1. Dr. JenniferVriend, Psychologist
Queensview Professional Services
Anna Aylett, Registered Dietitian
CHEO, Centre for Healthy Active Living

2.  Sleep inTeenagers (Jenn)
 Nutrition inTeenagers (Anna)
 Sleep and Nutrition inTeenagers (Jenn
and Anna)
 Questions
2

4. Sleep Pressure
Our bodies need
a ‘refill’ each
night
4

5. Clocks (Circadian Rhythm)
Internal clock tell us to be
tired at night and awake
during the day
Balances our sleep drive
keeps us awake during
the day
5

6.  Clock works by producing melatonin
 Melatonin makes us sleepy
 Melatonin is produced when it gets dark
 Melatonin levels rises in mid to late evening
 Remain high during night
 Drop in the morning
6

7. •Stage 1
•Stage 2
•Slow wave sleep
(Stage 3 and 4)
•Rapid eye movement
(REM) sleep

8. • Then you begin the cycle all over again
• You repeat the stages about every 90 minutes
until you wake up in the morning
• For most kids, that's about 4 or 5 cycles a
night
 Mostly NREM early in night
 Mostly REM in early morning hours

9.  There is no “correct” amount
 What determines the right amount of sleep
for each child is whether they wake up feeling
well-rested
 varies greatly between individuals
 Average sleep durations for specific age groups
are…

10. 10
 Infants 14-15 hours
 Toddlers 12-14 hours
 Preschoolers 11-13 hours
 School-Age Children 10-11 hours
 Teenagers 9-10 hours

11.  Struggle to get up in the morning
 Claim they aren’t tired at bedtime
 Sleep late on weekends
 Tired at school, struggle to concentrate
 Adolescents typically get about 6-7 hrs of
sleep – need 9-10 hours
11
The Perfect Storm

12.  The circadian clock
 Clock shifts to new phase during adolescents
 Phase delay occurs in association with puberty
 Circadian system has altered sensitivity to light
 Melatonin release occurs later
▪ More sensitive to evening light, less sensitive to morning
light
 Occurs in other mammals
▪ Suggests biological
12
Biological Pressure

13.  Set their own bedtimes
 = More likely to set later bedtimes and more likely
to need parents to wake them
 Jobs
 Academic Pressures
 Socializing
 Staying up late to talk on phone, parties
 Electronics
13

14.  Greater use of electronics before bedtime
leads to: shorter, later, and more disrupted
sleep
 Alerting
 Involve exposure to blue-
spectrum light, circadian
clock has greater sensitivity
toward
 Phase delay worsens
14

15.  Sleepiness, mood disturbances, inattention, poor
grades, behaviour problems, substance use,
driving crashes, weight gain, increased appetite,
increased stress, immune system compromise
 Sufficient sleep - Memory and learning,
energy, illness, mood, weight control, etc.

16. 16
 Common nutrition challenges for teens
 Benefits of Healthy Eating
 Hunger Management Strategies

17.  Skipped meals
 Low protein
 Screen time during meals/snacks
 Distracted/mindless eating
 Too many sweet drinks
 Too much restaurant/cafeteria food
 Over-hungry after school
 Late night snacking (usually treat foods)
17

18.  Energy
 Immune system
 Concentration and academic performance
 Athletic performance
 Mood
 Stress management
18

19. 19
Over-hunger  over-eating
Keep ahead of hunger by:
 Eat breakfast (and lunch and dinner)
 Listen and respond to hunger (snack as needed)
 Balance: 2+ food groups/snack
3+ food groups/meal
 Eat at a table, with others, no screens
 One small sweet drink per day max
 Plan meals and snacks as a family

20. 20
 Sleep affects Eating
 Hunger Hormones
 Insulin Resistance
 Stress Hormone
 Eating affects Sleep
 What foods make sleep worse
 What foods improve sleep

21. 21
• Produced in the
stomach, signals
hunger
Ghrelin
“GO” EAT
• Released by fat cells,
signals the brain to feel
full
Leptin
“STOP”
EATING

22. 22
Ghrelin
• You’re hungry
Leptin
• You aren’t full
InsufficientSleep
• MORE HUNGRY,
LESS SATISFIED
• = EAT MORE

