Several months ago, I blogged about the importance of sleep in a kid's life and Shift Work Disorder which both showed how important sleep is on both young and adults. While the Shift Work Disorder discussed how it came about and who are affected by this sleeping disorder, it also tackled the need to get back the proper sleep that is lost during the graveyard shift, rotating shifts or any other non-traditional work schedules.

Sleep is vital to our health and wellbeing, according to the National Sleep Foundation (NSF), yet millions are not getting enough sleep or are suffering from other sleep problems. Sleep has become an enemy by those who are working two to three jobs. They are even considered a waste of time by others because our lifestyles don’t call for it and is actually considered in conflict with sleep. According to one article I read this is what you call Sleep Machismo, a term coined by leading chronobiologist Dr. Charles Czeisler, which “means valuing sleep loss over sleep, placing all activities above the basic human need of sleep and celebrating the machismo of the sleep-deprived." The author Dr. Qanta Ahmed explained that instead of seeing sleep as a biological necessity American perceive it as an expendable luxury and choosing postpone sleep in order to work, watch a favorite TV show, answer an email, or like what I do often finish reading the book especially when am almost in the last chapter. By not sleeping on time and properly, we are accumulating sleep debt which will incur penalties or interest, just like a financial debt. And most likely you will also have a hard time paying it off.

Sleep deprivation is a serious health risk especially if it continues or persists for consecutive days. It not only affects your quality of life but can have serious, long-term health consequences. Sleep deprivation makes the day drag, makes you moody, and causes our body to use less energy and because of that you are not productive at all. But more than that, there are evidences that show how lack of sleep promotes weight gain by boosting hunger and by slowing the rate at which calories get burned. Sleepless nights can also slow down our reflexes and can put you and other people at risk for car accidents.

There are several reasons why we tend to overlook sleep, some intentionally do that in order that they can do more work while others are caused by what we may call sleep stealers or activities or situations that robs us of the much needed shut-eye.

1. You do your work in your bedroom.

Reserve the bedroom for sleep. Work should be done in your office otherwise every time you enter your bedroom you will think of work. Your bedroom should always be free of stimulating distractions like TV, computer and the likes. It should be quiet, cool and dark in order to encourage you to sleep.

2. You do not shut down.

After doing the dishes or the laundry and the kids are off to sleep you now feel it’s the best chance for you to turn on the TV or surf the Internet or chat with some friends online. Don’t make that mistake. Your computer or laptop is one of the biggest reasons why you don’t get to sleep on time. Worse it is so addicting that once you start you can’t go away.

According to experts, the computer’s light triggers the suprachiasmatic nucleus, a tiny receptor in the brain that regulates circadian, or body, rhythms, including the sleep-wake cycle. And when eyes are exposed to light the receptor thinks it’s time to get up.

3. You don’t have a consistent sleep schedule.

Each one of us has our own biological clocks or internal clock that tells us when it’s time to sleep. Sometimes, or maybe most often, we disrupt this in order to finish work or watch your favorite show. Unfortunately if your sleeping schedule, sleep and waking time, varies from day to day then this throws off your internal clock, making it harder to doze off. Ever notice that when you overdo your sleep, meaning waking up late in the morning, you actually feel sleepy? Better yet, set a regular sleep and wake-up times and strictly follow it. This is one of the problems often encountered by the people in work clothes who do not work the traditional 9 – 5 schedule.

4. You are thinking and worrying about things.

Thinking and worrying about your financial situation will definitely disturb anyone’s sleep. But then if you keep on worrying about money or about a relationship or a project, most likely you will not be able to sleep because of the stress. What’s more, you might worry also about the fact that you can’t sleep and that is because you have a lot of things on your mind. Watching news and violent TV shows does not really help; try distracting yourself with music or any soothing sounds. You can also try meditation or mind/body relaxation techniques.

