December 2014 Teacher's Guide for So Tired in the Morning: The Science of Sleep Table of Contents

References

(non-Web-based information sources)


Vandeborght, C. You’re getting Sleepy. ChemMatters 2004, 22 (1), pp 4–6. This article describes the body’s reaction to anesthesia including the gradual “shut down” of some brain areas during sedation.
Hersey, J. and Heltzel, C. Your Colorful Food. ChemMatters 2007, 25 (1), pp 12–15. Hersey and Heltzel discuss the suspected relationship between food dye and children’s behavior. The symptoms related to food dyes resemble those linked to sleep deprivation and ADHD: difficulty going to sleep, poor concentration, disturbing others, and temper tantrums.
Haines, J. Coffee: Brain Booster to Go? ChemMatters 2008, 26 (4), pp 7–9. Haines describes how coffee works in the brain to release adrenaline into body. The effects of and withdrawal symptoms of caffeine are compared to those of heroin and cocaine.
Tinnesand, M. Your Body under Construction ChemMatters 2011, 29 (4), pp 14–16. Tinnesand’s discussion of the endocrine system includes the effect of hormones on the brain. The Teacher’s Guide, Background Information section: “More on hormones and the endocrine system”, p 78, discusses the pineal gland secretion of melatonin.
Sitzman, B. and Goode, R. Caffeine ChemMatters 2013, 31 (3), p 5. The authors show the multitude of caffeine laden products on supermarket shelves, their caffeine content, and safe limits for teens. Caffeine metabolism, the side effects, and the danger involved in the consumption of excess caffeine are described.
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Wolf, L. Caffeine Jitters C&E N 2013, 91 (5), pp 9–12. In this article, Wolf uses real events to illustrate the dangers of caffeine “overdose”. A graph given in the Background Information section of this Teacher’s Guide shows the rapid increase in emergency room visits associated with the overconsumption of caffeinated products. Structural formulas are used in a discussion of caffeine metabolism. Free download is available at (http://cen.acs.org/articles/91/i5/Caffeine-Jitters.html).

Web Sites for Additional Information

(Web-based information sources)

More sites on sleep requirements for humans
This site from the Harvard Medical School covers age related stages of sleep requirements for people from infants to adults. Videos are included to illustrate the stages. REM and NREM patterns are discussed as well as sleep disorders. (http://healthysleep.med.harvard.edu/healthy/science/variations/changes-in-sleep-with-age)
The Sleepy Teenager is a health publication of Harvard Medical School. This article explains why teenage schedules don’t allow time for sufficient sleep and well describes the possible consequences of sleep deprivation. This article might be considered as a reading or research assignment for chemistry students. (http://www.health.harvard.edu/newsweek/The_Sleepy_Teenager.htm)
More sites on advocacy for later start times for high schools
The American Academy of Pediatrics (AAP) released a policy statement on August 25, 2014: “AAP recommends middle and high schools delay the start of class until 8:30 a.m. or later.” AAP rationale for the statement is discussed on this site: http://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.
A good YouTube video, “Matt’s Story Rethinking School Start Times”, by Kelley Ditzenberger shows a story similar to Jilly’s experience in the Harper sleep article. Matt, an advocate for later school start times, takes data from student polls to his high school principal. (https://www.youtube.com/watch?v=9aqopRzY2MA)
The Seattle Times “Education Lab Blog”, reports that even though it is logistically challenging to change school start time, nationwide 70 school districts have accomplished this.

(http://blogs.seattletimes.com/educationlab/2014/09/30/be-heard-on-school-start-times-for-teens-seattle-forms-task-force/)

More sites on myths about sleep
“Nine Sleep Myths that Make You Tired” in Prevention Magazine describes nine myths about sleep that will make you feel tired. The article suggests: “Ignore these myths and get more energy, sleep better and longer, and wake up happier.” Find the list at http://www.prevention.com/health/sleep-energy/9-sleep-myths-make-you-tired/1-many-people-are-short-sleepers.
More sites on consequences of teen sleep deprivation
Detailed information on sleep disorders is available from the Mayo Clinic and National Institutes of Health (NIH) at http://www.mayoclinic.org/healthy-living/tween-and-teen-health/in-depth/teens-health/art-20046157 and https://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm.
More sites on the biochemistry of sleep
The chemistry of the synthesis of melatonin from serotonin is discussed on the web page for the chemistry department of Imperial College, UK. Structural formulas for this multi-step process are shown. (http://www.ch.ic.ac.uk/local/projects/s_thipayang/synth.html)
The International Journal of Endocrinology paper, “Sleep and Metabolism: An Overview”, provides a comprehensive review of the links between sleep and metabolism. (http://www.hindawi.com/journals/ije/2010/270832/)
More sites on the NREM/REM cycles of sleep
University of California, Berkeley (UCB) describes “short-term euphoria” as a lesser known side effect of sleep deprivation leading to “poor judgment and addictive behavior”. This may occur as a result of NREM/REM sleep disruption. (http://newscenter.berkeley.edu/2011/03/22/pulling-an-all-nighter/)
More sites on jet lag
The journal Current Biology contains the article “Social Jetlag and Obesity” that describes the relationship between adult social jetlag and potential obesity. This can easily be compared to teen social jetlag. (Current Biology 22: 939–943, 10 May 2012; http://www.sciencedirect.com/science/article/pii/S0960982212003259)
You can find a 4:56 abstract of the article about jetlag cited above, “Social Jetlag and its Consequences”, on YouTube: https://www.youtube.com/watch?v=iZ_VH2Zh1lU. The video describes human life controlled by three clocks: alarm, social, and body (internal). The difference between the social and body clocks lead to sleep deprivation behaviors.
More sites on severe sleep disorders: insomnia, restless leg syndrome, narcolepsy
A comprehensive presentation of insomnia can be found on this Mayo Clinic website. Following a definition, causes, risk factors, and complications that are similar to those of other sleep disorders are listed.

