The Phantom Menace of Sleep-Deprived Doctors

The article written by Darshak Sanghave is aimed at discussing the causes that underlie medical errors in hospitals. In particular, the author focuses on such a problem as sleep-deprivation experienced by many interns. Furthermore, the author mentions the lack of coordination among different practitioners.

Yet, this article can be related to various economic aspects of economics. One should first speak about health economics that evaluates different strategies implemented by medical organizations. For instance, Darshak Sanghave discusses the advantages and disadvantages of 30-hour overnight shifts. The author shows that this approach is largely ineffective because it greatly impairs the quality of healthcare services that patients receive.

Additionally, Darshak Sanghave touches upon a question that has long been studied by many economists. In this case, one should focus on the relationship between demand and supply. Judging from the examples given by the author one can say that many medical organizations cannot meet the demand for their services. This is why interns have to work almost round-the-clock. This is one of the problems that should be addressed by hospital administrators.

Furthermore, economists often focus on the efficiency of investment that is aimed to improve the quality of products and services. Despite the increasing cost of healthcare, patients still fall victim to medical errors. Therefore, it is vital to develop strategies that can improve the work of medical institutions.

These issues are relevant not only to hospitals, but to many other organizations, including private businesses. On the whole, Darshak Sanghaves can be assigned in a course of economics, because it shows how different economic concepts such as production of services, supply, or demand can be applicable to various fields of human activity.

Sleep Problems Among Student-Athletes

Sleep is an essential and integral part of human life, as this process affects health, immunity, and behavior. In the absence of other influential problems, unhealthy sleep specifically interferes with mental and physical activity. In their article Poor sleep quality and insufficient sleep of a collegiate student-athlete population, Mah et al. (2018) investigate the problem of sleep among student-athletes. Despite the importance of the topic under study and the conclusions reached, the work raised additional questions and had some limitations.

Students experience severe stress and the lack of sleep every day. At the same time, athletes at colleges and universities, being full-time students, devote additional time to training and competitions. Six hundred twenty-eight athletes from twenty-nine varsity teams at Stanford University took part in a study by Mah et al. (2018). The authors purpose was to investigate their sleep quality, duration and sleepiness during the day since athletes risk not only failing in classes but also get injured during sports. The article may be interesting to such an audience as coaches and administration at universities to draw their attention to the problem. Furthermore, the source may be useful to sleep problem researchers to identify further study directions.

To achieve the stated purpose of the article, the authors chose to conduct a questionnaire among students. They answered questions about the sleep quality via a modified Pittsburgh Sleep Quality Index (PSQI) (Mah et al., 2018, p. 251). As a result, athletic students were found to typically lack quality sleep. This problems consequences are reflected in their daily routine in the form of frequent or even constant fatigue and sleepiness. Moreover, the authors presented a crucial finding that sleep is better during travel for competitions than while staying at home or campus.

Three authors of the group, Cheri Mah, Eric Kezirian, and William Dement, have a Doctorate of Medicine degree, and Brandon Marcello is a Ph.D. of the Department of Athletics. Their high academic achievements must attest to the reliability and value of the source. However, studying the article leaves many questions open, making it not convincing enough. For example, one of the aspects that attracted attention is the publication date. Particularly, the survey was held in 2011, and the article was published in 2018 (Mah et al., 2018). Such a long period could negatively affect both the relevance of the data and its quality. The choice of questionnaire as the only research method is quite unusual since it is more suitable for determining attitude or opinion. Nevertheless, PSQI is a useful tool for assessing sleep, and therefore, the findings should be correct.

The inconclusiveness of the findings is more likely justified by the absence of a control group of non-athletes. On the one hand, sleep deprivation are not uncommon among students of different departments. On the other hand, exercise should contribute to better quality and sleep duration (National Sleep Foundation, n.d.). For these reasons, a study of other students sleep patterns would help determine which aspects significantly impact the quality of rest. In this regard, one can formulate the first question generated from the article: Is the low quality of student-athletes sleep due to additional physical activity or student lifes specifics?

There is no exact answer to the formulated question in this work. However, when reviewing the finding that at home, the quality of sleep is lower than at away competitions, one can find some clues. For example, noise, lighting, and uncomfortable temperatures hinder better sleep on campus. These aspects cannot affect only athletes, thus being relevant to all students. Moreover, during travel competitions, the class load decreases, which also has an impact on sleep.

The source is organized carefully, has the necessary for the scientific article components, and tables supporting the text. However, many limitations, which the authors themselves recognize, indicate the need for additional content. For example, this study would be more substantial not as a separate work but as part of studying the problem of students lack of sleep. In that case, it would be appropriate to add a section on future research directions. Another aspect that remained under-stated is the relevance and uniqueness of the study. Specifically, it does not provide information on what other scientists have already said about the problem, or how common it is at universities other than Stanford. These limitations generate another question: Does the quality of sleep differ among student-athletes at other educational institutions, or does the problem present only at Stanford?

In conclusion, the reviewed study conducted by Mah et al. (2018) was formally written and organized in accordance with the main requirements for scientific articles. It raises an important issue that needs to be addressed. However, its uniqueness and relevance are not evident enough, and the conclusions are not convincing. Such deficiencies are due to severe research limitations and make this article less valuable. First, the study of only student-athletes without comparison with ordinary students does not reveal all aspects of the problem. Therefore, the article cannot provide solutions other than a general recommendation to revise the schedule. Second, the survey was conducted at only one university, and it is not clear whether the problem is valid for all institutions or only for one. Thus, the topic either requires further development into a large detailed study or it may be irrelevant at all.

References

Mah, C. D., Kezirian, E. J., Marcello, B. M., & Dement, W. C. (2018). Poor sleep quality and insufficient sleep of a collegiate student-athlete population. Sleep Health, 4(3), 251-257. Web.

National Sleep Foundation. (n.d.). Web.

Why Do We Need Sleep?: InFormative Speech

  • Title: Why do we need sleep?
  • General purpose: To emphasize the importance of proper sleep behavior.
  • Specific purpose: To enumerate the basic functions of sleep.
  • Main idea: Sleep refills the body with energy and helps the brain function properly.

Introduction

Have you ever wondered about the role of sleep? In your experience, you probably noticed that without proper sleep, it is difficult to concentrate and remain energetic. It is important to be aware of the basic functions of sleep to understand its significance for health and well-being.