5. Heavy late dinner, coffee or nightcap?

Either of the three can cause you to rev up when what you actually need is rest or sleep. Heavy dinner would need time to digest so better eat 2 – 3 hours before bedtime so that by the time you go to sleep your body is done digesting. Chocolate cakes, coffee both and energy drinks have caffeine. Alcohol on the other hand disrupts the production of serotonin and norepinephrine which are two neurotransmitters that regulates sleep stages. 

Sleep is the interest we have to pay on the capital which is called in at death;

and the higher the rate of interest and the more regularly it is paid, 

the further the date of redemption is postponed.

- Arthur Schopenhauer

If there is one person that has become synonymous to nursing this would be Florence Nightingale, the founder of modern nursing. And in her honor, the National Nurses Week is held annually from May 6th and ends on May 12 which is her birthday. 

May 8th has been designated as the National Student Nurse Day since 1998. 

As of 2003, National School Nurse Day is celebrated on the Wednesday within National Nurses Week (May 6-12) each year which falls on May 11th this year.

International Nurses Day is celebrated around the world on May 12th of each year.

The theme for National Nurses Week in 2011 is "Nurses Trusted to Care."

The theme for this year’s National Nurses Week certainly says it all. Nurses of all gender, colors, size, age, and shape are trusted and expected by their patients to give them the best care they can receive. Of course there are cases when these brave women in scrubs uniforms can also be so intimidating but I guess they need to be in order that patients follow the doctors’ orders as well as theirs. 

Getting to know your nurses or your loved ones nurses is just one way of showing them their efforts and patience with us are all appreciated. But if you want to do more, then let them know you treasure them by giving them a gift or a poem as a tribute this National Nurses Week. Recognize the special nurses in our lives – mother, sister, brother, daughter, son, cousin, aunt, friends, and colleagues – with a special gift or a simple thank you card.

When did we really start honoring these brave men and women in the nursing profession? Nurses have only recently been recognized with their special day. Although there have been so many efforts including that by Dorothy Sutherland of the U.S. Department of Health, Education, and Welfare in her 1953 proposal but this did not come into fruition until 1974 when President Richard Nixon issued a proclamation for National Nurses Week. By then the International Council of Nurses (ICN) has been celebrating International Nurse Day for almost 9 years. 

From 1978 to 1981 various personalities moved and took up the cause for the recognition of nurses in their states. It was in 1982 when the American Nurses Association (ANA) Board of Directors formally acknowledged May 6 as National Nurses' Day. President Ronald Reagan signed a proclamation on March 25, 1982 proclaiming May 6 to be National Recognition Day for Nurses. 

In 1990, the ANA Board of Directors expanded the recognition of nurses to a week-long celebration, declaring May 6 - 12, 1991, as National Nurses Week.

In 1993, the ANA Board of Directors designated May 6 - 12 as permanent dates to observe National Nurses Week in 1994 and in all subsequent years.

In 1996, the ANA initiated "National RN Recognition Day" on May 6, 1996, to honor the nation's indispensable registered nurses for their tireless commitment 365 days a year. The ANA encourages its state and territorial nurses associations and other organizations to acknowledge May 6, 1996 as "National RN Recognition Day."

In 1997, the ANA Board of Directors, at the request of the National Student Nurses Association, designated May 8 as National Student Nurses Day.

This year, the American Nurses Association has selected “Nurses Trusted to Care” as the theme of this year’s National Nurses Week. As it had been for the last decade, the week is devoted in highlighting the registered nurses invaluable contribution to our society and to the unwavering devotion to the healthcare needs of the American people by caring for the sick, educating the public on health issues, and continuously promoting wellness.

The recent data from the Centers for Disease Control and Prevention has shown us that we have a considerable public health problem that is very much preventable if only we act on it. The data shows that 1 in 6 Americans or 48 million people get sick, 128,000 are hospitalized, and 3,000 die each year largely due to food borne diseases. We have existing laws and oversight from the U.S. Food and Drug Administration (FDA) that have kept the vast majority of Americans safe from diseases brought about by consuming harmful bacteria, parasites, viruses and toxins found in some of our food. But, the data as well as several cases of contamination shows that we still have much to do to keep us safer. And that we make stricter laws and continuous improvements in food safety.

