Sleep and well-being

Transcription

1 True Grit Pastoral Conference Developing emotional resilience in schools King s College School, Wimbledon, London SW19 4TT Thursday 20th March am 4.00pm Sleep and well-being Russell G. Foster FMedSci FRS Professor of Circadian Neuroscience Head, Nuffield Laboratory of Ophthalmology Director, Sleep and Circadian Neuroscience Institute Fellow, Brasenose College

2 AND WELL-BEING o Overview of Sleep & Clocks o Sleep Across Society o Impact of Sleep Disruption o Sleep Hygiene

3 AND WELL-BEING o Overview of Sleep & Clocks o Sleep Across Society o Impact of Sleep Disruption o Sleep Hygiene

4 Lifetime Activities Sleeping General activities 19% Telephone/ Mail/ 1% 36% Sport/Exercise 1% Socialising 3% Household work 8% Eating & Drinking 11% Watching TV 11% Work & Work related 16% Data from - American Time Use Survey Summary

5 Information processing Tissue Repair Memory consolidation Metabolic Rebuilding Energy Replenishment Toxin Clearance

6 Acetylcholine Noradrenaline Histamine Dopamine Serotonin Glutamate GABA Galanin Orexin

7 Information processing Tissue Repair Memory consolidation Metabolic Rebuilding Energy Replenishment Toxin Clearance Adenosine Sleep Pressure Social Timing

8 Information processing Tissue Repair Memory consolidation Metabolic Rebuilding Energy Replenishment Toxin Clearance Time Stamp Sleep Activity Clock Sleep Pressure Social Timing

9 The Generation of 24h Rhythms Suprachiasmatic nuclei (SCN) The master body clock

10 Drosophila The basic building blocks of the molecular clock are conserved between all animals! Mouse Humans

11 Changes in these clock genes are being linked to particular morning and evening sleep types

12 Information processing Tissue Repair Memory consolidation Metabolic Rebuilding Energy Replenishment Toxin Clearance Eye Clock Sleep Pressure Social Timing

13 Photosensitive Retinal Ganglion Cells (prgcs) Freedman, M. S., Lucas, R. J., Soni, B., von Schantz, M., Munoz, M., David-Gray, Z. K. and Foster, R. G. (1999). Regulation of mammalian circadian behavior by non-rod, non-cone, ocular photoreceptors. Science 284,

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15 Clinical Implications

16 Visual blindness need not result in loss of all light detection by the eye! Sleep and 24h rhythm abnormalities are ignored in clinical ophthalmology

17 Oxford Eye Hospital

18 What is the impact of eye disease on human sleep/wake biology?

19 Patients with visual Cell Loss but intact prgcs Are encouraged to expose their eyes to sufficient daytime light to regulate sleepwake timing.

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21 Patients with visual Cell Loss but intact prgcs Are encouraged to expose their eyes to sufficient daytime light to regulate sleepwake timing. Patients with inner Retinal Cell Loss both visual and clock blind Provided with medications that consolidate sleep (e.g. melatonin + new drugs).

22 Clinical ophthalmology must understand that the eye not only provides us with our sense of space, but also our sense of time.

23 Processing information and Memory Emotional and Mental Health Metabolic/Immune/Cardiovascular Health Eye Clock Sleep Pressure Social Timing

24 AND WELL-BEING o Overview of Sleep & Clocks o Sleep Across Society o Impact of Sleep Disruption o Sleep Hygiene

25 Ideal Good Sleeper Tue Mon Sun Sat Fri Thur Wed Tue Mon 7am DAY 11pm NIGHT 7am Stable Sleep

26 Elderly Sleep/Wake Pattern Tue Mon Sun Sat Fri Thur Wed Tue Mon 7am DAY 11pm NIGHT 7am Reduced and Fragmented Sleep

27 In the elderly..sleep disruption may be made worse because of the failure to provide enough light..

28 Environmental Lighting Typical Range Lux Situation 100,000 Bright sunny day 10,000 Cloudy day Watch repairman's bench Typical office setting 1-10 Residential street lighting 0.25 Cloudy moonlight