In the modern world, insufficient sleep is a widespread problem for people of different ages. Therefore, many studies related to the role of sleep have been conducted in the sphere of psychology and medicine, and further, some of the aspects of sleep will be covered in detail. This speech aims to identify the functions of sleep and prove the importance of an adequate sleep-wake schedule.

Body

Sleep contributes to organizing information received during the day. During sleep, the brain processes a humans emotions and memories (McBurney et al., 2020). During sleep, the brain reorganizes the information by forming connections between neurons (McBurney et al., 2020). This function is essential for maintaining memory and learning ability.

Sleep helps get rid of tiredness and remain healthy and energetic. The function of sleep is to recover the body and prepare it for the next day (Bennis, 2020). Sufficient sleep reduces the risk of anxiety, depression, and other related effects (Leparski, 2019).

Sleep is needed to regulate biological processes happening in a humans body. An important function of sleep is to restore hormone balance (Leparski, 2019). During sleep, the human body normalizes the level of adenosine, which is responsible for feeling fatigue (Bennis, 2020).

Conclusion

To summarize, it is important to understand that sleep affects different aspects of a humans health and well-being. Firstly, during sleep, the brain processes all the information, memories, and emotions, preparing itself for the next day. Secondly, the human body gets rid of fatigue and averts stress and depression. Finally, sleep normalizes biological processes and restores hormone balance. Therefore, it is necessary for every person to pay attention to a sleep-wake schedule to remain healthy and energetic.

References

Bennis, T. (2020). Overthinking, photographic memory, habit stacking. Vaclav Vrbensky.

Leparski, S. (2019). The happy hormone guide: A plant-based program to balance hormones, increase energy, & reduce PMS symptoms. Blue Star Press.

McBurney, J.W., Weil, A.T., & Ruhoy, I.S. (Eds.). (2020). Integrative neurology. Oxford University Press.

Two Main Phases of Sleep, and Results of Sleep Deprivation

Sleep is regulated by homeostasis  the balance of chemical reactions in the body  and circadian rhythms, which depend on the time and season. Homeostatic regulation occurs due to the fact that certain neurotransmitters accumulate in the central nervous system, which subsequently activates the process of falling asleep. Meanwhile, the melatonin hormone is involved in the circadian rhythm as it provides an impetus for falling asleep in the evening, after sunset.

It is customary to divide sleep into two main phases: slow or NREM  non-rapid eye movement  and fast or REM  rapid eye movement. The slow phase takes up about 75% of the total sleep time and is divided into three stages  N1, N2, and N3. N1 is the intermediate stage between falling asleep and waking, the so-called shallow sleep.During it, various manifestations of hypnagogia occur: for example, a hypnagogic jerk  the sensation of falling and involuntary startle when falling asleep. Subsequently, the N2 stage takes up half of the total sleep time. Passing into it, a person ceases to be aware of their surroundings, and the body temperature begins to decrease. Finally, N3 is the deep slow-wave sleep during which blood pressure drops and breathing becomes slower; the muscles are relaxed, and blood flow to them increases. According to Fultz et al. (2019), during NREM sleep, low-frequency oscillations in neural activity support memory consolidation and neuronal computation (p. 628).

REM sleep takes about a quarter of the total sleep time. This phase, for the first time, occurs about an hour and a half after falling asleep and repeats every hour and a half  each time becoming longer. During this phase, eyes move quickly back and forth, dreams occur, and the body is motionless: all skeletal muscles, except for the oculomotor muscles, are as relaxed as possible.

Sleep disturbances and lack of sleep on a regular basis can cause a number of health problems. First of all, the brain and nervous system suffer those who sleep little often have mood changes and problems with memory, thinking, and concentration. Nollet et al. (2020) state that animals and humans experiencing partial sleep restriction usually exhibit detrimental physiological responses, while total and prolonged sleep loss could lead to death (p. 1). Thus, sleep is crucial for mental health and the normal functioning of the brain.

References

Fultz, N. E., Bonmassar, G., Setsompop, K., Stickgold, R. A., Rosen, B. R., Polimeni, J. R., & Lewis, L. D. (2019). Coupled electrophysiological, hemodynamic, and cerebrospinal fluid oscillations in human sleep. Science, 366(6465), 628631. Web.

Nollet, M., Wisden, W., & Franks, N. P. (2020). Sleep deprivation and stress: A reciprocal relationship. Interface Focus, 10(3), 20190092. Web.

Sleep and Exercise Effectiveness

Introduction

The assignment focuses on sleep and exercise. Regular physical activities are good for the body and well-being of people. One may not be sure of engaging in physical activities for fear of getting hurt. The good news is that physical activities are however safe when done well. Sleep has been regarded as a passive activity, but adequate sleep is vital for human well-being, prevention and management of ill health.

Exercise

Physical activities are vital for preventing aging and degenerative diseases. Certain exercises, for instance, provide significant improvements in pain and functional ability for aged people with degenerative joint conditions. 1 Further, regular exercise can reduce risks of diabetes, age-related morbidity in older adults and enhance glycémie control and insulin sensitivity. 2 On this note, it is vital for people to increase their physical activities. Enhanced physical activities will result in active body, improve muscle compliance and energy metabolism. 3 However, it is recommended to build slowly and train consistently to reduce chances of injury.

Individuals should choose appropriate physical activities to avoiding injuries while exercising. Generally, healthy individuals can engage in any form of exercise. However, people with certain conditions should choose appropriate physical activities based on their medical conditions or experts recommendations to avoid injuries. Strenuous exercise may create small microscopic tears in the affected muscle tissue, 4 joint pains, torn muscles, as well as bone fractures that occur during exercise activities. 5 Therefore, training slowly and consistently to avoid injuries during exercise is important. 4

Several components of exercise regiment exist for physical activities. First, stretches are necessary as full body exercises to enhance muscle control, overall strength and stability. 6 They include hamstrings, calves, ankles, triceps and wrist stretches. One can perform stretches to gain freedom for movement of the body to engage in activities that are more strenuous. Plyometric exercises improve stretching through rapid stretches and contractions of muscles. Such exercises improve joint stability. Stretches and dynamic warm-ups are movements that loosen tight muscles, enhance blood flow and stimulate the nervous system.

