Why students need to get enough sleep

This article explains why it is so important for young adults, especially students, need to get enough sleep.

Humans need sleep. Young adults especially need it, and more  of it if possible. While growth spurts may be over, teenaged brains are still developing, and they will not fully mature until a person’s mid-20s, at the least. While students are in school trying to expand their minds, the very structure of their brains is expanding at the same time. Young adults need to balance academics with their sleep, which actually aids in learning and development. It may often seem like these two activities are at odds with each other, but their correlation is important.

Young adults have odd sleeping schedules, and it is not completely their fault. Developing brains of adolescents are wired to go to sleep later. When combined with heavy collegiate workloads, freedom from parental restrictions and the atmosphere of the city that never sleeps, it is no wonder that NYU students often go to sleep extremely late. While late bedtimes alone can be troubling, affecting everything from throwing off our circadian rhythms to our immune systems, this issue is compounded during the winter time. Moreover, students from warmer regions with longer days and shorter nights may not be aware of the effects the winter can have on one’s system. By going to bed late, young adults exacerbate these effects, which can lead to medical issues.

Seasonal affective disorder — a form of depression caused by changes in seasons — is among the potential complications. It can be triggered by a variety of factors, including an unnatural sleep schedule and decreased exposure to light. Symptoms of seasonal affective disorder usually manifest during fall and winter, and deficient sleep during this period can make individuals more vulnerable to depression. Research indicates that going to bed late when the sun sets later is not necessarily problematic. An 11 a.m. wake-up time gives one plenty of sunlight to maintain proper Vitamin D levels and circadian rhythm. Going to bed late when the sun goes down early is a recipe for disaster, however, because an 11 a.m. wake-up time means five hours of sunlight at the most. Students should be wary of seasonal affective disorder and take sleep seriously. Depression in the middle of a semester can jeopardize both academics and social life.

In college, personal well-being is seldom prioritized. This should not be the case — sleep is an essential tool for physical and mental health. Sleeping in late for Palladium brunch rather than waking up to an early breakfast may seem preferable, but a balanced sleep schedule can literally make winter much brighter. Suspend late-night study sessions, close Netflix and go to sleep — your mind and body will be grateful.

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ADHD stimulants often abused by college students

This article discusses how stimulant use for ADHD is often abused by college students.

Nearly one in every five college students abuses prescription stimulants, according to a new survey sponsored by the Partnership for Drug-Free Kids. The survey also found that one in seven non-students of similar age also report abusing stimulant medications.

Young adults aged 18 to 25 report using the drugs to help them stay awake, study or improve their work or school performance. The most commonly abused stimulants are those typically prescribed for attention-deficit/hyperactivity disorder (ADHD), such as Adderall,Ritalin and Vyvanse, the survey found.

"The findings shed a new and surprising light on the young adult who is abusing prescription stimulants," said Sean Clarkin, director of strategy and program management for the Partnership for Drug-Free Kids. "While there is some 'recreational' abuse, the typical misuser is a male college student whose grade point average is only slightly lower than that of non-abusers, but who is juggling a very busy schedule that includes academics, work and an active social life."

Clarkin said the findings point to the need for parents and educators to increase their efforts to help young people develop effective time-management skills to balance academics, work and social activities.

"The profile that emerges is less that of an academic 'goof-off' who abuses prescription stimulants to make up for lost study time than a stressed out multitasker who is burning the candle at both ends and trying to keep up," Clarkin said.

The nationally representative study, conducted by independent researcher Whitman Insight Strategies, surveyed more than 1,600 young adults online this past summer, including approximately 1,000 college students.

Half of the students reported they took stimulant drugs to study or improve their academic performance, the survey noted. And, the survey found that two-thirds of those students believed the drugs helped them get a better grade or be more competitive at school or work. Around 40 percent took the drugs to stay awake. About a quarter of abusers said they took the stimulants to improve their work performance, according to the study.

These are the same reasons former user Linda Stafford said she began using the drugs.

Stafford began taking Adderall and Vyvanse without any prescriptions while she was a college student in Statesboro, Ga.

"I wanted to go to school, work and party, and Adderall helped me to focus pretty well at first," Stafford said. In reality, however, she said taking the stimulant did not change her test grades much. "Then," she said, "I got hooked."

Stafford began experiencing depression, paranoia and social anxiety and became unable to communicate even with her closest loved ones, she said.

"I was totally incapable of handling life," Stafford said. "I could not manage a simple job, my class assignments or relationships. Adderall was the center of my life."

Stafford has since been through recovery and uses a support network and support groups to manage, but her story is one that Miami University staff psychiatrist Dr. Josh Hersh has heard often.