For the first time in 70 years a major bill that tackles food safety was signed into a law. The Food Safety Modernization Act (FSMA), which was signed into law in January 4, 2011, gives the FDA the much needed mandate in protecting our food supply by pursuing a system that prevents food-borne illnesses from the onset. The system deals with the hazards from farm to table and checks on the production, processing, transport and food preparation to ensure the food supply safety. Previously, FDA could only negotiate with businesses to order voluntary recalls but the new food law gives them the authority better respond to issues including ordering recalls of contaminated foods. The new law requires companies to develop and implement written food safety plans making it easier for the agency to monitor. Also, under FSMA provisions, the FDA will be able to ensure that imported foods are as safe as the food produced in the US. 

Food borne illnesses are very much preventable is only there is an agency with enough authority, as well as tools and systems, to ensure proper monitoring and can make the necessary call in case there are food supply hazards. Also, food chains being held responsible and accountable at each step can ensure that they are very careful in making sure about their products. 

Here are some of the provisions or elements in the Food Safety Modernization Act:

Preventive controls plan – The whole new law is based on prevention and so the system created by FDA would require comprehensive, prevention-based controls across the food supply. In this case, FDA will require food chains and facilities to develop a written food safety plans that spell out what possible problems could affect the safety of their products and how they plan to prevent it from happening or minimize the possibility of it happening. This would include food processing apron and lab coats and other measures that help ensure workers do not contaminate their products.

Science-based standards – The FDA is tasked to establish science-based standards for safe production and harvesting of fruits and vegetables. Both natural and man-made hazards to the safety of fresh produce will be considered by the standards. 

Increased number of inspections – To ensure that the food industry is made responsible and accountable in guaranteeing that they produce safe food for the people, the FDA is directed to increase the frequency of their inspections based on risks. High-risk domestic food and facilities would be the priority of the initial inspections with recurring inspections thereafter. 

Issuing Recalls – FDA has now the authority to recall tainted and unsafe food products if the food company does not do so voluntarily. Previously, except for infant formula, the agency could only request food manufacturers and distributors to recall voluntarily. This time they are provided a more flexible standard for administrative detention and allowed to suspend the registration of food facilities who fails food safety. 

Imported food safety – Americans have enjoyed imported food for a long time but only the new law gives FDA new tools to ensure that these imported foods meet US standards and are safe for consumers. Included here is that importers are made accountable in verifying that their foreign suppliers have adequate preventive controls in place to ensure safety. FDA will be able to accredit qualified 3rd party auditors that certify that foreign food facilities are complying with US food safety standards and that they can refuse entry into the US of a food that has refused U.S. inspection.

Improved partnerships with other agencies – The law recognizes the need for strengthened inter-agencies relationships and collaboration to ensure the success of the law and to achieve public health goals. Hence, the FDA is directed to give trainings to local food safety officials.

Exemptions – Community supported agriculture programs (CSA) and small farms that sell directly to consumers are exempted from the produce safety standards.

The focus of the law is prevention and the process is long-term as a new food safety system is established. But some of the authorities of FDA take effect immediately, such as the mandatory recall authority, while some requires FDA to prepare and issue documents that would be the be the basis of the regulation. The new law is a step forward in making the food industry really safe for consumption. We have made steps in making sure medicine, medical devices and other products are safe for use. Therefore we have more reason to ensure that our basic needs, such as food, have high standards, too. The law may not be as perfect as we want it to be but it is a step towards it, especially for those who are not really conscious of what they buy and eat.