29 Environmental light as a time-giver ~ 20 lux

30 Teenagers

31 Teenager Sleep/Wake Tue Mon Sun Sat Fri Thur Wed Tue Mon 7am DAY 11pm NIGHT 7am Greatly Delayed and Reduced Sleep

32 Delayed Body Clock (Biology)

33 Chronotype (MSF sc, time around midnight) Evening Morning vs Evening Preference changes with age Male Morning Age Roenneberg et al., Curr Biol, 2004

34 Chronotype (MSF sc, time around midnight) Evening Morning vs Evening Preference changes with age Making a teenager get up at is the same as a 50 year old getting up at hour difference 4.0 Morning Male Female Age Roenneberg et al., Curr Biol, 2004

35 Reduced Sleep (Sociology)

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37 Mary Carskadon at Brown University suggests that, on average, US teenagers are getting about 7.5 hours a night's sleep on school nights, but as many as 25% get fewer than 6.5 hours per night. Mary estimates that to be optimally alert, teenagers need approximately 9 hours of sleep.

38 Does all this matter.?

39 Percent Correct Percentage of correct answers on cognitive tests Teenagers vs Adults 55.0 Teenagers Adults > 10% Improvement in scores > 7% Decrease in scores Mid-morning Mid-afternoon Time of Day David Goldstein and Lynn Hasher, University of Toronto

40 Impact of a later start time for school coupled with sleep hygiene

41 % Students Reaching Government Standard 5+ GCSE Passes Grade C or Higher Later Start Time - Monkseaton School (Newcastle, UK). Headmaster: Paul Kelly 60 National Average All Students Socially Disadvantaged (2010) (2011) (2012) n = n = School Start Time

42 AND WELL-BEING o Overview of Sleep & Clocks o Sleep Across Society o Impact of Sleep Disruption o Sleep Hygiene

43 Processing information and Memory Emotional and Mental Health Metabolic/Immune/Cardiovascular Health Eye Clock Sleep Pressure Social Timing

44 Rested Effect of sleep deprivation on brain activation while performing mathematical tasks (fmri)

45 Effect of sleep deprivation on brain activation while performing mathematical tasks (fmri) Rested Sleep Deprived

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47 Appetite Leptin Adipose Tissue Ghrelin + Sleep Disruption

48 Sleep Disruption + STRESS + Immunity Blood Pressure Impaired Memory Pituitary Gland Adrenal Gland CORTISOL Glucose Insulin Gastric Acid

49 The Impact of Sleep Disruption Processing & Memory Substance Abuse Metabolic Cardiovascular Immunity

50 AND WELL-BEING o Overview of Sleep & Clocks o Sleep Across Society o Impact of Sleep Disruption o Sleep Hygiene

51 Opinion 22 April 2013 Why teenagers really do need an extra hour in bed

52 Not getting enough sleep if. Opinion 22 April 2013 Why teenagers really do need an extra hour in bed You are dependent upon an alarm clock, or parent, to get you out of bed. You over-sleep on free-days. You take a long time to wake up. You feel sleepy and irritable during the day. Your behaviour is overly impulsive. Crave caffeinated and sugar-rich drinks. Listen to your friends and family about your day-time behaviour.

53 So. Take control. Opinion 22 April 2013 Why teenagers really do need an extra hour in bed Bedroom must be dark and not too warm. Wind-down at least 9h before the morning alarm. Don't text, watch TV, use computer etc. 30min before bed. Avoid bright lights 30min before bed. Try not to nap during the day. Seek out natural light in the morning to adjust the body clock and sleep patterns to an earlier time. Avoid caffeinated drinks after lunch.

54 AND WELL-BEING o Overview of Sleep & Clocks o Sleep Across Society o Impact of Sleep Disruption o Sleep Hygiene