<p>Our findings suggest that melatonin could reduce acts of self-harm in young people, particularly adolescent girls with anxiety or depression. Whether this is also true for adults is a question that warrants further research.</p>
<p>For young people struggling with sleep problems, and perhaps anxiety or depression as well, melatonin could be helpful. However, a doctor should always be consulted before starting any new medication, even if it’s available without a prescription.</p><img src="https://counter.theconversation.com/content/202895/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>This study was funded by the European Union’s Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement no. 721567. Two of the authors were employees of Johnson & Johnson during this study. One author reports receiving grants from Shire Pharmaceuticals; personal fees from and serving as a speaker for Medice,Shire/Takeda Pharmaceuticals and Evolan Pharma AB, all outside of the submitted work. The funders and companies had no part in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.</span></em></p>There are a few reasons melatonin, a medication commonly taken for sleep difficulties, might have this effect.Sarah Bergen, Principal Researcher, Department of Medical Epidemiology and Biostatistics, Karolinska InstitutetLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1973432023-03-06T13:34:30Z2023-03-06T13:34:30ZSpringing forward into daylight saving time is a step back for health – a neurologist explains the medical evidence, and why this shift is worse than the fall time change<figure><img src="https://images.theconversation.com/files/512086/original/file-20230223-5904-84e4k9.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5621%2C3677&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Daylight saving time is back again – amid some controversy. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/spring-forward-royalty-free-illustration/900655094?phrase=Daylight%2BSavings%2BTime">billhagolan/iStock via Getty Images Plus</a></span></figcaption></figure><p>As people in the U.S. prepare to set their clocks ahead one hour on Sunday, March 12, 2023, I find myself bracing for the annual ritual of <a href="https://www.inquirer.com/news/standard-time-daylight-saving-time-clock-change-sleep-20201031.html">media stories</a> about <a href="https://qz.com/1114163/daylight-saving-time-dst-is-incredibly-disruptive-heres-how-to-reset/">the disruptions to daily routines</a> <a href="https://doi.org/10.5664/jcsm.8780">caused by switching from standard time </a> to daylight saving time. </p>
<p>About one-third of Americans say they don’t look forward to these twice-yearly time changes. And nearly two-thirds <a href="https://today.yougov.com/topics/politics/articles-reports/2021/11/04/daylight-saving-time-americans-want-stay-permanent">would like to eliminate them completely</a>, compared to 21% who aren’t sure and 16% who would like to keep moving their clocks back and forth. </p>
<p>But the effects go beyond simple inconvenience. Researchers are discovering that “springing ahead” each March is connected with serious negative health effects, including an uptick in <a href="https://doi.org/10.3390/jcm8030404">heart attacks</a> and <a href="https://doi.org/10.5664/jcsm.4938">teen sleep deprivation</a>. In contrast, the fall transition back to standard time is not associated with these health effects, as my co-authors and I noted in a <a href="https://doi.org/10.1001/jamaneurol.2019.3780">2020 commentary</a>.</p>
<p>I’ve studied the pros and cons of these twice-annual rituals for more than five years as a <a href="https://scholar.google.com/citations?user=ZddlKEoAAAAJ&hl=en">professor of neurology and pediatrics</a> and the director of Vanderbilt University Medical Center’s sleep division. It’s become clear to me and many of my colleagues that the transition to daylight saving time each spring affects health immediately after the clock change and also for the nearly eight months that <a href="https://www.cnn.com/2022/11/06/health/permanent-daylight-savings-health-harms-wellness/index.html#">Americans remain on daylight saving time</a>.</p>
<h2>The strong case for permanent standard time</h2>
<p>Americans are split on whether they <a href="https://today.yougov.com/topics/politics/articles-reports/2021/11/04/daylight-saving-time-americans-want-stay-permanent">prefer permanent daylight saving time</a> or <a href="https://apnorc.org/projects/dislike-for-changing-the-clocks-persists/">permanent standard time</a>. </p>
<p>However, the two time shifts – jolting as they may be – are not equal. Standard time most closely approximates natural light, with the sun directly overhead at or near noon. In contrast, during daylight saving time from March until November, the clock change resulting from daylight saving time causes natural light to be present one hour later in the morning and one hour later in the evening according to clock time.</p>
<p>Morning light is essential for helping to set the body’s natural rhythms: It <a href="https://doi.org/10.1038/s41598-018-36791-5">wakes us up and improves alertness</a>. Morning light also boosts mood – light boxes simulating natural light are prescribed for morning use <a href="https://doi.org/10.1001/archpsyc.55.10.890">to treat seasonal affective disorder</a>.</p>
<p>Although the exact reasons why light activates us and benefits our mood are not yet known, this may be due to light’s effects on <a href="https://doi.org/10.1080/10253890.2020.1741543">increasing levels of cortisol</a>, a hormone that <a href="https://doi.org/10.1038/s41574-019-0228-0">modulates the stress response</a> or the effect of <a href="https://doi.org/10.1038/s41598-018-36791-5">light on the amygdala</a>, a part of the brain involved in emotions.</p>
<p>Adolescents also may be <a href="https://theconversation.com/school-start-times-and-screen-time-late-in-the-evening-exacerbate-sleep-deprivation-in-us-teenagers-179178">chronically sleep deprived due to school</a>, sports and social activities. For instance, many <a href="https://nces.ed.gov/pubs2020/2020006/index.asp">children start school around 8 a.m.</a> or earlier. This means that during daylight saving time, many young people get up and travel to school in pitch darkness.</p>
<p>The body of evidence makes a good case for adopting permanent standard time nationwide, as I testified at a <a href="https://democrats-energycommerce.house.gov/committee-activity/hearings/rescheduled-hearing-on-changing-times-revisiting-spring-forward-fall">March 2022 Congressional hearing</a> and argued in a <a href="https://doi.org/10.1093/sleep/zsac236">recent position statement</a> for the Sleep Research Society. The American Medical Association recently <a href="https://www.ama-assn.org/press-center/press-releases/ama-calls-permanent-standard-time">called for permanent standard time</a>. And in late 2022, <a href="https://www.timeanddate.com/news/time/mexico-abolishes-dst-2022.html#">Mexico adopted permanent standard time,</a>, <a href="https://thehill.com/policy/international/3708301-mexicos-senate-votes-to-end-daylight-saving-time-for-most-of-the-country/">citing benefits to health, productivity and energy savings</a>. </p>
<figure class="align-center ">
<img alt="An illustration of two clocks depicting Daylight Savings Time changes: Fall backward, and spring forward." src="https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=360&fit=crop&dpr=1 600w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=360&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=360&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=452&fit=crop&dpr=1 754w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=452&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/446653/original/file-20220215-13-1d96ozk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=452&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">In 2023, clocks spring forward one hour at 2 a.m. on Sunday, March 12. They fall back at 2 a.m. on Sunday, Nov. 5.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/daylight-saving-time-fall-backward-and-royalty-free-illustration/1356689682?adppopup=true">iam2mai/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<p>The biggest advantage of daylight saving time is that it provides an extra hour of light in the late afternoon or evening, depending on time of year, for sports, shopping or eating outside. However, exposure to light later into the evening for almost eight months during daylight saving time comes at a price. This extended evening light delays the brain’s release of melatonin, the hormone that promotes drowsiness, which in turn interferes with sleep and <a href="https://doi.org/10.1093/sleep/zsac236">causes us to sleep less overall</a>.</p>
<p>Because puberty also causes <a href="https://www.neurologylive.com/view/teenage-circadian-rhythm">melatonin to be released later at night</a>, meaning that teenagers have a delay in the natural signal that helps them fall asleep, adolescents are <a href="https://dx.doi.org/10.5664/jcsm.4938">particularly susceptible to sleep problems</a> from the extended evening light. This shift in melatonin during puberty lasts into our 20s.</p>
<h2>The ‘western edge’ effect</h2>
<p>Geography can also make a difference in how daylight saving time affects people. One study showed that people living on the western edge of a time zone, who get light later in the morning and later in the evening, <a href="https://doi.org/10.1016/j.jhealeco.2019.03.007">got less sleep</a> than their counterparts on the eastern edge of a time zone. </p>
<p>This study found that western-edge residents had higher rates of obesity, diabetes, heart disease and <a href="https://theconversation.com/breast-cancer-risk-higher-in-western-parts-of-time-zones-is-electric-light-to-blame-85803">breast cancer</a>, as well as lower per capita income and higher health care costs. Other research has found that <a href="https://doi.org/10.1158/1055-9965.EPI-16-1029">rates of certain other cancers are higher</a> on the western edge of a time zone. </p>
<p>Scientists believe that these health problems may result from a <a href="https://doi.org/10.3389/fphys.2019.00944">combination of chronic sleep deprivation and “circadian misalignment</a>.” Circadian misalignment refers to a mismatch in timing between our biological rhythms and the outside world. In other words, the timing of daily work, school or sleep routines is based on the clock, rather than on the sun’s rise and set. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/84aWtseb2-4?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">This video takes a deeper dive – all the way back to 1895 – into the history of daylight saving time.</span></figcaption>
</figure>
<h2>A brief history of daylight saving time</h2>
<p><a href="https://blogs.loc.gov/teachers/2017/03/world-war-i-and-daylight-savings-time/">Congress instituted year-round daylight saving time</a> during World War I and World War II, and <a href="https://www.mercurynews.com/2016/10/30/the-year-daylight-saving-time-went-too-far/">once again during the energy crisis</a> of the early 1970s.</p>
<p>The idea was that having extra light later into the afternoon would save energy by decreasing the need for electric lighting. This idea has since been <a href="https://doi.org/10.1016/j.jebo.2014.03.012">proved largely inaccurate</a>, as heating needs may increase in the morning in the winter, while air conditioning needs can also increase in the late afternoon in the summer.</p>
<p>Another pro-daylight saving argument has been that crime rates drop with <a href="https://doi.org/10.1162/REST_a_00547">more light at the end of the day</a>. While this has been proved true, the change is very small, and <a href="https://theconversation.com/is-daylight-saving-time-worth-the-trouble-research-says-no-86739">the health effects appear to outweigh</a> the benefits to society from lower rates of crime.</p>
<p>After World War II, designating the start and end dates for daylight saving time fell to state governments. Because this created many railroad scheduling and safety problems, however, Congress passed the <a href="https://www.transportation.gov/regulations/time-act#">Uniform Time Act in 1966</a>. This law set the nationwide dates of daylight saving time from the last Sunday in April until the last Sunday in October. In 2007, <a href="https://www.bts.gov/geospatial/daylight-savings-time">Congress amended the act</a> to expand the period in which daylight saving time is in effect from the second Sunday in March to the first Sunday in November – dates that remain in effect today.</p>
<p>The Uniform Time Act allows states and territories to opt out of daylight saving time, however. Arizona and Hawaii are on permanent standard time, along with Puerto Rico, the U.S. Virgin Islands, Northern Mariana Islands, Guam and American Samoa. </p>
<p>Now, many other states are considering whether to <a href="https://www.usatoday.com/story/news/nation/2021/11/04/daylight-saving-time-legislation-fall-back/6233980001/">stop falling back and springing ahead</a>. Several U.S. states have legislation and resolutions under consideration to support permanent standard time, while many others have been or are <a href="https://www.npr.org/2022/11/06/1134562545/daylight-saving-time-permanent-states">considering permanent daylight saving time</a>. Legislation and resolutions for permanent standard time have increased from 15% in 2021 to 31% in 2023. </p>
<p>In March 2022, the U.S. Senate <a href="https://www.congress.gov/bill/117th-congress/senate-bill/623">passed the Sunshine Protection Act </a> in a bid to <a href="https://www.reuters.com/world/us/us-senate-approves-bill-that-would-make-daylight-savings-time-permanent-2023-2022-03-15/">make daylight saving time permanent</a>. But the House did not move forward with this legislation. Florida Sen. Marco Rubio <a href="https://thehill.com/homenews/nexstar_media_wire/3880009-bill-to-make-daylight-saving-time-permanent-reintroduced-in-congress/">reintroduced the bill</a> on March 1, 2023. </p>
<p>The spike in activity among states seeking to break from these twice-yearly changes reflects how more people are recognizing the downsides of this practice. Now, it’s up to legislators to decide whether we end the time shift altogether, and to choose permanent standard or daylight saving time.</p>
<p><em>This is an updated version of an article <a href="https://theconversation.com/why-daylight-saving-time-is-unhealthy-a-neurologist-explains-175427">originally published on March 10, 2022</a>.</em></p><img src="https://counter.theconversation.com/content/197343/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Beth Ann Malow receives funding from the NIH as well as foundation funding, though none have been related to Daylight Saving Time.</span></em></p>Americans are divided on their preference for daylight saving time versus standard time. But research shows that our bodies fare better when aligned with the natural light of standard time.Beth Ann Malow, Professor of Neurology and Pediatrics, Vanderbilt UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1944172022-12-05T13:28:18Z2022-12-05T13:28:18ZShorter days affect the mood of millions of Americans – a nutritional neuroscientist offers tips on how to avoid the winter blues<figure><img src="https://images.theconversation.com/files/496594/original/file-20221121-18490-5tf8u2.jpg?ixlib=rb-1.1.0&rect=8%2C0%2C5742%2C3837&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">For those prone to seasonal affective disorder, a shift in the sleep cycle can impact energy levels.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/girl-alone-royalty-free-image/1129211268?phrase=seasonal%20affective%20disorder&adppopup=true">Ben Akiba/E+ via Getty Images</a></span></figcaption></figure><p>The annual pattern of winter depression and melancholy – better known as <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/symptoms-causes/syc-20364651">seasonal affective disorder, or SAD</a> – suggests a strong link between your mood and the amount of light you get during the day. </p>
<p>To put it simply: The less light exposure one has, the more one’s mood may decline.</p>
<p>Wintertime blues are common, but about 10 million Americans are affected every year by a longer lasting depression called <a href="https://www.bu.edu/articles/2019/seasonal-affective-disorder/">seasonal affective disorder</a>. Along with low mood, symptoms include anxious feelings, low self-esteem, longer sleep duration, constant craving for carbohydrates and low physical activity levels.</p>
<p><a href="https://www.binghamton.edu/decker/health-wellness-studies/profile.html?id=lina">I am a nutritional neuroscientist</a>, and my research focuses on the effects of diet and lifestyle factors on <a href="https://scholar.google.com/citations?user=sOMbzQ0AAAAJ&hl=en">mood and brain functions</a> such as mental distress, resilience and motivation. </p>
<p>Through my research, I have learned that seasonal affective disorder can strike anyone. However, people with a <a href="https://doi.org/10.1034/j.1600-0447.2000.101003176.x">history of mood disorders are at a higher risk</a>. In particular, young adults and women of all ages <a href="https://doi.org/10.1016/j.jadr.2021.100157">have an increased susceptibility</a>. </p>
<h2>Why seasonal depression happens</h2>
<p>When daylight saving time ends each fall, the one-hour shift backward reduces the amount of light exposure most people receive in a 24-hour cycle. As the days get shorter, people can experience general moodiness or a longer-term depression that is tied to a shorter exposure to daylight.</p>
<p>This happens due to a misalignment between the sleep-wake cycle, eating schedules and other daily tasks. Research shows that this mismatch may be associated <a href="https://doi.org/10.1038/s41398-020-0694-0">with poor mental health outcomes</a>, such as anxiety and depression. </p>
<p>Our sleep-wake cycle is controlled by the <a href="https://nigms.nih.gov/education/fact-sheets/Pages/circadian-rhythms.aspx">circadian rhythm</a>, an internal clock regulated by light and darkness. Like a regular clock, it <a href="https://theconversation.com/why-does-night-shift-increase-the-risk-of-cancer-diabetes-and-heart-disease-heres-what-we-know-so-far-190652">resets nearly every 24 hours </a> and controls metabolism, growth and hormone release. </p>
<p>When our brain receives signals of limited daylight, it <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">releases the hormone melatonin to support sleep</a> – even though we still have hours left before the typical bedtime. This can then affect how much energy we have, and when and how much we eat. It can also alter the brain’s ability to adapt to changes in environment. This process, called <a href="https://www.sciencedirect.com/topics/neuroscience/neuronal-plasticity">neuronal plasticity</a>, involves the growth and organization of neural networks. This is crucial for brain repair, maintenance and overall function.</p>
<p>It is possible to <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/diagnosis-treatment/drc-20364722">readjust the circadian rhythm</a> to better align with the new light and dark schedule. This means getting daylight exposure as soon as possible upon waking up, as well as maintaining sleep, exercise and eating routines that are more in sync with your routine prior to the time change. Eventually, people can gradually transition into the new schedule. </p>
<figure>
<iframe width="440" height="260" src="https://www.youtube.com/embed/HWBJpATz7-w?wmode=transparent&start=0" frameborder="0" allowfullscreen=""></iframe>
<figcaption><span class="caption">Sleeping too much or too little, bingeing on junk food and withdrawing from others are three symptoms of seasonal affective disorder.</span></figcaption>
</figure>
<h2>The intimate connection between serotonin and melatonin</h2>
<p>Serotonin is a chemical messenger in the brain that is a key player in regulating several functions such as <a href="https://my.clevelandclinic.org/health/articles/22572-serotonin#">mood, appetite and the circadian rhythm</a>. Serotonin also converts to melatonin with lower light intensity. As mentioned above, melatonin is a hormone that regulates the sleep-wake cycle and signals the brain that it’s time to sleep.</p>
<p>Less daylight exposure during winter months leads to the conversion of serotonin into melatonin <a href="https://doi.org/10.1126/science.7434030">earlier in the evening</a>, since it gets dark earlier. As a result, this untimely melatonin release causes a disruption in the sleep-wake cycle. For some people this can cause moodiness, daytime sleepiness and loss of appetite regulation, typically leading to unhealthy snacking. People with seasonal affective disorder often <a href="https://doi.org/10.1016/S0149-7634(02)00004-0">crave foods rich in simple sugars, such as sweets</a>, because there is an intimate connection between <a href="https://doi.org/10.1093/cdn/nzab049_009">carbohydrate consumption, appetite regulation and sleep</a>. </p>
<h2>Strategies to combat the winter blues</h2>
<p>In winter, most people leave work when it’s turning dark. For this reason, <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298">light therapy is typically recommended</a> for those who experience seasonal affective disorder, or even shorter periods of seasonal funk. </p>
<p>This can be as simple as getting some light shortly after awakening. Try to get at least one hour of natural light during the early morning hours, preferably about <a href="https://www.cdc.gov/niosh/emres/longhourstraining/light.html#:%7E:">one hour after your usual morning wake-up time</a> when the circadian clock is most sensitive to light. This is true no matter what your wake-up time is, as long as it’s morning. For people living at northern latitudes where there’s very little sun in winter, light therapy boxes – <a href="https://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/in-depth/seasonal-affective-disorder-treatment/art-20048298">which replicate outdoor light</a> – can be effective. </p>