Stretches are good for reducing possible injuries during intense training. Second, strength training involves preparing the body for physical activities beforehand. 6 Apart from gym training to build muscles, other strength exercises include squats, pushups, dips and abdominal crunches among others. Conducting preventive maintenance training is necessary to achieve body strength. Third, core exercises such as Kegel exercise, superman, clam, and push up should build strong core muscles between hips and shoulders. 7 Such exercises should involve several muscles across different joints and work together to enhance body stability.

That is, core muscles should relax and contract together to create stability. Body weight exercises are effective for building core muscles. Finally, cardiovascular exercises such as jogging, swimming, cycling, skipping and weight lifting among others enhance cardiovascular health. Such exercises should be routine and optimum for maximum benefits. 8

Different types of physical activities exist to healthy body. Power walking is an aerobic workout that involves speed blasts and slow recovery breaks to offer adequate intensity for improving cardiorespiratory fitness. 9 Although power walking is effective for burning calories quickly and enhancing muscle strengths, it is associated with certain muscles injuries particularly when done poorly through exaggerated strides. Jogging or running involves running at a restrained speed for a given distance outside or on a treadmill.

As an aerobic exercise, jogging is a fundamental means of burning more calories, improving health of the heart and enhancing density of bones. Jogging, however, is not for everyone. It may cause injuries and chronic pains. 5 Weight training such as biceps curls, pull-down, lunges and squats among others involves lifting of weight to build muscles. It is an effective method of improving bone density, enhancing the rate of metabolism and reducing muscle shrinkage during aging. Weight training also leads to strong muscles and stability.

Weight training, however, is associated with stress of the musculoskeletal system, which leads to tiny microscopic tears in the affected muscle tissue. 4 HIIT-High Intensity Interval Training is based on short yet intense exercises and then short rest or recovery time. 7 HIIT exercises such cardio workouts, drills and brisk walks improve oxygen consumption and metabolic activities. These outcomes facilitate fat loss for nearly a day after the exercise. HIIT may not be suitable for individuals who cannot endure intense training.

Yoga consists of exercise elements that entail different body postures mainly stretching and strengthening of the musculature and should bring balance to mental, emotional, and spiritual aspects of people. 9 This form of exercise is suitable for sedentary people.

Although studies have identified positive effects of yoga as similar to aerobic exercises, 10 different types of yoga exist and it could be difficult to determine the distinct benefits of this form of exercise. Pilates consists of a series of exercises to enhance physical and mental well-being. It develops core stability, body strength and flexibility through movement, posture and breathing controls. 1 Pilates exercises have been used to treat people with chronic low back pain (CLBP).

Sleep

The healing powers of sleep depend on its abilities to regulate health. A sleep deficit could result in several health issues, including sleep apnea and insomnia. 11 Studies have shown that sleep can be used to manage conditions of ill health that have been associated with increased cases of stroke, high blood pressure, heart attacks, diabetes, obesity, car accidents and workplace accidents.

Circadian rhythm, cortisol and melatonin are known to influence sleeping pattern of individuals. Circadian rhythm controls the release of melatonin hormone that is responsible for inducing sleep. Conversely, circulating cortisol (high or low levels) could disrupt sleep patterns. Sleeping patterns of sleep and wakefulness depend on activities of thalamus and cerebral cortex in the brain system. Sleep has a restorative impact on the brain and it is controlled by both homeostatic and circadian needs. 12

Insomnia is a lack of enough sleep due to sleep problems. 13 Many people get less sleep and are prone to insomnia. The condition can just affect anyone, but is generally more common in women than men are, and it advances with age. 13 It is difficult to define normal sleep, but healthy individuals sleep for an average of seven to nine hours. Sleep, however, depends on age, environments, lifestyle and diets.

Insomnia is associated with difficulties in sleeping and signs vary from one person to another. Causes of insomnia may differ but are usually worrying, stress, underlying physical conditions, menopause, drug abuse, obstructive sleep apnea, certain medications and restless legs syndrome. Treatments for insomnia are available, including over-the-counter drugs and natural remedies. Insomnia could also indicate other serious health issues and patients should consult their doctors about sleep patterns and recommended treatments.

There are tips for getting a good nights sleep. For instance, bedtime routine helps individuals to develop healthy, regular sleeping habits. Established activities before bedtime can assist in creating ease of sleep. Moreover, they create favorable conditions for sleeping. For effective sleep, it is vital to avoid certain habits. For instance, it is normally recommended to avoid alcohol and stimulants such caffeine, nicotine and alcohol. One can engage in several ways to wind down before bedtime. These may include a warm bath, relaxation exercise or avoiding naps during the day.

One can optimize a sleep environment by making it comfortable, not too hot, noisy, cold or bright. At the same time, there are recommended hours to sleep and catch up sleep. Many healthy people sleep for an average of seven to nine hours every night. Sleep, however, becomes difficult to maintain as age progresses. Nevertheless, the same amount of sleeping time is always recommended.

In case of sleep challenges, however, natural sleep remedies are available for patients. Herbal remedies, for instance, act as alternative treatments for persons with sleep challenges. Relaxation exercises can also act as natural remedies for sleep problems. They work by helping muscles to relax before bedtime. However, extensive exercises are not encouraged. Individuals with insomnia are also advised to avoid daytime naps and create a routine or fixed time for going to bed and waking up. Such persons should not engage in sleeping in to recover for lost sleep at night.

Conclusion

The essay has explored fundamental concepts of exercise and sleep and well-being. Regular physical exercises are needed for healthy body. However, one must be careful when choosing desired exercises to avoid potential injuries or over-exercising. A good night sleep is required for an individuals well-being. Sleep problems, however, have resulted in difficulties in sleeping, which require both medications and natural remedies.