"These survey findings have confirmed a lot of the things I have seen clinically," Hersh said. "Young adults are mainly using prescription stimulants to improve academic and work performance and to stay awake."

Although Hersh said some of the students taking these drugs may feel the invulnerability of youth, others are simply desperate to juggle everything even while they know the possible risks of taking the drugs, such as anxiety or panic attacks even with occasional use.

"The fact that students often use these drugs around deadlines, when their natural adrenaline is already high, elevates the risk even more," Hersh said. "Sporadic use can lead to severe sleep deprivation and cause stimulant-induced psychosis, when a student gets paranoid and may hallucinate."

He said snorting the pills can lead to internal nasal damage and regular use can lead to addictions that are destructive and difficult to treat.

Even young adults who are legally prescribed stimulants for specific health conditions can risk becoming more addicted, as happened to the son of Kathleen Dobbs, a retiree who co-founded the grass roots coalition Parent to Parent, Inc.

Her son was diagnosed with ADHD at age 8 and began taking Ritalin at age 10, but by high school doctors switched him to various other drugs before Dobbs requested no more prescriptions. By then, however, he was seeking out Ritalin from classmates and then moved on to cocaine to "feel normal," Dobbs said.

"Children with ADHD will do anything to fit in, to be able to learn and be like other kids," said Dobbs, adding that the addiction tore their family apart. "When you have a child who is addicted, it is like a bomb goes off in your home and everyone scatters. I prayed and did all the right things, but it creeps into your life and destroys your entire family and leaves you with pain and loss."

Her son is now married, sober and in ongoing recovery, but she recommends that parents remain vigilant and educate themselves about drugs, especially those their children are prescribed.

The survey found that 28 percent of people legally prescribed stimulants have exaggerated their symptoms to get a larger dose. The same percentage reported sharing their medicine with friends. Just over half the adults surveyed said stimulants were easy to obtain, usually from friends, and most said their friends abused them as well.

Red flags that parents can watch for in their children, Hersh said, include having dilated pupils, anxiety or manic behavior, talking about not sleeping for days and "crashing" when home from college, such as sleeping often and having difficulty concentrating.

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Migraines in children from toddlers to teens

This article discusses migraine headaches and how they present in children from toddlers to teenagers.

A toddler is having bouts of projectile vomiting, quite frequently but not every day. Fearing something is "terribly wrong" with her daughter's digestive system, her mother takes her to the doctor. Within 20 minutes, the pediatrician has traced the girl's symptoms to motion sickness – she gets sick every time she rides in the car, or shortly after. Although she's never had a headache, by age 3 the girl is diagnosed with the neurological disorder called migraine.

What Is Migraine?

A simple definition is a “recurrent, episodic headache, or head pain, that typically lasts between two and 72 hours untreated,” says Andrew Hershey, chair and a professor of neurology at Cincinnati Children's Hospital Medical Center​​​​. For some people,​ migraine comes with nausea or vomiting, while others experience light and sound sensitivity. Headaches are usually throbbing and partial​​ (involving one side of the head) and moderately or severely intense.​ Migraine has a strong genetic component.

Hershey, director of the CCHMC Headache Center, says while most migraine episodes come and go, they can evolve into chronic migraine: “About a third of our patients get to the point that the headache just never leaves them.”

At least 10 percent of kids have migraine, Hershey says.​ While the rate is about 4 percent in preschoolers, by late teens it affects up to 15 percent of boys and 20 to 25 percent of girls. The youngest patient Hershey ever treated started at 10 months old.

What Triggers Migraine​?

“Migraine is more than a headache. It’s a generalized disturbance of function that involves brain and body,” says Joel Saper,​ a neurologist and director of the Michigan Head Pain and Neurological Institute in Ann Arbor.

Although many people believe stress "causes" migraine, researchers are still working to determine the complex causes for the condition. What's known is that children have a variety of migraine triggers that can set off an episode, including food sensitivities, fatigue, bright lights, loud noises and sleep changes.​

In younger kids, non-headache signs or “migraine equivalents” can include stomach pain, episodes of dizziness, vertigo (spinning), visual disturbances and sudden mood changes, Saper says. Motion sickness is migraine equivalent, he notes, and it’s been recently established that colic in babies is a forerunner to migraine.

Before starting any kind of treatment, it’s crucial to pin down the diagnosis. Some 300 other medical conditions cause headache in kids, Saper says. Emotional causes also have to be ruled out – like school avoidance in a kid who’s anxious or being bullied.