<p>You can also improve your sleep quality by avoiding stimulants like coffee, tea or heavy meals close to bedtime. <a href="https://doi.org/10.1113/JP276943">Exercising during the day is also good</a> – it increases serotonin production and supports circadian regulation. A balanced diet of complex carbs and healthy proteins <a href="https://doi.org/10.1016/j.jand.2022.01.007">supports steady serotonin and melatonin production</a>, and practicing downtime before bed can reduce stress. </p>
<p>Taking these small steps may help the circadian rhythm adjust faster. For the millions with mood disorders, that could mean happier times during what are literally the darkest days.</p><img src="https://counter.theconversation.com/content/194417/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lina Begdache does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Research shows that young adults and women are particularly susceptible to seasonal affective disorder.Lina Begdache, Associate Professor of Health and Wellness Studies, Binghamton University, State University of New YorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1901292022-10-03T01:43:20Z2022-10-03T01:43:20ZMany parents use melatonin gummies to help children sleep. So how do they work and what are the risks?<figure><img src="https://images.theconversation.com/files/484778/original/file-20220915-18-1dz5mw.jpg?ixlib=rb-1.1.0&rect=14%2C5%2C1902%2C1431&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://pixabay.com/photos/baby-girl-sleep-sleeping-asleep-1151351/">Image by Daniela Dimitrova from Pixabay </a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span></figcaption></figure><p>Sleep is important for psychological and physiological health, but <a href="https://academic.oup.com/sleep/article/30/10/1371/2696851?login=false">many</a> <a href="https://www.sciencedirect.com/science/article/abs/pii/S1087079215001537?via%3Dihub">children</a> have trouble getting to sleep, or getting back to sleep when they wake in the night.</p>
<p>This can be exhausting for both children and parents, and some parents have turned to giving their kids lollies containing <a href="https://7news.com.au/lifestyle/health-wellbeing/melatonin-and-kids-how-exhausted-aussie-parents-are-buying-supplements-overseas-to-change-their-lives-c-8002693">melatonin</a>. These gummies, purchased overseas or online, are used to improve their children’s sleep.</p>
<p>I have spent the last 15 years researching diagnosing and treating children sleep problems and difficulties, and I’m also on the <a href="http://www.pedsleep.org/">International Pediatric Sleep Association</a>’s taskforce for melatonin use in children.</p>
<p>Here’s what the science says about the benefits and risks of melatonin gummies for children.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A child asleep with their toy." src="https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=461&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=461&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=461&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=579&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=579&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484809/original/file-20220915-1785-80hcei.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=579&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sleep is important for psychological and physiological health.</span>
<span class="attribution"><a class="source" href="https://pixabay.com/photos/dream-baby-boy-sleeping-with-a-toy-5076100/">Image by Victoria_rt from Pixabay</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/led-face-masks-are-popular-on-social-media-for-glowing-skin-but-they-could-disrupt-your-sleep-170108">LED face masks are popular on social media for glowing skin – but they could disrupt your sleep</a>
</strong>
</em>
</p>
<hr>
<h2>What is melatonin?</h2>
<p>Melatonin is a naturally occurring hormone secreted in our brains. It is related to the timing and quality of our sleep and wake rhythms and determined by our internal body clock. </p>
<p>Melatonin makes us <a href="https://meridian.allenpress.com/jppt/article-abstract/26/1/4/450658/Melatonin-Use-in-Pediatrics-Evaluating-the?redirectedFrom=fulltext">sleepy</a> at certain times of the day. It <a href="https://academic.oup.com/book/31721">starts to secrete</a> when our bodies are getting ready to go to sleep and usually takes about 30 to 45 minutes to take full effect. </p>
<p>Melatonin secretion is at its highest in the middle of the night and gradually starts to decrease until we are ready to wake up and start our day.</p>
<h2>A lack of long-term research</h2>
<p>For children who have a diagnosis of autism spectrum disorder or Smith Magenis Syndrome, the Therapeutic Goods Administration (TGA) in Australia <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/32-melatonin">recommends</a> melatonin – but that this should be prescribed by a health professional only, and should only be used when sleep hygiene measures have been insufficient. </p>
<p>It <a href="https://www.tandfonline.com/doi/full/10.1080/14656566.2019.1674283">has been shown</a> to be very helpful, effective and with minimum side effects (mainly headaches, drowsiness and sometimes irritability). </p>
<p>But the TGA <a href="https://www.tga.gov.au/sites/default/files/auspar-melatonin-201027.pdf">does not recommend</a> melatonin for children who do not have autism spectrum disorder or Smith Magenis Syndrome.</p>
<p>This is mainly because there is a lack of long-term research, and because most child sleep problems can typically be managed with behavioural and psychological sleep techniques, instead of drugs.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A child sleeps in his bed." src="https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484812/original/file-20220915-4859-kaprw2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Most child sleep problems can typically be managed with behavioural and psychological sleep techniques, instead of drugs.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/s/photos/child-sleeping">Photo by zhenzhong liu on Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>Melatonin sales are increasing rapidly across the US and Canada (where it is available <a href="https://doi.org/10.1177/1403494812464446">without a prescription</a>) and across <a href="https://www.tandfonline.com/doi/full/10.1080/14656566.2019.1674283">Europe</a>.</p>
<p>In Australia, prescription melatonin has historically been given to adults to treat sleep disorders, but <a href="https://7news.com.au/lifestyle/health-wellbeing/aust-counter-access-arrives-for-sleep-drug-c-2991193">is now available</a> over-the-counter for adults aged 55 and above. It’s efficacy and safety has been established in adults.</p>
<p>This is not the case for melatonin use in all children. </p>
<p>Despite this, melatonin use in children <em>without</em> autism spectrum disorder or Smith Magenis Syndrome still occurs.</p>
<p>One recent yet-to-be-published study on this topic (which is yet to be peer-reviewed by other experts in the field) was by CQU researcher Alison Glass, with myself as supervisor. This study involved surveying 255 Australian parents (recruited from online groups and networks) of sleep-disordered children. Of these, about 70% used melatonin to help their children sleep. </p>
<p>Of those who used melatonin for their children, about 25% had children with a diagnosis of autism spectrum disorder or Smith Magenis Syndrome. But almost 75% used melatonin for their children even though there was no autism spectrum disorder or Smith Magenis Syndrome diagnosis.</p>
<h2>Is melatonin safe for otherwise healthy children?</h2>
<p>There are very few long-term research studies on this question and even less on the question of quality and safety of melatonin bought online.</p>
<p>One <a href="https://www.semanticscholar.org/paper/Melatonin-Natural-Health-Products-and-Supplements%3A-Erland-Saxena/823e2e0f552708c95307f95075d0ea7d1ad2c68e">Canadian study</a> investigated 31 brands of melatonin supplements. The researchers found huge inconsistencies in the labelled amount of active melatonin and a contaminant (in this case, serotonin) in 26% of the supplements.</p>
<p>In other words, the exact quality or quantity of melatonin present in gummies may be unknown. That raises the question of whether giving these relatively unresearched drugs to children is warranted. </p>
<p>The TGA’s Advisory Committee on Medicines Scheduling <a href="https://www.tga.gov.au/resources/publication/scheduling-decisions-interim/scheduling-delegates-interim-decisions-and-invitation-further-comment-accsacms-november-2016/32-melatonin">said</a> in 2017 that </p>
<blockquote>
<p>Methods of deterring the increasing volume of personal imports, which are often inappropriate unregistered medicines, should be considered.</p>
</blockquote>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A kid sleeps in bed." src="https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=398&fit=crop&dpr=1 600w, https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=398&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=398&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=500&fit=crop&dpr=1 754w, https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=500&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/484813/original/file-20220915-8999-aziql2.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=500&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">What can sleep-deprived parents do? Talk to healthcare professionals.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/s/photos/child-sleeping">Photo by Brett Durfee on Unsplash</a>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<h2>Talk to health-care professionals</h2>
<p>Parental sleep deprivation can be debilitating and dangerous. It is understandable parents of sleep-disturbed children will seek out the fastest way to get children to sleep. But there is a dearth of long-term research about use of melatonin by children.</p>
<p>So what can sleep-deprived parents do?</p>
<p>Talk to health-care professionals. This is crucial when considering any medication for children; continual follow up to monitor side effects and progress is important.</p>
<p>Before considering melatonin or any other sedative, ask your health-care provider about behavioural techniques you can use to promote healthy sleep habits. </p>
<p>Behavioural techniques are well documented, successful and effective in <a href="http://dx.doi.org/10.4236/psych.2012.33035">children from infancy</a> to adolescence. </p>
<p>Well trained paediatric sleep psychologists and clinicians are available for referrals from health professionals. The <a href="https://www.sleep.org.au/">Australasian Sleep Association</a> lists specialist health professionals across Australia.</p>
<p>Sleep deprivation is exhausting and parents are understandably desperate. </p>
<p>However, I advise caution in buying melatonin online or without the guidance of a qualified health professional.</p>
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<em>
<strong>
Read more:
<a href="https://theconversation.com/what-is-brown-noise-can-this-latest-tiktok-trend-really-help-you-sleep-188528">What is brown noise? Can this latest TikTok trend really help you sleep?</a>
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<img src="https://counter.theconversation.com/content/190129/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sarah Blunden does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>But the Therapeutic Goods Association does not recommend melatonin for children who do not have autism spectrum disorder or Smith Magenis Syndrome.Sarah Blunden, Professor and Head of Paediatric Sleep Research, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1786012022-07-01T12:18:27Z2022-07-01T12:18:27ZYour body has an internal clock that dictates when you eat, sleep and might have a heart attack – all based on time of day<figure><img src="https://images.theconversation.com/files/471709/original/file-20220629-26-g88r2h.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C2121%2C1412&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Syncing your circadian rhythm to a natural light-dark cycle could improve your health and well-being.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/the-circadian-rhythms-are-controlled-by-circadian-royalty-free-image/1361759855">nambitomo/iStock via Getty Images Plus</a></span></figcaption></figure><p>Anyone who has suffered from jet lag or struggled after turning the clock forward or back an hour for daylight saving time knows all about what researchers call your <a href="https://doi.org/10.1126/science.aah4965">biological clock</a>, or circadian rhythm – the “master pacemaker” that synchronizes how your body responds to the passing of one day to the next. </p>
<p>This “clock” is made up of about <a href="https://doi.org/10.1038/nature00965">20,000 neurons</a> in the <a href="https://my.clevelandclinic.org/health/articles/22566-hypothalamus">hypothalamus</a>, the area near the center of the brain that coordinates your body’s unconscious functions, like breathing and blood pressure. Humans aren’t the only beings that have an internal clock system: All vertebrates – or mammals, birds, reptiles, amphibians and fish – have biological clocks, as do plants, fungi and bacteria. Biological clocks are why cats are most active at dawn and dusk, and why flowers bloom at certain times of day.</p>
<p>Circadian rhythms are also essential to health and well-being. They govern your body’s physical, mental and behavioral changes over each 24-hour cycle in response to environmental cues like light and food. They’re why more <a href="https://doi.org/10.1172/jci80590">heart attacks and strokes</a> occur early in the morning. They’re also why mice that are <a href="https://doi.org/10.1101%2Fgad.1432206">missing their biological clocks</a> age faster and have shorter lifespans, and people with a <a href="https://doi.org/10.1016/j.cell.2017.03.027">mutation in their circadian clock genes</a> have abnormal sleep patterns. Chronic misalignment of your circadian rhythm with external cues, as seen in <a href="https://doi.org/10.1038/nrn3743">night-shift workers</a>, can lead to a wide range of physical and mental disorders, including obesity, Type 2 diabetes, cancer and cardiovascular diseases. </p>
<p>In short, there is ample evidence that your biological clock is critical to your health. And <a href="https://scholar.google.com/citations?user=3id8z2UAAAAJ&hl=ja">chronobiologists like me</a> are studying how the day-night cycle affects your body to better understand how you can modify your behaviors to use your internal clock to your advantage.</p>
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<figcaption><span class="caption">Your body has an internal clock that helps keep it in working order.</span></figcaption>
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<h2>How biological rhythms affect your health</h2>
<p>Your biological clock affects your health by regulating your sleep-wake cycles and fluctuations in blood pressure and body temperature. It does this primarily by syncing your endocrine system to environmental light-dark cycles so that certain hormones are released in certain amounts at certain times of day. </p>
<p>The pineal grand in your brain, for example, produces <a href="https://www.nccih.nih.gov/health/melatonin-what-you-need-to-know">melatonin</a>, a hormone that helps regulate sleep in response to darkness. Doctors advise reducing exposure to artificial blue light from electronic devices before bedtime because it can disrupt melatonin secretion and sleep quality.</p>
<p>Your circadian rhythm also affects your metabolism. Among other things, sleep helps you regulate <a href="https://doi.org/10.1371/journal.pmed.0010062">leptin</a>, a hormone that controls appetite. Your leptin levels fluctuate throughout the day according to a rhythm set by your circadian clock. Insufficient or irregular sleep can <a href="https://doi.org/10.1016/j.cmet.2015.06.005">disrupt leptin production</a>, which can make us hungrier and lead to weight gain.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Chart showing cortisol and melatonin levels fluctuating over the course of the day, with cortisol levels peaking at around 6 AM and melatonin peaking at around midnight" src="https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=555&fit=crop&dpr=1 600w, https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=555&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=555&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=698&fit=crop&dpr=1 754w, https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=698&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/471958/original/file-20220630-12-3qhivk.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=698&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Your hormones fluctuate rhythmically over the course of the day. The stress hormone cortisol typically peaks in the morning, while the sleep hormone melatonin typically peaks in the night.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/illustration/sleep-wake-cycle-royalty-free-illustration/1398204621">Pikovit44/iStock via Getty Images Plus</a></span>
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<p>In recent years, researchers have discovered even more ways your circadian clock can affect your health. For example, there is now research suggesting that eating at set times of day, or <a href="https://doi.org/10.1016/j.cmet.2012.04.019">time-restricted feeding</a>, can prevent obesity and metabolic diseases. <a href="https://doi.org/10.1007/978-3-030-81147-1_3">Depression and other mood disorders</a> may also be linked to dysfunctional circadian control that lead to changes in how your genes are expressed.</p>
<p>The time of day when you <a href="https://doi.org/10.1016/j.cmet.2019.06.019">take your medicine</a> can also affect how well it works and how severe any side effects might be. Likewise, your biological clock is a <a href="https://doi.org/10.1056/NEJMra1802337">potential target</a> for <a href="https://doi.org/10.1038/nature25170">cancer chemotherapies</a> and anti-obesity treatments. </p>
<p>And finally, even your <a href="https://www.nature.com/articles/s41467-018-08259-7">personality</a> might be shaped by whether your internal clock make you a “morning person” or a “night person.”</p>
<h2>Getting the most out of exercise</h2>
<p>Circadian clocks also provide a potential answer to when is the best time of day to maximize the benefits of physical exercise.</p>
<p>To study this, my colleagues and I collected blood and tissue samples from the brains, hearts, muscles, livers and fat of mice that exercised either before breakfast in the early morning or after dinner in the late evening. We used a tool called a mass spectrometer to detect approximately 600 to 900 molecules each organ produced. These metabolites served as real-time snapshots of how the mice responded to exercise at specific times of day.</p>
<p>We stitched these snapshots together to create a map of how exercise in the morning versus evening affected each of the mice’s different organ systems – what we called an <a href="https://doi.org/10.1016/j.cmet.2021.12.016">atlas of exercise metabolism</a>. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="Silhouette of person running by the sea at sunrise" src="https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/471718/original/file-20220629-26-cxpext.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">The best time of day to exercise might be the time when you feel you perform best.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/silhouette-man-run-on-beach-with-sunrise-and-sea-royalty-free-image/1359952356">Anuruk Charoenamornrat/EyeEm via Getty Images</a></span>
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<p>Using this atlas, we saw that time of day affects how each organ uses energy during exercise. For instance, we found that early morning exercise reduced blood glucose levels more than late evening exercise. Exercise in the late evening, however, allowed the mice to benefit from energy they stored from their meals and increased their endurance.</p>
<p>Of course, mice and humans have many differences along with their similarities. For one, mice are more active at night than during the day. Still, we believe that our findings could help researchers better understand how exercise affects your health and, if timed appropriately, can be optimized based on time of day to meet your personal health goals.</p>
<h2>Getting along with your biological clock</h2>
<p>I believe that the field of chronobiology is growing, and we will produce even more research providing practical applications and insights into health and well-being in the future. </p>
<p>In <a href="https://www.bio.tamu.edu/faculty-page-shogo-sato/">my own work</a>, for example, a better understanding of how exercising at different times of day affects your body could help tailor exercise plans to maximize specific benefits for patients with obesity, Type 2 diabetes and other diseases. </p>