(http://www.mayoclinic.org/diseases-conditions/insomnia/basics/definition/con-20024293)
An in depth discussion of the symptoms and known causes of Restless Leg Syndrome (RLS) leaves the reader with the understanding that there are still gaps in our knowledge of gene function in the brain. This website shows an overview; the left margin contains links for other sections of the report. (http://www.hopkinsmedicine.org/neurology_neurosurgery/centers_clinics/restless-legs-syndrome/what-is-rls/)
A “Narcolepsy Fact Sheet” is located at the National Institute of Neurological Disorders and Stroke (NINDS). In narcolepsy, the brain fails to control the sleep cycle. Interference with normal NREM and REM patterns affects daily activities such as concentrating on studies, driving safely, and interacting socially.

(http://www.ninds.nih.gov/disorders/narcolepsy/detail_narcolepsy.htm)

More sites on obstructive sleep apnea (OSA), misdiagnosis, and obesity
To show your students exactly how OSA occurs, visit this site, scroll down to the illustration of the sleeping man, and click on the start button. An excellent animation with audio description shows the normal breathing process, snoring, and complete obstruction of the air passage. Written text of the audio portion is shown on the right of the screen.

(http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/)
There are also two good videos that show OSA in action. The first, a Mayo Clinic site video, is a one-minute video clip with the script written under the video, creating a very nice teaching tool. (http://www.mayoclinic.org/diseases-conditions/sleep-apnea/multimedia/obstructive-sleep-apnea/vid-20084717)
The second YouTube video on OSA, produced by Nuclear Medical Media, is more detailed and includes the causes and prevention. (https://www.youtube.com/watch?v=i6lxO6W2-m8)
This site from the Sleep Apnea Association discusses the symptoms of OSA in children and how those symptoms are frequently confused with similar behavioral patterns of children with attention-deficit hyperactivity disorder (ADHD). (http://www.sleepapnea.org/treat/childrens-sleep-apnea.html)
The American Academy of Sleep Medicine page, “Obstructive Sleep Apnea (OSA)”, describes treatments for the OSA. (http://www.aasmnet.org/resources/factsheets/sleepapnea.pdf)
Some of the “overabundance” of ADHD cases may be explained by the misdiagnosis of OSA due to symptoms caused by swollen tonsils. This article from the Columbia Chronicle (Columbia College, Chicago) provides a good explanation of the effect on NREM/REM sleep patterns by OSA and the resulting sleep deprivation. (http://www.columbiachronicle.com/arts_and_culture/article_f05d529a-525a-11e4-ac54-001a4bcf6878.html)
Material in this web site looks at the interactions between body weight and OSA and the implications for treatment. The authors conclude that due to the complex nature of OSA symptoms and their causes, treatment requires a multidisciplinary approach. (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364/)
More sites on dreams and nightmares
The following site suggests that taking a closer look at dreams may help the understanding of nightmares. The two website articles discuss sleep walking and acting out while dreaming or during a nightmare. (http://www.psychologytoday.com/conditions/nightmares) and (http://sleepfoundation.org/sleep-disorders-problems/abnormal-sleep-behaviors/nightmares-and-sleep)
More sites on teen at-risk behaviors as a consequence of sleep deprivation
On the Florida International University (FIU) site, sleep deprivation is linked to risky behavior in teens such as substance abuse, drunk driving, suicidal tendencies, and obesity. (http://news.fiu.edu/2014/04/research-links-extreme-sleep-deprivation-to-health-and-behavior-problems-in-teens/76986)
The United States Center for Disease Control and Prevention (CDC) states that almost 70 percent of high school students do not sleep long enough each night. Listed are the risky behaviors associated with teen sleep deprivation.

(http://www.cdc.gov/media/releases/2011/a0926_insufficient_sleep.html)
The National Institutes for Health (NIH) provides additional details on risky behavior caused by sleep deprivation, specifically due to disruption of the NREM/REM cycle. The publication also states: “In addition, sleep deficiency has played a role in human errors linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and aviation accidents.”