Image: blastmagazine.com, freshplaza.com, thekindlife.com

Every now and then we read news that can baffle even the most knowledgeable people or the experts in their particular field. In this case of Chase Britton, the experts in lab coat are definitely flummoxed with his case. The second son of Heather and David Britton was born prematurely, was legally blind and when he was 1 year old it was discovered that he is without a cerebellum and pons. The cerebellum is the region of the brain that plays an important role in motor control, and though it does not initiate movement it does contribute to coordination, precision, and accurate timing. Pons, on the other hand the part of the brain stem that controls basic functions, such as sleeping and breathing. The pons has nuclei that deal primarily with sleep, respiration, swallowing, bladder control, hearing, equilibrium, taste, eye movement, facial expressions, facial sensation, and posture. It also contains the sleep paralysis center of the brain as well as generating the dreams of REM sleep.

A human brain, with the cerebellum colored in purple                                   Drawing of the human brain, showing cerebellum and pons.

According to his mother, Chase is a happy person who loves to play tricks on people and aims to make people smile. While some people might feel that his is a really sad story, his family does not believe so especially because the whole family is extremely happy and Chase is well-loved. His being without cerebellum and pons was discovered when experts in medical uniform did an MRI expecting to find Chase has a mild cerebral palsy. What they saw was only fluid where the cerebellum and the pons should be. And very bright and specialized people in lab coat are bewildered. To these experts, the absence of these 2 parts is a mystery that has made them thinks about what they all thought they knew about the brain. Neurologists say the occurrence is impossible because Chase has the MRI of a vegetable.

Intensifying the mystery is the fact that when Britton was pregnant, ultrasound pictures show that he has a cerebellum when he was inside her womb. She was closely monitored by her doctors since she has already lost one child who was also born premature and she had a complicated pregnancy. Ultrasound was made during the various fetal development and detailed pictures confirm the presence of cerebellum. But what happened to it is the mystery that has confounded even a lab coat clad expert like Dr. Adre du Plessis, chief of Fetal and Transitional Medicine at Children's National Medical Center in Washington, D.C

According to my research, the cerebellum is relatively well protected compared to the frontal and temporal lobes and brain stem. And we should be thankful for that especially because the cerebellum is involved in the coordination of voluntary motor movement, balance and equilibrium and muscle tone. Any Damage to the cerebellum can lead to:

1. Loss of coordination of motor movement (asynergia),
2. The inability to judge distance and when to stop (dysmetria),
3. The inability to perform rapid alternating movements (adiadochokinesia),
4. Movement tremors (intention tremor),
5. Staggering, wide based walking (ataxic gait),
6. Tendency toward falling,
7. Weak muscles (hypotonia),
8. Slurred speech (ataxic dysarthria), and
9. Abnormal eye movements (nystagmus).

But, Chase does not just have damaged cerebellum. He does not have one and even an expert like Dr du Plessis admits Chase situation challenges ‘fundamental principles’. Despite having balance problems, little Gremlin (as he is fondly called by parents) learned to sit up, then crawl and is now learning to walk with the help of a frame. He has even started studying at a special pre-school near their New York home.

Most would probably think this is a little late or too early to be discussing about. I certainly don’t think so. With kids, you always need to be one step ahead and for those who will be sending their kids to school for the first time, it is but high time you start the practice so that by the time comes, you’ll be ready because they are used to it already. Getting them ready in their school uniform every morning need not be a hardship as long as they have done it a million times. The same discipline that you instill in them early on is something that will benefit them in the long run.

After a long summer vacation where there wasn’t any need to wake up that early for a hectic and packed daily schedule going back can be quite daunting. After a lazy and very relaxed month or two, going back to school with its very fast paced and tightly packed school schedule is tough. It not only means waking up really early but then there is also a need to adjust parents schedules to accommodate breakfast, lunch box preparation, bathroom use and many more. So after getting used to making it in their business casual very leisurely, now they also have to rush in order to be able to finish all tasks and still manage to come to work on time.

So, while it is not yet school time, get the kids used to earlier wake-up times. Once a good routine has been established getting them ready and off to school is a breeze. Let them enjoy waking up late during the summer but don’t make a habit of it. There is absolutely nothing wrong with kids waking up early as long as they still have enough quality sleep which means of course having them sleep early to fulfill that. Consistency and routine make life so much easier for you when school starts in September or February (if you are from Australia).