For parents, Saper says it’s key to find a knowledgeable health care provider, whether it’s a specialist, family practice doctor, nurse practitioner or physician assistant.

Life With Migraine for Kids

Two decades ago, Cathy Glaser ​was concerned about her 3-year-old daughter Samantha, who was having cyclical bouts of vomiting and upset stomach. Through careful questioning, the pediatrician traced the episodes to motion sickness.

Glaser knows a lot about migraine. “We like to say my daughter was doomed since both parents have migraine. It runs through both of our families,” says Glaser, who eventually started the Migraine Research Foundation in New York.

Although Samantha was stoic, Glaser could always tell when she had a migraine coming on. “I could look into my daughter’s eyes and see she was getting a headache,” she says. “I could look at her face – she was ashen. All of a sudden those sparkly child’s eyes were absolutely dead. And her whole affect changed.”

Migraine invaded every aspect of Samantha’s childhood, and she visited the emergency room several times a year. It hijacked family trips. On their way to a family reunion at Hersheypark in Pennsylvania, they were forced to pull off the New Jersey Turnpike, because Samantha was green with motion sickness.

School presents many challenges for kids with migraine. Glaser says that as a parent, you need to be your child’s advocate. And you have to be proactive.

“I used to go to school every year at the beginning, or before, with a doctor’s note about migraine and my own daughter’s treatment explain when she raises her hand and says, ‘I need to take my medication now,’ they need to let her go,” she recalls.

Samantha “didn’t want to miss her life,” Glaser says. Even as an 8-year-old, she would say “Mom, I can be alone and feeling horrible, or I can be at school with my friends feeling horrible. I choose school.”

Every summer Samantha's parents sent her off to sleep-away camps, ​and every time they got calls in the middle of the night to come get her – the camp couldn’t handle it. “This is the life of a child who has regular headaches who insists on living the life of a kid,” Glaser says.

Sameness Helps

Boys and girls get headaches equally until age 12 or 13 – but when girls start their periods, the picture changes. Migraine is an “estrogen-vulnerable” disorder, Saper explains. Hormone cycling in girls and later women – from menstruation, oral contraceptives and menopause – can make migraines worse. Boys are more likely to grow out of migraines than girls.

As she entered her teens, Samantha developed menstrual migraine. (She also gets weather headaches, when there’s a change in barometric pressure or a storm’s coming on.)

With migraine, “Sameness helps,” Saper says. Sleep is a big issue, and regular bedtimes and waking times are important. If kids have trouble sleeping, he says melatonin “is a particularly good medicine” to help.

Some children with migraine are food sensitive. “What they eat may make a difference, whether it be the gluten, cheese or dairy products – there’s a long list,” Saper says. Kids shouldn’t miss meals or skip breakfast.

Dehydration can also trigger migraines, and healthy habits include drinking plenty of water or other non-caffeine drinks. Exercise also helps, and so do relaxation and stress-management techniques. 

Not Your Parents’ Headache

For migraine that goes beyond a headache or two a month, research suggests the best approach combines medication and cognitive behavioral therapy. The two main drug categories are medications for treatment and for prevention.

NSAIDs such as Aleve and Ibuprofen are used to break acute headaches in kids, Hersey says ­– aspirin should be avoided because of the risk of liver problems. And parents and patients should be alert to overuse. For prevention, the drugs amitriptyline and topiramate are most commonly prescribed.

At Cincinnati Children’s Headache Center, after kids undergo a neurological and headache exam, the team comes up with a multipronged treatment plan, including medication choices and learning healthy habits. Kids with chronic headaches return for cognitive behavioral therapy, which takes about six weeks to absorb.

Part of the goal is getting kids to accept that they have a chronic illness and teaching them to manage their own care, Hershey says: “We often say to the kids, ‘It’s your headache – it’s not your mom and dad’s.”

Scott Powers, a pediatric psychologist at the center, is working with his team to fine-tune a migraine app that kids can use to track their episodes and symptoms electronically. The app also allows researchers to better connect the dots between triggers and headache timing.

College and Migraines

With the importance of regular sleep, healthy eating habits and keeping stress on an even keel – what could possibly go wrong when kids with migraine leave for college?

But when the time came, Samantha insisted on going away to a big school, Glaser says. After much discussion they agreed that Samantha would go to a school within driving distance, near a hospital and with a well-staffed campus health center.

“Her view about college was ‘I want to stop being 'Migraine Girl,'" Glaser recalls her daughter saying. “’I want to stop being defined by my disease.’” 

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Importance of getting enough sleep

This article explains the importance of people getting enough sleep each night.

