Over the last few weeks, millions of children across the Northern Hemisphere have headed back to school for the beginning of a new school year. Sadly, for many of them, the beginning of the school year also marks the beginning of a prolonged period of cumulative sleep deprivation that will progressively affect their physical and mental well-being and consequently their capacity to learn.
As many a parent with teenagers will attest, rousing an adolescent for the start of a school day requires near-heroic levels of perseverance and patience; and as the school year progresses, the latter often gives way to increasing levels of cajoling, bargaining, and punishment.
We all know from experience that, when left to their own devices, teenagers like to go to bed late and will happily sleep in until late morning or even early afternoon. For many parents, this is simply yet another manifestation of the moodiness and rebelliousness associated with adolescence. And as for the difficulties in getting up in the morning, these too are viewed as either self-inflicted or just another ruse to avoid the unpleasant business of having to go to school. But what if the causality worked the other way round? What if the moodiness and rebelliousness were, at least in part, caused by cumulative sleep deprivation over which adolescents and their parents have little or no control? What if there were easy policy and parental solutions that, at little or no cost, could improve both the health and academic performance of middle and high schoolers?
The effects of extreme sleep deprivation are well understood, particularly by the military, which, for self-evident reasons, takes a keen interestin the topic. Most studies and experiments show that after about 36 hours without sleep, soldiers begin to experience a significant deterioration in both physical and mental performance. The effects are cumulative and exponential, so that after about 72 hours without sleep, soldiers are unable to perform complex tasks such as driving a vehicle or arming, aiming, and firing a weapon toward its intended target. Most soldiers will begin falling asleep involuntarily even when standing up and many will begin experiencing hallucinations. In experiments involving civilians, participants subjected to sleep deprivation were also reported as becoming progressively more moody, irritable, and rude. How very teenage of them.
What has been less well understood until recently is that not getting enough quality sleep over an extended period of time (a condition known as chronic sleep deprivation) can also have a detrimental effect on physical and mental well-being. Even getting just one and a half fewer hours of sleep than the recommended amount over the course of just one night can reduce alertness by almost a third. Other short-term effects include memory and cognitive impairment and a higher propensity for getting involved in automobile accidents. Over the long term, chronic sleep deprivation has been linked to other harmful conditions, including hypertension, heart disease, and obesity.
While the causes of chronic sleep deprivation in adults are many and varied, there is a growing body of evidence to suggest that we may be intentionally subjecting our adolescents to this unhealthy condition. According to the guidelines issued by the National Sleep Foundation in February 2015, adolescents from the ages of 14 to 18 need between 8 and 10 hours of quality sleep per day. This means that for a school start time of 8 a.m. and assuming an hour for waking up, getting ready, having breakfast, and traveling to school, then the average adolescent would need to be in bed and fast asleep sometime between 9 and 11 p.m. at the latest. The trouble with this scenario is that it fails to take into account the natural changes to the sleep cycle of adolescents that occur with the onset of puberty.
Anecdotally, we have known for some time that different people have different routines when it comes to sleep and consequently how alert they feel and are during different times of the day. In the workplace we tend to categorize people rather simplistically as being either “a morning person” or “not a morning person.” What is becoming apparent, however, is that these routines are not the result of individual preferences and choices but biological imperatives.
Indeed, our understanding of the mechanics of sleep is now sufficiently well-developed that scientists can plot individual cycles over the course of a day by measuring the presence and levels of the hormones and chemicals involved in the two dominant biological processes: one that governs falling asleep (the homeostatic sleep drive), and one that governs waking up (the circadian arousal system). It turns out that these processes ebb and flow in our bodies following a set and predictable pattern that varies slightly for each individual. Leaving aside extraneous and environmental factors that can disrupt these cycles, the main driver of change over time is aging. These changes affect both the quantity of sleep (it declines as we age) and, more importantly for the purposes of this article, its timing. For reasons that we don’t yet understand, the onset of puberty shifts the sleep cycles of adolescents back by around two hours. Most adolescents find it difficult if not impossible to fall asleep before 11 p.m.
