The Cumulative Impact of Adolescent Sleep Loss: Next Steps.
The Cumulative Impact of Adolescent Sleep Loss: Next Steps.
复制标题
青少年睡眠不足的累积影响：后续步骤。
作者：
D. Beebe
众所周知，睡眠生理学的发展变化和社会压力缩短了青少年在上学之夜的典型睡眠时间。1在过去的世纪中，青少年的睡眠时间也比年幼的儿童或成年人下降得更快。2，3然而，这些趋势的影响引起了激烈的争论。2012年发表的两篇论文引发了儿科睡眠界的不安。其中一项研究质疑睡眠不足的证据基础。4另一项研究提出的“最佳”睡眠时间远低于普遍推荐的9小时，5而与美国青少年在学校晚上的平均睡眠时间密切相关。6对这些挑战有三种主要反应：（1）媒体报道过度简化了对话7;（2）对现有数据进行重新分析，扩大了被认为是“建议“的范围8;（3）扩大科学知识基础，纳入替代分析方法和更复杂的研究设计。在这一期中，Lo和同事们采取了第三条路线，并通过第一次检查实验诱导的慢性部分睡眠限制对青少年注意力，工作记忆，处理速度，主观嗜睡和情绪的影响的日常变化来推动该领域的发展。虽然不是完全重复，但这些发现让人想起了10年前发表的关于成年人的研究，此后被引用了近1,000次。10与成年人一样，青少年在每一个累积的限制睡眠的夜晚后，表现出持续恶化的注意力和较小程度的工作记忆。这种影响在整整一周内没有表现出平稳的迹象，即使主观嗜睡和情绪在几天后趋于平稳（但不会逆转）。主观体验和客观缺陷之间的这种脱节可能导致对损伤的渐进性低估，这不仅可能影响学习和社会互动，而且还可能影响安全性（例如，11）Lo及其同事的开创性工作9清楚地表明，青少年部分睡眠限制相关的累积成本是客观可验证的，渐进的，反映了真正的因果关系，并且可能需要多个恢复夜晚才能逆转（尽管即使是一个恢复夜晚也会导致显着的改善）。这些都是对青少年睡眠建议辩论的重要贡献。然而，这些研究结果提出了新的问题，这些问题的答案将具有非常实际的意义，这似乎总是正确的。首先，该领域必须确定调查结果可以推广的程度。正如Lo和同事们所指出的，参与他们研究的精英学生是一个重要的群体，他们本身就是一个重要的群体，但他们是一个独特的少数群体。很难知道努力学习的学生和人口统计学上不同的青少年是否会表现出更大的，dx.doi.org/10.5665/sleep.5512
It is well recognized that developmental shifts in sleep physiology and societal pressures shorten the typical sleep of adolescents on school nights.1 Adolescents have also shown a steeper decline in sleep duration over the past century than younger children or adults.2,3 However, the implications of these trends are hotly debated. Two papers published in 2012 stoked unrest in the pediatric sleep community. One questioned the evidence base underlying sleep recommendations.4 The other suggested “optimal” sleep durations that were much less than the prevailing recommendation of 9 hours,5 and instead corresponded closely to the average sleep of United States adolescents on school nights.6 There have been three primary responses to those challenges: (1) media coverage that oversimplified the conversation7; (2) re-analysis of existing data that broadened the range of what is considered “recommended”8; and (3) expansion of the scientific knowledge base to incorporate alternative analytic approaches and more sophisticated research designs. In this issue, Lo and colleagues9 take the third route, and propel the field forward by examining, for the first time, day-to-day changes in the effects of experimentally induced chronic partial sleep restriction on adolescents’ attention, working memory, processing speed, subjective sleepiness, and mood. Although not an exact replication, the findings are reminiscent of work with adults published a decade ago and since cited nearly 1,000 times.10 As in adults, adolescents show consistently worsening attention and, to a lesser degree, working memory after each cumulative night of restricted sleep. This effect shows no sign of leveling off across a full week, even though subjective sleepiness and mood level off (but do not reverse) after a few days. This disconnect between subjective experience and objective deficits could lead to a progressive underestimation of impairment,10 which could affect not only learning and social interactions, but also safety (e.g., automobile accidents by adolescent drivers.11) Lo and colleagues’ pioneering work9 clearly shows that there is a cumulative cost associated with partial sleep restriction in adolescents that is objectively verifiable, progressive, reflects a true cause-effect relationship, and may take multiple recovery nights to reverse (though even a single recovery night results in striking improvements). These are critical contributions to the debate over adolescent sleep recommendations. Nevertheless, as seems invariably true, the findings raise new questions, the answers to which will have very practical implications. First, the field must determine the degree to which the findings can be generalized. As Lo and colleagues note, the elite students who participated in their study are an important group to understand in their own right, but they are a unique minority. It is hard to know whether struggling students and demographically dissimilar adolescents will show a greater, pii: sp-00025-16 ht tp://dx.doi.org/10.5665/sleep.5512
影响因子：
5.6
作者：
Van Dongen, HPA;Maislin, G;Dinges, DF
通讯作者：
Dinges, DF
睡眠和认知表现：收入和呼吸性窦性心律失常反应性的作用。
影响因子：
2.2
作者：
Staton,Lori;Hinnant,JBenjamin;Buckhalt,Joseph;El-Sheikh,Mona
通讯作者：
El-Sheikh,Mona
DOI：
10.1056/nejmoa1215881
发表时间：
2013-06-20
期刊：
The New England journal of medicine
影响因子：
--
作者：
Marcus CL;Moore RH;Rosen CL;Giordani B;Garetz SL;Taylor HG;Mitchell RB;Amin R;Katz ES;Arens R;Paruthi S;Muzumdar H;Gozal D;Thomas NH;Ware J;Beebe D;Snyder K;Elden L;Sprecher RC;Willging P;Jones D;Bent JP;Hoban T;Chervin RD;Ellenberg SS;Redline S;Childhood Adenotonsillectomy Trial (CHAT)
通讯作者：
Childhood Adenotonsillectomy Trial (CHAT)