Reference List

  1. Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. The Effectiveness of Pilates Exercise in People with Chronic Low Back Pain: A Systematic Review. PLoS ONE. 2014; 9(7): e100402. doi:10.1371/journal.pone.0100402.
  2. Wentworth A. Helping Patients Discover the Benefits of Exercise. Coming of Age. 2014; 7-10.
  3. Teo W, Newton M J, McGuigan MR. Circadian rhythms in exercise performance: Implications for hormonal and muscular adaptation. Journal of Sports Science and Medicine. 2011; 10: 600-606.
  4. Wren P. Weight Training for Women. Alive. 2014; 61-65.
  5. Grote D. Are You Over-exercising? Washingtonian Magazine. 2014; 109-112.
  6. Foston M. 4 Steps to a Safe Workout. Alive. 2014; 112-115.
  7. Matusek J. HIIT Yourself Up. Ultimate MMA. 2013; 70.
  8. Roxburgh BH, Nolan PB, Weatherwax RM, Dalleck LC. Is Moderate Intensity Exercise Training Combined with High Intensity Interval Training More Effective at Improving Cardiorespiratory Fitness than Moderate Intensity Exercise Training Alone? Journal of Sports Science and Medicine. 2014; 13: 702-707.
  9. Smith JA, Greer T, Sheets T, Watson S. Is There More to Yoga Than Exercise? Alternative Therapies. 2011; 13(3): 22-29.
  10. Ross A. The Health Benefits of Yoga and Exercise: A Review of Comparison Studies. The Journal of Alternative and Complementary Medicine. 2010; (16 1): 312. doi: 10.1089=acm.2009.0044.
  11. Tweed J. The healing power of a good nights sleep. Lake Country Journal. 2012; 51-52.
  12. Saper CB, Scammell TE, Lu J. Hypothalamic regulation of sleep and circadian rhythms. Nature. 2005; 437: 1257-1263. doi:10.1038/nature04284.
  13. Oxtoby K. Sleepless nights: The role you can play in tackling insomnia. Chemist & Druggist. 2012; 23-25.

Factors Influencing Sleep Quality Among Female Staff Nurses

The ongoing coronavirus pandemic challenged every level of hospital management. The number of confirmed cases and deaths from COVID-19 is growing daily, overwhelming healthcare institutions with a shortage of staff, equipment, and medications. Hospital staff had to work long hours, resulting in sleep deprivation and various health problems (Kim-Godwin et al., 2021). Since the performance of healthcare personnel influences patient outcomes, hospital administration should assess and manage issues that cause reduced productivity (Wu et al., 2021). One of the main reasons for low job satisfaction and poor performance among hospital staff is fatigue and burn-out due to an increased workload and sleep disturbance (Kim-Godwin et al., 2021). The 2019 statistics showed that one-third of the U.S. medical personnel suffered from sleep problems (Sagherian et al., 2020). Since workload during the pandemic increased, the number of healthcare workers with insomnia also grew. For example, it was reported that 40% of Chinese nurses had problems with sleep because of longer shifts and disturbing schedules (Sagherian et al., 2020). This data is necessary to elucidate the issue of understaffing and overwhelmed healthcare workers during the pandemic.

The first level question that should be asked is the prevalence of severe sleep disturbance among healthcare workers in the United States. The significance of this question is in health outcomes that are impacted by staff productivity. Sagherian et al. (2020) reported 40% subthreshold insomnia and 5% severe sleep disturbance among 420 nurses who participated in the survey. Another study identified that 21-point Sleep Quality Index among nurses was 9.85 (Kim-Godwin et al., 2021). Unfortunately, I could not find the collective data about the prevalence of sleep disturbance for all healthcare organizations in the United States. The second level question is related to the complications of insomnia among nurses and physicians who provided care to COVID-19 patients. The sequelae of chronic insomnia include metabolic syndrome, diabetes, hypertension, dysfunctional eating, and fatigue (Kim-Godwin et al., 2021). Indeed, lethargy and fatigue increase the frequency of medical errors; therefore, recruiting more nursing staff and optimizing schedules is vital for reducing insomnia and the associated adverse consequences among hospital workers. I want my peers to address external factors, other than hospital management, that resulted in poor patient outcomes during the pandemic.

References

Kim-Godwin, Y. S., Lee, M. H., Logan, J. G., & Liu, X. (2021). Factors influencing sleep quality among female staff nurses during the early COVID-19 pandemic in the United States. International Journal of Environmental Research and Public Health, 18(9), 1-10.

Sagherian, K., Steege, L. M., Cobb, S. J., & Cho, H. (2020). Insomnia, fatigue and psychosocial well-being during COVID-19 pandemic: A cross-sectional survey of hospital nursing staff in the United States. Journal of Clinical Nursing, 1-14.

Wu, C.-H., Lin, H.-H., Lai, S.-Y., Tseng, K.-C., & Hsu, C.-H. (2021). A study of leisure constraints and job satisfaction of middle-aged and elderly health care workers in COVID-19 environment. Healthcare, 9(6), 11-18.

Sleep: Non-REM and REM Phases

Sleep has great general biological significance, playing an important role in the function of the brain. During sleep, metabolic rates and muscle tone decrease, contributing to the restoration of physical and psychological resources. Due to the most common sleep disorder  insomnia, there is great exposure to heart diseases such as myocardial infarction and stroke. It negatively affects the learning processes, short-term and long-term memory. This condition can cause mental disorders, leg cramps, and abnormal heart rhythms. This disorder increases the level of blood sugar, chronic fatigue.

The sleep period consists of two phases: non-REM and REM, or rapid eye movement. During REM sleep, the brain filters the information received per day, discarding unnecessary data. Hippocampus, facilitating long-term memory consolidation, is associated with non-REM sleep. A study shows that the REM phase erases some amount of data (Li, Ma, Yang, & Gan, 2017). Neurons in the hypothalamus, also known for producing hormones stimulating appetite, are responsible for this cleansing. One of REM sleep characteristic features is a vivid dream when the brain recalls the period of wakefulness. Dreams are related to ones actual experiences as an individual and are a significant part of peoples consciousness. People solve some difficult tasks in a dream, make a breakthrough into a new field of knowledge, and generate brilliant ideas.

REM sleep is especially crucial for newborns, providing nerve stimulation that promotes the general development of the nervous system. Different stages of life correspond to varying amounts of sleep. A newborn might spend about 50% in the REM phase, while at the age of two, this phase takes about 25% from the whole sleep period (Li, Ma, Yang, & Gan, 2017). Teenagers sleep longer, and older people need more time to fall asleep. The reason for these changes lies in the fact that sleep has a different purpose at different stages of life. In youth, it plays a vital role in brain maturation; in old age, it is necessary to prevent degenerative conditions.

Reference

Li, W., Ma, L., Yang, G., & Gan, W. B. (2017). REM sleep selectively prunes and maintains new synapses in development and learning. Nature Neuroscience, 20(3), 427-437.

The Characteristics of Sleep Deprivation

Abstract

The term sleep deprivation can be defined as a psychological condition in which a person does not get the needed amount of sleep. The disorder can be evident for adults if they dont attain seven to eight hours duration while sleeping. On the other hand, children will be associated with sleep deprivation if they sleep for less than ten hours. Lack of sleep is a psychological order since it affects how human beings think and feel. When sleep deprivation is experienced for a long time, there can be short-term or long-term chronic conditions that may lead to physical and mental issues health-wise. Sleep deprivation is caused by various factors such as work obligations, poor hygiene, lifestyle choices among others.