Studies conducted by the National Sleep Foundation reported that around 70 sleep disorders disturbed 40 million Americans between 1999-2004. Therefore, it may come as no surprise that college students have adapted a disorder of their own, commonly known as the "pull-an-all-nighter" syndrome. This disorder haunts those in hopes of remembering material that is impossible due to lack of sleep.

Did anyone attempt studying until 4 a.m for that 8 a.m biology midterm last week? Think about how much information you actually remembered from cramming and what went out the window once entering the testing center.

Now, think about the correlation between sleep and memory. It is actually impossible for one to properly remember and process information learned without adequate sleep. So how can one maximize sleep time and still be a college student? By finding balance.

“There is a lot of pressure on college kids nowadays,” said Francesca Johnson, junior in psychology. “...it’s hard to keep a balance.”

Well, what happens when balance isn’t found?

“Some short-term physical consequences are a slower metabolism and weakened immune system, on top of your body simply being physically tired,” stressed Carina Hanson, senior in kinesiology and health.

Sleep deprivation causes irritability, affects judgements and can make one feel drunk or hungover by not allowing complete rejuvenation from daily stress. It is also associated with obesity and increased obesity risks. 

Averaging less than 6 hours of sleep a night doesn’t give the body enough time to finish all of the phases of sleep.

Someone who has had a good night’s sleep will pass through the five stages of sleep cycle every 90 - 110 minutes. The National Sleep Foundation recommends seven to nine hours per night for college students, and each stage is vital to every individual’s overall health.

"The more sleep you get, the more you feel in control of your life and your body,” said Johnson. 

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Binge drinking, marijuana use, and poor academic performance predicted by sleeping problems

A study shows that binge drinking, marijuana use, and poor academic performance are predicted by problems sleeping.

While the temptations to stay up late are many, a small new study suggests a very good reason for college students to hit the hay. Those who are poor sleepers are more likely to get worse grades and to withdraw from a course, according to a new study. In fact, the effects of poor sleep were about as strong as binge drinking and marijuana use on a student's academic performance.

The researchers analyzed data from over 43,000 students included in the spring 2009 American College Health Association's National College Health Assessment (NCHA). After controlling for potentially confounding factors that might predict how a college student fares academically, like clinical depression, feelings of isolation or chronic health problems, the researchers found that getting poor sleep was a strong predictor of problems at school.

While few students are likely to have a clinical sleep disorder, Roxanne Prichard, Ph.D., associate professor of psychology at the University of St. Thomas in St. Paul, Minnesota tells The Huffington Post, about 60 percent say they have some kind of problem sleeping. But for all the effort colleges put into anti-drinking and de-stressing campaigns, little time or money is spent to promote better sleep -- and doing so could help both students and the colleges themselves, she says.

"Sleep really isn't systematically approached in a way that could have major economic benefits to both the students and the universities in terms of increased retention," she says. Indeed, reducing the number of courses a student withdraws from by just one ups his or her probability of graduating by 14 percent, she says -- and it goes without saying that student retention is good for a university's bottom line.

Prichard hopes more schools decide to include a screening for sleep problems among students, which could ultimately limit costs of care of university health centers, she says. "I don't think sleep problems are showing up on the questionnaire intake forms for health services, and that could be explaining a lot of the other problems that you see showing up," she says. "Recurrent illness could be sleep problems."

Prichard and co-investigator Monica Hartmann, Ph.D., professor of economics at the University of St. Thomas, found that poor sleep was even more detrimental among freshmen, according to the study. "I think that's partially because freshmen have the worst sleep of any age group," she says. Not only are they hungry for independence from their parents, but they also are more likely to be "delayed phase" -- essentially, they are more biologically inclined to be night owls because of their age, she says. Focusing especially on first-year students is a smart idea for universities, she says, because freshmen-year success (or lack thereof) is a strong predictor of whether or not a student drops out his or her sophomore year.

The research, published in an online supplement of the journal SLEEP, will be presented Tuesday, June 3, at SLEEP 2014, the 28th annual meeting of the Associated Professional Sleep Societies.

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One stop shop for a scholarly review of state-of-the-art research on autism in children

This article reviews the recent research that has been done on autism in 6 main areas.

Recent years have seen exciting progress in key areas of research on autism spectrum disorders (ASD): from possible genetic causes, to effective treatments for common symptoms and clinical problems, to promoting success for young people with ASD entering college. Updates on these and other advances in ASD research are presented in the March special issue of Harvard Review of Psychiatry.

"Autism is one of the most challenging disorders to treat and the public health concerns associated with the disorder are numerous due to its burden on the individual, on the family and on society," write guest editors Drs Jean A. Frazier of University of Massachusetts Medical School and Christopher J. McDougle of Harvard Medical School. The special issue provides a timely update on research into the causes, important clinical issues, and evidence-based treatments for ASD.