The implications are staggering. With most middle and high schools around the world starting between 7:30 and 8:30 a.m., our education systems are knowingly subjecting teenagers to cumulative sleep deprivation (sometimes up to two hours or more per night) during the course of the school year. And if teenagers are sleep-deprived, is it any surprise that they become moody, intemperate, and prone to making poor decisions?
The matter is now considered serious enough by health professionals, and the evidence so compelling, that last year both the American Association of Pediatrics (AAP) and the Centers for Disease Control issued warnings and policy recommendations strongly advocating later starting times for middle and high schools. The policy statement from the AAP could not have been more explicit. Citing the lead author, Dr. Judith Owens, the press release reads:
“Chronic sleep loss in children and adolescents is one of the most common–and easily fixable–public health issues in the U.S. today. . . . The research is clear that adolescents who get enough sleep have a reduced risk of being overweight or suffering depression, are less likely to be involved in automobile accidents, and have better grades, higher standardized test scores and an overall better quality of life. . . . Studies have shown that delaying early school start times is one key factor that can help adolescents get the sleep they need to grow and learn.”
And yet despite the weight of scientific evidence and the clarity of the policy recommendations, not a single major education system around the world has announced–let alone implemented–changes to traditional school hours for middle and high schools. The only notable exception to this is the United Kingdom, which has sanctioned a series of potentially groundbreaking trials involving students in grades 9 and 10 in 100 schools, who will be allowed to start at 10 a.m. In one early pilot study involving a single school, starting school one hour later was found to have improved exam performance in core subjects by around 20%.
As our children ease back into school, policymakers, educators, and parents need to all ask themselves why such a seemingly simple and sensible policy prescription has not yet been adopted more widely. Why aren’t there more countries, states, and cities following the example of the United Kingdom? And if our systems are incapable of introducing changes to something as simple as school hours, what hope is there for introducing the more substantive innovations that many of us agree are necessary to realize the full potential of education?
While waiting for policymakers to act, here are a few common-sense ideas of what parents and educators could do to minimize the detrimental effects of cumulative sleep deprivation:
1. Keep Adolescents Away From Backlit LED Light
At least one hour–and preferably two–before they need to be asleep, all the screens should be off. Several studies have shown that levels of melatonin (a chemical that helps us fall asleep) decrease with exposure to a type of blue light emitted by LED screens. This means no reading, gaming, or texting from smartphones, tablet computers, or laptops before bedtime. This is also good advice for adults!
2. Let Them Sleep In
On weekends and holidays, let them make up the sleep they’ve missed, and avoid the temptation of organizing too many activities in the early morning. Extra sleep during weekends and holidays can, to a certain but not total extent, replenish the shortfall accumulated during the week.
3. Bring Back The Afternoon Nap
It appears that the tendency many people have to want to sleep sometime in the afternoon is a normal part of the biological processes we discussed above. Many teenagers come back from school in the afternoon feeling tired. Our temptation as parents is to prevent them from going to sleep because we believe that this will prevent them from going to bed early enough at night. But the evidence shows that even short naps of around 30 minutes can help improve performance in adults. In the case of teenagers, naps can also make up for some of the lost sleep. For that matter, why not introduce nap rooms in middle and high schools so that adolescents can take advantage of free periods during school or downtime between afternoon extracurricular activities to catch up on sleep?
4. Start Every School Day With A Brisk 30-Minute Walk
There is increasing evidence to support the proposition that light exercise and movement are just as important for mental well-being as they are for physical fitness. It stands to reason, therefore, that a brisk but not strenuous 30-minute walk at the beginning of the school day can compensate for some of the effects of insufficient sleep.
Of course, at the end of the day, the above are little more than Band-Aids. What we really need is for policymakers to act.
Insomniacs rarely forget when their sleeplessness first began. For some, like the writer Margaret Drabble, it emerges with the birth of a child; for others, it’s an episode of illness or the loss of someone they love. For me, it starts at an uncle’s house in Essex. I am four or five and my uncle is telling me wonderful bedtime tales of adventures in far flung parts, narrative distractions, or perhaps rewards, designed to see off any protests against what his hands are doing under the sheets. Sleep eludes me then not only because I am disconcerted and a little afraid, but also because the stories are too good to give up.
