CHAPTER 2

REVIEW OF RELATED LITERATURE

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Sleep is one of the most essential parts of our everyday lives. It plays a significant role
in the excellent health and well-being of a person throughout their life. It’s like food to our
brain. Sleep is essential and provides various physical benefits to our body. Not getting
enough or proper sleep often has several emotional and mental outcomes. This vital
biological activity gives individuals the energy needed to perform even the simplest of tasks,
such as walking, concentrating, and conversing (Morgan Persky, 2018).

Sleep allows one to be alert, insightful, and sharp. Sleep allows students to properly
solve problems. But, if a person -specifically a student - did not meet the recommended
sleeping time, it could negatively affect their performance on their various activities. Poor
sleep can negatively affect a student’s grades, increase the odds of emotional and behavioral
disturbance. Insufficient sleep among adolescents may not only contribute to lower grades
and a lack of motivation, but may also increase the odds of serious levels of emotional and
behavioral disturbances, including ADHD (Sleep Habits, Emotional Disturbance, and ADHD
in High School Freshmen,2017).

According to the study of Morgan Persky (2018) sleep serves to re-energize the body’s
cells, clear waste from the brain, and support learning and memory. It even plays vital roles in
regulating mood, appetite and libido. Based on the study of Sleep Habits it is recommended
that adolescents get nine hours of nightly sleep.

The brain generates two distinct types of sleep—slow-wave sleep (SWS), known as
deep sleep, and rapid eye movement (REM), also called dreaming sleep. SWS takes up
most of the time during sleep, characterized by large, slow brain waves, relaxed muscles and
deep breathing, which may help the brain and body to recuperate after a long day. After
SWS, REM sleep begins. In REM sleep, a dreamer’s brain becomes highly active while the
body’s muscles are paralyzed, and breathing and heart rate become erratic. The purpose of
REM sleep remains a biological mystery. sleep is not prioritized in society, and often needs to
be sacrificed by high school students.
 Multiple studies have shown that present day high school students do not receive an
optimal amount of sleep. “According to most sleep experts, most adolescents need about 9
hours of sleep per night. Today, nearly two thirds of adolescents get under 8 hours of sleep,
and two fifths get under 6 hours of sleep per night” .

There are excessive demands placed on teenagers, which prevent them from receiving
the required amount of sleep that they desperately need. Often, high school students stay up
until the wee hours to study. Time after time, students push academic requirements to the
end of their schedule because of extracurricular activities such as school clubs, sports
practices, music rehearsals, or work (Morgan P., 2018).

According to the study of Shelley D Hershner and Ronald D Chervin (2014), daytime
sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among
college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The
consequences of sleep deprivation and daytime sleepiness are especially problematic to
college students and can result in lower grade point averages, increased risk of academic
failure, compromised learning, impaired mood, and increased risk of motor vehicle accidents.

During sleep, the plasma growth hormone is secreted, which helps the body to grow.
Also, sleep maintains healthy body weight. Besides these, there are other benefits of sleep
too. The sleeping pattern varies in different age groups. It means that the amount of sleep
needed by a child is different from a teenager and an adult. Usually, high school students
suffered from sleep deprivation (Michell Starc, 2019).

Daytime sleepiness is a major problem, exhibited by 50% of college students compared

to 36% of adolescents and adults. At least 3 days a week, 60% of students report that they
are dragging, tired, or sleepy.

Sleepiness is defined as the inability or difficulty in maintaining alertness during the

major wake period of the day, resulting in unintended lapses into drowsiness or sleep. It is
important to note that sleepiness is often circumstance-dependent, with many aspects of the
students’ learning environment exacerbating sleepiness.

Sleep deprivation and sleepiness are caused by a host of reasons and have numerous
negative consequences. In the literature, sleep deprivation is often termed either acute sleep
deprivation or chronic partial sleep deprivation.
 Colloquially for students, acute sleep deprivation is termed “pulling an all-nighter”,
meaning that a person stays up for 24 hours or longer. More typically, sleep deprivation
consists of chronic partial sleep deprivation, where a student obtains some, but not adequate
sleep. Sleepiness can be an obvious consequence of sleep deprivation, but sleepiness can
be caused by other circumstances, most commonly sleep disorders (Shelley D Hershner and
Ronald D Chervin, 2014) .

Sleep deprivation increases the likelihood teens will suffer myriad negative
consequences, including an inability to concentrate, poor grades, drowsy-driving incidents,
anxiety, depression, thoughts of suicide and even suicide attempts.

