Sleep and Nutrition May 2016

Sleep and Nutrition in Teenagers

Dr. Jennifer Vriend, PsychologistQueensview Professional Services

Anna Aylett, Registered DietitianCHEO, Centre for Healthy Active Living

Tonight

Sleep in Teenagers (Jenn)Nutrition in Teenagers (Anna)Sleep and Nutrition in Teenagers

(Jenn and Anna)

Questions

2

Sleep in Teenagers

What makes us sleepy?Sleep Pressure

Our bodies need a ‘refill’ each night

4

What makes us sleepy?Clocks (Circadian Rhythm)

Internal clock tell us to be tired at night and awake during the day

Balances our sleep drive keeps us awake during the day

5

Melatonin – the hormone of darkness

Clock works by producing melatonin

Melatonin makes us sleepy Melatonin is produced when it gets

dark Melatonin levels rises in mid to late

evening Remain high during night Drop in the morning

6

The Stages of Sleep•Stage 1

•Stage 2

•Slow wave sleep (Stage 3 and 4)

•Rapid eye movement (REM) sleep

• Then you begin the cycle all over again

• You repeat the stages about every 90 minutes until you wake up in the morning

• For most kids, that's about 4 or 5 cycles a night

Mostly NREM early in nightMostly REM in early morning hours

How much sleep do our children need?There is no “correct” amount What determines the right amount of

sleep for each child is whether they wake up feeling well-rested varies greatly between individuals Average sleep durations for specific age

groups are…

10How much sleep do children need?

Infants 14-15 hours Toddlers 12-14 hours Preschoolers 11-13 hours School-Age Children 10-11 hours Teenagers 9-10 hours

Sleep in Teens Struggle to get up in the morning Claim they aren’t tired at bedtime Sleep late on weekends Tired at school, struggle to

concentrate Adolescents typically get about 6-7

hrs of sleep – need 9-10 hours

11

The Perfect Storm

The circadian clock Clock shifts to new phase during

adolescents Phase delay occurs in association with

puberty Circadian system has altered sensitivity to

light Melatonin release occurs later▪ More sensitive to evening light, less sensitive to

morning light Occurs in other mammals▪ Suggests biological

12Biological Pressure

Psychosocial Factors

Set their own bedtimes = More likely to set later bedtimes and

more likely to need parents to wake them

JobsAcademic PressuresSocializing

Staying up late to talk on phone, parties Electronics

13

ElectronicsGreater use of electronics before

bedtime leads to: shorter, later, and more disrupted sleep

Alerting Involve exposure to blue- spectrum light, circadian clock has greater sensitivity toward

Phase delay worsens

14

Consequences of inadequate sleep Sleepiness, mood disturbances,

inattention, poor grades, behaviour problems, substance use, driving crashes, weight gain, increased appetite, increased stress, immune system compromise

Sufficient sleep - Memory and learning, energy, illness, mood, weight control, etc.

Nutrition and Teenagers16

Common nutrition challenges for teens

Benefits of Healthy Eating Hunger Management Strategies

Nutrition Challenges for Teens

Skipped mealsLow proteinScreen time during meals/snacksDistracted/mindless eatingToo many sweet drinksToo much restaurant/cafeteria foodOver-hungry after schoolLate night snacking (usually treat

foods)

17

Benefits of Healthy Eating

Energy Immune system Concentration and academic

performance Athletic performance Mood Stress management

18

Hunger Management19

Over-hunger over-eatingKeep ahead of hunger by: Eat breakfast (and lunch and dinner) Listen and respond to hunger (snack as

needed) Balance: 2+ food groups/snack 3+ food groups/meal Eat at a table, with others, no screens One small sweet drink per day max Plan meals and snacks as a family

Sleep and Nutrition (and Exercise)

