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88 HEALTH SLEEP DISORDERS FROM PAGE 87 collar jobs take their work home and are often expected by their bosses to be on call.” An idea that Professor Bruck suggests is choosing not to answer emails after 7pm. “Work things can be quite stimulating or distressing, so it’s quite a good idea that people think about boundaries between work time and leisure time, even when working from home,” she said. Losing track of time Over the past couple of years, scientists have been delving into what makes social media apps so addictive. The truth is, most apps are designed to keep users engaged with them for as long as possible, so it’s unsurprising that people lose track of time while scrolling on apps downloaded to their device.3 “People can be absorbed and continue using their \\\\\\\\\\\\\\\[devices\\\\\\\\\\\\\\\] beyond their usual bedtime, so they can spend more hours of the night on screens, leaving fewer hours for sleep,” Mr Hart said. Referring especially to adolescents and young adults, Professor Bruck said: “They often really like these games \\\\\\\\\\\\\\\[downloaded to their devices\\\\\\\\\\\\\\\], and sometimes they get home from school, they do their homework and then they do their games as the last thing that night.” She says that for those who use a computer in their home, “it’s very easy to lose track of time”, adding that in the case of young adults “it’s often that there’s less parental control – and rightfully so, as they’re 18, 20, 22”. “They don’t have parental control to say, ‘look it’s bedtime and you’ve got to get up in the morning’,” Professor Bruck continued, adding that for many young people, their body’s natural tendency is go to bed a little later. This is associated with delayed melatonin release, which Professor Bruck says occurs naturally as adolescents become older anyway. “That happens even in adolescent monkeys,” she said, “so it’s not just the lifestyles. There’s something about those years after puberty that delays the melatonin, so \\\\\\\\\\\\\\\[many young people\\\\\\\\\\\\\\\] don’t feel sleepy, no matter what they’re doing, whether with a computer or not.” This, she says, explains the natural tendency in the young to want to go to bed later. Blue light Mr Hart touches on the specific blue light emitted by devices that affects sleep. “This bright screen light can cause increased alertness,” he said. “When the sun rises, your body produces cortisol, a hormone that makes you feel awake and alert. At the end of the day, as daylight fades, the body releases another hormone, melatonin, that produces feelings of sleepiness.” Professor Bruck describes melatonin as a “hormone of darkness”. “Like a vampire, it likes darkness, it doesn’t like light, and once you have light, it suppresses the level of melatonin.” Mr Hart added: “Electronic devices like mobile phones, tablets, readers and computers emit short-wavelength enriched light, also known as blue light. This light is also emitted by fluorescent and LED lights. It’s the blue light that has been shown to reduce or delay the natural production of melatonin in the evening and thereby decrease feelings of sleepiness and interfere with sleep.” Mr Hart cites some of the side effects of poor sleep: • Reduced alertness. • Shortened attention span. • Slower than normal reaction time. • Poorer memory. • Reduced concentration. • Increased likelihood of moodiness and bad temper. • Reduced work efficiency. • Loss of motivation. • Microsleep – brief periods of involuntary sleeping that range from a few seconds to a few minutes in duration. RETAIL PHARMACY • MAY 2021 Delayed sleep phase insomnia The condition of delayed sleep phase insomnia (or disorder) is quite often observed in adolescents. “Circadian rhythms gets shifted,” Professor Bruck said, “so that it’s not just them staying up later, beyond when their body really wants to go to sleep. Their whole body clock shifts, to want to go to sleep later. “In some cases, this type of insomnia can be quite serious, and we can see it a lot in adolescents, where they just don’t get sleepy at the time we would want them to ... so that they can get a full eight to 10 hours \\\\\\\\\\\\\\\[of sleep\\\\\\\\\\\\\\\].” The delayed sleep phase involved with this disorder means that young people “don’t even have the right amount of melatonin until after midnight to make them sleepy, so that’s when they go to bed”, Professor Bruck continues. “Then their alarm goes off at 7am to go to school, and that creates a whole legacy of sleep deprivation during the week.” What happens after the initial sleep deprivation, Professor Bruck says, is that the young person will generally sleep a lot on Saturdays, “because their natural body clock \\\\\\\\\\\\\\\[for sleeping\\\\\\\\\\\\\\\] is not 11pm to 7am, but perhaps 2am to 10am – that can be a common pattern among some young people”. TO PAGE 90