Sleep deprivation can be a result of decisions made, for instance, staying for a long while when watching television at night, engaging in relationship battles, and so forth. The symptoms include spending a notable daytime while feeling sleepy, reduced concentration during the day, and mood swings. To prevent sleep deprivation, it is important to address the issue when it is realized, and therefore, forecasting on sleep hygiene through the assistance of a physician can be applicable. This paper explores sleep deprivation by addressing the causes, symptoms, the number of people affected, and ways to prevent the disorder.

Major Causes of Sleep Deprivation

Factors that cause sleep deprivation can be catalyzed by voluntary habits, personal actions, work obligations, and medical issues. Under this note, one of the essential matters to note is that chronic sleep deprivation is a condition based on emotional response (Atrooz & Salim, 2018). Thinking about sleep issues or having anxiety feeling about not getting sleep on time are key contributors to this problem.

The first factor this paper explores is sleep deprivation due to voluntary decisions. Some individuals may not decide to follow the normal way of doing their stuff but rather alter their schedules. Thus, at night you may find these people reading books, newspapers, listening to the radio, and watching television (Thomas, 2021). Others have the habit of sticking to their mobile phones to socialize with their friends and relatives. In contrast, having an individual who is not well health-wise can restrict peoples sleeping time.

Certain health problems such as tonsillitis or cold may lead to snoring that leads to a person awake when sleeping. The disruption can be significantly experienced at night which makes the victims have anxiety about the likelihood of getting enough sleep. People who have sleep disorders such as apnea and period limb alteration can also be affected by sleep deprivation (Atrooz & Salim, 2018). Furthermore, some health issues, for instance, depression or anxiety makes people have sleep interference.

Medical conditions such as specific medicine that is useful in treating diseases for example epilepsy and hyperactivity deficit problem are also key contributors to sleep deprivation. The reason is that the medical prescriptions may lead to one having an altered sleep pattern that makes them lack sleep at night(Tuan & Lee, 2017). Additionally, individuals who go through stressful situations in their lives, for instance, getting fired from a place of work, the death of a close friend, moving to a new place among others, may face acute sleep deprivation though in a short-term basis.

Furthermore, environmental factors may also be key contributors when it comes to sleep deprivation. For instance, extremely hot environments or cold temperatures may make an individual to be uncomfortable while sleeping which makes them stay awake for long hours at night. Similarly, bright lights, loud noise, and stereotypes when someone is sleeping may be a cause of this disorder. It is also important to note that lifestyle habits such as food and beverage intake may lead to sleep deprivation (Atrooz & Salim, 2018).

For example, taking coffee or an energy drink at night may restrict someone from getting sleep due to the presence of high contents of nicotine in the items. The same effect is felt when one is indulged in drug intakes such as alcohol, chewing of khat, and other dangerous drugs. Lastly, aging people can suffer from sleep deprivation especially those persons 65 years and older. The reason is that as they get older, medical problems are highly witnessed and also lack of physical activity that will make them require sleeping time.

Types of Sleep Deprivation

Sleep deprivation can be of various types depending on the level of the disorder in someones normal way of living. The first type is acute sleep deprivation that means a short-term period that can be one week or less when a person experiences a reduction in their sleeping time (Tuan & Lee, 2017). This is caused by a temporary issue that is running in someones mind such as stress due to relationship issues, fear due to some threats happening, and also recovering from a frightening moment.

The other type is chronic sleep deprivation which is mostly referred to as insufficient sleep syndrome by the American Academy of Sleep Medicine (AASM). In this case, sleep deprivation persists for more than ninety days or more (Tuan & Lee, 2017). It can be caused by depression for example, when someone is subjected to situations such as the death of an individual, having been dumped by a lover among other intensive issues. Lastly, chronic sleep deficiency is a type that sleep deprivation that occurs due to sleep fragmentation and other distractions. This type can be a result of medical issues that have not been addressed in someones healthy life. It can persist for more than six months and a severe one a year or longer.

Population Affected by Sleep Deprivation

Sleep disorders and loss are among the most commonly disregarded problems in the world. Approximately, more than 50 million US citizens are affected by sleep deprivation. That has led to the alteration of the normal way of functioning as per humans daily obligations (Gonzalez & Tyminski, 2020).

90% of older people with sleep deprivation are not exposed to medical interventions as some people the problem still undiagnosed (Gonzalez & Tyminski, 2020). The population that is mostly affected by this disorder are people living with underlying medical issues. For instance, 56% of people with sleep loss have hypertension and diabetes. More than 45% of people with obesity, heart attack, and stroke have been said to suffer from this psychological issue (Gonzalez & Tyminski, 2020). The problem has been highly manifested to people with more than 60 years especially the female gender.

Generally, sleep deprivation affects nearly everyone but mostly for people with health conditions or adults who have lifestyle challenges. Additionally, the young people below 25 years similarly get this disorder due to the desire to fit in the social stratification system such as employment, rush to marriage, and also get powerful positions to meet their goals. However, only 8% of young adults experience sleep deprivation due to social mobility issues (Thomas, 2021).

Many young people have suffered the condition due to prolonged hours while doing fun activities and also challenges in maintaining romantic and relationship affairs. 20% of people in the world sleep deprived according to survey reports in American research institutes (Gonzalez & Tyminski, 2020). That translates to a significant population of people living the problem as doctors testify that sleeping pills frequently purchase over the counter.

Adolescents are frequently reported to have sleep deprivation due to growth issues and also naiveness due to the developmental stage that one has yet to discover themselves. For instance, a survey of more than 3000 adolescents in Rhode Island reported that 15% of the participants sleep more than 8.5 hours while 26% slept for less than 6 hours (Thomas, 2021). The trend shows that sleep deprivation can affect anyone but it will depend on the nature of activities and the factors that play a part in causing the problem.

Furthermore, the degree of sleep deprivation is common to people who have advanced to higher social class. The reason is that those people tend to have business obligations that require them to stand firm and defend their occupation especially if the enterprises have some uncompleted certifications. Most people who participate in unclear businesses tend to lack sleep because they have battles with authorities and rival firms.