Anxious in the dark, I would check for monsters. I sleepwalked. I began to tell stories of my own, and a gradual transformation happened. My stories started to act as guardians against the terrors of the night: so long as I was spinning stories, the dark was dumb and powerless, the monsters had no hold over me. Over the years, narrative became my night-time ally. Sleeplessness and storytelling became woven together in my mind so intricately that today the two are almost inseparable.
For me and many other insomniacs sleep is a sort of necessary evil. We are aware that we are treading on delicate ground, that our failure to sleep might any day cross over into a failure to thrive. Insomnia, we know, increases the risk of heart attacks, strokes and mental illness. Still, insomniacs remain too attached to the narrative of the day to want to let it go. Wakefulness is too enchanting, a tableau vivant fabulously embroidered with incident, plot and character. So long as one is awake, the narrative remains open, the threads of life continue to spin in more or less limitless combinations.
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Being awake at night affords the insomniac the power of reimagining the day. Without the intervention of sleep, we can ignore the intimations of mortality brought nightly as the sun sets. And though it’s true that a lack of sleep can give rise to feelings of frustration and occasionally despair, insomnia is also, in its strange way, a hopeful condition, ripe with the possibility of other endings. Why shut the door on the light when our days are both fragile and finite?
The facts, as sleep scientists are increasingly discovering, are that sleep is not a shadow of wakefulness, but an independent state, busy with its own mental and physical events. The brain, we now know, uses as many calories for its processing activities by night as by day, even if those calories are put to different uses. But the events of sleep are ones that exclude our conscious selves, so they can feel as though they do not exist at all. Closing the narrative of the day by sleeping seems to stop time. It is, like sleep itself, a little death. And there lies the rub. Whatever the reality, sleep feels like a state of non-existence. And that is something many insomniacs cannot abide.
A friend recently suggested I download a mobile phone app, which purports to track brain patterns in sleep. Insomniacs tend (often unwittingly) to exaggerate their periods of wakefulness, and the friend thought it would be useful for me to know exactly how much sleep I actually get as opposed to how little I think I do. Though I appreciated her concern, the suggestion was one only a good sleeper would ever make. Apart from drawing too much attention to sleep, thus making it even more elusive, a sleep map would seem to offer a specious guide to a terra nullius whose topography might well be sketched in by science, but whose more subtle landscapes must forever remain undefined. If we were ever conscious enough to register it, we would not, by definition, be fully asleep.
There’s a freedom to the night, an unconstrained permissiveness. Under cover of darkness, anything goes
Though sleep is not a story, dreams might be. Rather more often, though, they are hints at storytelling, fragments of narrative that can, even at the time of dreaming, feel random or perhaps simply experimental. As signposts to the otherwise unknowable realm of the unconscious, dreams are instructive and useful to me as a writer but, even so, they hold none of the seductive power of being awake. Even dreams about sex, intensely pleasurable though they can be, rarely hold a candle to the real thing.
That said, I’ve had to learn to view my sleeplessness as a gift, and I’m still often unable to experience it that way. Looking back, I can see that my adult life has been ordered around my insomnia and, in some respects, limited by it. My early adult life was dominated by an unwelcome familiarity with sleep clinics and their often vaguely totalitarian-sounding ‘sleep hygiene’ routines, as well as with visits to therapists, meditation rooms and prescription-friendly GPs.
The frustrations of failing at something so basic are hardly tempered by the humbling, almost daily confirmation of the limits of my ability to control my own body. Sleep is an elemental human function at which I am, to say the least, inexpert. Being self-employed allows me to escape from the daily alarm call, but it also means that I have had to adapt to living with financial insecurity. Not having children has relieved me from what was — at the time I was considering motherhood — the terrorising prospect of having to deal with someone else’s sleepless nights as well as my own.