Start Early With a Plan
Don’t wait until it’s too late to start planning for the changes that will no doubt occur. Have a family meeting three or two weeks before the start of classes to discuss the plan that has to be implemented. This is the time when you need to announce the new sleep schedule which is the hardest part because then parents would also need to change the computer time, TV time and all the things tweens live for. This is the time when parents need to explain the importance of sleep to growing children and the danger of not getting enough sleep.

According to the National Sleep Foundation, kids ages 5 to 12 need 10 to 11 hours of sleep each night. Although parents do understand that children need enough sleep but because they are also busy they are not able to give their children the critical sleep they need to develop and function properly. Sound sleep is very important because it ensures that children will have a sound foundation for proper mind and body development. If children need to fulfill the 10 to 11 hours of sleep, they need to sleep really early say 7 pm and wake up really late like 6 am. Sometimes with the busy schedule in the office and long hours of work, dinner and bedtimes are pushed back late but children would still need to wake up early in order to be able to eat breakfast and be in their school uniform before the school bus arrives. This then causes children to miss out on the necessary amount of sleeping.

Marc Weissbluth, MD in his book Healthy Sleep Habits, Happy Child shares some insightful comments to show how important sleep is:

"Sleep is the power source that keeps your mind alert and calm. Every night and at every nap, sleep recharges the brain's battery. Sleeping well increases brainpower just as weight lifting builds stronger muscles, because sleeping well increases your attention span and allows you to be physically relaxed and mentally alert at the same time. Then you are at your personal best."

Making your children realize the value of sleeping allows the whole family to be in the same page and see the need to set and follow the new sleep schedule and won’t see it as a dictatorship.

It’s Not All about Bedtime
Researchers at SRI International, an independent American research institute based in California, have found that children who had a regular bedtime performed better at languages, reading and maths than those who went to bed at different times. They also found that the earlier the child who went to bed, the better they performed at school.

When we say bedtime it does not only mean being in their beds early. What we want is to get them into an after school routine or a bedtime routine and that also means having them on the dinner table on a set time, limited time on computer, TV, and video and with enough time for studies. Setting a study time with a parent is also important in the after school routine. Let us not expect children to sleep early if they eat late. And when we say bedtime, it does not mean being in their bedrooms or their bed and still online or on the phone. In order that they can still get the much needed sleep they would have to forego some online time.

Bedtime routine is not set by children but by the parents. Setting a bedtime routine especially for babies and toddlers is important in making a significant impact on children’s emergent literacy and language skills. The data of the research done by SRI International on 8000 children showed that having a regular bedtime was the most consistent predictor of positive developmental outcomes. Children whose parents have rules on what time their children go to bed scored higher receptive and expressive language, phonological awareness, literacy and early math abilities.

Establish a Good Routine
After weeks of staying up late and sleeping in during the summer months becomes a routine. Changing that would be a little hard. What parents can do is establish the same routine whether school days or not when it comes to sleeping and waking up late. If you do change it a bit during the summer vacation, the make sure you go back to the same routine 2 or three weeks before school starts. Now, it’s not possible to immediately change the routine that has already been established. With the help of the alarm clock, adjust the body clock of our children little by little. Maybe for the first day, let them sleep at the usual time but wake them a little bit earlier than the usual. Then for that day adjust the sleeping time since they woke up earlier until they have adjusted their body clock to going to bed at the same time they will go during the school year.

Getting All the Help
One other tip that can help is getting all things ready the night before. Make sure all the things needed are in their backpacks or bags. Let your children do this after studying, it is their responsibility, but it is still important for parents to check it. Ready their school uniform or whatever they are going to wear for school so that they do not have to take too long while thinking of what to wear. This routine is for younger school children but can also be done for tweens with them choosing what to wear but having it ready for the next day. Asking one of them to help in preparing breakfast or the lunch bags will also help. Make sure that every time they do well and follow the established routine is recognized, praised or appreciated. It also helps in bolstering their self-esteem.