<p>There is still much to learn about how your circadian clock works. But in the meantime, there are some tried and true ways people can synchronize their internal clocks for better health. These include regular exposure to sunlight to trigger the endocrine system to produce vitamin D, staying active during the day so you fall asleep more easily at night and avoiding caffeine and reducing your exposure to artificial light before bedtime.</p><img src="https://counter.theconversation.com/content/178601/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Shogo Sato receives funding from the Brain & Behavioral Research Foundation (NARSAD Young Investigator Grant, 28681) and start-up funds from Texas A&M University. </span></em></p>Your body follows a circadian rhythm that influences everything from how well your medications work to the best time for exercise.Shogo Sato, Assistant Professor of Biology, Texas A&M UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1793872022-03-30T12:42:05Z2022-03-30T12:42:05ZMelatonin’s role in protecting the heart – the evidence so far<figure><img src="https://images.theconversation.com/files/455242/original/file-20220330-25-kewimx.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C6230%2C4147&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/close-cropped-image-millennial-mixed-race-1477334069">fizkes/Shutterstock</a></span></figcaption></figure><p>Many people know of melatonin as the <a href="https://link.springer.com/article/10.2165/00023210-200721120-00004">sleep hormone</a> – and, indeed, that’s what most of the research on melatonin has focused on. However, melatonin is also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6017920/">an antioxidant</a>, protecting cells from <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249911/">harmful “free radicals”</a> that can damage DNA – and this includes protecting cells in the <a href="https://pubmed.ncbi.nlm.nih.gov/14740000/#:%7E:text=Melatonin's%20functions%20as%20an%20antioxidant,augmenting%20the%20efficiency%20of%20other">heart and blood vessels</a>.</p>
<p>Given that heart disease is the leading cause of death in the world, killing around <a href="https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_1">17.9 million people each year</a>, this action is of particular interest to researchers.</p>
<p>Research shows that people with cardiovascular disease have <a href="https://www.imrpress.com/journal/FBL/17/7/10.2741/4063">lower levels of melatonin in their blood</a> compared with healthy people. And there is a strong <a href="https://pubmed.ncbi.nlm.nih.gov/20536686/">inverse relationship</a> between melatonin levels and cardiovascular disease. In other words, the lower a person’s melatonin level, the higher their risk of cardiovascular disease. </p>
<p>Melatonin supplements (2.5mg taken one hour before sleep) have been shown to <a href="https://www.ahajournals.org/doi/10.1161/01.hyp.0000113293.15186.3b">reduce blood pressure</a>. And, of course, high blood pressure (hypertension) is a known <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5059018/#:%7E:text=High%20blood%20pressure%20(BP)%20is,the%20leading%20cause%20of%20mortality.&text=Approximately%2054%25%20of%20strokes%20and,are%20attributable%20to%20high%20BP.">risk factor for cardiovascular disease</a>. Also, so-called cardiovascular events, including heart attacks and sudden cardiac death (unexpected death caused by a change in heart rhythm), occur at a higher rate <a href="https://www.frontiersin.org/articles/10.3389/fphys.2018.00528/full">in the early morning</a> when melatonin is at its lowest. These studies strongly suggest that melatonin protects the heart and blood vessels. </p>
<figure class="align-center ">
<img alt="Man in bed reaching to switch off his alarm clock" src="https://images.theconversation.com/files/455243/original/file-20220330-5868-14bm8d6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/455243/original/file-20220330-5868-14bm8d6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/455243/original/file-20220330-5868-14bm8d6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/455243/original/file-20220330-5868-14bm8d6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/455243/original/file-20220330-5868-14bm8d6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/455243/original/file-20220330-5868-14bm8d6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/455243/original/file-20220330-5868-14bm8d6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Heart attacks are more common in the morning when melatonin is at its lowest.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/hand-turns-off-alarm-clock-waking-549102646">Ko Backpacko/Shutterstock</a></span>
</figcaption>
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<p>Importantly, patients who have had a heart attack have <a href="https://www.imrpress.com/journal/FBL/17/7/10.2741/4063">reduced nighttime melatonin levels</a>. This observation has led to the theory that melatonin may be able to improve recovery from a heart attack and form part of the standard treatment given immediately after a heart attack occurs. </p>
<p>Laboratory studies of <a href="https://pubmed.ncbi.nlm.nih.gov/23276991/">heart attack</a> (using rats’ hearts kept alive outside of their bodies) have shown that melatonin does indeed protect the heart from damage after a heart attack. Similar studies have shown that when rats’ hearts are deprived of oxygen, as occurs in a heart attack, providing the heart with melatonin had a <a href="https://pubmed.ncbi.nlm.nih.gov/23276991/">protective effect</a>. </p>
<h2>Evidence less certain in people</h2>
<p>In humans, the evidence is less clear. A large trial where melatonin was injected into patients’ hearts after a heart attack <a href="https://clinicaltrials.gov/ct2/show/NCT00640094">showed no beneficial effects</a>. A later analysis of the same data suggested that melatonin <a href="https://pubmed.ncbi.nlm.nih.gov/28645475/">reduced the size of damage</a> caused to the heart by being starved of oxygen during a heart attack. And a <a href="https://pubmed.ncbi.nlm.nih.gov/29027116/">similar clinical trial</a> suggested no beneficial effects of giving melatonin to people who had suffered a heart attack. So the evidence is contradictory and no clear picture of melatonin’s role in helping to prevent damage to the heart during a heart attack has emerged so far. </p>
<p>It has been suggested that giving melatonin orally after a heart attack, rather than directly to the heart, <a href="https://www.frontiersin.org/articles/10.3389/fphys.2018.00528/full">could explain the contradictory findings</a> in clinical trials. </p>
<p>Trials looking at the effect of melatonin on heart attack are still in the relatively early stages, and it is clear further studies are needed to look at how and when melatonin could be administered after a heart attack.</p>
<p>However, it is clear that melatonin levels <a href="https://pubmed.ncbi.nlm.nih.gov/15582288/">decline as we get older</a>, and this may lead to an increased risk of heart disease. </p>
<p>As melatonin pills are only available on prescription in the UK, EU and Australia, melatonin levels can’t be topped up with a supplement – as can be done with other hormones, such as vitamin D. Ultimately, eating a diet that contains foods rich in melatonin, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409706/">milk, eggs, grapes, walnuts and grains</a>, may help protect you from cardiovascular disease. Melatonin is also found in wine, and some suggest that this may explain red wine’s <a href="https://www.sciencedirect.com/science/article/pii/S0006291X1530454X?casa_token=r6roti4mZYUAAAAA:rmgLdEKgAxb4nPf3st63_pM3_-Xr-CjqBvfRdoHPdCvoC87T-01oAlo_CaMUzlSk5b445ZoHiA">heart-protective effects</a>.</p><img src="https://counter.theconversation.com/content/179387/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Brown does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Melatonin may play a role in protecting people who have had a heart attack, but the evidence is still unclear.James Brown, Associate Professor in Biology and Biomedical Science, Aston UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1790532022-03-17T11:07:28Z2022-03-17T11:07:28ZMelatonin: should I take it to help me sleep?<figure><img src="https://images.theconversation.com/files/452419/original/file-20220316-17-1995law.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C5991%2C3979&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/belgrade-serbia-april-2018-5mg-melatonin-1079372021">TB photo/Shutterstock</a></span></figcaption></figure><p>I have been a doctor for over 20 years, 12 of which were dedicated exclusively to the practice of sleep medicine. Over the years, I have seen an enormous increase in the use of melatonin by my patients and their families. Although melatonin has helped many of my patients, there are some concerns that I have that are worth sharing. </p>
<p>First, I am not sure most of my patients that took melatonin before my clinical evaluation knew exactly what melatonin was. <a href="https://theconversation.com/uk/topics/melatonin-15404">Melatonin</a> is a hormone produced by a gland in the brain called the pineal gland. The main function of melatonin is sleep regulation. </p>
<p>Melatonin levels increase in response to darkness, telling the brain that night has arrived and it is time to sleep. When there is bright light, as in the morning, melatonin production shuts down and the brain knows that it is daytime. </p>
<p>The day-night regulation properties of melatonin and light make them the two key factors in the establishment of the internal sleep-wake clock, or what is called the “circadian cycle”. </p>
<figure class="align-center ">
<img alt="The pineal gland" src="https://images.theconversation.com/files/452442/original/file-20220316-17-1ft40ke.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/452442/original/file-20220316-17-1ft40ke.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=504&fit=crop&dpr=1 600w, https://images.theconversation.com/files/452442/original/file-20220316-17-1ft40ke.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=504&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/452442/original/file-20220316-17-1ft40ke.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=504&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/452442/original/file-20220316-17-1ft40ke.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=633&fit=crop&dpr=1 754w, https://images.theconversation.com/files/452442/original/file-20220316-17-1ft40ke.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=633&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/452442/original/file-20220316-17-1ft40ke.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=633&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The pea-sized pineal gland regulates the sleep-wake cycle.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-illustration/pineal-gland-labeled-diagram-166170098">Alila Medical Media/Shutterstock</a></span>
</figcaption>
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<p>A circadian disorder occurs when there is a mismatch between the internal clock and the socially accepted time to go to sleep or to wake up, as is seen when someone travels across time zones and has jet lag. But jet lag sometimes can occur in the absence of travel. For example, when you remain in an environment of bright lights until late hours of the night, you fool your brain into thinking that it is still daytime. In this case, melatonin production does not occur and you don’t feel sleepy until the late hours of the night, or sometimes early hours in the morning. </p>
<p>I have seen many teenagers come to my clinic because they can’t sleep until 2am or 3am, but they’re up watching videos on their electronic devices until late at night.</p>
<p>I usually recommend my patients turn the lights off at a reasonable time and expect sleepiness to start occurring within one hour. But it takes time for the natural clock to adjust to a new schedule, and often my patients prefer to use a melatonin supplement to quicken the circadian time adjustment.</p>
<p>With the increase in use of electronic devices, sleep disorders have <a href="https://pubmed.ncbi.nlm.nih.gov/30577441/">become quite common</a> and melatonin use has increased. Because of its sleep-promoting properties, melatonin is also an incredibly attractive option for people who suffer from insomnia or sleep disruption. </p>
<h2>Over-the-counter melatonin</h2>
<p>In some countries, such as the US, melatonin can be bought without a prescription. This situation concerns me because a lack of regulation can mean an increased risk of taking a different dose or ingredients than those reported. In fact, a study of melatonin supplements found that the <a href="https://pubmed.ncbi.nlm.nih.gov/27855744/">content of the hormone</a> ranged from -83% to +478% of the labelled content. The researchers also found other substances that were not reported to be in the preparation, including serotonin and valerian. </p>
<p>In the EU, the UK and Australia, melatonin is obtained <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5263069/#:%7E:text=OTC%20melatonin%20has%20been%20banned,medicine%2C%20available%20only%20by%20prescription.">only by prescription</a> for the short-term treatment of insomnia. This approach allows for better regulation, understanding and explanation of risks, benefits and alternatives to the use of melatonin. </p>
<p>Even though melatonin is a naturally occurring hormone, it does not come without side-effects, the most common being <a href="https://www.nhs.uk/medicines/melatonin/">headaches and dizziness</a>. It can <a href="https://pubmed.ncbi.nlm.nih.gov/12076414/">also interact</a> with other medicines, such as anticoagulants (drugs that help prevent blood clots). </p>
<p>The <a href="https://pubmed.ncbi.nlm.nih.gov/30148726/">best evidence of safety</a> for the use of melatonin is for short-term use only (one to three months) and in low doses (0.5-1mg). The long-term effects of melatonin remain unknown. </p>
<p>Have I used melatonin or recommended it to my patients? Absolutely. But only when I know exactly what I am recommending it for. Insomnia can be a symptom of a sleep disorder like restless legs syndrome or obstructive sleep apnoea, or it can be a symptom of another condition, such as depression, asthma or pain. </p>
<p>When a sleep specialist identifies the correct diagnosis, then the treatment options can be explored. When I need to prescribe melatonin, I usually recommend starting with the lowest dose possible (0.5mg) one to two hours before their current bedtime, and I recommend that the patient turns their lights off, or dims them, before taking melatonin. I also recommend avoiding other contributors to poor sleep, such as caffeinated products after 3pm, heavy exercise in the evening, or the use of electronic devices before bedtime. </p>
<p><em>Correction: An earlier version of this article stated that melatonin supplements are only available on prescription in Canada. This is incorrect.</em></p><img src="https://counter.theconversation.com/content/179053/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lourdes M. DelRosso does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Melatonin can be useful as a sleep aid, but should be prescribed by a physician after a careful analysis of the causes of sleep loss.Lourdes M. DelRosso, PhD Candidate, Sleep Disorders, University of PortsmouthLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1701082021-11-01T02:27:07Z2021-11-01T02:27:07ZLED face masks are popular on social media for glowing skin – but they could disrupt your sleep<figure><img src="https://images.theconversation.com/files/429513/original/file-20211101-23-k9xukq.jpg?ixlib=rb-1.1.0&rect=42%2C42%2C4681%2C3109&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/woman-led-light-therapy-facial-beauty-1506384749">Shutterstock</a></span></figcaption></figure><p>LED face masks are the latest device promoted on social media as a marriage of technology and beauty. </p>
<p>A range of celebrities have endorsed portable versions of the product that was previously offered in beauty salons. Actress Olivia Munn <a href="https://www.usmagazine.com/stylish/pictures/celebrities-who-use-led-light-therapy-at-home-treatment-benefits/olivia-munn-19/">carries hers with her at all times</a>. Julia Roberts, Victoria Beckham and Chrissy Tiegen are also <a href="https://www.harpersbazaar.com/uk/beauty/skincare/a31908990/celebrity-led-mask/">reportedly</a> fans. The trend has even achieved the social media holy grail – a Kardashian Instagram <a href="https://www.instagram.com/p/BCemzbnk1qQ/?taken-by=kourtneykardash&hl=en%22">post</a>. </p>
<p>But regardless of whether they’ll help make your skin glow, our understanding of circadian rhythms suggests they have the potential to disrupt users’ sleep-wake cycles.</p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://twitter.com/TheCut/status/1445116733170278403","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/6-ways-to-stop-daylight-saving-derailing-your-childs-sleep-123871">6 ways to stop daylight saving derailing your child’s sleep</a>
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<hr>
<h2>Daily rhythms</h2>
<p>The human body has its own internal clock which, among other things, helps to control our sleep-wake patterns. This internal clock is influenced by several factors, the most potent being light exposure directly into the eyes. More specifically, short-wavelength “blue light” <a href="https://journals.sagepub.com/doi/10.1177/0748730415585413">influences this system the most</a>. </p>
<p>Exposure to this type of light at night has been shown <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/jpi.12562">interrupt the production of melatonin</a> – also known as “the sleep hormone”. <a href="https://www.psychiatrictimes.com/view/role-melatonin-circadian-rhythm-sleep-wake-cycle">Melatonin</a> is produced by the pineal gland in the brain and released within 2 hours of your habitual bedtime – preparing the body for sleep. But bright blue light exposure may interrupt this process. </p>
<p>There are a range of sources for blue light – including our beloved phones, electronic devices and also the room lighting in our homes. While it has become a common recommendation to avoid using electronic devices close to bedtime, in the context of blue light exposure, our phones and tablets <a href="https://winksleep.online/blog/65-blue-screenlight-making-it-harder-to-fall-asleep-is-the-number-1-sleep-myth-of-our-time">do not seem to be bright enough to impact sleep</a>. In fact, home lighting appears to have a greater influence – likely due to the <a href="https://sleepjunkies.com/home-lighting-circadian-rhythms/">transition to energy-efficient LED, “blue light” wavelength light</a>.</p>
<p>Last year, Monash University researchers examined sleep and light exposure in 57 participants, finding that <a href="https://www.nature.com/articles/s41598-020-75622-4#Sec7">nearly half of them had LED lighting that suppressed melatonin by 50%</a>. The study also found those with greater evening light exposure had increased wakefulness after bedtime. </p>
<p>Insufficient sleep has been shown to increase the likelihood of poor health outcomes, including <a href="https://academic.oup.com/eurheartj/article/32/12/1484/502022">cardiovascular disease</a>.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="woman with phone in bed" src="https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/427973/original/file-20211022-23-1twj2py.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption">Room LED lighting may be a bigger issue than phones and devices when it comes to sleep disruption.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/closeup-asian-women-using-smartphone-late-1746438284">Shutterstock</a></span>
</figcaption>
</figure>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/poor-sleep-is-really-bad-for-your-health-but-we-found-exercise-can-offset-some-of-these-harms-163270">Poor sleep is really bad for your health. But we found exercise can offset some of these harms</a>
</strong>
</em>
</p>
<hr>
<h2>How face masks compare to other LED sources</h2>
<p>LED mask manufacturers say they are <a href="https://www.marieclaire.com/beauty/g32894063/led-light-therapy-masks/">the “future of skin care”</a>, with masks emitting light at different wavelengths to target particular skin-related outcomes. </p>
<p>Several devices are FDA-approved in the United States, and claim to <a href="https://www.violetgrey.com/product/led-mask/DG-BA568110?utm_source=pepperjam&utm_medium=affiliate&utm_campaign=21181&clickId=3730626806">target acne with “blue light” modes</a> – the precise wavelength range that may impact melatonin production. </p>
<p>To date, no experimental research studies have examined the impact of these devices, and their blue light settings, on sleep or the human body clock. But given the device’s proximity to users’ eyes and the intensity of LED light bulbs, it is reasonable to flag concerns about their possible impact on our body clock. </p>
<p><a href="https://lens.monash.edu/@sean-cain">Sean Cain</a>, a leading scientist on the impact of light exposure on human health, coined an analogy to provide perspective to the sources of artificial light. The light we receive from electronic devices can be thought of as like a glass of water being poured over your head, while home LED lighting is more like a bucket of water. In keeping with this analogy, could LED masks be something on the scale of a bathtub or swimming pool? Further research could quantify their effect. </p>
<p><div data-react-class="InstagramEmbed" data-react-props="{"url":"https://www.instagram.com/p/BCemzbnk1qQ/?taken-by=kourtneykardash\u0026hl=en","accessToken":"127105130696839|b4b75090c9688d81dfd245afe6052f20"}"></div></p>
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<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/snooze-blues-how-using-your-favourite-song-as-an-alarm-can-help-you-wake-up-more-alert-158233">Snooze blues? How using your favourite song as an alarm can help you wake up more alert</a>
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</em>
</p>
<hr>
<h2>You can still make like a Kardashian … in the daytime</h2>
<p>These concerns, based on well-established circadian principles, do not rule out the use of these devices entirely. However, it is important for people who use them to avoid doing so at night – especially on the blue light settings. </p>