Sleep is believed to reinforce learning and memory, with studies showing that people
perform better on mental tasks when they are well-rested. “We hypothesize that when teens
sleep, the brain is going through processes of consolidation — learning of experiences or
making memories,” Yuan said. “It’s like your brain is filtering itself — consolidating the
important things and filtering out those unimportant things.” When the brain is deprived of that
opportunity, cognitive function suffers, along with the capacity to learn.

Sleep problems among adolescents are a major risk factor for suicidal thoughts and
death by suicide, which ranks as the third-leading cause of fatalities among 15- to 24-year-
olds. And this link between sleep and suicidal thoughts remains strong, independent of
whether the teen is depressed or has drug and alcohol issues, according to Somchter (2019).

The American Academy of Sleep Medicine (AASM) offers the following tips on how to
get a good night’s sleep:

 Follow a consistent bedtime routine.

 Establish a relaxing setting at bedtime.
 Get a full night’s sleep every night.
 Avoid foods or drinks that contain caffeine, as well as any medicine that has a
stimulant, prior to bedtime.
 Do not stay up all hours of the night to “cram” for an exam, do homework, etc. If after-
school activities are proving to be too time-consuming, consider cutting back on these
activities.
 Keep computers and TVs out of the bedroom.
 Do not go to bed hungry, but don’t eat a big meal before bedtime either.
 Avoid any rigorous exercise within six hours of your bedtime.
 Make your bedroom quiet, dark and a little bit cool.
 Get up at the same time every morning.
The following were a given list of the causes, effects and tips for the prevention of sleep
deprivation based on the study of the Better Health Channel (2018).

Causes of teenage sleep deprivation

Some of the reasons why many teenagers regularly do not get enough sleep include:

 hormonal time shift – puberty hormones shift the teenager’s body clock forward by
about one or two hours, making them sleepier one to two hours later. Yet, while the
teenager falls asleep later, early school starts don’t allow them to sleep in. This
nightly ‘sleep debt’ leads to chronic sleep deprivation
 using screen based devices – smart phones and other devices used around bed
time reduce sleep time. Teens who put down their smart-phones an hour before bed
gain an extra 21 minutes sleep a night, (that's one hour and 45 minutes over the
school week) according to a study by Vic Health and the Sleep Health Foundation
 hectic after-school schedule – homework, sport, part-time work and social
commitments can cut into a teenager’s sleeping time
 leisure activities – the lure of stimulating entertainment such as television, the
internet and computer gaming can keep a teenager out of bed.
 light exposure – light cues the brain to stay awake. In the evening, lights from
televisions, mobile phones and computers can prevent adequate production of
melatonin, the brain chemical (neurotransmitter) responsible for sleep
 vicious circle – insufficient sleep causes a teenager’s brain to become more active.
An over-aroused brain is less able to fall asleep.
 social attitudes – in Western culture, keeping active is valued more than sleep
 sleep disorder – sleep disorders, such as restless legs syndrome or sleep apnoea,
can affect how much sleep a teenager gets.

Effects of teenage sleep deprivation

The developing brain of a teenager needs between eight and 10 hours of sleep every
night. The effects of chronic (ongoing) sleep deprivation may include:

 concentration difficulties
 mentally ‘drifting off’ in class
 shortened attention span
 memory impairment
 poor decision making
 lack of enthusiasm
 moodiness and aggression
 depression
 risk-taking behaviour
  slower physical reflexes
 clumsiness, which may result in physical injuries
 reduced sporting performance
 reduced academic performance
 increased number of ‘sick days’ from school because of tiredness, and
 truancy.

Preventing sleep deprivation in teenagers – tips for parents

 Try not to argue with your teenager about bedtime. Instead, discuss the issue with
them. Together, brainstorm ways to increase their nightly quota of sleep.
Suggestions include:
 Allow your child to sleep in on the weekends.

 Encourage an early night every Sunday. A late night on Sunday followed by an early
Monday morning will make your child drowsy for the start of the school week.
 Decide together on appropriate time limits for any stimulating activity such as
homework or screen time. Encourage restful activities during the evening, such as
reading.
 Avoid early morning appointments, classes or training sessions for your child if
possible.
 Help your teenager to better schedule their after-school commitments to free up time
for rest and sleep.
 Assess your teenager's weekly schedule together and see if they are over
committed. Help them to trim activities if they are.
 Encourage your teen to take an afternoon nap after school to help recharge their
battery, if they have time.
 Work together to adjust your teenager’s body clock. You may like to consult with
your doctor first.

According to the National Sleep Foundation (2019), Teenagers are notorious for staying
up late at night. When they are not working on school projects, they are usually socializing
late into the night and missing out on valuable sleep. A recent study published in the Journal
of Adolescent Health found that as much as two-thirds of high school students get less than
seven hour so sleep nightly. The study also found that girls and students in higher grades are
getting the least amount of sleep.