There are times parents have established a different routine and if it works then there is no problem. There are different factors to consider when establishing a routine that can be specific to your family. What is important is that children get the necessary sleep and that you are consistent. Consistency with any routine will benefit you and your child in less time than you may think.

Creating Positive Bedtime Rituals
Pediatrician Dr. Scott Cohen says: "Routine and predictability is the key."
Limit Sugar before Bed
Limit TV/Video Games 1 hour before bed

Parenting Consultant Ann Corwin, Ph.D says: "Kids need to feel safe when they go to bed."
Remember , for a child, going to bed is the ultimate separation from their parent.
Bedtime should always be about teaching kids to be able comfort themselves and feel safe even though their parents cannot be with them at that moment. So NEVER tell kids they need to 'go to bed' as a punishment/discipline technique.
Pick an Attachment Object.

Mommy Blogger Lisa Belkin, says: "Rituals that worked best at our house have varied from age to age."
Tucking in the stuffed animals.
Have your kids recount their day.
If your kids can't sleep, develop a special snack.
Singing a favorite lullaby.
Give them something to concentrate on once you leave the room.

Are you one of those who work at night or what they often call the graveyard shift? Or does your office have rotational shifts? If this is the case, you might be having some difficulties sleeping or worse you now have a sleeping disorder. Shift work sleep disorder or simply shift work disorder (SWD) is a sleep disorder commonly affecting those who frequently work on a night shift, have rotating shifts or any non-traditional work schedule. Meaning, those who do not work the normal 9-5 work hours. According to the experts, the change in the normal work schedule goes against the body’s natural Circadian rhythm. This is the physical, mental and behavioral changes that follows roughly 24-hour cycle which responds primarily to the light and darkness in the environment. Some may think this is simply biological block. Although closely related, these two are different. It is our biological clock that drives our Circadian rhythm.

Approximately 15 million Americans work on a non-traditional work shift and 10% to 25% of night shift workers and/or rotating-shift workers suffer from shift work disorder (SWD). Meaning 1 out every 4 people working the night or rotating shifts may be suffering from SWD. You might not often see or notice but there are actually a wide range of occupations that require permanent or occasional shift work such as the professional and business service. The accountants, stockbrokers, customer service reps, IT support staff and other people who simply hung their corporate uniforms on the back of their seats are part of the professional and business service.  Healthcare professionals including nurses, emergency room physicians, and overnight pharmacists have to stay up late too. Production and manufacturing workers in their work uniforms such as steel, textile, and other factory workers as well as those in the protective services like firefighters, security guards and even cops need to work on shifts. There are 3.75 Americans at risk with SWD.

 Once these workers don their work uniforms, they know that they have to do their task even if they feel sleepy. This runs contrary to their biological clocks or the body’s internal sleep-wake clock and thus causes sleeping disorders. Normally, our body tells us when to sleep and people sleep when they feel sleepy. Not so in the case of healthcare professionals and others who work on a night shift. Even if they are sleepy in their medical scrubs they have to stay awake in order to perform their duties to their patients and often living on coffee and snack bars to stay awake. While both men and women can be affected by SWD, those who are 50 years and older, those with history of sleep disorder or stomach disorder, diabetics and those with heart disease will have more difficulty coping with shift work and become more vulnerable.

Unfortunately, shift work disorder has other consequences other that its effect to the person suffering with it. This disorder increase accidents, work-related errors, sick leave, irritability and other problems. That is because people with SWD struggle to stay awake during their waking hours and still have problem sleeping during their sleeping hours. Most often it’s because of the environment; they are trying to sleep when the whole world is bright and awake. So, in order that these shift workers not suffer from SWD, they need to make sleep a priority. They and their family should help in making sure they get to sleep during the day. Families should avoid doing household chores that can disturb the sleep. The family should be able to create a quiet and peaceful setting that is conducive to sleeping.