And so I remain childless. Relationships have sometimes been blighted, at least in their early stages, by the months it takes for me to accustom myself to having someone beside me in the bed. And then there’s the thumping head and the numbing mental fizz of the day following a sleepless night, which so often coincides with a long journey, an important interview or a deadline of some kind or other, and leads to the inevitable sense that one is never at one’s best when it is most required.
But for the most part, I have accommodated to living with my disorder. Acceptance, or perhaps just age, has altered our relationship. The battle of mutually assured destruction it once was has significantly mellowed. We have both stopped wanting to change one another and, like any long-paired couple, we’re now fully, if not always comfortably, adjusted to our life together. Which is just as well given that, whether we like it or not, fate has made us companions for life.
For me, insomnia’s greatest gift is the uninterrupted time and mental space it allows for reading and thinking. There’s a freedom to the night, an unconstrained permissiveness. Under cover of darkness, anything goes. Being awake in the night feels like stealing a march on time. Senses sharpen, so does the memory. The air stills and it is as though you have passed into some other, more magical dimension in which earthly rules no longer apply. There’s an exploratory feeling to the night, a special magic, as anyone who regularly stays awake through it knows. The night’s sounds, smells and sights are exclusive. The quiet lends itself to brooding, even to epiphany, at the very least to an intense focus, what Seamus Heaney calls ‘the trance’ which can be both alluring and, for creativity, highly fruitful.
My body keeps me awake until my mind has sculpted something more shapely from the day
And so I think and I read. Sometimes I get up and make toast but generally I find it most pleasurable and productive to drift in the still waters between wake and sleep, neither fully alert, nor exactly dozy. For me, the right kind of story, fiction or non-fiction, holds a real promise of sleep. At least, a firm literary resolution can mimic a narrative closure that I’m reluctant to concede in real life. I look back at day’s end, reconstructing the events of the previous 12 hours as narrative. By the time I get into my bed, the day has acquired a fully formed shape that it might have lacked as it went along.
Experience has taught me that the less satisfying the narrative of the day has been, the more likely I am to be unable to let it go. My body keeps me awake until my mind has sculpted something more shapely from the day or I am able to distract it with a more engaging narrative borrowed from the pages of a book. The vigilance of the waking hours is over but so is the magic lantern of event. No matter how glad I am to sink into unconsciousness, this always feels like a loss. Children, who are in so many ways more fully alive than us, understand this intuitively, I think. It’s a rare child who volunteers to go to bed: they too need stories, borrowed narratives to persuade them away from the thrills and puzzles of their own day.
There have been numerous experiments in which rats have been deprived of sleep. At first, sleeplessness makes them eat more, but within a few days they start to fade and die. Exactly why remains something of a mystery to scientists, though to insomniacs perhaps less so. A little bit of wakefulness goes a long way. The all-night vigil, less frequent in my life than it once was, can be numbingly, despairingly lonely, the hours endless and cheerless. At those times the sound of the first plane of the morning or the tell-tale shaking of the bed announcing the day’s first Tube train, can seem like the peal of celebratory bells.
And yet the seven- or eight-hour night, which even the best sleepers among us increasingly regard as unattainable, is nothing more than an invention of the industrial revolution. We never used to sleep this way. Two or three hundred years ago, you would go to bed for four hours directly after sundown, rise again for a period of two or three hours to write, read, pray or have sex, then settle down again for what was then known as ‘the second sleep’.
In his survey of sleep, At Day’s Close (2005), the American historian Roger Ekirch finds more than 500 literary references to the second sleep from sources as diverse as Homer, Cervantes and Dickens. It appears that this humane and creative arrangement began to be phased out in the late 17th century by the demands of the workplace and the exigencies of modern life. To return to it would be neither practical for most people nor, possibly, even desirable.
All the same, I can’t help feeling that we’re losing out. A few hours’ sleep followed by a few hours’ wakefulness, a whole night-time of remembered dreams and magic lantern shows, and the time and mental space between in which to record them. Imagine the stories we could tell in the morning.
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writes narrative non-fiction and crime novels. Her new novel The Boy in The Snow is published by Mantle.