16 March 2015
Dear Mayor Holman and Members of the City Council:
The alarming number of youth suicides in our community is a matter demanding the attention of the City Council, and indeed all citizens of Palo Alto, in addition to our School Board. Whatever has caused this suicide epidemic in our community, it is imperative that we take immediate action to protect our students.
I use the term epidemic deliberately, because if the same number of teens in our community had died from cancer or an infectious disease, we would approach this as a matter of public health. Certainly its appropriate and necessary to increase counseling services aimed at students, and to take measures to reduce opportunities to use CalTrain for suicide attempts. But because we don’t know which students are most at risk, or why they are at risk, I believe that a public health type approach is warranted.
Last Thursday I attended a meeting with board members and staff from Family and Children Services of Silicon Valley at which this matter was discussed. I was shocked to hear a parent state that many students in Palo Alto Schools may only sleep five hours per night. My shock was because I know the impact of sleep deprivation in industrial settings, where impaired judgment and performance can cause injury, death, and disaster.
Let me cite a few of the consequences of sleep deprivation from the National Institutes of Medicine publication Sleep Disorders and Sleep Deprivation: An Unmet Public Health Problem.
“The public health consequences of sleep loss and sleep-related disorders are far from benign. The most visible consequences are errors in judgment. Less visible consequences of sleep conditions are far more prevalent, and they take a toll on nearly every key indicator of public health: mortality, morbidity, performance, accidents and injuries, functioning and quality of life, family well-being, and health care utilization.
“The main symptom of sleep loss is excessive daytime sleepiness, but other symptoms include depressed mood and poor memory or concentration. Chronic sleep loss, while neither a formal syndrome nor a disorder, has serious consequences for health, performance, and safety.
“Adolescents also frequently report receiving insufficient sleep. Contrary to public perceptions, adolescents need as much sleep as preteens. The optimal sleep duration for adolescents, about 9 hours per night, is based on research about alertness, sleep-wake cycles, hormones, and circadian rhythms.
“Sleep loss is associated with adverse effects on mood and behavior. Several studies of adolescents, including one with more than 3,000 high school students, found that inadequate sleep is associated with higher levels of depressed mood, anxiety, behavior problems, alcohol use, and attempted suicide.”
It should be clear that sleep deprivation could be a common factor in the Palo Alto suicide epidemic. The good news is that we can implement measures to reduce the risk of anxiety, depression and poor judgment that may be critical factors in suicide attempts.
And by actively paying attention to the sleep patterns of our children we may also be able to identify at-risk teens in order to take timely and effective action. Citing the NIM report again:
“Sleep disturbances are common features of psychiatric disorders. The most frequent types of sleep disturbances are insomnia, excessive daytime sleepiness (hypersomnia), and parasomnia. Sleep disturbances are so commonly seen as symptoms of certain psychiatric disorders that they are listed as diagnostic criteria under DSM-IV.
“Adolescents with major depressive disorders report higher rates of sleep problems and, conversely, those with sleep difficulties report increased negative mood or mood regulation. In addition, sleep-onset abnormalities during adolescence have been associated with an increased risk of depression in later life.”
Palo Alto is a leader in business, technology, education and the environment and we work very long hours to sustain that leadership. To work safely and sustainably, we need adequate sleep, as mentioned above.
But children and adolescents are not adults. They need more sleep. And they need adults to make sure they get it.
This is a community-wide problem, so I am asking the City and this Council to take a leadership role to:
- Alert all parents of the vital importance of adequate sleep to assure the health and well-being of their children and ask parents to monitor their children’s sleep.
- Implement measures to assess the quantity and quality of sleep, perhaps by questionnaires or an app, by parental observation and reporting, or by working with experts to implement in-school alertness testing to identify those who may be troubled or over-worked.
I believe that these measures can help to save lives and protect our children, but they need your consideration and action. Please sleep on it.
Very truly yours,
William M. Conlon