<p>Ideally, use of the masks should be during daylight hours, to avoid potential sleep disturbances and/or shifts in the human body clock. Future research could clarify any negative outcomes associated with these devices and potentially prompt manufacturers to provide recommendations on the timing of their use.</p><img src="https://counter.theconversation.com/content/170108/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Dean J. Miller's position at CQUniversity is funded by WHOOP inc . </span></em></p>LED face masks are popular with celebrities and promise a glowing complexion. But should they come with ‘daytime use’ recommendation?Dean J. Miller, Research Officer, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1578522021-04-02T12:18:32Z2021-04-02T12:18:32ZUnwanted weight gain or weight loss during the pandemic? Blame your stress hormones<figure><img src="https://images.theconversation.com/files/392966/original/file-20210331-21-h3dbvx.jpg?ixlib=rb-1.1.0&rect=0%2C0%2C3902%2C2561&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Stress hormones are closely tied to hunger and motivation.</span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/young-woman-is-weighing-herself-in-a-weighing-scale-royalty-free-image/1139272587?adppopup=true">Karl Tapales/Moment via Getty Images</a></span></figcaption></figure><figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=255&fit=crop&dpr=1 600w, https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=255&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=255&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=321&fit=crop&dpr=1 754w, https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=321&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/392963/original/file-20210331-17-1uy16hd.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=321&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
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<span class="caption"></span>
<span class="attribution"><a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
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</figure>
<p>If you have experienced unwanted weight gain or weight loss during the pandemic, you are not alone. According to a poll by the American Psychological Association, <a href="https://www.apa.org/news/press/releases/2021/03/march-weight-change">61% of U.S. adults reported undesired weight change</a> since the pandemic began. </p>
<p>The results, released in March 2021, showed that during the pandemic, 42% of respondents gained unwanted weight – 29 pounds on average – and nearly 10% of those people gained more than 50 pounds. On the flip side, nearly 18% of Americans said they experienced unwanted weight loss – on average, a loss of 26 pounds.</p>
<p>Another study, published on March 22, 2021, assessed weight change in 269 people from February to June 2020. The researchers found, on average, that people gained a <a href="https://doi.org/10.1001/jamanetworkopen.2021.2536">steady 1.5 pounds per month</a>.</p>
<p>I am a <a href="https://scholar.google.com/citations?hl=en&user=sOMbzQ0AAAAJ">nutritional neuroscientist</a>, and my research investigates the relationship between diet, lifestyle, stress and mental distress such as anxiety and depression. </p>
<p>The common denominator to changes in body weight, especially during a pandemic, is stress. Another poll done by the <a href="https://www.apa.org/news/press/releases/2021/02/adults-stress-pandemic#:%7E:text=The%20majority%20of%20adults%20reported,the%20U.S.%20Capitol%20on%20Jan">American Psychological Association</a> in January 2021 found that about 84% of U.S. adults experienced at least one emotion associated with prolonged stress in the prior two weeks.</p>
<p>The findings about unwanted weight changes make sense in a stressful world, especially in the context of the body’s stress response, better known as the fight-or-flight response.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A 3D model of cortisol" src="https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=357&fit=crop&dpr=1 600w, https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=357&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=357&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=449&fit=crop&dpr=1 754w, https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=449&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/392964/original/file-20210331-23-o2jkk1.png?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=449&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Neurotransmitters – like cortisol, seen here – mediate the fight-or-flight response and can have a huge impact on eating and behavior.</span>
<span class="attribution"><a class="source" href="https://commons.wikimedia.org/wiki/File:Cortisol-3D-balls.png#/media/File:Cortisol-3D-balls.png">Ben Mills/Wikimedia Commons</a></span>
</figcaption>
</figure>
<h2>Fight, flight and food</h2>
<p>The fight-or-flight response is an innate reaction that evolved as a survival mechanism. It empowers humans to react swiftly to acute stress – like a predator – or adapt to chronic stress – like a food shortage. When faced with stress, the body wants to keep the brain alert. It decreases levels of some hormones and brain chemicals in order to turn down behaviors that won’t help in an urgent situation, and it increases other hormones that will.</p>
<p>When under stress, the body lowers levels of neurotransmitters such as <a href="https://dx.doi.org/10.4103%2F0975-7406.111818">serotonin, dopamine and melatonin</a>. Serotonin regulates emotions, appetite and digestion. So, low levels of serotonin <a href="https://doi.org/10.1016/j.pbb.2010.09.003">increase anxiety and can change a person’s eating habits</a>. Dopamine – another feel-good neurotransmitter – regulates <a href="https://doi.org/10.7554/eLife.58321">goal-oriented motivation</a>. Dwindling levels of dopamine can translate into lower motivation to exercise, maintain a healthy lifestyle or perform daily tasks. When people are under stress, they also produce <a href="https://doi.org/10.1016/j.pbb.2010.09.003">less of the sleep hormone melatonin</a>, leading to trouble sleeping.</p>
<p>Epinephrine and norepinephrine mediate the physiological changes associated with stress and are <a href="https://dx.doi.org/10.4103%2F0975-7406.111818">elevated in stressful situations</a>. These biochemical changes can cause mood swings, impact a persons’s eating habits, reduce goal-oriented motivation and disrupt a person’s circadian rhythm. </p>
<p>Overall, stress can throw your eating habits and motivation to exercise or eat healthy way out of balance, and this last year has certainly been a stressful one for everyone. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="A spoon with chocolate spread" src="https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=384&fit=crop&dpr=1 600w, https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=384&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=384&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=483&fit=crop&dpr=1 754w, https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=483&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/392967/original/file-20210331-17-1qi0k5s.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=483&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Sugars give an immediate but short-lasting mood boost.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/chocolate-spread-in-spoon-a-jar-of-hazelnut-royalty-free-image/613319032?adppopup=true">MarianVejcik/iStock via Getty Images Plus</a></span>
</figcaption>
</figure>
<h2>Easy calories, low motivation</h2>
<p>In both of the studies, people self-reported their weight, and the researchers didn’t collect any information about physical activity. But, one can cautiously assume that most of the weight changes were due to people gaining or losing body fat.</p>
<p>So why did people gain or lose weight this last year? And what explains the dramatic differences?</p>
<p>Many people find comfort in high-calorie food. That is because chocolate and other sweets can make you happy by <a href="https://pubmed.ncbi.nlm.nih.gov/27166525/">boosting serotonin levels in the short term</a>.
However, the blood clears the extra sugar very quickly, so the mental boost is extremely short-lived, leading people to eat more. Eating for comfort can be a natural response to stress, but when combined with the lower motivation to exercise and consumption of low-nutrient, calorie-dense food, stress can result in unwanted weight gain. </p>
<p>What about weight loss? In a nutshell, the brain is connected to the gut through a <a href="https://www.healthline.com/nutrition/gut-brain-connection#TOC_TITLE_HDR_2">two-way communication system called the vagus nerve</a>. When you are stressed, your body inhibits the signals that travel through the vagus nerve and slows down the digestive process. When this happens, people experience fullness. </p>
<p>The pandemic left many people confined to their homes, bored and with plenty of food and little to distract them. When adding the stress factor to this scenario, you have a perfect situation for unwanted weight changes. Stress will always be a part of life, but there are things you can do – like <a href="https://www.healthline.com/health/positive-self-talk#_noHeaderPrefixedContent">practicing positive self-talk</a> – that can help ward off the stress response and some of its unwanted consequences.</p>
<p>[<em><a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=experts">Expertise in your inbox. Sign up for The Conversation’s newsletter and get expert takes on today’s news, every day.</a></em>]</p><img src="https://counter.theconversation.com/content/157852/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Lina Begdache receives funding from the National Science Foundation, Academy of Nutrition and Dietetics, New York State Health Foundation, Regional Economic Development Council and other foundation and intramural sources.</span></em></p>It’s been a stressful year, and for 61% of US adults, a year of unwanted weight change too. This isn’t surprising, as stress, eating and motivation are all linked through hormones in the brain.Lina Begdache, Assistant Professor of Nutrition, Binghamton University, State University of New YorkLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1469562020-10-28T18:59:30Z2020-10-28T18:59:30ZDaylight saving time could be especially hard this weekend because of COVID-19 sleep loss<figure><img src="https://images.theconversation.com/files/389136/original/file-20210311-19-1mzgc1.jpg?ixlib=rb-1.1.0&rect=0%2C249%2C5357%2C3148&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"> Sleep loss was an issue even before COVID-19. </span> <span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/news-photo/news-photo/107693557?adppopup=true">Thurston Hopkins/Picture Post/Hulton Archive via Getty Images</a></span></figcaption></figure><p>The clock springs forward one hour on Sunday morning, March 14 for most people in the U.S. That is not an appealing thought for those who have suffered sleep problems because of the pandemic. </p>
<p>Sleep this past year has been affected by a variety of factors, including anxiety, inconsistent schedules and increased screen time. This affects our health, as getting adequate sleep is important to assure our immune system can fend off and fight infections. </p>
<p>Even before the pandemic, about 40% of adults – 50 to 70 million Americans – <a href="https://doi.org/%2010.17226/11617">got less than the recommended</a> minimum seven hours per night.</p>
<p>And, many researchers were already concerned about how the twice-a-year switch affects our body’s physiology. <a href="https://doi.org/10.5664/jcsm.8780">The American Academy of Sleep Medicine</a>, the largest scientific organization that studies sleep, in October 2020 suggested nixing daylight saving time and moving to a year-round fixed time. That way, our internal circadian clocks would not be misaligned for half the year. And it would eliminate the safety risk from sleep loss when transitioning to daylight saving time.</p>
<p><a href="https://neurology.ufl.edu/profile/jaffee-michael/">I am a neurologist</a> at the University of Florida. I’ve studied how a lack of sleep can impair the brain. In the 1940s, most American adults averaged 7.9 hours of sleep a night. Today, it’s only 6.9 hours. To put it another way: In 1942, 84% of us got the recommended seven to nine hours; in 2013, it was 59%. To break it down further, a January <a href="https://blog.fitbit.com/sleep-study/">2018 study from Fitbit</a> reported that men got even less sleep per night than women, about 6.5 hours. </p>
<figure class="align-center ">
<img alt="A 6-year-old needs 9-12 hours of sleep a day." src="https://images.theconversation.com/files/365135/original/file-20201023-15-1stabfx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/365135/original/file-20201023-15-1stabfx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/365135/original/file-20201023-15-1stabfx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/365135/original/file-20201023-15-1stabfx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/365135/original/file-20201023-15-1stabfx.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/365135/original/file-20201023-15-1stabfx.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/365135/original/file-20201023-15-1stabfx.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Children age 12 and under need 9-12 hours of sleep per night.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/boy-sleeping-in-bed-royalty-free-image/630159689?adppopup=true">Tetra Images/DigitalVision via Getty Images</a></span>
</figcaption>
</figure>
<h2>The case for sleep</h2>
<p>Problems from sleep shortage go beyond simply being tired. Compared to those who got enough sleep, adults who are short sleepers – those getting less than seven hours per day – <a href="https://www.nichd.nih.gov/health/topics/sleep/conditioninfo/inadequate-sleep">were more likely to report</a> 10 chronic health conditions, including heart disease, diabetes, obesity, asthma and depression. </p>
<p>Children, who need more sleep than adults, face even more challenges. <a href="https://jcsm.aasm.org/doi/10.5664/jcsm.5866">To promote optimal health</a>, 6- to 12-year-olds should sleep nine to 12 hours a day; teens from 13 to 18, eight to 10 hours. But a Sleep Foundation poll of parents says children are getting at least one hour less than that. And <a href="https://doi.org/10.1093/sleep/30.9.1079">researchers have found</a> that sleep deprivation of even a single hour can harm a child’s developing brain, affecting memory encoding and attentiveness in school.</p>
<p>Sleep affects <a href="https://theconversation.com/why-are-we-so-sleep-deprived-and-why-does-it-matter-91803">every one of our biological systems</a>. Serious consequences can result with poor sleep quality. Here’s a short list: <a href="https://doi.org/10.1378/chest.09-2954">Blood pressure</a> may increase. <a href="https://doi.org/%2010.2174/157340310790231635">Risk of coronary heart disease</a> could go up. Our endocrine system releases more cortisol, a stress hormone. We become more aroused by “fight or flight” syndrome. There’s a reduction of growth hormone and muscle maintenance. There’s a higher chance of increased appetite and weight gain. The body has less glucose tolerance and greater insulin resistance; in the long term, that means an increased risk for Type 2 diabetes. </p>
<p>Sleep deprivation is associated with increased inflammation and a decreased number of antibodies to fight infections. It may also cause a decrease in pain tolerance, reaction times and memory. Occupational studies show sleep loss can cause poor work performance, including more days missed and more car accidents.</p>
<p><a href="https://doi.org/10.1016/j.cophys.2019.10.020">Recent research suggests</a> the body’s waste removal process relies on sleep to get rid of harmful proteins from the brain, particularly abnormal variants of amyloid. These are the same proteins that are elevated in Alzheimer’s patients. <a href="https://www.alzforum.org/news/research-news/lymphatic-brain-drain-withers-aging-worsens-disease">Studies show</a> that older adults who sleep less have greater accumulation of these proteins in their brains.</p>
<p>On the other hand, getting enough sleep helps the body in many ways by protecting against some of these damaging effects and by boosting the immune system.</p>
<figure class="align-center ">
<img alt="Some educators worry about transporting schoolchildren at dusk." src="https://images.theconversation.com/files/365140/original/file-20201023-15-1lg3bgv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/365140/original/file-20201023-15-1lg3bgv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/365140/original/file-20201023-15-1lg3bgv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/365140/original/file-20201023-15-1lg3bgv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/365140/original/file-20201023-15-1lg3bgv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/365140/original/file-20201023-15-1lg3bgv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/365140/original/file-20201023-15-1lg3bgv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Some educators worry about the safety factor when transporting schoolchildren at dusk.</span>
<span class="attribution"><a class="source" href="https://www.gettyimages.com/detail/photo/diverse-group-of-happy-children-getting-on-school-royalty-free-image/1166892600?adppopup=true">FatCamera/E+/E+ via Getty Images</a></span>
</figcaption>
</figure>
<h2>The problem with DST</h2>
<p>Most of the risk associated with daylight saving time occurs in the spring, when we turn the clock forward and lose one hour of sleep. The idea of a national permanent year-round time has support, but disagreements exist on whether the fixed time should be standard time or daylight saving time.</p>
<p>[<em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters/the-daily-3?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>.]</p>
<p><a href="https://www.ncsl.org/research/transportation/daylight-savings-time-state-legislation.aspx">States advocating</a> for permanent daylight saving time are typically those that rely on tourism. Environmentalists, favoring less energy consumption from morning heating and evening air conditioning, <a href="https://savestandardtime.com/pdfs/kotchen_and_grant-2008_12.pdf">often support permanent standard time</a>. Religious groups, whose prayer times are linked to sundown and sunrise, <a href="https://vosizneias.com/2018/03/13/miami-floridas-proposed-change-to-permanent-daylight-savings-time-could-create-halachic-problems-for-jewish-community/">also tend to prefer</a> permanent standard time. <a href="https://savestandardtime.com/pdfs/mercury_news-2018.pdf">So do many educators</a>, opposed to transporting children to school during mornings when it’s still dark. </p>
<p>As you ponder what system is best for a national year-round standard, consider this: The American Academy of Sleep Medicine has recommended we go with permanent standard time – a better way to align with our natural circadian clock and minimize health and safety risks.</p>
<p>And just think: If we change to permanent standard time, then for the first time in decades, you won’t lose an hour of sleep every spring.</p>
<p><em>Editor’s note: This story is updated from its original version, which was published Oct. 28, 2020.</em></p><img src="https://counter.theconversation.com/content/146956/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Michael S. Jaffee does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Springing forward for daylight saving time will be especially hard this year due to sleep loss from COVID-19. Why does the US keep doing this?Michael S. Jaffee, Vice Chair, Department of Neurology, University of FloridaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1176382019-06-18T13:29:41Z2019-06-18T13:29:41ZSleep training for your kids: Why and how it works<figure><img src="https://images.theconversation.com/files/278998/original/file-20190611-32347-1t2w284.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Getting a baby to fall asleep can be exhausting.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/attractive-bald-latin-new-father-exhausted-188170451?src=GbHOJafMSQBB1MKRl3R7jQ-1-2">Marcos Mesa Sam Wordley/Shutterstock.com</a></span></figcaption></figure><p>For thousands of years, <a href="https://www.bbc.com/news/magazine-21035103">mothers have sung lullabies</a> to help their babies and children fall asleep. In more recent times, gadgets and devices have been invented and marketed to help the tired child – and weary parent.</p>
<p>One of these devices has been linked in recent years to the tragic deaths of 32 babies. Fisher Price <a href="https://www.consumerreports.org/recalls/fisher-price-recalls-rock-n-play-sleeper/">recently recalled</a> its Rock ‘n Play Sleeper after the deaths. </p>
<p>The popularity of the device and others shows the widespread desire for help getting babies and children to sleep. Consider that nearly <a href="https://doi.org/10.1093/sleep/29.10.1263">30% of young children experience sleep problems</a> that warrant clinical attention. </p>
<p>As behavioral sleep medicine specialists, we completed postdoctoral training in assessment and treatment of behavioral sleep problems in children and teens. Our knowledge of pediatric sleep research suggests children won’t outgrow sleep problems, and sleep problems may even <a href="https://doi.org/10.1016/j.pcl.2011.03.002">worsen over time</a>. Yet children with sleep problems are not destined to be sleep deprived forever. There are sleep training methods for babies and young children that can work.</p>