Symptoms of Sleep Deprivation

The primary symptoms that can be evident when it comes to sleep deprivation include extreme daytime sleepiness and daytime weakening. Someone will be experiencing low concentration, changes in temperament, and challenges in cognitive functioning. In this case, a victim will have reported tiredness during the working time and will occasionally take a nap to recover (Mohammadi, 2018). When a person has excess daytime drowsiness, they will feel dozy and experience difficult moments in being awake when they are required to undertake a given activity. Microsleeps occur at this condition when someone dozes for a minute or second unwarily.

Similarly, sleep deprivation can show signs such as worsened memory where someone experiences interference in reasoning, concluding, and contributing to teamwork. Therefore, when this is realized, there are chances of risky decision-making that can lead to individual or group liability when undertaking a specific duty. A persons signs can range depending on their bodily adaptations to the disorder as some individuals will show no symptoms but at night, they experience deprived sleep (Mohammadi, 2018).

That will be determined by the type of sleep deprivation as discussed earlier under the categories of sleep deprivation. Genetics plays a key role when it comes to symptoms as some victims of sleep deprivation will not be experienced until at the last stage. Lastly, patients with this disorder will occasionally have frowned facial expressions with their eyes red or discolored depending on the stage of the disorder.

Sleep Deprivation Treatment

When a patient feels the symptoms mentioned above, the first step to take is to get an intervention from a physician. It is wrong to decide to buy presumed drugs over the counter when not prescribed by the doctor. Working with a doctor will help determine the stage of the matter and guide one perfectly on the appropriate course of action for the disorder (Thomas, 2021). After doctors assess the situation, from there a patient can start treatment that best suits their needs.

A doctor will prescribe an individual to purchase sleeping pills that do not have long-term health effects after one recovers. Light therapy can be relevant in this case after one experiences hectic insomnia. The therapy is designed to aid in resetting a patients internal clock hence get enough sleep. In cases such as sleep apnea, a breathing device is advisable that will prevent disruptions that lead to weakness (Thomas, 2021). A common machine that is used in this perspective is Continuous Positive Airway Pressure (CPAP).

However, treating this condition requires someone to have self-driven measures that can get them back to sleeping normality. This includes making sleep a priority when somebody notices that they have challenges in sleeping (Tuan & Lee, 2017). That can be achieved by having a consistent sleep schedule that strives a patient to have specific periods that they must be a bed. Other interventions include setting boundaries in working and social life. That will ensure that one is not provoked beyond a logical margin when it comes to social interaction when working and outside the workplace (Atrooz & Salim, 2018). Lastly, it is important to customize the bedroom environment to be free from excess lighting and loud noise.

Conclusion

Sleep deprivation is a health issue that makes a victim experience a short duration of sleep when it is time to rest at night. The condition is caused by factors such as work-life obligations, mental health, consequences of decisions in social life among other issues. Sleep deprivation can be either acute or chronic. The disorder may be easily seen when someone has sleepiness in the daytime and also loses concentration. To prevent and treat the problem, it is important to seek medical attention from a physician and indulge in personal motives that make sleep a priority.

References

Atrooz, F., & Salim, S. (2018). 0021 Early life sleep deprivation by enhancing neuronal expression of MKP1. Sleep, 41(suppl_1), A9-A9. Web.

Gonzalez, A., & Tyminski, Q. (2020). Sleep deprivation in an American homeless population. Sleep Health, 6(4), 489-494. Web.

Mohammadi, A. (2018). Prevalence of sleep disorders and sleep deprivation symptoms in nurses and allied health professionals; a cross-sectional analytic-descriptive study. Nursing & Care Open Access Journal, 5(4), 7. Web.

Thomas, S. (2021). Sleep deprivation: time to intervene. Sleep Medicine, 7(4), 33-39. Web.

Tuan, L., & Lee, L. (2017). 0044 Differential effects of paradoxical sleep deprivation on adolescents and adults. Sleep, 40(suppl_1), A17-A17. Web.

Relation Between Sleep and Work Productivity

Introduction

In the busy and interconnected world of today, sleep is often a commodity not every person can afford. The importance of sleep as a resource and a human need can often be undervalued, especially with the raising needs of many workplaces and the social requirements each person bears. In this discussion then, it can be especially crucial to re-state the role of sleep as an agent of healthy lifestyle and good human performance. While many people understand the need of a human body to get rest, only a minor portion of them truly understands how a lack of rest can impact all aspects of their daily lives. In this work, the discussion regarding sleep will cover both the benefits and detriments of a healthy sleep, as well as some issues concerning peoples sleep patterns. Additionally, the text will relay how the current work culture and its constraints produce unhealthy individuals and limit their ability to live full lives. As a result of this work, more people will be informed in regards to the way their lives can be impacted by sleep, as well as possible ways to remedy the situation.

Thesis Statement

Quality of sleep impacts social, physical, and emotional aspects of life, and the present-day norms of work expectations systematically act as a tool that deteriorates peoples productivity. The 8-hour work week and constraints on many jobs impact sleep quality and the quality of life for their workers, decreasing the overall quality of life and the effectiveness of labor.

Healthy Sleep and its Duration

The need of human beings to get rest and sleep well is uncontended truth, supported both by common assertion and scientific fact. However, the definition of healthy itself, and the particular timeframe that is used can be subjective, depending on the person one asks. In this vein, a person might feel that getting 4 hours of sleep a night is perfectly sufficient for them, while another might find 7 working for them better. Regardless of personal preference or habit, however, the quality and quantity of sleep can be scientifically measured. First, it must be established what constitutes good, healthy sleep, and how it is determined.

In terms of sleep duration, research has most often found that around 6 to 8 hours is sufficient for every individual, bringing them enough time to rest and having no negative impact on cognitive or social function. Alternatively, both longer and shorter sleep have been associated with significant detriments. The aforementioned 4-hour sleep, in particular, was noted by scholars to be equivalent to aging 8 years (Wild et al.). Measures of wellness and sleep pattern results have been taken from a large sample of participants all over the world, making this study both relevant to many and credible. In terms of rest, the quality of sleep has been noted to have been even more important than its duration, significantly affecting the way people act and perform tasks. A cross-sectional study done on Australian adults have found that poor sleep quality negatively impacts a person the most, regardless of sleep duration. For the study, poor sleep is defined broadly as the type of sleep that is often interrupted or accompanied by physical pain or discomfort. In particular, it was noted that bad sleep in combination will all types of sleep length was associated with worse physical, emotional and social functioning (Lallukka et al.). For the purposes of this discussion, these results mean that 6-8 hour uninterrupted, comfortable sleep is considered to be healthy, with all other deviations contributing to an overall decrease in sleep quality.