20

Sleep affects Eating Hunger Hormones Insulin Resistance Stress Hormone

Eating affects Sleep What foods make sleep worse What foods improve sleep

21

Regulation of Eating

• Produced in the stomach, signals hunger

Ghrelin“GO” EAT

• Released by fat cells, signals the brain to feel full

Leptin“STOP” EATING

22

Regulation of appetite

Ghrelin• You’re

hungry

Leptin• You aren’t

full

Insu

fficie

nt

Slee

p

• MORE HUNGRY, LESS SATISFIED

• = EAT MORE

What is Insulin

Insulin is needed for glucose to get inside the cell

Glucose is the fuel for our cells

23

Insulin

Eat

Food broken down

to glucose

Glucose

enters blood

stream

Glucose

levels high = releas

e insulin

Insulin signals to cells to take

in glucos

e

24

Healthy Functioning

Insufficient sleep causes Insulin Resistance

Eat

Food broken down

to glucos

e

Glucose

enters blood

stream

Glucose is

locked out of cells

Glucose level ↑ in

blood

25

Health Problems- Impaired ability to burn and digest fat- pre-diabetic state

Cortisol

Cortisol The stress hormone

Poor sleepers secrete more cortisolSleep deprivation

Can increase cortisol▪ Crave sugary and high-fat foods

26

Insufficient Sleep Leads to

Insufficient Sleep Hungrier Less satisfied, don’t feel full Affects insulin levels Less likely to eat healthy foods

Chronic sleep deprivation increased risk of obesity, diabetes, heart disease

Good Sleep Helps control appetite and promote healthy eating

patterns

How does eating affect sleep?

27

Choosing FoodSleep can affect what you eat, BUT

what you eat also affects sleep Caffeine Alcohol▪ Initially can make sleepy▪ Disrupts REM sleep

Vitamins and Minerals

28

Lack of Sleep

Caffeine

cravings

More Caffein

e

Poor Sleep

Vitamins and MineralsVitamin B6

Helps with melatonin production = more sufficient sleep

Fish, chick peas, bananasCalcium

Deficits make it hard to fall asleep▪ Dairy products, kale, soy products

Magnesium Deficits make it hard to stay asleep▪ Nuts and seeds, spinach, bananas

29

The “Not-So-Secret” Formula

Healthy

Sleep

Healthy Food Choice

s

Improved

Health

30

Tips for Improving Sleep and NutritionBedroom

Comfortable, quiet, and darkUse bedroom for sleeping, not

punishment or entertainment zoneHave “shut-off” time for electronicsDim lights in the evening

Sleep Schedule Bedtime and wake-up time

Bedtime Routine 20-30 min bedtime routine ▪ Same each night▪ Calming activities such as a bath,

reading a book, listening to music, drawing, etc▪ Go to bed when sleepy

Tips for Improving Sleep and Nutrition

Positive Associations

If you are in bed and awake for more than 20 - 30 mins, you should get out of bed

Stay out of bed for about 30-minutes (or less if you are sleepy) doing a non-alerting activity, then go back to bed

Goal is to associate bed with sleeping, rather than with being awake

33

Faded Bedtime If you are having difficulty getting to sleep

within about 30 mins Try staying up a bit later (about an hour) If you go to bed when tired, you are likely

fall asleep faster After a night or two of this later bedtime, go

to bed about 15-20 mins earlier. Continue this pattern until you are going to bed at an appropriate time

Make sure your teen wakes up at the same time every day and that s/he doesn’t nap during the day.

This will help get your teen’s Internal Clock back on track

34

Choosing FoodLimit caffeine after 3 pmSmall snack before bedAvoid large meals 3-4 hrs before bed

Especially spicy, acidic, or greasy foods▪ Increase heartburn and acid reflux

Hydrate with waterConsume foods rich in B6

Salmon, bananas, fortified cereals and oatmeal, chickpeas, walnuts, tart cherry juice

35

Choosing Food

Treat yourself to a snack having a small, protein rich snack before

bed ▪ keep your belly happy overnight ▪ provide fuel to muscles to aid in the

rebuilding and recovery process▪ protein sources: nuts, seeds, dairy, beans,

eggs, meat Eat breakfast every day (within 1

hour of waking up)Avoid going more than 2-4 hours

without food (avoid over-hunger)

36

For further information:www.css-scs.cawww.dietitians.ca

Take Aways• Sufficient sleep + regular sleep schedule • critical in controlling appetite • promoting healthy eating patterns

• Healthy eating promotes • Better quality and quantity of sleep• Healthier sleep patterns

= OVERALL IMPROVEMENT IN HEALTH