Updates on ASD Research in Six Key Areas

Leading experts provide state-of-the-art reviews on six topics: the genetics of ASD; the use of psychoactive drugs; symptoms of special clinical problems, including obesity, gastrointestinal problems, and sensory issues; and transitioning to college.

Genetics. Over the last few years, there have been "unprecedented advances" in understanding the genetic causes of ASD. Hundreds of genes conferring varying degrees of ASD risk have been identified to date. Many of these genes also appear to be risk factors for related neurodevelopmental disorders and psychiatric problems. While many unanswered questions remain, it may soon be possible to make specific genetic diagnoses in children with ASD.

Psychoactive medications. Despite limited evidence, psychotropic drugs are widely used to manage behavior problems and mental health disorders in children with ASD. For medication classes -- including antidepressants and stimulants -- effectiveness may differ for youth versus adults with ASD. New treatments affecting specific neurotransmitters and the hormone oxytocin are under development, and may help in targeting the "core symptoms" of ASD.

Obesity. Obesity is a common problem with a major impact on the health of children with ASD. Some ASD-related genes may also promote obesity; the same is true for antipsychotic drugs used to help manage behavior problems. Other contributing factors may include sleep disorders and barriers to getting enough exercise. Childhood obesity and related health issues may be a "significant threat" to the health and quality of life of children with ASD.

Gastrointestinal issues. Children with ASD also have high rates of gastrointestinal symptoms and disorders. Some genes linked to ASD may also play a role in gastrointestinal disturbances, with a possible link to immune system dysfunction. There's also emerging evidence of a potential "gut-brain" connection, with gastrointestinal dysfunction contributing to the development or severity of ASD symptoms.

Sensory symptoms. Children with ASD have various abnormalities of sensory function, including both over- and under-responsivity as well as "sensory seeking behavior." Although the neurobiology of these sensory symptoms remains unclear, some researchers suggest they are related to known abnormalities of brain structure and function. Recent studies show that sensory symptoms are related to other ASD-related symptoms and behaviors; more research is needed to demonstrate the effectiveness of "sensory integration therapy" and other occupational therapy approaches.

Preparing for college. The final article highlights the need for new approaches to meeting the needs of "high-functioning" ASD patients entering college. Students "on the spectrum" transitioning to college are at risk of both academic and social problems, and may benefit from accommodation and supports. Based on a growing body of research, a set of recommendations for developing more effective transition plans for children with ASD are proposed.

Along with the editors of Harvard Review of Psychiatry, Drs Frazier and McDougal hope their special issue will provide a useful update for clinicians caring for the growing numbers of individuals and families living with ASD. They conclude, "Clearly, more research is needed on every level for the field to help support and treat individuals on the spectrum so that they can optimize their developmental trajectory and as adults become integral members of our work force."

The journal can be found online at:http://journals.lww.com/hrpjournal/Pages/default.aspx

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http://journals.lww.com/hrpjournal/pages/currenttoc.aspx

Challenges for college students with ADHD

This article looks into challenges that college students with ADHD face.

Many students with Attention Deficit Hyperactivity Disorder (ADHD) attend college. College students with ADHD face a number of challenges, including choosing a supportive school and community where they can:

• find and access medical services


• get help with organizing their schedule and life


• succeed academically

Most people with ADHD are diagnosed before college. However, some people may not recognize the signs and symptoms of ADHD until they are at college. Trying to balance school work and the freedom of living away from home for the first time may be challenging. It can be natural to feel unfocused, distracted, overwhelmed, or disorganized when attending college. However, if these issues have caused significant problems in the past and are getting in the way of current functioning, the student may have ADHD.

If a student is struggling, it may be helpful to seek consultation with a qualified mental health professional. The diagnosis of ADHD is made based on a comprehensive clinical assessment. This may include information from multiple sources, including rating scales, getting history from the student, family, or past teachers if possible. There is no single test (brain imaging, blood testing, or psychological testing) that can reliably diagnose ADHD. Research shows that medication is the most effective treatment for ADHD. Cognitive-behavioral therapy, social skills training, and academic support can also be helpful.

There are many ways to successfully manage ADHD before and during college.

Preparing for and Staying Organized While at College

• Consider the best college environment to meet your needs, such as class size, workload, academic calendar, and availability of support services. Resources to help you find the best college include: high school counselors, parents, friends who are in or have attended college, and national ADHD organizations or websites.