Most students probably know that depriving themselves from sleep is bad, but
nonetheless they’re willing to sacrifice sleep and as a consequence, health, telling
themselves it’s just for a short time and they can soon start sleeping 12-hours a day once the
semester draws to a close.
 Students are known for slapdash sleeping habits, but these patterns could be
detrimentally impacting your performance, and it’s time to nip them in the bud.students who
had more regular sleep patterns had better average school grades.This goes to show that it’s
not always the hours of sleep you’re getting but rather the fact you’re not sleeping regularly,
that can affect your performance.students who slept for less than six hours showed signs of
anxiety, neurotic feelings, lack of creativity, and more prone to hallucination.

Students must be encouraged to take an afternoon nap after school. It is because many
studies reveal that short nap helps in the optimal functioning of the body.

Sleep is imperative to memory consolidation and cognition.maintaining bad sleeping

habits will be detrimental to your health. Not getting at least seven to eight hours’ sleep a
night on a regular basis has been shown to increase your risk of getting diseases like
diabetes, while also promoting weight gain and lower immune systems (Sharuna Segaren,
2018).

Schools should start classes later in the morning to allow students to get more sleep, as
sleep deprivation not only inhibits academic performance, but hinders the ability to drive and
also negatively impacts an individual’s physical and mental health. High schools, specifically,
should start the school day later in the morning, because as children mature into post-
pubescent adolescents, their demands for sleep substantially increase (Morgan P., 2018).

Children and adolescents who do not get enough sleep have a higher risk of obesity,
diabetes, injuries, poor mental health, and problems with attention and behavior. How much
sleep someone needs depends on their age.teenagers aged 13–18 years should sleep 8–10
hours per 24 hours(Centers for Disease Control and Prevention,2018).

Sleep loss can take a devastating toll on the mind and body at any stage of life, from
early childhood to older adulthood. But for teenagers, who are at a critical stage of
development, skipping out on sleep can be particularly dangerous. sleep is arguably most
critical during the teen years, teenagers are the least likely of any age group to be getting
sufficient rest.teenagers need at least nine hours of sleep per night, only 9 percent of high
school students are actually meeting these recommendations.lost sleep is associated with a
38 percent increased risk of feeling sad or hopeless and a 58 percent increase in suicide
attempts.

Acute sleep deprivation has a significant effect on post exercise blood pressure and
reaction time in students. These changes are likely due to neuroendocrine changes and
downregulation in salience and motor areas of the brain. An “all-nighter” does not affect a
student’s cognitive ability, whilst physical performance is significantly affected.
 Teens who sleep an average of six hours per night are also three times more likely to
suffer from depression (Carolyn Gregoire,2018).

Adolescents who get less sleep than they need are at higher risk for depression,
suicide, substance abuse and car crashes. They don't perform as well in school. Evidence
also links short sleep duration with obesity and a weakened immune system.tight link
between school performance and sleep. For one, sleep deficiency increases the risk of
attention problems (Karen Weintraub, 2016).

Lack of sleep affects various aspects of high school students’ lives. Teenagers who
suffer from sleep deprivation are more likely to get poor grades, sleep during the classes,
remain absent from school, and negate the hours of sleep which were lost due to studying.
Not getting enough sleep regularly often leads to severe sleep deprivation. It can have dire
effects on a student’s life, affecting their mental comfort, academic performance, and
increasing the risk of anxiety, depression, and low self-esteem (Thrive Global, 2019).

Parents also have a role to play in setting bedtimes and other limits. In families where
parents don't enforce a typical bedtime of about 10 p.m., researchers found that their high
schoolers have an increased risk of depression and suicidal thinking (Sleep, 2010).

Schools are putting all of these vital components at risk. Sleep deprivation leads to poor
academic performance. High school students are under much more pressure than previous
generations of students, and don’t have enough time for both their schoolwork,
extracurricular activities, and sleep. High schools make students wake up before sunrise,
which undeniably inhibits one’s chances for success (Morgan P., 2018).

Growing competition between high school students has lead to higher percentages of
students who are experiencing sleep deprivation, anxiety, stress, depression, and suicidal
thoughts or actions. Health risks from sleep deprivation range from yawning and moodiness
all the way to brain problems involving: hallucinations, memory problems, cognitive
dysfunction, depression, and being more accident prone.
 Local

Sleep is so much more than just resting. Sleep deprivation has serious consequences
on a child's growth and development. Lack of sleep is likewise implicated in deterioration of
executive control. Sleep deprivation has serious consequences on a child's growth and
development. During sleep, the brain forms new pathways to help one learn and remember
information. It is no surprise then that children and adolescents require more sleep as their
brains are still rapidly developing (Philippine Basic Education, 2014).

