The goals of this International Conference are:
 he need for the Conference arises from a number of sources, including increased international concern about the fact that so many individuals are critically sleep deprived. For example, the Congressionally-mandated National Commission on Sleep Disorders Research cited insufficient sleep as a major problem associated with significant costs in terms of performance, productivity, and human suffering. Major catastrophic events, such as Three Mile Island, Chernobyl, the Exxon Valdez, and the Challenger reflect just a few of the examples of performance and judgment deficits that have occurred as a result of sleep deprivation. Recent interest has also focused on "personal catastrophes" due to mismanaged sleep or sleep disorders, such as automobile, trucking and airplane crashes. Unfortunately, adolescents are rarely included in such assessments -- with the exception of automobile crashes where epidemiological data point to an overrepresentation of young drivers in sleep-related crashes: interestingly, adolescents as a group appear to be among the most sleep-deprived in our society.
This Conference brought together an interdisciplinary group to engage in a discussion of the genesis and development of sleep patterns during adolescence, to examine biological and cultural factors influencing these patterns, to examine risks that may be a consequence of adolescent sleep patterns, and to explore environmental factors such as work and school schedules and their effects on sleep. The biology of pubertal development and the changes which affect circadian rhythms that, in turn, influence the timing of sleep are surveyed in Dr. Richardson's review. In the papers of Drs. Tate and Golub, these influences are examined in two animal models: the Octodon degus and the Rhesus monkey. They discuss the extent to which puberty plays a significant role in the timing of sleep behavior. Regional perspectives that may reflect cultural influences are presented in the following series of papers: Dr. Wolfson provides a view from the United States, extending her observations to pose predictions for the future for adolescents. Dr. Andrade, a Brazilian scientist, describes patterns of sleep in adolescents from largely urban regions in her country. Dr. Giannotti's paper addresses the patterns of sleep that appear in adolescents growing up in Italy. Dr. Worthman, brings to this section the perspective of anthropology, integrating the findings from modern adolescence into a broader view of the role of sleep in human development. A major issue stemming from concerns over adolescent sleep patterns emanates from the potential consequences of inadequate sleep. Dr. Carskadon presents findings indicating that the known high risks for automobile crashes in sleepy adolescents are not mitigated by an understanding of the problems of sleepiness nor by appropriate countermeasures. From another perspective, Dr. McCracken highlights the relation between sleep and major depressive disorders in young people with a high risk of developing depression. The association of stress and sleep during adolescent development is highlighted by Dr. Sadeh. One of the major phenomenological aspects of sleep in adolescents is the often quite extreme variation between school-day and weekend patterns. Dr. Acebo's paper highlights the risks that are increased not only by insufficient sleep, but also by an irregular pattern of the timing of sleep. The discussion by Dr. Ferber integrates these areas from the perspective of a sleep disorders physician. When one considers the obligations confronting and opportunities available to youth in today's society, identifying and obtaining sufficient time for sleep in their lives is almost always difficult, if not impossible. After-school jobs which are now often initiated as part of officially sanctioned school-to-work programs, and school schedules themselves, have substantial effects on the sleep patterns of adolescents. Dr. Rosa identifies similarities of adolescent work/school schedules with adult working behavior. Can our knowledge about the adult workplace help in identifying ways for adolescents to cope with increasingly full days? With data from schools in the state of Minnesota, where a vigorous debate about school starting times is under way, Dr. Wahlstrom explores the impact of school demands on today's adolescents. With these issues in mind, and from the perspective of the biological changes influencing developing sleep patterns, Dr. Carskadon's paper models the current outlook for sleep in teenagers and identifies several areas of vulnerability that may be exposed when these factors are combined. Dr. Dement's discussion frames these issues in a public-policy framework. In the summary paper, Dr. Dahl presents an overview of adolescence and examines the factors raised in the preceding papers which ultimately affect the integration of an adolescent's regulatory functions. Where do modern phenomena and the stresses and strains of today's culture, combined with or culminating in often ill-timed and insufficient sleep, affect the average adolescent in terms of an ability to achieve a fulfilling lifestyle? What can we learn from these phenomena and relationships? What can they teach us about depression, aggression, and other mood disturbances? These questions and others are discussed in the contributions which are included in this volume. It is clear that sleep patterns have a tremendous influence on the lives of adolescent young people and that deleterious effects on their emotional and physiological development arise when their sleep is disturbed. The range of data and diversity of perspectives presented in these papers will hopefully stimulate interest in the nocturnal well-being of today's youth and highlight the impact of sleep on adolescents' waking lives. |