<h2>Sleep, my child … so I can, too</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/278999/original/file-20190611-32327-1tmdr01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/278999/original/file-20190611-32327-1tmdr01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/278999/original/file-20190611-32327-1tmdr01.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/278999/original/file-20190611-32327-1tmdr01.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/278999/original/file-20190611-32327-1tmdr01.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/278999/original/file-20190611-32327-1tmdr01.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/278999/original/file-20190611-32327-1tmdr01.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A mother rocks her baby to sleep.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-mother-holding-her-newborn-child-329743067?src=TtMKlfeLNhjlohddWKwrjA-1-9">FamVeld/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>We sleep doctors have seen that sleep problems correlate with a host of daytime problems, such as <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3630973/">overactivity and attentional impairments</a>, <a href="https://doi.org/10.1016/j.smrv.2009.10.004">poor school performance,</a> and excessive <a href="https://doi.org/10.1016/j.smrv.2011.03.007">moodiness and irritability</a>. As many as 20% of adults experience <a href="https://doi.org/10.1177/070674371105600905">persistent insomnia</a>, and many can trace their sleep problems to childhood.</p>
<p>The most common sleep problems in young children are difficulties falling asleep at bedtime, disruptive nighttime awakenings, or needing special conditions to fall asleep, such as the presence of a parent. These problems, in turn, are likely to cause parental stress and next-day <a href="https://doi.org/10.1016/j.pcl.2011.03.010">impairments for the entire family</a>. </p>
<p>People often equate sleep with “tiredness” and “fatigue.” In fact, <a href="https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Understanding-Sleep#3">sleep is its own process</a>. It is an interaction of sleep-promoting brain chemicals and consistent daily rhythms of wake and sleep produced by bright light exposure in the morning. The bright light signals suppression of the sleep-promoting hormone melatonin.</p>
<p>Darkness, on the other hand, signals the brain via direct connection from receptors in the eye: “Produce melatonin; Go to sleep.” At the end of the day, there is nothing parents can do safely to make their children sleep. But there are many things parents can do to teach their children the skills necessary for good sleep.</p>
<p>Insomnia responds well to a number of <a href="https://doi.org/10.1016/S0022-3999(03)00061-8">behavioral treatment</a> interventions.</p>
<h2>From crying it out to teaching a skill</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/278995/original/file-20190611-32331-pt7yql.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/278995/original/file-20190611-32331-pt7yql.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/278995/original/file-20190611-32331-pt7yql.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/278995/original/file-20190611-32331-pt7yql.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/278995/original/file-20190611-32331-pt7yql.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/278995/original/file-20190611-32331-pt7yql.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/278995/original/file-20190611-32331-pt7yql.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Timed checks on a baby can be more effective than constantly watching him or her.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/young-parents-sleepless-newborn-baby-night-1012918264?src=ELf8_5kRm0stEyrN9O6UpA-1-27">Elnur/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Many families have heard of the conventional “cry it out” approach – formally known as <a href="https://doi.org/10.1093/jpepsy/24.6.465">unmodified extinction</a>. Although research supports the effectiveness of this method with infants and young toddlers, it is our clinical experience that few parents find this approach bearable. Furthermore, “cry it out” is not intended for use with older toddlers or preschool-aged children. </p>
<p>Instead, a method called <a href="http://dx.doi.org/10.4135/9781412950534.n2063">graduated extinction</a> is the mainstay of current behavioral intervention for bedtime resistance and sleep association problems. There are several approaches, used from toddlerhood through middle childhood, consisting of techniques such as timed checks, or the “walking chair.” </p>
<p>In timed checks, parents enter and exit the bedroom on a strictly timed schedule. This breaks the connection between problem child behavior, such as crying and calling out, and parental response. </p>
<p>The <a href="https://www.todaysparent.com/baby/baby-sleep/most-popular-sleep-training-methods-explained/">walking chair method</a> involves the parent moving further and further from the child’s bed until outside the bedroom door and, eventually, back to the parent’s own bed. Our clinical experience is that sometimes a combination of these methods is needed. </p>
<p>Although these procedures emphasize the importance of limiting attention to problem behavior, they differ from unmodified extinction by providing attention for positive sleep behaviors, such as lying quietly in bed.</p>
<p>Consider a child who has a longstanding history of needing parental presence to fall asleep. The child can be said to have a skill deficit of being unable to fall asleep on her own. Learning to fall asleep can be likened to learning to ride a bike, first with training wheels, then without, and then without the parent steadying the handlebar. Little by little, the parent takes away her hand, and the child learns balance and eventually pedals away on her own. </p>
<p>With sleep training, the parent teaches the child to practice behaviors that are compatible with sleep, such as lying still and quiet in bed with their head on the pillow. When the parent enters the room every five minutes to say, “Good job staying in bed and lying so still” and offers a quick kiss and pat on the back, the child knows exactly what is pleasing to the parent. Once the child learns to lie quiet and still in bed, sleep physiology takes over.</p>
<h2>Healthy sleep now, healthy sleep in adulthood</h2>
<p>Many parents may incorrectly believe that sleep training is damaging to the parent-child relationship or <a href="https://doi.org/%20doi:10.1542/peds.2011-3467">attachment</a> bond. In fact, we argue that healthy attachment bonds are formed by high rates of reinforcing parent-child interaction such as those used to teach behavior that is compatible with sleep. </p>
<p>Sleep training at younger ages may protect against more serious sleep problems later in life. For instance, at the onset of puberty, most <a href="http://www.nhlbi.nih.gov/files/docs/public/sleep/pslp_fs.pdf">teens</a> experience a natural biological shift that causes them to prefer later bedtime and later wake time. </p>
<p>For most, this preference does not subside until <a href="https://www.sleepfoundation.org/articles/teens-and-sleep">young adulthood</a>. If this natural shift in bedtime and wake time is paired with already problematic sleep habits learned in childhood, the results can be serious. Kids can get <a href="https://www.sleepfoundation.org/articles/teens-and-sleep">behind at school</a> because they fall asleep in class, or they may become truant. Furthermore, when teens attempt to self-correct problem sleep schedules, they often find themselves unable to fall asleep easily at an appropriate bedtime. Many end up spending excessive time awake in bed, placing them at risk for <a href="https://www.sleepfoundation.org/articles/teens-and-sleep">chronic insomnia</a> that could persist well into middle age. </p>
<p>So, that conversation that you are thinking about having with your child’s pediatrician: Have it. Your pediatrician also can help you decide when it might be time to seek specialty care with a <a href="https://www.behavioralsleep.org/">behavioral sleep specialist</a> or <a href="http://sleepeducation.org/find-a-facility">sleep medicine physician</a>. </p>
<p>If your child doesn’t sleep, don’t lose hope. Change is possible. You already have taught and will continue to teach your child many important lessons in life. With persistence, good information and willingness to try new things, healthy sleep habits and a good night’s sleep are within reach.</p>
<p>[ <em>Deep knowledge, daily.</em> <a href="https://theconversation.com/us/newsletters?utm_source=TCUS&utm_medium=inline-link&utm_campaign=newsletter-text&utm_content=deepknowledge">Sign up for The Conversation’s newsletter</a>. ]</p><img src="https://counter.theconversation.com/content/117638/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Ryan Anderson is a licensed psychologist working in behavioral sleep medicine at the UPMC Children's Hospital of Pittsburgh. Dr. Anderson also provides autism services and receives funding from the Autism Treatment Network.</span></em></p><p class="fine-print"><em><span>Hannah Ford does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>Adults are not the only people in the US who have problems with sleep – babies and children suffer from loss of sleep, too. Two pediatric sleep experts explain how you can help your little ones.Ryan Anderson, Researcher, Child Psychology, University of PittsburghHannah Ford, Researcher, Pediatric Sleep Disorders, University of PittsburghLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1134892019-04-03T12:47:44Z2019-04-03T12:47:44ZLight pollution: the dark side of keeping the lights on<figure><img src="https://images.theconversation.com/files/265870/original/file-20190326-36276-1pr2wgj.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption"></span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Twenty five years ago Los Angeles experienced a <a href="https://timeline.com/los-angeles-light-pollution-ebd60d5acd43">massive power blackout</a> due to an earthquake. The entire city was thrust into darkness. The emergency call service, 911, was inundated with panicked residents reporting “a giant silvery cloud”, was engulfing the sky. Unknown to the callers, they were seeing the Milky Way, the galaxy containing our Solar System, in the night sky for the first time. Some of these urbanites had never before experienced a non-light polluted sky.</p>
<p>Light pollution is the excessive and obtrusive light produced by humans at night. This light is from artificial sources, mainly electricity from houses, offices, streetlamps, billboards or car headlights. There are two main types of light pollution: point source, that is light directly from a source, and skyglow, the combined and accumulated effect of point source lighting that spreads through the atmosphere. This is the slight glow one can see on the horizon if looking towards a city from a rural area. </p>
<p>Almost <a href="http://advances.sciencemag.org/content/2/6/e1600377">a quarter</a> of global land area is now under light polluted skies. And 80% of the world’s population now lives under such light polluted skies, meaning a third of humanity can no longer see the Milky Way. </p>
<p>The introduction of artificial light at night has occurred in a universe, that is, in fact, exceedingly dark. Apart from the soft glow of celestial light, it is remiss of us to forget that half the earth always used to be, at any moment in time, in utter darkness. We only experience sunlight daily because of the random virtue of happening to be close to a star. That means that over evolutionary timescales, life on earth, and humans also, have adapted to constant and regular day-night cycles. </p>
<p>Many species use these sunlight cycles, and moonlight cycles, to time their behaviour, activity and sleep patterns as well as when to mate and when to feed. But now, the spatial coverage of light pollution is large, and its intensity is increasing. </p>
<p>But there’s a bigger problem: there’s mounting <a href="https://link.springer.com/article/10.1007/s00442-014-3088-2">evidence</a> that increased lighting has a range of negative effects. </p>
<h2>Lighting’s bad side</h2>
<p><a href="https://link.springer.com/article/10.1007/s00442-014-3088-2">Lighting negatively</a> affects the environment as it disrupts the natural light cycles that species are cued into. These include changes in time partitioning such as singing, activity and foraging in animals, or altering individual health.</p>
<p>And there’s increasing <a href="https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/about-ama/councils/Council%20Reports/council-on-science-public-health/a16-csaph2.pdf">evidence</a> that lighting has negative effects on human health. Melatonin is the hormone that regulates human sleep patterns and is expressed under light. Changes in light regimes away from day-night cycles caused by light pollution means that it can disrupt this vital hormone’s natural expression. This has been <a href="https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/about-ama/councils/Council%20Reports/council-on-science-public-health/a16-csaph2.pdf">linked</a> to obesity, reduced sleep quality and impaired memory. </p>
<p>Because melatonin is an anti-oxidant that can remove free radicals, the disruption of its expression by artificial light may <a href="https://www.ncbi.nlm.nih.gov/pubmed/29687979">increase cancer risk</a>. Disruption of natural light cycles is particularly acute with newer LED (Light Emitting Diode) lights, which are <a href="https://www.ecmag.com/section/your-business/global-led-market-expected-reach-427-billion-2020">increasingly being adopted globally</a> for their energy efficiency benefits. Yet, there’s little consideration of their negative health consequences.</p>
<h2>Managing the problem</h2>
<p>A recent <a href="http://science.sciencemag.org/content/362/6416/744.summary">review in Science</a> has outlined five key strategies to reduce lighting globally, which will not necessarily compromise its benefits. They are: </p>
<ul>
<li><p>The introduction of light to previously dark areas should be avoided. </p></li>
<li><p>Lighting should be at the lowest usable intensity.</p></li>
<li><p>Lighting should only be used where it’s directly needed and shielded where possible. </p></li>
<li><p>Lighting should only be used when required. </p></li>
<li><p>Lighting should be “warmer”, meaning more orange colours should be used rather than in the harsh white spectrum.</p></li>
</ul>
<h2>African research required</h2>
<p>Given the extent and severity consequences, the dearth of light pollution research in Africa is a surprising oversight. Africa still remains <a href="http://advances.sciencemag.org/content/2/6/e1600377">one of the least light polluted continents</a>, but this is rapidly changing with the expansion of lighting infrastructure, which it is closely tied with economic development. This is especially true for rural areas that may increasingly gain access to electrical grids and LED lights. </p>
<p>The recent <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5389131/">global atlas of artificial skyglow</a> did not make any ground-based measurements in Africa (nor South America or most of Asia), and serves as an example of how desperately a more robust and widespread understanding is required of its impacts.</p>
<p>Light pollution is a pernicious and increasingly understood global change driver. While many Africans may still see the Milky Way, the expansion of lighting infrastructure is imminent. As with other global change drivers, the continent is at an important juncture to ensure that its economic trajectory does not compromise its human and environmental health. How best to do so for light pollution still remains to be decided.</p><img src="https://counter.theconversation.com/content/113489/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Bernard Coetzee is affiliated with the Global Change Institute, WITS & Organization for Tropical Studies</span></em></p>There’s mounting evidence that increased lighting has a range of negative effects.Bernard Coetzee, Conservation scientist, University of the WitwatersrandLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1117972019-03-04T22:05:20Z2019-03-04T22:05:20ZHow much sleep do teenagers really need?<figure><img src="https://images.theconversation.com/files/259160/original/file-20190214-1736-gk4n1k.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Research shows that physical activity and avoiding screens before bed are both strategies to protect your teenagers' sleep.</span> <span class="attribution"><span class="source">(Unsplash/Andrea Tummons)</span>, <a class="license" href="http://creativecommons.org/licenses/by-sa/4.0/">CC BY-SA</a></span></figcaption></figure><p>Parents worry about whether their teenagers are getting enough sleep. Research studies suggest that teenagers are suffering an “<a href="https://www.cbc.ca/news/health/national-sleep-deprivation-teenagers-youth-learning-1.4929842">epidemic of sleep deprivation</a>” globally — one that will have <a href="http://dx.doi.org/10.1136/bmjpo-2018-000335">long-term health impacts</a>.</p>
<p>So how much sleep do adolescents really need and how can parents help them achieve it? </p>
<p>The first thing to understand is that teenagers are still growing and their brains are still developing — so they need more sleep than adults. </p>
<p>They also have different sleep-wake rhythms and release melatonin (a natural hormone to prepare for sleep) later, which means <a href="http://dx.doi.org/10.1016/j.smrv.2014.08.002">evening sleepiness takes longer to occur</a> and they have a tendency to go to bed later and to sleep later in the morning. Of course, they still have to rise early for school. </p>
<p>Peers also influence teenagers more than they influence younger children. <a href="http://dx.doi.org/10.1016/j.jadohealth.2015.12.011">Increased social demands</a> — in the form of online chat, social networking and web browsing — combine with greater academic pressures as children enter high school. At this age parents also tend to exert less control over teenagers’ bedtimes. </p>
<h2>Eight to 10 hours, regularly</h2>
<p>So what are optimal sleep times to support adolescent health? Experts reviewed 864 papers examining relationships between children’s sleep duration and health. They suggested that those between 13 and 18 years of age should <a href="http://dx.doi.org/10.5664/jcsm.6288">sleep eight to 10 hours per 24 hours on a regular basis</a> to promote optimal health. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/259167/original/file-20190214-1742-i5ll64.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/259167/original/file-20190214-1742-i5ll64.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/259167/original/file-20190214-1742-i5ll64.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/259167/original/file-20190214-1742-i5ll64.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/259167/original/file-20190214-1742-i5ll64.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/259167/original/file-20190214-1742-i5ll64.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/259167/original/file-20190214-1742-i5ll64.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Video games at night are a recipe for disrupted, short or low-quality sleep.</span>
<span class="attribution"><span class="source">(Shutterstock)</span></span>
</figcaption>
</figure>
<p>Unfortunately, worldwide studies show that in 53 per cent of cases <a href="https://doi.org/10.1016/j.sleep.2010.11.008">teenagers are getting less than eight hours of sleep per night on school days</a>. </p>
<p>A recent report indicated that only five per cent of adolescents in the United States meet recommendations for sleep, physical activity and screen time. Older adolescents were <a href="http://www.dx.doi.org/10.1001/jamapediatrics.2018.4847">less likely than younger adolescents</a> (14 years or less) to achieve the recommendations.</p>
<h2>Sex hormones and the stress response</h2>
<p>A lot of action takes place in teenage brains due to their developmental stage. During adolescence, there are major changes to thinking, emotions, behaviour and interpersonal relationships. </p>
<p>Changes to brain connections contribute to improvements in thinking abilities and changes in brain signalling. Shifts in balance between brain systems create a period where <a href="https://doi.org/10.1016/S2215-0366(14)00081-9">teens may take increased risks or engage in more reward seeking</a>. </p>
<p>Teenagers react a lot to stress and their stress-response systems are maturing. Sex hormones affect the neurotransmitters in their brains and increase their reactivity to stress. When we add inadequate sleep time to the picture there can be many implications. </p>
<p>A recent review identified increased risk for suicide, being overweight, high rates of injury, poor sustained attention and low school grades for teens sleeping less than eight hours. </p>
<p>Sleeping nine or more hours has, on the other hand, been associated with better life satisfaction, fewer health complaints and <a href="http://dx.doi.org/10.5664/jcsm.6288">better quality family relationships for teens</a>. </p>
<p>And a recent study in two high schools in the Seattle school district found that a later school start time led to an increase in teens’ average sleep duration, which was associated with <a href="https://www.scientificamerican.com/article/the-one-change-that-boosts-a-high-schools-academic-performance/">an increase in average grades and an improvement in school attendance</a>.</p>
<h2>Drugs, alcohol and high cholesterol</h2>
<p>Teen drivers sleeping six or less hours per night on weekdays and on weekends reported riskier driving, sensation seeking and greater drug and alcohol intake than those sleeping more than six hours. </p>
<p>Less than six hours per night of sleep time <a href="https://doi.org/10.1001/jamapediatrics.2013.1429">increased the teenagers’ risk for multiple vehicle crashes</a>, after taking into account exposure to driving. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/259156/original/file-20190214-1751-zfhj2e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/259156/original/file-20190214-1751-zfhj2e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/259156/original/file-20190214-1751-zfhj2e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/259156/original/file-20190214-1751-zfhj2e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/259156/original/file-20190214-1751-zfhj2e.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/259156/original/file-20190214-1751-zfhj2e.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/259156/original/file-20190214-1751-zfhj2e.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Lack of sleep may be associated with greater intake of drugs and alcohol.</span>
