Sleep inadequate

QUALITATIVE COMMENTS (with 24 mg) There was a slow buildup to a ++ or more over the course of about three hours. Extremely tranquil, and no hint of any body toxicity whatsoever. More than tranquil, I was completely at peace, in a beautiful, benign, and placid place. There was something residual that extended into the sleep period, and was possibly still there in the morning. Probably I was simply tired from an inadequate sleep. ... 

We are using the term inadequate sleep instead of sleep deprivation in our title for a number of reasons. First, few studies have aimed specifically to deprive children or adolescents of sleep. We describe some research on experimental sleep restriction in children but most of these studies fall far short of common deprivation paradigms in animals or even adult humans. Instead, most research in younger humans has assessed outcome measures such as school grades, self-reported sleepiness, and so forth as a function of variations in self-selected or usual sleep patterns with the expectation that children and adolescents who obtain lower than normal amounts of sleep will manifest deficits. Thus, inadequate sleep is defined by sleep characteristics of a sample. We also wanted to note some of the literature on sleep that is disturbed or disrupted due to disease processes such as apnea or periodic leg movements the duration of sleep in sleep disorders may or may not be shortened or restricted although it is likely fragmented and otherwise abnormal. We decided on the term inadequate sleep with the hope that it would encompass these different areas of concern. 

Infants, school-age children, and adolescents have been studied in the laboratory, hospital nurseries, schools, institutions, and their homes with polysomnography, time-lapse video monitors, activity monitors, diaries, and self- and parent-report instruments. Children both with and without sleep disorders have been evaluated with these various assessment procedures, and researchers have used a wide range of study designs to investigate the impact of inadequate sleep. For example, in laboratory studies children and adolescents have been assessed on their usual (often arguably inadequate) schedules as well as on study-defined optimized and restricted... 

In the following sections we briefly review some of the literature related to inadequate sleep in young humans with an emphasis on older children and adolescents. This is not intended to be a comprehensive review but we hope we have provided a sense of the directions of previous research and indications of unanswered questions. 

Problems related to inadequate sleep in children and adolescents are fairly common. Studies have shown that inadequate or irregular sleep usually results in some variation of daytime sleepiness, but may also result in behavior problems, difficulties with alertness, concentration, attentiveness, problem solving, memory, school problems, and other daytime behavior problems. Adolescents health may also be compromised by poor sleep/wake habits, with increased irritability... 

Furthermore, in addition to restricted sleep, many other factors potentially magnify the effects of inadequate sleep in medical trainees. These include fre-... 

In summary, generally studies suggest that residents may be able to compensate on tests of factual knowledge for the negative effects of sleep loss and fatigue and that they are appropriately confident about their performance. However, trainees motivation to learn appears to be significantly impacted by inadequate sleep. 

The scope, prevalence, and significance of the problem of inadequate sleep and fatigue in residents must be more specifically and rigorously defined, particularly in regard to the impact on performance in actual clinical settings, on the physician-patient relationship, on the health and safety of residents, and on the quality of their medical education. 

---