• Learn about the medical services available at colleges before choosing where to go. Some college and university health centers do not prescribe ADHD medications. You may need to find a doctor in the surrounding community. Think about the transportation options and ease of access to that provider.


• Talk with your doctor about how to best manage your medications when at college. Do not make changes in your medication without consulting your doctor. Ask your current doctor and the doctor at college to coordinate care. It is also helpful to have a history of your medications and your response to those medications for your new doctor.


• If you have used tutors or support before college, think about continuing at college, at least for a little while.


• If you need specific support or accommodations, register at the college disability office. If you have a summary of treatment or any psychological tests that were done within the last 3 years, bring them to the visit.


• Practice using planners, calendars, or scheduling apps while still in high school. The demands on time management and organization increase greatly in college. Even if your parents helped you in the past, it is important to learn to do it yourself.

Managing Medications at College

• Many medications prescribed for ADHD have to be monitored regularly. While at college, you need to schedule and keep your own medical appointments. Changes to your medication should only be made after talking with your doctor.


• Learn how to use pharmacy services. Pay attention to prescription start dates and expiration dates. Many medications prescribed for ADHD are “controlled substances” so states may have additional rules on how these medicines can be provided, including limits on how often prescriptions can be refilled.


• Taking medication that is not prescribed for you, sometimes called “diversion” or “academic doping,” is illegal and unsafe. Your medications were prescribed by your doctor who knows you and your medical history. They should only be taken by you. There are serious cardiac, neurological, and psychological risks of misusing ADHD medications. There can also be serious risks to mixing medications with alcohol or other drugs.


• Keep medications safely stored or hidden to protect against theft. If medications are stolen, report it to campus or local police.

Adjusting to the academic, social, and organizational demands of college is difficult for most students. It can be especially difficult for students with ADHD. Arranging for support from medical and school professionals can help students with ADHD have a successful college experience, as well as a long career after graduation.

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Texting leads to sleep problems in college students

A study claims that text messaging results in sleep disorders for college students.

College students, you might want to give your phones a rest for the sake of your sleep.

A small new study from Washington and Lee University researchers shows an association between more texting among college freshmen, and worse sleep.

The findings, published in the journal Psychology of Popular Media Culture, are based on questionnaires answered by 83 first-year undergraduate students. They were asked about the amount of text messages they send and receive each day, as well as their sleep problems, well-being, and academic and social burnout.

The researchers found that the more daily texts, the worse the sleep of the college freshmen. They also identified an association between texting and psychological well-being, but noted that this association depended on the stress level the students were already facing.

Some potential reasons for the link between texting and sleep are that cell phone message notifications might wake students as they sleep; they may also feel pressure to respond immediately to texts no matter the time of day, researchers said.

Recently, LiveScience reported that sleep-texting -- when a person text messages in the middle of the night during sleep, with little recollection of it the following morning -- is becoming a trend reported by sleep disorder specialists.

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Sleep Disorders in College - Highly Prevalent

An interesting article discussing the severity of sleep disorders for students as well as the prevalence throughout the US. JR

Brittany Barnhill had been awake for three days.

A University of Georgia senior from Thomson, Barnhill has struggled with insomnia since entering college.

Her condition is cyclical, meaning she is sporadically unable to sleep. But one of her worst experiences came during her sophomore year, when a night of studying for organic chemistry turned into a three-day sleepwalk.

“I had a lot of trouble with organic chemistry. It was the bane of my existence for a very long time,” Barnhill said. “I had an exam coming up for it and so one night I stayed up to study for it and pulled an all-nighter. That was Monday night.”

Monday night bled into Tuesday morning, and Barnhill planned to sleep that night, but found herself unable.

“I couldn’t get to sleep because I was stressed out about the exam the next day,” she said. 

Though she passed the test, Barnhill said the erratic sleep schedule of a college insomniac is hardly healthy.

“My roommates thought I was dead,” Barnhill said. “[Being tired is] like I’m walking through a haze. I won’t recognize people, things. I definitely shouldn’t drive. It feels like I’m swimming.”

Barnhill’s tale, while extreme, is familiar for college-aged students, who are more likely to experience sleep disorders than other age groups. The average college student gets 6-6.9 hours of sleep a night, much less than the recommended eight hours. Less sleep can cause increased weight gain, mental illness and automobile accidents, while resulting in decreased academic performance, according to the University Health Center. 

Students with sleep problems can find relief at the health center. If a student’s insomnia is cyclical, an assigned physician may prescribe sleep aids or advise altered sleep habits. But if the condition has psychological roots, the student may also seek aid from Counseling and Psychiatric Services.