Effects of Sleep

Physical

The physical effects of the lack of sleep are among the most well-known in the general population, and are often made the central focus of the discussion in popular media discussions. Physical alterations to the appearance of a person, and the deterioration of their athletic performance can be noted as major side effects of poor sleep. Dark bags under a persons eyes, their skin quality and functioning of their internal organs  all of these factors are brought upon by not having enough rest. In particular, people with insufficient or excessive amount of sleep can often find themselves more physically exhausted after the completion of basic activities or regular tasks.

For other populations, such as athletes in particular, the amount and quality of sleep can also make a large difference in physical performance. Research on rugby players has found that healthy sleep quantities correlated with better reaction times, skill execution, as well as personal ratings of physical wellness. Authors state, however, that the effects of sleep extension on physical activity are also contentious, and are currently shown to be varied depending on the person. Even if an an athletes response to sleep extension appears to be highly variable, as the work emphasises, it is still said that the lack of sleep can be dangerously detrimental to physical wellness (Swinbourne et al.). The research supports the assertion that a lack of healthy sleep impedes the way a person functions in their day to day life.

Since people live in a social environment, it is crucial that they are able to have adequate reaction times and a basic capacity for motor skills, especially in cases where their occupation requires it. Many individuals spend their time behind the steering wheel of a car, either for their work necessities or in transit. Driving is an activity that walks closely with danger, especially in populated cities with many distractions. Drivers, passengers and passerbys need to have the capacity for alertness, and the reaction times to respond to danger. In many cases, traffic accidents happen when an individual cannot respond to an emerging situation in time, resulting in a car crash or other kind of accident. As the quantity and quality of sleep impacts a persons reaction times, healthy sleep is a requirement to make sure that unfortunate accidents do not happen. This point is further bolstered in cases of public transportation, where a working individual may be responsible not only for themselves, but for the lives of others as well. An inability to sleep enough endangers the workings of society and lives of people.

Emotional

Similarly to the physical manifestations of poor sleep, the practice can affect a persons emotional wellbeing and stability as well. An individuals emotions underpin many of their actions, thoughts and decisions in their daily life. Despite often considering them to be secondary to human functioning in a more formal setting, an individuals emotional spectrum more often than not shapes the particular methods with which they interact with the world and others. An individuals ability to handle stress, respond to external stimuli appropriately, or find emotional balance can all be influenced by their sleep schedule. This fact is particularly notable in a work environment, where many people have to operate on a shared goal or project for a prolonged amount of time. Poor sleep leads itself to irritability and stress, which can negatively impact the mood of a person and attitudes of those that have to interact with them. This means that the lack of sleep can in turn harm work communication and professional relationships, and present problems in many social settings. Research into the correlations between emotional human responses and sleep has found a mutually affective relationship, where a persons emotions affect their ability to sleep, and the quality of sleep shapes their emotions. It is noted that a persons affective states, in particular, share a reciprocal relationship between subjective sleep variables (Konjarski et al.). This means, overall, that the ability of a person to feel excited, happy, sad, fearful or in any other way is specifically impacted by the quality and quantity of their sleep. The consideration of this fact is crucial in professional and informal settings alike, as human communication forms the foundation of society.

Sleep and Working Hours

Early Working Hours are Detrimental To Productivity

Sleep has historically been considered something of an enemy to productivity in a professional setting. Ever since the industrial age, workplaces have been attempting to extract as much labor and workforce out of their employees as possible. This process was Accompanied and regulated by the establishment of work schedule, and the standard work week. While the particular way a 9 to 5 job operates now has changed with the introduction and development of modern tech, the time an average person often spends on the job has largely been similar. Even the existence of days off and holidays has been something workers had to actively advocate for, as the corporate organization attempted to extract as much productivity from the people as possible. However, there is a large and apparent problem with this approach, one that is yet to be fixed on a large scale. In particular, it should be said that the 8 hour work day is ineffective at extracting productivity from workers and is actively detrimental to their lives.

As noted by a variety of written research on the subject, an 8 hour workday rapidly drains both the cognitive and physical resources of a person, leaving them with only a small period of productivity over a long stretch of time. In practice, the majority of office-type jobs can be fulfilled with 6-hour or even 4-hour workdays, which are much more beneficial to human wellness. The current length of an average workday additionally has specific serious effects on the quality of sleep for most individuals. Longer work hours put significant stress on individuals, leading to more anxiety and exhaustion from their daily work (Rhéaume and Mullen). Additionally, many common jobs have irregular work schedulers or a shift-based structure, where individuals are put under an even higher degree of stress. Researchers of nurse work state that Extended work hours and shift work are an occupational and safety hazard for many, especially those working in the care industry (Rhéaume and Mullen). Quick changes that often accompany shift work additionally present people with even more stress, which comes from both working for a long time and having to work in unexpected conditions (Härmä et al.,). As noted by one of the previous section of the text, an emotional state of agitation, worry, exhaustion or anxiety can decrease a persons quality and quantity of sleep. This means that a prolonged work day leaves many individuals too stressed to properly rest, while also requiring them to wake up early each day.

Other types of research have noted that the particular schedules and early hours of typical workdays can often be damaging to workplace productivity. In addition, the 8 hour work day leaves many people unable to tend to the daily necessities of their life in time, such as childcare, groceries or homemaking, which are increasingly becoming needed in todays world. Overall, it should be said that the nature of the current work climate works against the wellbeing of people, their ability to perform tasks, and their capacity to function in the modern world setting.

Conclusion

In conclusion, it should be stated that the people of today are lacking in good, high quality sleep, as a result of many social and economic factors. The workplace environment present in many countries and societies around the world has developed to be antithetical to the notion of productivity and optimization. While jobs require many to wake up early and work for prolonged periods of time, they also leave individuals too exhausted to keep up with other necessities of daily life, while also not achieving their perceived notion of employee efficiency as imagined. People are being overworked, leading to them developing unhealthy or inadequate sleep schedules, which then lend themselves to worse cognitive, emotional and physical functioning. The inability of individuals to perform tasks on time is then attributed to a their personal failure, and not a systematic issue that impacts a major part of the workforce, leading to many people suffering in the process. The problem is then left unattended as workplaces keep setting unreasonable performance expectations on employees and demanding 8 or 12 hour workdays. A need to deviate from this structure becomes apparent if scientific basis of good sleep and workplace efficiency is considered, however. Both employees and their workers need to understand that good rest is the basis upon which other considerations should be built.

