Impact of sleep deficiency on surgical performance: a prospective assessment

1.However, Non-Technical Skills for Surgeons ratings demonstrated poorer performance while
post-call for situational awareness, decision-making, and communication/teamwork. Fewer hours
of sleep also were related to lower ratings for situational awareness and decision-making.
Decreased self-reported alertness was observed to be associated with increased procedure
time.
2. Sleep deficiency in attending surgeons was not associated with greater errors during
procedures performed during the next day. However, procedure time was increased, suggesting
that surgeons were able to compensate for sleep loss by working more slowly. Ratings on
nontechnical surgical skills were adversely affected by sleep deficiency.

Later School Start Time: The Impact of Sleep on Academic Performance and Health in the
Adolescent Population
1. Studies investigating the effects of different sleep-wake schedules on academic achievement
showed that impaired sleep quality and quantity are associated with decreased learning ability
and compromised daytime functioning.

Mental health and sleep habits during preclinical years of medical school (https://
pubmed.ncbi.nlm.nih.gov/36148761/)
1.Depression, anxiety, and sleep habits displayed a cyclical change that was associated with the
academic/seasonal cycle. The COVID-19 pandemic was never found significant. Medical
students who had a chronic disease diagnosis and fewer hours of sleep had increased severity.
2. Based on our sample, the main driver for depression, anxiety, and poor sleep quality appears
to be the academic/seasonal cycle

[Sleep status associated with psychological and behavioral problems in adolescents and
children]
(https://pubmed.ncbi.nlm.nih.gov/34814479/)
1. The sleep duration of four grades students were 90.4％,90.1％, 98.2％, and 98.4％,
respectively. 19.9％ did not have a post-lunch nap. 19.6％ had a wake-up delay of more than or
equal to 2 h weekend morning. 35.1％ had an inconsistent bedtime and 15.5％ had an
inconsistent awakening time. The multivariate logistic regression model showed that compared
with 8-9 h, the sleep duration of elementary school juniors at night less than or equal to 7 h, 7-8
h increased the risk of psychological behavior problems.
2. Sleep duration, no post-lunch sleep, and daily intraindividual variability of sleep is positively
associated with poor mental health. Additionally, social jet lag is associated with mental health
problems in students.

Adolescent sleep misalignment: a chronic jet lag and a matter of public health.(https://
pubmed.ncbi.nlm.nih.gov/23542542/)
1. A large number of adolescents sleep for 7-8h instead of 9-10h per night, which can lead to a
cumulative sleep debt with fatigue, behavioral problems and poor academic achievement.

Disruption of adolescents' circadian clock: The vicious circle of media use, exposure to light
at night, sleep loss and risk behaviours
( https://pubmed.ncbi.nlm.nih.gov/28487255/)
1. Adolescent sleep becomes irregular, shortened and delayed in relation with later sleep onset
and early waking time due to early school starting times on weekdays which results in rhythm
desynchronization and sleep loss.
2. Exposure of adolescents to the numerous electronic devices prior to bedtime has become a
great concern because LEDs emit much more blue light than white incandescent bulbs and
compact fluorescent bulbs and have therefore a greater impact on the biological clock.
3. A large number of adolescents move to evening chronotype and experience a misalignment
between biological and social rhythms which, added to sleep loss, results in e.g. fatigue, daytime
sleepiness, behavioral problems and poor academic achievement.

[The use of social media modifies teenagers' sleep-related behavior]

(https://pubmed.ncbi.nlm.nih.gov/28602529/)
1. Use of screens has been shown to delay sleep onset and melatonin secretion and stimulation
of wake systems by interaction with social media may exacerbate these effects.
2. Sleep deprivation had an effect on daytime performance: teenagers deprived of sleep were
more likely to report a need to fight sleepiness, (5.93±3.24 vs. 2.84±2.44 P<0.0001) and had
reduced energy during the day (6.21±2.86 vs. 7.77±2.07 P<0.0001).
2. A negative effect on mood was evident: in sleep, deprived teenagers irritability (5.28±3.12 vs.
3.30±2.34; P<0.0001) and feelings of sadness (3.97±2.99 vs. 2.59±2.15; P=0.003) were more
common.
common.
3. Access to social media and especially a cell phone in teenagers' bedrooms is associated with
a reduction in sleep time during the school week with negative effects on daily functioning and
mood which increases with increasing age.

Age-related changes in sleep/wake patterns among Korean teenagers

(https://pubmed.ncbi.nlm.nih.gov/15866859/)
1. The chief reasons students cited for their sleep deprivation differed across grades: Academic
demands and entertainment (such as Internet and television) were reported by 5th- and 6th-
graders, entertainment and then academic demands by 7th-, 8th-, and 9th-graders, and early
school start time and academic demands by 10th-, 11th- and 12th-graders.
2. This study also demonstrates that academic demands/stress and early school start time are
the most important contributing factors for sleep deprivation among Korean adolescents.

The impact of school daily schedule on adolescent sleep

(https://pubmed.ncbi.nlm.nih.gov/15930216/)

1.Adolescents lost as much as 120 minutes of sleep per night during the week after the start of
school, and weekend sleep time was also significantly longer (approximately 30 minutes) than
that seen before the start of school (August).
2. Students in early morning classes reported being wearier, being less alert, and having to
expend greater effort.
3. The results of this study demonstrated that current high school start times contribute to sleep
deprivation among adolescents. Consistent with a delay in circadian sleep phase, students
performed better later in the day than in the early morning.
4. Both short-term and long-term strategies that address the epidemic of sleep deprivation
among adolescents will be necessary to improve health and maximize school performance.

Impact of delaying school start time on adolescent sleep, mood, and behavior
(https://pubmed.ncbi.nlm.nih.gov/20603459/)
1. After the start time delay, mean school night sleep duration increased by 45 minutes, and
average bedtime advanced by 18 minutes (95% confidence interval, 7-29 minutes [t(423) =
3.36; P < .001]); the percentage of students getting less than 7 hours of sleep decreased by
79.4%, and those reporting at least 8 hours of sleep increased from 16.4% to 54.7%. Students
reported significantly more satisfaction with sleep and experienced improved motivation.
Daytime sleepiness, fatigue, and depressed mood were all reduced.
2. A modest delay in school start time was associated with significant improvements in measures
of adolescent alertness, mood, and health. The results of this study support the potential
benefits of adjusting school schedules to adolescents' sleep needs, circadian rhythm, and
developmental stage.

The sleep needs of adolescents

(https://pubmed.ncbi.nlm.nih.gov/10745797/)
1. Lack of sleep increases the possibility of increased daytime sleepiness, which may result in a
tragic automobile or work accident. Other consequences of sleep deprivation include poor
school performance, heightened risk of drug and alcohol use, increased irritability, and
aggressive behavior, all of which can interfere with relationships with classmates, parents, and
teachers.

Sleep in adolescence: a review of issues for nursing practice

(https://pubmed.ncbi.nlm.nih.gov/19638045/)
1. Disturbed sleep in adolescents has several potential consequences, including daytime
sleepiness, reduced academic performance and substance use/abuse.

Sleep disorders in general and in adolescence

(https://pubmed.ncbi.nlm.nih.gov/19517946/)
1. Adolescence may bring particular sleep problems such as delayed sleep phase syndrome
(DSPS), which is common in teenagers. Late-night social or other activities make it
physiologically impossible to get to sleep, leading to insufficient sleep and sleep debt which, if
unrecognised or incorrectly diagnosed and left untreated, may cause daytime sleepiness and
under-functioning.