<span class="attribution"><span class="source">(Unsplash/Ant Rozetsky)</span>, <a class="license" href="http://creativecommons.org/licenses/by/4.0/">CC BY</a></span>
</figcaption>
</figure>
<p>There is also evidence that teens who sleep for more hours and have better quality sleep have a <a href="http://www.dx.doi.org/10.1542/peds.2017-4085">decreased risk for high blood pressure and cholesterol, insulin resistance and larger waist circumference</a> than teens with shorter sleep times and lower sleep quality. This is after taking into account other risk factors such as body fat, physical activity, television viewing and diet quality.</p>
<p>Finally, a recent report has highlighted links between teens’ <a href="https://www.psychologytoday.com/us/blog/sleep-newzzz/201901/what-modern-science-says-about-teen-sleep">sleep time, screen time and poorer mental health</a>.</p>
<h2>Park the electronic devices</h2>
<p>Parents can work with teens to set bedtimes. They should encourage the use of beds only for sleep and for relaxing before sleeping. </p>
<p>Using electronic technology before bed and during the night <a href="https://doi.org/10.1016/j.prrv.2018.10.005">increases the risk for shorter sleep time</a>. Research shows that physical activity and avoiding screens before bed are both strategies to promote earlier bedtimes and <a href="http://dx.doi.org/10.1016/j.smrv.2014.08.002">protect your teenagers’ sleep</a>. </p>
<p>Parents can support screen downtime before bedtime and through the night by parking phones at a charging pad away from bedrooms.</p>
<p>Parents can also help their teens achieve achieve the recommended eight hours or more of sleep by engaging in relaxing family activities with them in the evening.</p><img src="https://counter.theconversation.com/content/111797/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Wendy Hall does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>When teenagers sleep for less than eight hours a night, they are at increased risk of suicide, being overweight, high rates of injury, poor sustained attention and low school grades.Wendy Hall, Professor, School of Nursing, University of British ColumbiaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1025272018-10-05T11:44:55Z2018-10-05T11:44:55ZThe best foods to eat for a good night’s sleep<figure><img src="https://images.theconversation.com/files/239145/original/file-20181003-52691-1akb3jw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>Sleep has become widely recognised as playing <a href="https://theconversation.com/what-is-going-on-in-your-brain-when-you-sleep-39723">a really important role</a> in our overall health and wellness – alongside diet, stress management and exercise.</p>
<p>Recently, researchers have been learning more about how poor sleep influences our dietary choices, as well as how diet influences sleep quality. <a href="https://theconversation.com/how-a-lack-of-sleep-affects-your-brain-and-personality-66604">Not sleeping for long enough</a> or poor quality sleep are associated with increased food intake, a less healthy diet and <a href="https://www.ncbi.nlm.nih.gov/pubmed/24051052">weight gain</a>. <a href="https://www.ncbi.nlm.nih.gov/pubmed/30151232">Lack of sleep</a> also leads to increased snacking and overeating. And it causes us to want to eat foods <a href="https://www.ncbi.nlm.nih.gov/pubmed/30151232">high in fat and carbohydrates</a> – with increased chemical rewards to the brain when we do eat these foods. </p>
<p>Essentially, poor sleep <a href="https://theconversation.com/does-a-lack-of-sleep-really-make-children-overweight-heres-the-science-74478">drives your body to find high energy foods</a> to keep you awake which makes fighting the cravings for unhealthy foods very difficult to resist. But, on the other hand, when we have slept well our appetite hormones are at a normal level. We don’t crave unhealthy food so much – and we can make better choices about what to eat.</p>
<h2>The science of sleep</h2>
<p>All cultures around the world have traditions about which foods promote sleep. <a href="https://www.ncbi.nlm.nih.gov/pubmed/22652369">Foods</a> such as milk, chamomile, kiwi fruit and tart cherries, have all been said to work wonders for a good night’s sleep. Given how much the food we eat affects us on a day-to-day basis, it is not surprising that our diet plays such a big role in our quality of sleep. What we eat also has a big impact on our organ function, immune system, hormone production and brain function. </p>
<p>A really important hormone that controls our sleep patterns is <a href="https://www.ncbi.nlm.nih.gov/pubmed/30148726">melatonin</a>. Melatonin is produced in the brain and the amount of melatonin you produce and how efficiently our brain uses it is affected by our diet. One of the biggest influence on our melatonin levels appears to be our <a href="https://www.ncbi.nlm.nih.gov/pubmed/25407790">intake of a type of protein</a> called <a href="https://www.ncbi.nlm.nih.gov/pubmed/27934652">tryptophan</a>. Tryptophan is an essential amino acid – the building blocks of proteins. Essential amino acids are a group which our bodies cannot make, it can only be sourced through diet. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/239146/original/file-20181003-52672-bq1te4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/239146/original/file-20181003-52672-bq1te4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=399&fit=crop&dpr=1 600w, https://images.theconversation.com/files/239146/original/file-20181003-52672-bq1te4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=399&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/239146/original/file-20181003-52672-bq1te4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=399&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/239146/original/file-20181003-52672-bq1te4.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/239146/original/file-20181003-52672-bq1te4.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/239146/original/file-20181003-52672-bq1te4.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Eating and drinking for better sleep is about more than just avoiding caffeine.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p>Other nutrients that appear to be helpful for sleep include B vitamins and magnesium. This is because they help tryptophan to be <a href="https://www.ncbi.nlm.nih.gov/pubmed/30151232">more available in the body</a>. If your diet is lacking tryptophan, B vitamins or magnesium. It is very likely that your melatonin production and secretion will be affected and your <a href="https://www.ncbi.nlm.nih.gov/pubmed/22652369">sleep quality will be poorer</a>. </p>
<h2>Eat to sleep</h2>
<p>It stands to reason then that following overly restrictive diets or diets that put you at risk of nutrient deficiencies can really affect your sleep. But by increasing your intakes of foods rich in specific nutrients, it may well help to promote better sleep quality and duration. </p>
<p><a href="https://www.bbcgoodfood.com/howto/guide/how-get-good-nights-sleep">Dairy foods</a>, for example, can be great at helping you sleep. Not only is dairy an excellent source of tryptophan, but it also contains magnesium and B vitamins which help to promote the activity and availability of tryptophan. Nuts, like dairy, also contain all the nutrients known to promote increase melatonin production and support its release.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/239147/original/file-20181003-52660-q44ucv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/239147/original/file-20181003-52660-q44ucv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/239147/original/file-20181003-52660-q44ucv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/239147/original/file-20181003-52660-q44ucv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/239147/original/file-20181003-52660-q44ucv.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/239147/original/file-20181003-52660-q44ucv.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/239147/original/file-20181003-52660-q44ucv.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">‘To dreams made of milk’</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
</figcaption>
</figure>
<p><a href="http://time.com/5077404/fish-omega-3-sleep/">Fish is a great source of tryptophan</a> and B vitamins. Fish with bones, such as sardines, will also provide magnesium. Including fish in your diet regularly may help to promote healthy melatonin production when you need it. Pulses, beans and lentils also contain <a href="https://www.myfooddata.com/articles/high-tryptophan-foods.php">high amounts of tryptophan</a> and B vitamins. Adding some tofu or paneer to a vegetable stew or curry can also help to increase your likelihood of having a great night’s sleep. You could also add in some soya – which is another good source of tryptophan – to optimise your sleep potential. </p>
<p>And if you’re still struggling to sleep, it might be that you’d benefit from some meat. Meat of all kinds contains all the essential ingredients for a good night’s sleep. So if you can’t nod off at night, maybe think about adding some lean meat to your diet. </p>
<p>If you find yourself hungry before bed, for the ideal bed time snack, try a glass of semi-skimmed or skimmed milk, a small banana or a few nuts – all of which can really help to improve your sleep and your willpower the next day. It’s also worth pointing out that it takes <a href="http://www.bbc.co.uk/guides/z282p39">around an hour</a> for the tryptophan in foods to reach the brain, so don’t wait until just before bedtime to have your snack. And it’s also advisable to have a balanced diet that includes plenty of foods that are high in tryptophan throughout the day to optimise your chances of a good night’s sleep.</p><img src="https://counter.theconversation.com/content/102527/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Sophie Medlin does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A dietician recommends her top foods for a peaceful sleep.Sophie Medlin, Lecturer in Nutrition and Dietetics, King's College LondonLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/949522018-04-17T10:43:00Z2018-04-17T10:43:00ZLight at night can disrupt circadian rhythms in children – are there long-term risks?<figure><img src="https://images.theconversation.com/files/214832/original/file-20180413-540-1a6oi6i.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Could too much light in the evening affect children's sleep? Recent research suggests that it could.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/sweet-little-girl-asleep-her-bed-121356385?src=xNY9DJGugwRUYT9TbC-pow-1-30">Giideon/Shutterstock.com</a></span></figcaption></figure><p>A new scientific study shows that bright electric light exposure of preschool children in the evening suppresses <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835497/">melatonin production almost completely</a>, an important addition to the growing body of research in this area. Melatonin suppression is a marker of <a href="https://theconversation.com/a-dark-night-is-good-for-your-health-39161">disruption of our circadian rhythms</a>.</p>
<p>Ten kids, ages 3 to 5, were exposed to bright light (~1000 <a href="https://www.noao.edu/education/QLTkit/ACTIVITY_Documents/Safety/LightLevels_outdoor+indoor.pdf">lux</a> from a light box) for one hour before their habitual bedtime, about 8 p.m. Melatonin suppression (where the body stops producing this hormone) began within 10 minutes and continued for another hour after the bright light was turned off at 8 p.m., which was well into their usual sleep period. <a href="https://sleepfoundation.org/sleep-topics/melatonin-and-sleep">Melatonin is a hormone</a> that is important for healthy circadian rhythms and good sleep. </p>
<p>This could undoubtedly reduce <a href="https://www.washingtonpost.com/posteverything/wp/2015/10/27/we-dont-need-more-sleep-we-just-need-more-darkness/?utm_term=.cf74c9001415">sleep quality</a>, but may also cause other serious problems in the longer term.</p>
<h2>When seeing the light can be bad</h2>
<p>The new study built upon a <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4702443/">2015 study of children and adolescents</a> ages 9 to 16. It reported greater sensitivity to light exposure in the younger children compared to the older. That study used several different evening light levels in a laboratory setting that ranged from dim (~15 lux), to moderate (~150 lux, like a 60W incandescent lamp bulb), to bright (~500 lux) and showed a dose response; the dim light suppressed melatonin about 9 percent; moderate light about 26 percent; and bright light about 37 percent in the younger children, less so in the older kids. </p>
<p>Although the researchers used fluorescent room lights in their study, the authors make a point of suggesting that since smartphone use is <a href="http://pediatrics.aappublications.org/content/140/Supplement_2/S92.long">now common in children</a>, even preschoolers, the circadian effects from their use could be considerable because they expose children to bright light close to the face.</p>
<p>There are at least three reasons that too much light during the evening could matter to the health of children, and all are terrible: depression, suicide and cancer. </p>
<p>Excess evening electric light is part of what I call “light pollution,” which is defined as “pollution of night by electric light, whether inside at home or outside in the neighborhood and city.” It is a rapidly <a href="https://www.sciencealert.com/new-atlas-shows-extent-of-light-pollution-what-does-it-mean-for-our-health">growing problem in the modern world</a>.</p>
<h2>Light pollution at its most intimate – the smartphone</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/214836/original/file-20180413-584-1fn7q9b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/214836/original/file-20180413-584-1fn7q9b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/214836/original/file-20180413-584-1fn7q9b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/214836/original/file-20180413-584-1fn7q9b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/214836/original/file-20180413-584-1fn7q9b.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=502&fit=crop&dpr=1 754w, https://images.theconversation.com/files/214836/original/file-20180413-584-1fn7q9b.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=502&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/214836/original/file-20180413-584-1fn7q9b.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=502&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A girl with a smartphone at bedtime. Research suggests that the lights from smartphones could be disrupting circadian rhythms.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/little-girl-smartphone-lying-bed-bedtime-418297288?src=hbTypcNW1M8ZV3YMXFx6nQ-1-17">Halfpoint/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>A common response to <a href="https://caps.ucsc.edu/resources/depression.html">severe depression is suicide</a>. Well over 40,000 Americans <a href="https://afsp.org/about-suicide/suicide-statistics/">die by suicide each year</a>, more than from <a href="https://www.asirt.org/safe-travel/road-safety-facts/">automobile crashes</a> and close to the <a href="https://www.cancer.org/cancer/colon-rectal-cancer/about/key-statistics.html">number of deaths from colon cancer</a>. In addition, nearly a half million are hospitalized for self-harm, many of whom were injured in their failed attempt at suicide. </p>
<p>This is especially tragic when it happens to the very young.</p>
<p><a href="http://www.jeantwenge.com">Jean Twenge</a> studies mental health and social adjustment in young people, particularly those born after 1995. Her research has focused on smartphones, as described in several informative and provocative recent <a href="https://theconversation.com/with-teen-mental-health-deteriorating-over-five-years-theres-a-likely-culprit-86996">articles published by The Conversation</a>. The articles are based on her own studies published in peer-reviewed scientific journals.</p>
<p>Twenge has found links between “new media” screen time (e.g., smartphones) and risk of depression and suicide in teenagers based on <a href="http://www.monitoringthefuture.org/">two large samples</a> of <a href="https://www.cdc.gov/healthyyouth/data/yrbs/index.htm">young people</a> in the U.S.</p>
<p>Twenge proposes as possible causes for her findings social isolation, sleep deprivation, or both. In <a href="http://www.sleep-journal.com/article/S1389-9457(17)30350-7/fulltext">another recent analysis</a>, Twenge focused on sleep duration and concluded that “increased new media screen time may be involved in the recent increases (from 35 percent to 41 percent and from 37 percent to 43 percent) in short sleep among adolescents.”</p>
<p>Circadian disruption could be the underlying culprit. Bright light in the evening <a href="https://theconversation.com/a-dark-night-is-good-for-your-health-39161">delays transition to nighttime physiology,</a> which should begin at dusk. It thereby <a href="http://www.pnas.org/content/112/4/1232.long">degrades sleep quality</a>. </p>
<p>There is also evidence that circadian disruption can cause depression and other <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4490783/">adverse mood changes</a>. </p>
<h2>Light pollution and cancer in children</h2>
<p>In 2012, I was invited to speak at a conference on causes of childhood cancer sponsored by the charity Children with Leukaemia UK. My charge was to discuss possible mechanisms by which excessive exposure to electric light at night might increase a child’s risk of cancer. I wrote a scientific paper on the subject that was <a href="http://cebp.aacrjournals.org/content/21/5/701.long">published</a> just before the conference. </p>
<p>This charity has a tragic origin story. The son of a very wealthy man in Britain, Eddie O’Gorman, died of leukemia in 1987 at age 14. His name was Paul. Before his death, Paul asked his parents to help other children with cancer. With the determined assistance of his sister Jean, his parents, Eddie and Marion, began fundraising. </p>
<p>Jean then died of breast cancer at age 29, only nine months after Paul’s death. Princess Diana heard of the tragedy, and offered to charter the charity in 1988. She remained involved with the activities of the charity until her own death in 1997. </p>
<p>The charity was renamed <a href="https://www.childrenwithcancer.org.uk">Children with Cancer UK</a> a few years ago.</p>
<p>The basis for concern about cancer in children is the fact that ill-timed electric light can disrupt circadian rhythms, and circadian disruption has been <a href="http://rstb.royalsocietypublishing.org/content/370/1667/20140120.long">implicated in cancers in adults</a>, although few if any studies have directly examined cancer in children. The evidence for an effect in children is indirect, but the issue is critical.</p>
<p>Leukemia is the most <a href="https://www.cancer.org/cancer/cancer-in-children/types-of-childhood-cancers.html">common childhood cancer</a>. It is a disease of uninhibited growth of white cells in the blood. These white cells are generated by stem cells, which when behaving normally produce just enough white cells for a healthy immune system to <a href="https://stemcells.nih.gov/info/2001report/chapter6.htm">function as it should</a>. When the stem cells go haywire, the result is leukemia. Recent studies have shown that the proliferation of <a href="http://www.cell.com/cell/fulltext/S0092-8674(16)30271-9">stem cells is under circadian control</a>. Thus, too much light at night could destabilize stem cell growth. </p>
<p>Children with Cancer UK will host its next scientific meeting in <a href="http://www.childhoodcancer2018.org.uk/programme.asp">Westminster, London, in September of this year</a>. I will focus on these new results of evening light-induced melatonin suppression in children for my presentation.</p>
<h2>Too much light at night early in life, even in utero</h2>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/214882/original/file-20180415-566-2ln76p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/214882/original/file-20180415-566-2ln76p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=401&fit=crop&dpr=1 600w, https://images.theconversation.com/files/214882/original/file-20180415-566-2ln76p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=401&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/214882/original/file-20180415-566-2ln76p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=401&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/214882/original/file-20180415-566-2ln76p.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=504&fit=crop&dpr=1 754w, https://images.theconversation.com/files/214882/original/file-20180415-566-2ln76p.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=504&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/214882/original/file-20180415-566-2ln76p.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=504&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Too much light even in utero could be dangerous, some research suggests.</span>
<span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/upset-pregnant-woman-sitting-computer-desk-369968993?src=StTy2Yj8LPY4BD9INLTBDg-1-2">Andrey_Popov/Shutterstock.com</a></span>
</figcaption>
</figure>
<p>Early life, including in utero, is a <a href="http://www.oxfordreference.com/view/10.1093/oi/authority.20110803095447459">particularly vulnerable period</a>. The establishment of circadian rhythms begins early in gestation but is <a href="http://pediatrics.aappublications.org/content/112/2/373.long">not fully established at birth</a>, as any new parent becomes acutely aware. </p>