Sleep allows the body to rest, sufficient, quality sleep allows our minds to refresh, and
facilitates the transfer of short-term to long-term memory. Proper sleep has been proven to
help students perform better in school the following day, particularly in complicated tasks like
mathematics. Decision-making and emotional stability are also affected by the right amount
of good sleep.

During sleep, the brain purges itself, flushing out its own chemical waste through a
hidden network of channels that resemble a plumbing system. These pipes simulate opening
up during sleep. In addition, researchers think that this cleansing process uses up a lot of
energy, which may explain why the brain waits until bedtime to take out its own trash. Also,
your body saves the energy it uses to see while you are sleeping, which possibly adds
needed fuel to this process.

The brain are more active during sleep which allow time to clear away toxic products that they
theorized would otherwise cause problems which could lead to Alzheimer’s disease. It is confirmed
that the things that we learned during the day are also strengthened and reinforced when we sleep.
There is no substitute for restorative sleep. A certain amount of care should be taken to prevent the
persistence of sleep deprivation in all individuals of all ages. People who get less than six hours sleep
per night have an increased risk of dying prematurely. Those who slumbered for less than that
amount of time were 12 percent more likely to die early. If you sleep little, you can develop diabetes,
obesity, hypertension and high cholesterol.

Oversleeping is more likely to be an effect of illness, rather than a cause. Researched shows
that there no adverse effects for those sleeping between six to eight hours per day. This finding was
published in the Sleep Journal.
 National Sleep Foundation (NSF) recently released the key indicators of a good quality sleep. It
includes sleep at least 85 percent total time in bed, falling asleep in 30 minutes or less, waking up no
more than once per night, and being awake for 20 minutes or less after initially falling asleep Studies
confirmed a good quality sleep improves learning, problem-solving skills, creativeness, focus and
concentrations and the opposite frequently causes anxiety, poor concentration, loss of focus, and
depression.

Obstructive Sleep Apnea (OSA) considered a common cause of sleep deprivation is often
overlooked and undiagnosed. Although snoring doesn’t mean that you have OSA, Sleep apnea is
always accompanied with snoring or even worst, cessation of regular breathing ending up with
increased frequency of waking up in the middle of the night gasping for air leading to interruptions of
an excellent sleep. With sleep deprivation already lurking in an individual, the body always takes its
toll. It has been implicated in a lot of acute damages like car crash, and work accidents to a chronic
more devastating effect. Sleep Deprivation can substantially lower an individual’s overall quality of life.
While the occasional poor night’s sleep is not a serious problem in itself, persistence of sleep
deprivation can be (Rommel Tan, 2018).

Losing sleep for a day or so makes you less alert, forgetful, moody and irritable, less active ,
and accident-prone. It affects basic brain functions like reasoning, problem-solving, and decision-
making, which you need for everyday tasks. If you process a lot of data at work, those “sharp wave
ripples” during deep sleep is exactly what you need to consolidate new information and lock it to
memory. Students are more likely to develop long-term anxiety, depression, and other mood
disorders. Chronic sleep deprivation weakens your immune system, leaving you vulnerable to serious
health problems. Long-term sleep loss cause your body to change the way it processes glucose,
which may lead to adult-onset diabetes. Your heart rate and blood pressure increase, which lead to
inflammation and puts you at a higher risk for heart disease. Also, more likely to develop long-term
anxiety, depression, and other mood disorders (Marella Castro, 2017).

Irregular sleepers were also found to have less exposure to light during the day but more
exposure at night, which also can affect the circadian clock, whether it's sunlight, fluorescent light in a
classroom or artificial light from a phone or another electronic device. Irregular sleepers, melatonin is
released later in the night, pushing the circadian clock later as well.

Early bedtime is not a requirement for making your sleep pattern more regular: "The results of
this study are not suggesting everybody has to be a goody-two-shoes. So if you go to bed at 2 and
get up at 9, that's fine. You just have to consistently do the same thing (Victoria Knight, 2017 )."

Technology addiction has made surfing the Net before sleep a fact of life. Unfortunately, it bodes
ill for your body’s ability to get a good night’s rest. The artificial light emitted by computers not only
makes you alert but supresses melatonin, the hormone that makes you sleep. Finish all your Web
surfing hours before you sleep and keep your gadgets away or in silent mode. Unrealistic
expectations pressure people into thinking that sleep isn’t very important.