November 20, 2005
Give Sleeping Drugs To Adolescents?
The New York Times has an interesting article on the appropriateness of sleep aid drugs for adolescents.
Because teenagers are more likely to have trouble falling asleep than staying asleep all night, shorter-acting drugs, like Sonata and Ambien, may be more appropriate for them than Lunesta, which is longer-lasting, the specialists say.
Rozerem, an insomnia medication just approved by the F.D.A. in July for use in adults, may have an even more selective effect on the brain.
It is directed at receptors in the suprachiasmatic nucleus, which sets the body's internal clock.
And because this clock is thought to shift adolescents' sleep patterns, some doctors suspect that Rozerem may be useful in treating their sleep problems.
Since adolescents tend to stay up later and get up later why not just shift schools to later hours to make school hours fit the natural body rhythms of adolescents? To say that adolescents have sleep problems implies a medical condition like an illness. But we do not know why so many adolescents operate on later sleep cycles. Their behavior might be the result of Darwinian natural selection for effective mating strategies. Or their minds might respond more to light stimuli and artificial lighting might be shifting their melatonin production to make them stay out later. Or perhaps adolescent brains develop better if they can spend part of their days in lower light conditions and hence natural selection produced this behavior to improve brain development.
I'm speculating. But my point is that we do not know what causes adolescent sleeping patterns. Therefore efforts to pharmaceutically interfere with natural sleep cycles in order to make adolescents fit in better in institutions shaped for adult convenience seem ill advised. Such interference might produce unforeseeable and harmful consequences on brain development or other aspects of the body's growth.
Perhaps the use of high intensity lights to shift adolescent sleep patterns would be a less risky alternative. If the adolescent brain's sleep regulating mechanism can be fooled into thinking the day starts earlier and ends earlier then it might be able to function just fine on earlier real clock times.
But, again, why not just shift school schedules a couple of hours? Start schools at 10 AM or 11 AM. The kids sitting like zombies in classes at 8 AM aren't learning as much as they could learn at later hours in the day. Teachers could handle teaching till 5 PM rather than 3 PM in the afternoon. Institutions should be molded around human biology rather than the other way around. Or instead of listening to so many hours of live lectures in the morning when so many kids are half asleep the kids could watch more high resolution recorded lectures in the evenings when their minds are sharp. We can use technology to adjust institutions to humans. Why not do it?
"why not just shift schools to later hours to make the natural body rhythms of adolescents?"
Because it would get in the way of Football practice.
The main argument I have heard against shifting school later is, in fact, extracurricular activities. It never made sense to me that elementary schoolers, who were much more capable (on average) of getting up early actually had a later start time for school (at least where I lived). But high schoolers have more after school activities like sports and band. Ideally, I would say move the extracurricular activities to early in the morning. Sports in particular would serve to wake the students up and wouldn't be too demanding on a tired mind. Then, when they get to class, they'll be alert and ready to learn. Unfortunately, the side effect of that may be that fewer kids would participate in extracurricular activities because it would require them to get up earlier than just going to school.
This is strange, but I don't ever remember having trouble waking up when I was a teenager. Except when I stayed up past midnight watching TV.
Maybe if they went to bed earlier and stopped being such crybabies?
"Unfortunately, the side effect of that may be that fewer kids would participate in extracurricular activities because it would require them to get up earlier than just going to school."
If P.E. were useful, it would teach more valuable lessons like martial arts. Alternatively, it could be used for dedicated training in every sport. More often, it seems to be a place to hold the mandatory physical testing that occurs once a year.
In my experience, early morning P.E. or sports was always something difficult to attend by rewarding by the end.
Either way, any comment on education, and why it isn't as dynamic as desired, should be directed to the large corpus of evidence that government administration is a poor choice. A voucher system would allow greater experimentation, such as the recorded lectures, shifted P.E./sports schedules, etc.
Starting school later has been brought up several times in my county where the high school hours are 7:20am - 2:10pm. But the students by and large oppose having school start later because they want to be able to work at after school jobs. This reason is considered important enough that high school hours have actually been shifted to earlier times. High school used to start at 7:40 am.
After-school activities and jobs should take a back seat to fixing academic performance.
One reason school schedules are the way they are is that the administration, unlike Ed Dept academics, views the average student not as a potential Mozart but as a future time-card puncher who needs to be whipped into shape before arrival to the job market. So school is their "9 to 5" (well 7 to 3) where they sit around all day bored as hell doing whatever the boss tells them to do, and where they need to ask permission to go to the bathroom. Now, in fairness, I think this is needed for some who are clearly not interested in anything academic and are largely there to screw off, bully others, etc. But the average student -- er, I guess depending on the race / class make-up of the school -- is usually above this lowest level, even if they're not bright. And certainly the bright students rebel against being treated like prisoners.