<p>For these reasons, research attention should be directed to the effects of ill-timed electric lighting on pregnant women, such as alterations in hormone production that could then affect fetal development. Scientists who study this also need to focus on developmental effects in young children and adolescents. </p>
<p>For example, it is unknown the extent to which night lights in the nursery alter the consolidation of circadian rhythmicity in infants, and whether toddlers exposed to highly lit evenings at home are at risk. I believe this is an urgent issue because adverse effects could launch a child on a lifetime trajectory of ill-health and early death.</p><img src="https://counter.theconversation.com/content/94952/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Richard G. "Bugs" Stevens does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A recent study suggested that a chemical responsible for getting the body ready for sleep was suppressed in children by too much evening light. A circadian rhythm expert explains the dangers.Richard G. "Bugs" Stevens, Professor, School of Medicine, University of ConnecticutLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/880072017-12-26T19:55:25Z2017-12-26T19:55:25ZWhy getting enough sleep should be on your list of New Year’s resolutions<figure><img src="https://images.theconversation.com/files/199183/original/file-20171214-27588-qw0ooc.jpg?ixlib=rb-1.1.0&rect=53%2C597%2C2941%2C1396&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Getting enough sleep can help our memory, waistline and our performance at work.</span> <span class="attribution"><a class="source" href="https://unsplash.com/photos/m0l5J8Lqnzo">David Mao</a></span></figcaption></figure><p>If you need an alarm to get up in the morning, you’re probably not getting enough sleep. </p>
<p>More than <a href="https://www.ncbi.nlm.nih.gov/pubmed/28346149">40% of Australians</a> get too little sleep to feel rested and able to function at their best. The average amount for an adult is around seven hours, while only 8% are lucky enough to get more than nine hours. Some 12% of Australians get less than 5.5 hours, and three-quarters of those struggle to get through their day. </p>
<p>These holidays, ditch the alarm clock and make getting enough sleep one of your New Year’s resolutions. Your memory, waistline and even your employer may thank you for it. </p>
<h2>Why getting enough sleep should be a priority</h2>
<p>Our brains use sleep time to sort through our experiences. We “clean up” and get rid of information connections we don’t need from the day just gone. Without adequate sleep, we may not be making enough space for new learning and memories. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/why-our-brain-needs-sleep-and-what-happens-if-we-dont-get-enough-of-it-83145">Why our brain needs sleep, and what happens if we don’t get enough of it</a>
</strong>
</em>
</p>
<hr>
<p>Getting enough sleep also ensures we are safe to drive on the roads and less likely to make costly mistakes at work and home. <a href="https://www.nature.com/articles/40775">Being awake for longer than 17 hours</a> impairs your ability to think clearly as much as having a blood alcohol concentration above 0.05. After 24 hours awake, your ability to perform cognitive tasks is as poor as if you had a blood alcohol concentration of 0.10. </p>
<p>Last year’s <a href="https://www.ncbi.nlm.nih.gov/pubmed/28346149">Australian sleep survey</a> found 29% of Australian workers reported making errors at work in the previous three months specifically because they hadn’t got enough sleep. One in five respondents reported having nodded off while driving. </p>
<p>Getting enough sleep may also be helpful for <a href="http://www.news.com.au/lifestyle/fitness/weight-loss/sleep-the-most-overlooked-cause-of-belly-fat/news-story/e218a48550ae0b63535f459fc57719b6">managing our food intake</a>. When people are only allowed to sleep for short periods of time, they are more likely to choose to snack food, <a href="http://www.sciencedirect.com/science/article/pii/S000145751100265X">particularly sweet snacks</a>. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/199613/original/file-20171218-17884-t47oe0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199613/original/file-20171218-17884-t47oe0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199613/original/file-20171218-17884-t47oe0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199613/original/file-20171218-17884-t47oe0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199613/original/file-20171218-17884-t47oe0.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199613/original/file-20171218-17884-t47oe0.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199613/original/file-20171218-17884-t47oe0.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">It’s natural to reach for sweet snacks when we don’t get enough sleep.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/_yB6kWwSDAs">Sarah Swinton</a></span>
</figcaption>
</figure>
<p>The body’s response to eating food changes when sleep is restricted; as little as one week of restricted sleep <a href="http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0041218">is associated with</a> glucose (sugar) levels approaching pre-diabetic levels. </p>
<p>The benefit is not limited to individual well-being. Australian workers who feel they get inadequate sleep are more likely to take a sick day than those <a href="http://www.sleephealthjournal.org/article/S2352-7218(17)30128-6/abstract">who feel they get enough</a>. </p>
<h2>So, how much sleep do we need?</h2>
<p>The <a href="https://sleepfoundation.org/press-release/national-sleep-foundation-recommends-new-sleep-times">American Sleep Foundation recommends</a> adults aged between 18 and 64 get between seven and nine hours of sleep a night, while older adults should aim for seven to eight hours. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/explainer-how-much-sleep-do-we-need-29759">Explainer: how much sleep do we need?</a>
</strong>
</em>
</p>
<hr>
<p>Your ideal sleep duration will be unique to you and fall somewhere within the recommended range. To find out how much sleep <em>you</em> need, try a week-long experiment and modified sleep regime. Think of it as your holiday homework:</p>
<ul>
<li><p>Cut back on how much you are doing during the week, particularly in the evening, to give yourself time to wind down</p></li>
<li><p>Put away the technology. A tech ban in the bedroom might be the best start </p></li>
<li><p>Create a dark sleeping space </p></li>
<li><p>Get rid of the alarm clock so your body has the chance to tell you how much sleep you need</p></li>
<li><p>Keep a week-long diary of your sleep times and daytime energy levels to get a feel for how much sleep feels good the next day. </p></li>
</ul>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/199624/original/file-20171218-17857-u9140r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199624/original/file-20171218-17857-u9140r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199624/original/file-20171218-17857-u9140r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199624/original/file-20171218-17857-u9140r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199624/original/file-20171218-17857-u9140r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199624/original/file-20171218-17857-u9140r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199624/original/file-20171218-17857-u9140r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Over a week, see how much sleep you actually need to feel fresh.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/WukitUSJRgY">Warren Wong</a></span>
</figcaption>
</figure>
<p>You might find you need to sleep longer than usual for the first couple of nights. But remember, this is an exercise to work out how sleep can help you feel good rather than a test to see how much sleep you “must” or “can” get as this pressure may not help with sleeping well.</p>
<p>You might feel a little groggy the next morning which is normal, but you should wake up – and get up – when you feel well-rested. </p>
<hr>
<p><em><strong>Further reading – <a href="https://theconversation.com/health-check-how-can-i-make-it-easier-to-wake-up-in-the-morning-82081">Health Check: how can I make it easier to wake up in the morning</a></strong></em></p>
<hr>
<p>By seeing where you sit on the sleep spectrum, you can work out the bed and wake times that best suit your needs.</p>
<h2>How to get more sleep</h2>
<p>Here are some starting points to make sleep more of a priority. </p>
<p><strong>1) Reduce your exposure to bright lights in the evening</strong></p>
<p>Allowing your body to naturally respond to the light and dark cycle each day can lead to earlier bed times. </p>
<p>Ditching distractors that delay our bedtimes <a href="http://www.cell.com/current-biology/fulltext/S0960-9822(16)31522-6">can help shift the increase</a> in the hormone melatonin, which makes us sleepy, to earlier in the evening. </p>
<p>As little as one weekend of camping away from electrical lighting, including blue light in our devices, can help us become early risers.</p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/199614/original/file-20171218-17878-1idg2q6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/199614/original/file-20171218-17878-1idg2q6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/199614/original/file-20171218-17878-1idg2q6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/199614/original/file-20171218-17878-1idg2q6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/199614/original/file-20171218-17878-1idg2q6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/199614/original/file-20171218-17878-1idg2q6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/199614/original/file-20171218-17878-1idg2q6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Camping is a good way to reset the body clock.</span>
<span class="attribution"><a class="source" href="https://unsplash.com/photos/eDgUyGu93Yw">Patrick Hendry</a></span>
</figcaption>
</figure>
<p>If there’s no time for camping this Christmas, try a “camp at home” approach by reducing your light exposure throughout the house at night; dim and fewer lights in the evening is ideal.</p>
<p><strong>2) Establish a routine</strong> </p>
<p>While some find falling asleep a breeze, this can be a slow process for many. Consistent activities – such as brushing your teeth, reading a book – at a regular time each evening can help your body recognise and prepare for heading to bed. </p>
<hr>
<p>
<em>
<strong>
Read more:
<a href="https://theconversation.com/health-check-how-to-soothe-yourself-to-sleep-83154">Health Check: how to soothe yourself to sleep</a>
</strong>
</em>
</p>
<hr>
<p>Make sure this time is in addition to the time you set aside for sleep, so you have enough time to wind down before bed.</p>
<p>This routine extends to consistent wake times. A regular bed and wake time schedule should be complimentary.</p>
<p><strong>3) Talk to your doctor about your sleep</strong></p>
<p>If you’re told you snore, or you never feel refreshed even after what seems to be a long sleep, talk to your GP about whether you might have an underlying disorder that makes getting enough sleep harder. </p>
<p>According to <a href="https://www.ncbi.nlm.nih.gov/pubmed/28346149">last year’s national sleep survey</a>, 8% of Australians have diagnosed <a href="https://theconversation.com/health-check-heres-what-you-need-to-know-about-sleep-apnoea-26402">sleep apnoea</a>, 18% have <a href="https://theconversation.com/explainer-what-is-restless-leg-syndrome-56140">restless leg syndrome</a> and 20% have <a href="https://theconversation.com/explainer-what-is-insomnia-and-what-can-you-do-about-it-36365">insomnia</a>. Getting help for these conditions will impact your physical and mental health. </p>
<p>While time spent sleeping may feel akin to “doing nothing” for your health, the benefits of regular, refreshing sleep for your brain and body mean that it should be on your New Year’s resolution list right next to healthy eating and exercise.</p><img src="https://counter.theconversation.com/content/88007/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Amy Reynolds has received funding from the Freemason's Foundation (Trevor Prescott Memorial Scholarship) and the Australasian Sleep Association (Helen Bearpark Memorial Scholarship and Rob Pierce Grant in Aide). She is a current member (and committee member) of the Australasian Sleep Association, and is a member of the Sleep Health Foundation. She has a non-financial research relationship with microbial genomics company uBiome. </span></em></p><p class="fine-print"><em><span>Doug McEvoy receives funding from the National Health and Medical Research Council and Philips Respironics</span></em></p><p class="fine-print"><em><span>Robert Adams receives funding from the National Health and Medical Research Council, The Hospital Research Foundation and the ResMed Foundation. </span></em></p><p class="fine-print"><em><span>Sally Ferguson receives funding from the Australia Research Council through her institution. She has a non-financial research relationship with microbial genomics company uBiome. </span></em></p>If you need an alarm to get up in the morning, you’re probably not getting enough sleep.Amy Reynolds, Lecturer in Psychology, CQUniversity AustraliaDoug McEvoy, Chief investigator, National Centre for Sleep Health Services Research, Flinders UniversityRobert Adams, Professor of Medicine, University of AdelaideSally Ferguson, Research professor, CQUniversity AustraliaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/851572017-10-19T13:51:20Z2017-10-19T13:51:20ZTeens are sleeping less – but there’s a surprisingly easy fix<figure><img src="https://images.theconversation.com/files/189309/original/file-20171009-25792-iceli6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-vector/vector-illustration-bored-woman-lying-alone-721523575?src=gmb2eysLqZDfwHUIH_X_RA-1-8">jesadaphorn</a></span></figcaption></figure><p>Something is stealing teens’ sleep.</p>
<p><a href="http://www.sleep-journal.com/article/S1389-9457(17)30350-7/fulltext">In a newly released analysis of two large national surveys</a>, my co-authors and I found that the number of U.S. teens who reported sleeping less than seven hours a night jumped 22 percent between 2012 and 2015. Sleep experts agree that <a href="https://sleepfoundation.org/ask-the-expert/sleep-and-teens-biology-and-behavior">teens need at least nine hours of sleep a night</a>. But by 2015, 43 percent of teens reported sleeping less than seven hours a night on most nights – meaning almost half of U.S. teens are significantly sleep-deprived.</p>
<p>What could have raised sleep deprivation among teens to such unprecedented levels? Some factors are easy to rule out. For example, we found that the amount of time teens spent working, doing homework and participating in extracurricular activities held steady during those years. </p>
<p>But there was one large change in teens’ lives between 2012 and 2015: More owned smartphones.</p>
<h2>It starts as an alarm clock…</h2>
<p>Today’s teens – <a href="http://www.simonandschuster.com/books/iGen/Jean-M-Twenge/9781501151989">whom I call “iGen”</a> – are the first generation to spend their entire adolescence with smartphones. </p>
<p>In our analyses, we found that teens who spent more time online and on social media were more likely to sleep less. Time spent watching television had a much weaker link to fewer hours of sleep, and teens who spent more time with their friends in person or on sports or exercise actually slept more. </p>
<p>Time spent online, however, was the one teen activity that both increased during the 2010s and was linked to shorter sleep, making it the most likely cause of teen sleep deprivation. Seventeen- and 18-year-olds – <a href="http://onlinelibrary.wiley.com/doi/10.1111/cdev.12930/full">who spend more time online than younger teens</a> – were also the most sleep-deprived: The majority, 51 percent, slept less than seven hours on most nights by 2015.</p>
<p>The link between time spent online and less sleep was considerable. Spending five or more hours a day online (vs. one hour) upped the risk of sleeping too little more than 50 percent. Spending three hours a day (vs. one hour) upped the risk nearly 20 percent. </p>
<p>Smartphones – <a href="http://www.pewresearch.org/fact-tank/2017/01/12/evolution-of-technology/">which the majority of Americans owned by the end of 2012</a> – allow mobile and instant internet access. It’s difficult to prove what causes what in an analysis like this, but it seems much more likely that teens’ increased smartphone use between 2012 and 2015 led to less sleep than less sleep leading to more smartphone use. </p>
<p>Why might smartphones cause teens to sleep less? Unlike other electronic devices such as TVs and desktop computers, smartphones (and tablets) are easily carried into the bedroom and held by hand in bed. </p>
<p>Most of the students I interviewed for my book “iGen” told me they kept their phones within reach as they slept, in part, because they all used it as their alarm clock. </p>
<p>Many also told me that their smartphones were the last thing they looked at before they went to sleep at night. That’s a problem, because answering texts and scrolling through social media is mentally and emotionally stimulating, which <a href="http://www.sciencedirect.com/science/article/pii/S0091743516000025">leads to disturbed sleep</a>. Others told me that they also regularly reached for their phones, often just out of habit, when they woke up in the middle of the night. </p>
<p>There’s a physiological response as well: The blue light emitted by smartphones and tablets simulates daylight, <a href="http://www.pnas.org/content/112/4/1232">inhibiting the brain’s production of melatonin</a>, the hormone that helps us fall asleep and stay asleep.</p>
<p>And that’s if teens try to go to sleep at all. </p>
<p><a href="https://theconversation.com/awake-online-and-sleep-deprived-the-rise-of-the-teenage-vamper-34853">A 2014 study</a> found that 80 percent of teens admitted to using their phones when they were supposed to be sleeping – a practice some call “vamping.” Some said they stayed up most of the night when their parents thought they were asleep. </p>
<h2>Some simple limits</h2>
<p>Sleep deprivation can have serious consequences for teens. </p>
<p>Those who don’t sleep enough <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3707878/">perform more poorly in school</a> and are <a href="http://pediatrics.aappublications.org/content/134/3/e921">at greater risk of developing obesity</a>. Sleep deprivation is also linked to mental health issues <a href="http://www.sciencedirect.com/science/article/pii/S0165178108004113">including depression and anxiety</a> among both teens and adults. </p>
<p>When conducting research for my book, I found that iGen teens are more likely to be <a href="http://pediatrics.aappublications.org/content/early/2016/11/10/peds.2016-1878">depressed</a> and anxious than previous generations. If smartphones cause teens to sleep less, and less sleep leads to depression, sleep deprivation might explain why teen depression increased sharply after 2012 – exactly when smartphones became common, and exactly when sleep deprivation began to increase among teens.</p>
<p>What can be done? <a href="http://pediatrics.aappublications.org/content/134/3/642">Later start times at high schools have significant positive impacts</a> on teen sleep, but school start times aren’t something parents and teens can control. </p>
<p>In contrast, limiting smartphone use before bed is a strategy that can be immediately implemented (ideally for the whole family, adults included). A “no phones in the bedroom after bedtime” <a href="https://theconversation.com/wired-and-tired-why-parents-should-take-technology-out-of-their-kids-bedroom-50406">rule</a> can work. If your family uses phones as alarm clocks, buy inexpensive alarm clocks. Put an app on phones that shuts them down during certain hours, or leave phones and tablets in another room overnight. Suggest reading a book, taking a bath or writing in a journal in the hour before bed.</p>
<p>Your teens will probably get some more sleep – and they might find themselves healthier and happier as well.</p><img src="https://counter.theconversation.com/content/85157/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Jean Twenge has received funding from the Russell Sage Foundation and the National Institutes of Health.</span></em></p>The amount of time teens have spent working and participating in extracurricular activities has held steady in recent years. There has, however, been one big change in their lives: smartphones.Jean Twenge, Professor of Psychology, San Diego State UniversityLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/824842017-09-13T02:37:05Z2017-09-13T02:37:05ZSleepy teenage brains need school to start later in the morning<figure><img src="https://images.theconversation.com/files/185684/original/file-20170912-19567-vrlesw.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Their hormones mean they still need zzz's even when they're already supposed to be in homeroom.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/wake-asleep-girl-stopping-alarm-clock-315886649">Antonio Guillem/Shutterstock.com</a></span></figcaption></figure><p>Millions of high schoolers are fighting with their alarm clocks as they start another academic year. As they struggle to get up early, parents battle to get them out of bed and off to school – a stressful way for everyone involved to start the day.</p>
<p>Are teenagers just being lazy when they have to be dragged out of bed in the morning?</p>
<p>According to the National Sleep Foundation, the <a href="https://dx.doi.org/10.1016/j.sleh.2014.12.010">sleep requirement for teenagers</a> is eight to 10 hours per night. Yet, the average teen in America obtains <a href="https://doi.org/10.1111/josh.12388">less than seven hours</a> of sleep on a school night. A big part of the reason why is that nearly half of all high schools in the U.S. start before 8:00 a.m., and <a href="https://www.cdc.gov/mmWR/pdf/wk/mm6430.pdf">over 85 percent are starting before 8:30 a.m.</a></p>