(http://www.nhlbi.nih.gov/health/health-topics/topics/sdd/)
More sites on general references for sleep
Section 3.9, “Evolution of sleep”, found in the National Institutes of Health (NIH) Teacher’s Guide, Information about Sleep, compares the patterns, habits, postures, and places of sleep for various animals. Mammals usually follow NREM/REM cycles, but the time spent in each pattern is different (brown rats average 19.9 hours per day, while giraffes average only 1.9 hours) than that required for quality human sleep. Birds spend only 2.5 minutes in NREM and 9 seconds in REM; lizards have not demonstrated REM patterns in current studies.

(https://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm)

Sleep deprivation in teens may lead to risky behaviors such as drug use, especially performance enhancing drugs such as steroids. The following references provide details on the increase in drug abuse visits to emergency rooms, the effects of steroid abuse, and what is being done to identify and reduce drug use at high schools and colleges.
Another interesting topic is the connection between lack of sleep and impaired memory. Since sleep deprivation is one of the tools used in the interrogation of prisoners, one could question the reliability of testimony obtained from a sleep deprived individual. The next sites provide information on memory loss or distortion due to lack of sleep.
Sleep deprivation may lead to loss or clouding of memory. A University of California, Irvine (UCI) study led by Steven Frenda and published in Scientific American found that after hours of interrogation by the police, people who average less than 5 hours of sleep a night frequently mixed facts with imagination and even reported things that never happened. See more at http://www.scientificamerican.com/article/all-nighters-could-alter-your-memories/.
Frenda’s work on false memories is also discussed in “Let the Body Rest, for the Sake of the Brain”, published in The Atlantic Monthly, 2014. (http://www.theatlantic.com/health/archive/2014/10/let-the-body-rest-for-the-sake-of-the-brain/381582/)
Frenda’s research was also published in the Journal of the Association for Psychological Science. (http://www.psychologicalscience.org/index.php/news/releases/sleep-deprivation-may-increase-susceptibility-to-false-memories.html)
Sleep Medicine at Harvard Medical School links types of memory with stages of sleep. (http://healthysleep.med.harvard.edu/healthy/matters/benefits-of-sleep/learning-memory)
Quanta Magazine, published an article, “Mental Leaps Cued by Memory’s Ripples”, that reports on studies of how the brain organizes memories. The studies show links between memory and decision making that involve sharp-wave ripples (SWRs). Studies on rats show that SWRs occur only during sleeping, under anesthesia, or periods of immobility. (http://www.quantamagazine.org/20141022-mental-leaps-cued-by-memorys-ripples/)

General Web References

(Web information not solely related to article topic)
The Drug Abuse Warning Network (DAWN) is a public health surveillance system that monitors drug-related visits to hospital emergency departments (ED). From 2005 to 2011, there was a 51 percent increase in drug related ED visits involving suicide attempts among people 12 and older. Data is charted and discussed here:

http://www.samhsa.gov/data/sites/default/files/DAWN-SR154-SuicideAttempts2014/DAWN-SR154-SuicideAttempts2014.htm.
This Cleveland Clinic article details many of the health effects of steroid abuse: http://my.clevelandclinic.org/health/drugs_devices_supplements/hic_Steroids_Anabolic-Androgenic.
The next three sites discuss banned substances and drug testing in schools:
This article from The School Administrator (online) highlights the effort of several school districts to test for steroids: http://www.aasa.org/SchoolAdministratorArticle.aspx?id=8104.
The National Institute of Drug Abuse frequently asked questions about drug testing schools can be found at http://www.drugabuse.gov/related-topics/drug-testing/faq-drug-testing-in-schools.
The National Collegiate Athletic Association (NCAA) site on banned and restricted substances is found here: http://www.ncaa.org/health-and-safety/policy/drug-testing.
Another interesting topic relates to the circadian rhythms of people who live at the far north and far south latitudes. They experience 24 hour days when the sun either shines or doesn’t shine. Researchers have found “evidence of clock gene alleles along latitudinal/photoperiod clines in humans”. The report of the study “Genetic Differences in Human Circadian Clock Genes among Worldwide Populations” can be found at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579796/.

More Web Sites on Teacher Information and Lesson Plans

(sites geared specifically to teachers)
The National Institutes for Health (NIH) has posted a very comprehensive, well organized, and easy to read teacher’s guide, “Information about Sleep”: https://science.education.nih.gov/supplements/nih3/sleep/guide/info-sleep.htm#content. This publication begins with, “Sleep is not just something to fill time when a person is inactive. Sleep is a required activity, not an option.” The guide, designed for teacher use, proceeds to provide details on the physiology of sleep and the consequences of sleep deprivation.
An almost-companion guide, published by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) places additional emphasis on the problems associated with lack of sleep, “What are Sleep Deprivation and Deficiency?” (http://www.nhibi.nih.gov/health/health-topics/add/printall-index.html)
The Oregon Health Science University (OHSU) has designed training programs (ATLAS and ATHENA) for coaches that are specifically designed to discourage steroid use among student-athletes. The home page of the ATLAS program provides a basic description, research findings, and program materials. Further information on these programs can be found at

http://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/medicine/divisions/hpsm/research/atlas-and-athena-program.cfm.

www.acs.org/chemmatters