Works Cited

Härmä, Mikko, et al. Association of Changes in Work Shifts and Shift Intensity with Change in Fatigue and Disturbed Sleep: A within-Subject Study. Scandinavian Journal of Work, Environment & Health, vol. 44, no. 4, [Scandinavian Journal of Work, Environment & Health, Danish National Research Centre for the Working Environment, Norwegian National Institute of Occupational Health, Finnish Institute of Occupational Health], 2018, pp. 394402, Web.

Konjarski, Monika, et al. Reciprocal Relationships between Daily Sleep and Mood: A Systematic Review of Naturalistic Prospective Studies. Sleep Medicine Reviews, vol. 42, 2018, pp. 4758.

Lallukka, Tea, et al. Association of Sleep Duration and Sleep Quality with the Physical, Social, and Emotional Functioning among Australian Adults. Sleep Health, vol. 4, no. 2, 2018, pp. 194200.

Rhéaume, Ann, and Jane Mullen. The Impact of Long Work Hours and Shift Work on Cognitive Errors in Nurses. Journal of Nursing Management, vol. 26, no. 1, 2017, pp. 2632.

Swinbourne, Richard, et al. The Effects of Sleep Extension on Sleep, Performance, Immunity and Physical Stress in Rugby Players. Sports, vol. 6, no. 2, 2018, p. 42.

Wild, Conor J, et al. Dissociable Effects of Self-Reported Daily Sleep Duration on High-Level Cognitive Abilities. Sleep, vol. 41, no. 12, 2018.

Gwen Dewars Research of the Electronic Media Impact on the Sleeping

Scrolling through posts on Instagram or Facebook, chatting with friends on WhatsApp are everyday activities that each of us performs before finally going to bed. Nevertheless, researchers argue that such types of entertainment disrupt healthy sleeping patterns, especially among children. A number of various works analyze this issue and determine whether or not these devices are harmful; the article by Gwen Dewar is one of them. This researcher is an anthropologist with a big experience in studying issues related to parenting, psychology, biology and many other topics. However, there are several features that distinguish this study from others. For instance, aside from presenting reasons as to why electronic media cause trouble, the author also provides tips to help children to improve their sleep. Dewar achieves the purpose of spreading awareness about this problem by conducting thorough literature research and introducing factual evidence.

The author begins by mentioning that even though electronic devices are essential for modern life, they also cause trouble. Dewar presents the issue and wonders how serious it is and how parents can help children to sleep better. After that, she talks about the reasons as to why media disrupts sleep patterns, which includes exposure to blue light, as well as questionable or violent content. Then, the author emphasizes the fact that the vast majority of studies report a link between electronic media use and altered sleep patterns (Dewar para. 43). Nevertheless, she points out that correlation does not mean causation and then presents tips to prevent sleep problems.

First of all, it should be pointed out that in this article, the author presents a number of proofs as to why researchers are worried about electronic media causing sleep problems. For instance, she submits accurate information from various sources, such as studies by Goh et al., Hysing et al., Higuchi et al., and many others. They argue that indoor lighting suppresses melatonin production, which disrupts normal sleeping patterns (Dewar para. 26). In addition, Dewar also talks about studies that proved how changing media content could help children to sleep better (Dewar para. 56). The author manages to use reliable sources and incorporates them well in her own research.

Most of the information Dewar collects from scholarly articles that were published in various periodicals, such as The Journal of Pediatrics or Journal of Sleep Research. These academic sources are international and publish expert reviews and ideas on several medical issues on a global level. Moreover, the author also includes data from different national surveys, which is a common method of collecting data. According to them, a significant number of children use electronics before bed and sleep less than those who do not have any devices in their rooms. There are no logical fallacies in the presented information as every article, trial and study indicates that media has a negative effect on sleep patterns. Since all data was gathered from different credible peer-reviewed sources, it can be assumed that the author conducted comprehensive literature research. It makes the article more believable, and the authors arguments seem convincing.

Furthermore, after presenting proof, Dewar points out that even though there is compelling evidence, this issue is not researched well enough to make claims. For this reason, it would be wrong to jump to the conclusion that electronic devices are necessarily harmful. Since Dewar makes assumptions that, perhaps, some children use devices to help them fall asleep: such a position is not biased and allows room for discussion. Nevertheless, although Dewar accepts the fact that researchers still do not know everything about this topic, the power of electronic media cannot be underestimated. However, in this part of her research, Dewar does not present any evidence-based information or publications from other sources. Instead, she indicates the necessity of further research on this topic, and it is still early to blame electronic devices for everything.

Therefore, the author feels the need to provide tips for parents that can help to prevent sleep problems among children. This part of the article is especially helpful since it offers support and beneficial advice. Moreover, Dewar credits the guide, from which tips were collected, which means that the author of the article also thoroughly studied the topic instead of making up these tips.

As for my opinion on this article, I would say that the author manages to present convincing arguments with the help of a significant amount of data. For this reason, I could definitely use it in my own final paper. From this research, I discovered why electronic devices disrupt sleep among children and how it is possible to mitigate the negative effects. However, I would also like to get more information about the other side of the argument. In other words, it would be useful to implement citations from credible resources that doubt the connection between electronics and sleep problems. The paragraph about how correlation does not mean causation was relatively small compared to other parts of the article, where Dewar discussed the adverse outcomes.

In conclusion, it would appear that by writing this article, Dewar manages to not only educate the readers on the topic of disruptive electronic media but also to offer help. There is a significant amount of information that can be used in my final paper, as well as several thought-provoking questions for further studies. For instance, it would be interesting to discuss further if every individual is affected by electronic media. Through comprehensive research, the author provides reasonable arguments as to why exactly devices harm sleep patterns among children. Out of credible scholarly articles from international journals, she gathers a number of evidence about the adverse impact of electronics. However, through this study, Dewars position remains objective, and she does not preach on this subject. In addition, she also gives valuable advice which can be used by parents in order to help their children.

Work Cited

Dewar, Gwen. Tech before bedtime: Do electronic media devices cause sleep problems in children? Parenting Science, 2018, Web.