“Sleep is probably one of the number one problems on campus, so it’s something a lot of students come in for,” said Liz Cheely, the case manager at the health center. “They need to do a phone screening, which takes about 15 minutes, where they tell us what is going on...after that, we get them scheduled for an intake [counseling session], which takes about an hour.”

A psychologist might then write a prescription for sleep aids or offer further psychiatric sessions.

Alexis Havrilla, a sophomore from Cumming, said her experiences with chronic (long-term) insomnia led to a lost scholarship and disappointing class results.

“I lost [the HOPE scholarship] because I got two C+ grades in classes because of my sleep habits,” said Havrilla, who is working with CAPS to address her condition. “I didn’t get enough sleep. It affected study habits. I just felt like doing other things because I don’t like to sleep — I do have a sleep fear.”

Insomnia leaves students searching for limited answers. Insomniacs are advised by most physicians to avoid caffeine, maintain a regular sleep schedule and develop other sleep-friendly habits. But students report habit-changing techniques as only marginally effective.

When the techniques work, they seem to only work for a short time. Even then, it’s difficult to change unhealthy habits while meeting the demands of college life.

Potent sedatives and antidepressants, such as Ambien and Trazodone, provide a quick fix for sleeplessness, but their addictive nature deters some students.

“It just seems like with the medicines and choices that are there, they aren’t very long term,” Barnhill said. “It’s all habit forming and you get dependent on it, and I don’t want to be stuck on that for the rest of my life.”

There is another option for students. 

The Athens Sleep & Wellness Center, located on Prince Avenue, conducts overnight sleep tests to diagnose common sleep ailments. The test, which costs about $150 for patients with insurance, provides answers to the uncertainty surrounding sleep deprivation.

Meredith Petry, the Sleep Lab Administrator at the center, said it was important to diagnose the root of insomnia, rather than mask symptoms.

“The actual true, true insomnias are much more rare than you think of,” Petry said. “Most students should not go on sleep aids, because it’s usually pretty clear that they have bad habits and that they can be corrected. You don’t want to just give them a sleep aid to knock them out when they want to go to sleep or try to go to sleep because it’s not that simple.”

The Southeast in particular struggles with insomnia, with 13.1 percent to 19.3 percent of adults reporting insufficient rest in the past 30 days, according to a study done by the Centers for Disease Control and Prevention in Atlanta.

The region’s higher reported rates of insufficient sleep could be traced to higher obesity rates.

“If you look at that map, with obesity and weight, it’s going to be very close,” Petry said. “There is much more of a weight issue in the Southeast than there is in the West. The more of a weight issue there is, it’s probably highly correlated.”

Petry said students make up a low percentage of the center’s patient base because most students don’t prioritize sleep.

“Maybe five percent would be students, if that,” Petry said. “But what it should be is at least 20 to 25 percent. There are a lot of students with these issues, but sleep gets put so low on the priorities.”

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The latest research on brain trauma and young athletes

This article discusses many different studies done on young athletes and concussions done recently.

First the good news: There's little to no evidence that the average high school athlete faces a scenario similar to former professional football players who exhibit signs of serious depression or early-onset dementia linked to their years on the playing field.

"We're not seeing an epidemic of men in their early 50s with early Alzheimer's because they played high school football," said Steven Broglio, director of the Neurotrauma Research Laboratory at University of Michigan.

But new research conducted by Broglio and others around the country now shows troubling evidence that high school football and other contact sports can take a more subtle long-term toll on the brain -- and it's not just concussions that are problematic.

In fact, for all the focus on concussions, the bigger worry for athletes may be the accumulation of body blows that jolt the head, shaking the brain like a bowl of Jello and traumatizing fragile brain tissue and nerves.

The issue is especially worrisome in football, a sport built around plays where athletes slam into each other as hard as possible. Football players can experience as many as 1,000 impacts or more over the course of season. Researchers say that, in terms of g-forces and stress on the body, playing in a high school football game is comparable to being in a 20- or 30-mph car crash.

Those so-called sub-concussive impacts may not cause concussions, but it appears they can add up and result in damage to the brain.

Broglio and his colleagues at U-M recently published a study that looked at college students with and without a history of concussions. There were no outward differences between the two groups. But on close examination, the students with histories of concussions showed changes in gait, balance and in the brain's electrical activity, specifically attention and impulse control.  

In a U-M press release on the study, Brolgio offered this analogy: 

The signaling pathways in our brains are analogous to a five-lane highway. On a new highway, traffic runs smoothly and quickly as all lanes are in top shape. However, during normal aging, the asphalt deteriorates and lanes might become bumpy or even unusable. Traffic slows.