23.  Insulin is needed for glucose to get inside the
cell
 Glucose is the fuel for our cells
23

24. Eat
Food
broken
down to
glucose
Glucose
enters
blood
stream
Glucose
levels
high =
release
insulin
Insulin
signals
to cells
to take
in
glucose
24
Healthy
Functioning

25. Eat
Food
broken
down to
glucose
Glucose
enters
blood
stream
Glucose
is locked
out of
cells
Glucose
level ↑ in
blood
25
Health
Problems
- Impaired
ability to
burn and
digest fat
- pre-
diabetic
state

26.  Cortisol
 The stress hormone
 Poor sleepers secrete more cortisol
 Sleep deprivation
 Can increase cortisol
▪ Crave sugary and high-fat foods
26

27.  Insufficient Sleep
 Hungrier
 Less satisfied, don’t feel full
 Affects insulin levels
 Less likely to eat healthy foods
 Chronic sleep deprivation
 increased risk of obesity, diabetes, heart disease
 Good Sleep
 Helps control appetite and promote healthy eating patterns
 How does eating affect sleep?
27

28.  Sleep can affect what you eat, BUT what you
eat also affects sleep
 Caffeine
 Alcohol
▪ Initially can make sleepy
▪ Disrupts REM sleep
 Vitamins and Minerals
28
Lack of
Sleep
Caffeine
cravings
More
Caffeine
Poor
Sleep

29.  Vitamin B6
 Helps with melatonin production = more sufficient
sleep
 Fish, chick peas, bananas
 Calcium
 Deficits make it hard to fall asleep
▪ Dairy products, kale, soy products
 Magnesium
 Deficits make it hard to stay asleep
▪ Nuts and seeds, spinach, bananas
29

30. Healthy
Sleep
Healthy
Food
Choices
Improved
Health
30

31.  Bedroom
 Comfortable, quiet, and dark
 Use bedroom for sleeping, not punishment or
entertainment zone
 Have “shut-off” time for electronics
 Dim lights in the evening

32.  Sleep Schedule
 Bedtime and wake-up time
 Bedtime Routine
 20-30 min bedtime routine
▪ Same each night
▪ Calming activities such as a bath, reading a
book, listening to music, drawing, etc
▪ Go to bed when sleepy
Tips for Improving Sleep and Nutrition

33.  If you are in bed and awake for more than 20 -
30 mins, you should get out of bed
 Stay out of bed for about 30-minutes (or less
if you are sleepy) doing a non-alerting
activity, then go back to bed
 Goal is to associate bed with sleeping, rather
than with being awake
33

34.  If you are having difficulty getting to sleep within
about 30 mins
 Try staying up a bit later (about an hour)
 If you go to bed when tired, you are likely fall asleep
faster
 After a night or two of this later bedtime, go to bed
about 15-20 mins earlier. Continue this pattern until
you are going to bed at an appropriate time
 Make sure your teen wakes up at the same time every
day and that s/he doesn’t nap during the day.
 This will help get your teen’s Internal Clock back on
track
34

35.  Limit caffeine after 3 pm
 Small snack before bed
 Avoid large meals 3-4 hrs before bed
 Especially spicy, acidic, or greasy foods
▪ Increase heartburn and acid reflux
 Hydrate with water
 Consume foods rich in B6
 Salmon, bananas, fortified cereals and oatmeal,
chickpeas, walnuts, tart cherry juice
35

36.  Treat yourself to a snack
 having a small, protein rich snack before bed
▪ keep your belly happy overnight
▪ provide fuel to muscles to aid in the rebuilding and
recovery process
▪ protein sources: nuts, seeds, dairy, beans, eggs, meat
 Eat breakfast every day (within 1 hour of
waking up)
 Avoid going more than 2-4 hours without
food (avoid over-hunger)
36

37. For further information:
www.css-scs.ca
www.dietitians.ca
• Sufficient sleep + regular sleep schedule
• critical in controlling appetite
• promoting healthy eating patterns
• Healthy eating promotes
• Better quality and quantity of sleep
• Healthier sleep patterns
= OVERALL IMPROVEMENT IN HEALTH