In essence, school should be aimed at where the kids are going. So keep the 7 to 3 schedule for those who are basically being baby-sitted, then let them go to their after-school job. Having to get up at 6:30 or earlier means they can't be out raising hell late at night. Tailor their classes toward the kind of math, english, and so forth that they'll need for where they're going. Making change, balancing a checkbook, reading your credit card statement so you can stay out of debt, basic arithmetic...
However, for the average and bright students who'll actually take school seriously, let them arrive at 10am and leave at 3:30pm -- that allows for 5 academic classes of 50 min each, 4 min to get to your next class, and 1 hr for lunch. Gym, art, music, creative writing, and so on would be optional extra-curriculars. That way athletes won't have to sit through gym class *and* practice, ditto for band members, etc. For nerds, maybe offer a computer literacy or computer programming extra-curricular. Those who would opt out of taking any extra-curricular wouldn't contribute much to a required course anyway. If you really wanted them to do so, offer an incentive: you don't *need* to take this, but if you want an honors certificate or something upon graduation, you need X number of extra-curriculars.
Gym is option in college, unless you go someplace like Stevens Institute of Technology. A friend of mine went to their engineering school where they had a policy stated approximately as follows:
"Due to the sedentary nature of an engineering student's lifestyle, a physical education course is required for each semester of attendance".
Of course, these courses were better funded than a high school class; so 'free' racquetball lessons weren't too bad.
Perhaps the problem with teen groginess in school is that they haven't done the things that bring alertness. The teen is roused, washes a moment, eats mostly sugar at breakfast, doesn't have the cup of coffee the adult drinks, picks up or drags a parcel of books to a bus, sits, enters school just as classes start, sits. Little of interest is happening. How awake would you be?
Teens don't want to get up? Maybe they don't look forward to the next boring hours. How do they function as soon as school lets out? Fine. How do they function on weekends? Fine - mom doesn't care what they gobble and activities are not precisely ordered.
Ban the sugar calories at breakfast. Keep all calories low. No milk. A little coffee. At school they should have conditioning first, a ten minute vigorous walk. Then fifteen to socialize. Then they are ready.
Adults arrive at work. They have already dealt with kids, traffic, and mentally reviewed what needs to be done that day. But still they normally socialize for a few minutes, maybe glance at the news, have a little more coffee. Then the job gets done because they are ready.
YTF we feel the need to keep getting up earlier and earlier in the morning, as a species, I just don't understand.
(ok I know its a by-product of the information age and growing global market - but it still seems irrational)
But seriously no one in power is interested in school reform.
Under the worlds current predominantly class based social system, education of the masses is considerably less important than the passification of them.
Therefore no improvements in education for the proletariats will be seriously implemented on a large scale.
Everyone knows this is not a sustainable situation as technology and population increases - but the elite hope to perfect civilian manipulation technologies before improving the educational system.
Until this class based social system is reformed, other significant and important social reforms will take a back seat.
Unfortunately the number of social conservatives who have already drunk the kool aid around here sometimes makes me less than optimistic.
Most of this increase in hypnotic prescriptions to youth is due to the psycho-stimulants also being prescribed to the same youth, for ADD, ADHD, etc. In other words, kids fall into the same upper/downer drug cycle that so many adults fall prey to. When I was treating a lot of kids for ADD, ADHD, . . . , I was concerned about all the ramifications of drugging a child to improve his behavior, and was quite selective. Sometimes the stimulants made all the difference in the world for the child's performance at school and social behavior at home. I tended to keep the doses of stimulants relatively low compared to other clinicians, and never prescribed sleeping pills for children. That leads to a slippery slope, traversed by a lot of deceased rock stars and others.
Good common sense suggestions. Drugs are not always the answer to everything. Our teenagers don't need to be taking more drugs, particularly not sleeping pills.
Research shows that melatonin levels in teens are the highest at different times than adults and children. It's not our fault. I'll admit, some teenagers stay up later than they should, but school starts earlier than it should. Even many of the adults don't begin work as early as we begin school. We start at 7, and many adults don't clock in until 8 or later. Teenagers who are aroused from sleep early may still have elevated levels of melatonin, a hormone associated with sleep, and those who try to go to bed early may not be able to sleep, as melatonin levels indicate that their bodies are still fully awake. So I understand the concerns, but as a 16 year old high school junior, I say skip the sleeping pills unless necessary, and move the school hours! However, sleeping pills are sometimes needed. I have several mental conditions that prevented me from sleeping, and eventually I got new medication to help me sleep (prescribed by my doctor). Even though I sleep better, it's not enough. I go to bed after I finish my homework, so anywhere from 9-10 (and I DO my homework well, and take a college class), and wake up at 5:45 to get to school on time.
"This is strange, but I don't ever remember having trouble waking up when I was a teenager. Except when I stayed up past midnight watching TV.
Maybe if they went to bed earlier and stopped being such crybabies?"
Well for those of us who play varsity sports and then go home and have 4 to 5 hours of homework we would appreciate the change and just because you didn't have trouble getting up doesn't mean that the rest of us don't.