Similarly, our brains start with all pathways clear to transfer electrical signals rapidly. As we age, the brain's pathways break down and can't transfer the information as quickly. Concussive and other impacts to the head may result in a 'pothole' on the brain's highway, causing varying degrees of damage and speeding the pathway's natural deterioration.

"These are all very high-functioning college students," Broglio said about the subjects in the study with a history of concussion. "But on a very subtle level, something has changed. It appears that because of concussive or sub-concussive blows, there has been a permanent change in the brain and as they grow older, this could magnify."

In short, he said, it's possible that the changes could speed up the memory problems and other mental deterioration that people experience as they age. 

'Totality of blows'

Meanwhile at Purdue University, researchers studied the issue of sub-concussive blows by putting sensors in the helmets of Lafayette, Ind., high school football players for two seasons. 

Their conclusion: Concussions are likely caused by many hits over time and not from a single blow to the head, as commonly believed.

"The most important implication of the new findings is the suggestion that a concussion is not just the result of a single blow, but it's really the totality of blows that took place over the season," Eric Nauman, an associate professor of mechanical engineering and an expert in central nervous system and musculoskeletal trauma, said in a press release about the study. "The one hit that brought on the concussion is arguably the straw that broke the camel's back."

The Purdue researchers had additional findings contrary to conventional thinking.

"Most clinicians would say that if you don't have any concussion symptoms you have no problems," Larry Leverenz, an expert in athletic training and a clinical professor of health and kinesiology, said in the press release. "However, we are finding that there is actually a lot of change, even when you don't have symptoms."

In the two seasons studied, there were six players with concussions but 17 that showed brain changes even though they did not have concussions. 

Players in the study received from 200 to nearly 1,900 hits to the head in a single season. Helmet-sensor data indicated impact forces to the head ranged from a g-force of 20 to more than 100. The worst hit was almost 300 g.

Nauman said that a person in a 30 mph car crash experiences a g-force of 30 if he/she is wearing a seatbelt and 150 without a seatbelt.  

"The average hit we record is about 22 Gs,' Nauman said about the Lafayette football players. "So it's not that different (from a car crash). It is not uncommon for a player to  have one 80-100 G hit, a couple of 50-60s and a bunch of smaller ones."

The Purdue research mirrors the findings of a similar study at the University of Rochester Medical Clinic in upstate New York, where high school football and hockey players showed changes in their brain scans even when they hadn't experienced a concussion.

That study involved nine athletes and six people in a control group. Among the nine athletes, only one was diagnosed with a sports-related concussion, but six others showed abnormalities on their post-season scans that were closer to the concussed brain than to the normal brains in the control group.

The brain scans also correlate to the number of head hits and symptoms experienced, the researchers said.

No clear answers
So what's the take-away message for parents and athletes about the research?

First, Broglio stressed that brain function is affected by many factors, including genetics and lifestyle choices such as smoking and alcohol consumption.

"Concussion may be only one small factor," he said.

He also pointed out higher risk factors are just that: Not every cigarette smoker gets lung cancer, not every blonde with a history of sunburns gets skin cancer, people with a family history of heart disease  may or may not  have heart problems.

In addition, Broglio stressed that the brain research on the young athletes is still in its infancy.

"It's not entirely clear" if and how the brains of young athletes are affected by the sports they play, Broglio said. "We are realizing it's probably not how many concussions you have that makes a difference, but the total exposure" to concussive and sub-concussive impacts.

He added that it appears that playing contact sports in high school is a "very small risk" in terms of overall long-term health.

But, he acknowledged, at what point contact sports becomes too risky for teenagers is a "very big question. We don't have clear answers."

For that reason, Dr. Robert Baker, a family practitioner with Bronson Orthopedics & Sports Medicine in Kalamazoo, said one of the biggest challenges for doctors who treat sports-related concussions is recommending if and when a youngster should end his or her sports career.

"The best we can do is look at the type of hits they've experienced, the periods of recovery," Baker said. Determining the threshold where enough is enough "is a very difficult issue."

But Baker and other local doctors say it rarely gets to that point, and it's important for parents to keep the risk of sports-related concussions in context.

"You're more at risk by not wearing a seatbelt," said Dr. James VanHuysen, of Bronson Orthopedics & Sports Medicine.

Dr. Daniel Fain, of Kalamazoo's Bronson Pediatric Neurology, agreed.

"I think sports are important," he said, and fear of sports-related concussions shouldn't keep kids out of sports.

That said, "parents need to understand the severity of concussions" so that when they do occur, families respond appropriately, he said. "If I were a parent, I'd hope my kid would be looking at this."

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