<p><iframe id="r0RTS" class="tc-infographic-datawrapper" src="https://datawrapper.dwcdn.net/r0RTS/2/" height="550px" width="100%" style="border: none" frameborder="0"></iframe></p>
<p>Sleep deprivation in teenagers as a result of early school hours has been <a href="https://www.cdc.gov/media/subtopic/matte/pdf/2011/teen_sleep.pdf">a topic of concern</a> and <a href="http://www.nytimes.com/2016/03/29/upshot/schools-are-slow-to-learn-that-sleep-deprivation-hits-teenagers-hardest.html">debate</a> for over two decades. Districts <a href="https://www.bostonglobe.com/metro/2016/03/29/suburban-boston-superintendents-group-favors-later-high-school-start-time/8BdOOrfP03XP0CpuLxbchI/story.html">across the country</a> have wrestled with the question of whether their local high school <a href="http://sheu.org.uk/x/eh332ss.pdf">should start later</a>.</p>
<p>I’ve been studying the <a href="http://hdl.handle.net/11299/3902">effects of later high school start times</a> for 20 years. My research shows that teens’ inability to get out of bed before 8 a.m. has serious consequences for learning and health outcomes. Essentially, the adolescent inability to be fully awake before then is <a href="https://doi.org/10.1111/j.1467-8624.1998.tb06149.x">a matter of human biology</a> – not a matter of attitude.</p>
<h2>Gotta get to class</h2>
<p>In the earliest days of American education, students of all ages attended a single school with a single starting time. In fact, as late as 1910, half of all children <a href="https://books.google.com/books/about/Community_and_class_in_American_educatio.html?id=B3-cAAAAMAAJ">attended one-room schools</a>. As <a href="https://books.google.com/books?id=6JoOAQAAMAAJ">schools and districts grew in size</a> in the early 1930s, staggered starting times became increasingly common. The oldest students in cities and large towns were given the earliest starting time, with the thought that high school was <a href="http://dx.doi.org/10.1162/002219599551868">preparation for the adult world of work</a>. Many rural schools continue to have only a single starting time, as buses pick up students of all ages on a single run. </p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=254&fit=crop&dpr=1 600w, https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=254&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=254&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=319&fit=crop&dpr=1 754w, https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=319&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/185393/original/file-20170911-9457-30xndu.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=319&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Start times can be more about district logistics than what’s best for high school students.</span>
<span class="attribution"><a class="source" href="https://www.flickr.com/photos/dhendrix/6906652333/">dhendrix73</a>, <a class="license" href="http://creativecommons.org/licenses/by-nd/4.0/">CC BY-ND</a></span>
</figcaption>
</figure>
<p>Since 2014, however, major national health organizations have taken a policy stand to support the implementation of later starting times for high school. The <a href="https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/let-them-sleep-aap-recommends-delaying-start-times-of-middle-and-high-schools-to-combat-teen-sleep-deprivation.aspx">American Academy of Pediatrics</a>, the <a href="http://www.ama-assn.org/ama/pub/news/news/2016/2016-06-14-ama-supports-delayed-school-times.page">American Medical Association</a>, the <a href="http://www.cdc.gov/media/releases/2015/p0806-school-sleep.html">Centers for Disease Control and Prevention</a> and most recently the <a href="http://dx.doi.org/10.5664/jcsm.6558">American Academy of Sleep Medicine</a> have all come out with <a href="http://www.startschoollater.net/position-statements.html">statements that recommend</a> high schools start at 8:30 a.m. or later.</p>
<p>A <a href="https://www.nytimes.com/2017/05/22/well/family/the-science-of-adolescent-sleep.html">national conference</a> held in April 2017 showcased the research linking teen sleep, later high school start times and significantly positive academic, health and safety outcomes.</p>
<p>Since the experts have started to weigh in, <a href="http://www.startschoollater.net/success-stories.html">hundreds of schools</a> in 45 states across the country have been able to make the shift. In fact, the state of California is currently <a href="http://leginfo.legislature.ca.gov/faces/billNavClient.xhtml?bill_id=201720180SB328">considering a bill</a> that would require all middle and high schools in the state to start school no earlier than 8:30 a.m. by the year 2020. Legislators are starting to consider teens’ sleep deficit as an issue of public health. </p>
<h2>Why does it matter if teens are tired?</h2>
<p>Studies on <a href="https://doi.org/10.1093/sleep/11.1.100">sleep in general</a> and <a href="https://doi.org/10.1111/mbe.12059">sleep in teens in particular</a> have revealed the <a href="https://doi.org/10.1016/j.ypmed.2011.06.020">serious negative consequences</a> of lack of adequate sleep. Teens who are sleep-deprived – defined as obtaining less than eight hours per night – are significantly <a href="http://dx.doi.org/10.15585/mmwr.mm6513a1">more likely to use cigarettes, drugs and alcohol</a>. </p>
<p>The <a href="https://doi.org/10.2147/IJGM.S11557">incidence of depression among teens</a> significantly rises with less than nine hours of sleep. Around half of teens who sleep four hours or less per night <a href="https://doi.org/10.1007/s10964-014-0170-3">feel sad and hopeless</a>, compared to just 19 percent of their well-rested peers. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603528/">Teen car crashes</a>, the <a href="https://www.cdc.gov/nchs/data/databriefs/db37.pdf">primary cause of death for teenagers</a>, significantly decline when teens obtain more than eight hours of sleep per night.</p>
<p>A newly released report by the RAND Corporation <a href="https://www.rand.org/pubs/research_reports/RR2109.html">quantified the “costs”</a> to our society of early high school start times in terms of lost income due to impaired academic and professional performance and car crashes for teens who are sleep-deprived. The report projected annual gains to the U.S. economy of nearly US$9.4 billion over 15 years if high school starts nationwide at 8:30 a.m.</p>
<h2>Biology of the teenage brain</h2>
<p>So what exactly is going on with teenagers and their sleep patterns? Can’t they just go to bed earlier?</p>
<p>Research informing expert recommendations began in the 1980s, with <a href="http://www.sleepforscience.org/stuff/contentmgr/files/94a9f6f63ae18bc30f3d2d0b005e42fa/pdf/carskadon_pediatrician1990.pdf">studies that cast new light</a> on what goes on in the teenage brain.</p>
<p>Our brains release the sleep hormone melatonin as a signal that allows us to fall and stay asleep. In preteens and adults, the secretion of melatonin is flexible and variable, and sleep timing preferences are genetically based. But the timing is different in teens, as it is related to puberty.</p>
<p>For virtually all adolescents, the <a href="https://doi.org/10.1016/j.pcl.2011.03.003">secretion of melatonin</a> doesn’t begin until about 10:45 p.m. and continues until about 8 a.m. This means that most teenagers are <a href="https://doi.org/10.1016/j.sleep.2006.12.002">unable to fall asleep</a> until <a href="https://doi.org/10.1093/sleep/21.8.871">melatonin secretion begins</a>, and it’s hard to wake up until the melatonin secretion stops. This fixed pattern of melatonin secretion in teens changes back to an individual’s genetically preferred sleep/wake timing once puberty is over.</p>
<p>The <a href="https://doi.org/10.1093/sleep/28.11.1446">unique sleep/wake pattern of teens</a> is beyond their control. Just expecting teens to minimize distractions and <a href="http://www.sleepforscience.org/stuff/contentmgr/files/20d6c68507ee07477d59ce0d1de97b15/pdf/phi_delta_kappan.pdf">go to bed earlier</a> is not a solution. </p>
<p>I have <a href="http://hdl.handle.net/11299/139295">interviewed hundreds of teens</a> who all said that if they went to bed early, they were unable to fall asleep – they just stared at the ceiling until sleep set in around 11 p.m.</p>
<p>Researchers <a href="https://doi.org/10.1002/dev.20605">around the world</a> <a href="https://doi.org/10.1093/sleep/11.4.378">corroborated these findings</a>. At the <a href="https://doi.org/10.1093/sleep/32.12.1602">onset of puberty</a>, nearly all humans (and most mammals) <a href="https://doi.org/10.1111/j.1467-8624.2004.00655.x">experience</a> a <a href="https://www.ncbi.nlm.nih.gov/pubmed/2315238">delay of sleep timing in the brain</a>.</p>
<p>Medical researchers have also found that sleep patterns of <a href="https://doi.org/10.1016/j.sleep.2008.07.016">younger children</a> enable them to rise early and <a href="https://doi.org/10.1016/j.sleh.2015.02.004">be ready for learning</a> much earlier than adolescents. </p>
<p>In other words, the biology of the teenage brain is in <a href="https://doi.org/10.1016/j.pcl.2011.03.003">direct conflict with school schedules</a>, which typically require adolescents to begin school earlier and younger children to start later.</p>
<figure class="align-center zoomable">
<a href="https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/185685/original/file-20170912-19534-8jtbu6.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Well-rested students who are awake when they hit campus do better in a variety of ways.</span>
<span class="attribution"><a class="source" href="http://www.apimages.com/metadata/Index/First-Day-of-School-NYC/ae5ac2c5f6c74e7199b58baf00199a2a/1/0">AP Photo/Mark Lennihan</a></span>
</figcaption>
</figure>
<h2>What happens with a later start?</h2>
<p>Results from schools that switched to a late start time are encouraging. The students <a href="https://doi.org/10.1111/josh.12388">do in fact get more sleep</a>, tending to go to bed at the same time but getting to rise a bit later in the morning. Not only does the teens’ use of drugs, cigarettes and alcohol decline; <a href="https://doi.org/10.1111/josh.12388">their academic performance</a> <a href="http://conservancy.umn.edu/handle/11299/162769">improves</a> significantly with later start time.</p>
<p>Most recently, car crash rates for <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2603528/">teen drivers have declined</a> with the implementation of a later high school start time. In fact, the crash rate for <a href="http://hdl.handle.net/11299/162769">teens in Jackson Hole, Wyoming</a> in 2013 dropped by 70 percent in the first year the district adopted a later high school start.</p>
<p>Plenty of schools and districts across the U.S. are <a href="http://www.mlive.com/news/muskegon/index.ssf/2011/12/why_do_high_school_kids_go_to.html">resisting delaying the starting time</a> of their high schools <a href="http://www.csun.edu/%7Eamg69708/prickly_politics.pdf">for many reasons</a>.</p>
<p>Issues such as changing transportation routes and altering the timing for other grade levels often head the <a href="https://doi.org/10.3102/0013189X11402323">list of factors</a> making the later start difficult. Schools also must consider the effects on <a href="http://www.aasa.org/content.aspx?id=36418">after-school sports and activities</a>.</p>
<p>Such concerns are valid. However, <a href="http://www.aasa.org/content.aspx?id=36907">schools that have delayed start times</a> found creative solutions. For example, schools adopted <a href="http://www.aasa.org/content.aspx?id=36418">mixed-age busing</a>, coordinated with public transport systems, and expanded after-school child care.</p>
<p>There’s clearly more that needs to be addressed in making the change. But, in the end, communities that value maximum development for all of its children should also be willing to grapple with solutions. </p>
<p>After all, our children’s ability to move into healthy adult lives tomorrow depends on what we as adults are deciding for them today.</p>
<p><em>This is an updated version of an <a href="https://theconversation.com/why-teen-brains-need-a-later-school-start-time-65308">article originally published</a> on Sept. 19, 2016.</em></p><img src="https://counter.theconversation.com/content/82484/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Kyla Wahlstrom received a 3-year research grant from the Centers for Disease Control and Prevention to examine possible health and academic outcomes for students whose schools changed to a later starting time.</span></em></p>Teenagers aren’t just lazy. Their sleep hormones aren’t calibrated to let them get up and go until later in the morning – which has academic and health consequences when school starts too early.Kyla Wahlstrom, Senior Research Fellow in Organizational Leadership, Policy and Development, University of MinnesotaLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/725252017-02-23T10:26:52Z2017-02-23T10:26:52ZWhy both teens and teachers could benefit from later school start times<figure><img src="https://images.theconversation.com/files/157915/original/image-20170222-6406-zi6ws8.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">'Wakey, wakey, sleepy head.'</span> <span class="attribution"><span class="source">shutterstock</span></span></figcaption></figure><p>A typical school day in the UK starts around 8.30am. This is often even earlier elsewhere in the world, with students sitting down to their first lesson at 7.30am in the US. </p>
<p>But these early start times can play havoc with teenager’s natural sleeping patterns – with research showing that waking a teenager at seven in the morning for school is similar to <a href="https://www.aeaweb.org/articles?id=10.1257/pol.3.3.62">waking an adult at four in the morning</a>. And while many adults wouldn’t relish such an early alarm call every working day, it’s a “non-negotiable” expectation for teenagers. </p>
<p>The average teenager ideally needs <a href="http://pediatrics.aappublications.org/content/early/2014/08/19/peds.2014-1697">eight to nine hours’ sleep</a> each night, but in reality a lot of teenagers struggle to get this much – which can then impact their performance in the classroom.</p>
<p>A lot of the problems arise because our sleep patterns are not fixed, and <a href="https://www.aeaweb.org/articles?id=10.1257/pol.3.3.62">they change as we grow</a>. For teenagers, melatonin – the sleep hormone – doesn’t start being produced until 11pm. This is why teens don’t start feeling sleepy until late at night, and why simply telling a teenager to go to bed earlier doesn’t work. </p>
<p>This has <a href="https://theconversation.com/why-teen-brains-need-later-school-start-time-65308">led to calls for later school start times</a> for teenagers to align more closely with their bodies’ biology.</p>
<h2>What the research shows</h2>
<p><a href="http://conservancy.umn.edu/handle/11299/162769">A major study published in 2014</a> examined the impact of later start times on 9,000 US teenagers. Researchers found that:</p>
<blockquote>
<p>Grades earned in core subject areas of math, English, science and social studies, plus performance on state and national achievement tests, attendance rates and reduced tardiness show significantly positive improvement with the later start times. </p>
</blockquote>
<p>They also found that with less sleep than recommended, the students reported that they had:</p>
<blockquote>
<p>Significantly higher depression symptoms, greater use of caffeine, and are at greater risk of making poor choices for substance use.</p>
</blockquote>
<p>In the US – where teenagers can legally drive from the age of 16 – the research also found later start times led to a decrease in car accidents involving teenage drivers.</p>
<h2>Why teenagers sleep differently</h2>
<p>To understand why a later school start time can make such a difference to teenagers’ lives, we need to take a look at the biology that governs their sleep wake cycle. </p>
<p>We all have a sort of hardwired “clock” in the brain – this is often referred to as our body clock. This “clock” controls the production of the hormone melatonin, and in turn, melatonin controls sleep. Melatonin is naturally produced in the brain and <a href="https://www.ncbi.nlm.nih.gov/pubmed/12622846">starts the process of sleepiness</a> by telling your body that it’s time for bed.</p>
<p>Once asleep, <a href="https://psychcentral.com/lib/stages-of-sleep/">we normally go through five sleep stages</a> a night. And one of the stages – the REM (Rapid Eye Movement) stage – varies significantly with age. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/157916/original/image-20170222-6409-190j3hh.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/157916/original/image-20170222-6409-190j3hh.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/157916/original/image-20170222-6409-190j3hh.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/157916/original/image-20170222-6409-190j3hh.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/157916/original/image-20170222-6409-190j3hh.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/157916/original/image-20170222-6409-190j3hh.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/157916/original/image-20170222-6409-190j3hh.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">The fact that many teens are sleep-deprived is reason enough to start school later in the morning.</span>
<span class="attribution"><span class="source">Pexels.</span></span>
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</figure>
<p>REM sleep is linked to learning, and it’s during REM sleep that we dream. It is characterised by quick, random movements of the eyes and paralysis of the muscles. REM sleep normally makes up around 20-25% of an adult human’s total time spent asleep – or 90 to 120 minutes. We get to REM sleep about 70 to 90 minutes after falling asleep. And if we don’t achieve REM sleep, we wake up feeling tired. </p>
<p>Studies have also shown that lack of REM sleep <a href="https://www.nichd.nih.gov/health/topics/sleep/conditioninfo/Pages/rem-sleep.aspx">can impact our ability to learn</a>. And this is what happens to teenagers who do not get their full allocation of sleep. They fail to get to REM sleep and then wake up feeling tired, which can then impact their ability in the classroom that day.</p>
<h2>The benefits for late starters</h2>
<p>So a later school start time could help to solve this problem, by ensuring teenagers get their eight plus hours of sleep and react properly to their body’s natural rhythms.</p>
<p><a href="http://pediatrics.aappublications.org/content/early/2014/08/19/peds.2014-1697">The American Academy of Pediatrics</a>, said in a policy statement in 2014 that:</p>
<blockquote>
<p>Delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety, and academic achievement.</p>
</blockquote>
<p>I believe we should also look again at the timing of the whole school day and see if we can make it better for everyone. Because in my experience, there has been a general shift over the past 25 years to shorten the school day. </p>
<p>This is not at the cost of teaching time (which has remained constant) but at the cost of natural breaks, which has led to reduced lunch times and lesson breaks. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/157917/original/image-20170222-6440-1kqevew.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/157917/original/image-20170222-6440-1kqevew.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=400&fit=crop&dpr=1 600w, https://images.theconversation.com/files/157917/original/image-20170222-6440-1kqevew.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=400&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/157917/original/image-20170222-6440-1kqevew.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=400&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/157917/original/image-20170222-6440-1kqevew.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=503&fit=crop&dpr=1 754w, https://images.theconversation.com/files/157917/original/image-20170222-6440-1kqevew.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=503&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/157917/original/image-20170222-6440-1kqevew.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=503&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">Later start times could help teens’ grades and health.</span>
<span class="attribution"><span class="source">Shutterstock</span></span>
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</figure>
<p>This is mainly because it makes the management of children easier. Supervising hundreds of children “playing” requires effective staffing. And there is always the fear that behaviour deteriorates during breaks. So the theory goes that having them in class and strictly supervised must be better.</p>
<p>But this means that students barely have enough time to absorb what they were doing in maths before suddenly they are thrust into ancient history. And teaching staff also transition from one class to another, with hardly a rest or time to refocus. </p>
<p>Clearly rethinking the school day could benefit everyone involved. Yes, there may be challenges in terms of parental work patterns, transport to school or changing childcare arrangements, but it could also lead to better achievement in teenagers and less of a struggle for parents in the mornings. For teachers, it could also mean a less stressful day all around – and what could be better than that?</p><img src="https://counter.theconversation.com/content/72525/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>James Williams does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>A wake-up call for early school mornings?James Williams, Lecturer in Science Education, Sussex School of Education and Social Work, University of SussexLicensed as Creative Commons – attribution, no derivatives.