Through the Healthy School approach, schools are given the tools to address this issue. In the Haaglanden region too, the topic of sleep is brought to the attention of schools through the Healthy School adviser. Irene den Heijer and Muriel Weltens wrote an article in which they provide, among other things, examples of possible interventions at and around school, based on the pillars of the Healthy School approach.
Healthy School approach
Children spend a large part of their day at school. As a result, schools can have a major influence on a healthy lifestyle. Paying attention to a healthy sleep pattern is part of this, particularly because children and young people who do not sleep well may be unable to participate in lessons. Through the Healthy School approach, schools are given the tools to address this issue. In the Haaglanden region too, the topic of sleep is brought to the attention of schools through the Healthy School adviser. Below are examples of possible interventions at and around school, based on the pillars of the Healthy School approach.
Pillar 1. Health education
To promote a healthy sleep pattern, it is important to increase knowledge of the subject among both pupils and teachers. The topic could, for example, be discussed during biology or health education lessons. Various teaching packages are available for schools. This enables symptoms and complaints associated with sleep deprivation and sleep disorders to be recognised in good time and support to be provided. The GGD Healthy School adviser has an overview of the options and can assist in making choices.
For example, a toolkit has been developed for schools, containing a selection of available programmes and background information on this subject for teachers.
Pillar 2. Physical and social environment
The environment to which children are exposed during the day is important for sleep quality. Air quality, temperature, and exposure to noise and light in a classroom can affect daytime fatigue and pupils’ learning performance. Sufficient exposure to (day)light during the day is important for sleep quality at night because of its influence on melatonin production.
When pupils see little daylight, particularly during the winter months, this can cause daytime sleepiness and disrupt the day-night rhythm. Exposure to sufficient daylight, on the other hand, contributes to pupils’ learning performance.
Physical exertion and regular exercise during the day support a healthy sleep-wake rhythm. By designing the school building in such a way that movement is encouraged and by creating opportunities for physical activity during the school day, the school contributes to the pupils’ healthy sleep pattern. This applies to both primary and secondary schools.
Pillar 3. Identification: psychological factors
An important risk factor for reduced sleep duration among young people is the thoughts and emotions they experience before going to sleep. Worrying is the strongest predictor of perceived sleep quality. Young people appear to experience considerable performance pressure. School and concerns about tests or homework are often mentioned as sources of stress.
Pillar 4. Policy: School (and work) hours and homework
Because of teenagers’ sleep patterns, delaying school start times can have a major influence on sleep duration. Researchers have shown that delaying the start of the school day by 40–70 minutes results in more hours of sleep among pupils and less daytime sleepiness. Less absenteeism is observed among young people who start the school day later; they are more satisfied with their sleep and report less sadness and fewer fatigue-related complaints.
Moving test times to the early afternoon instead of the morning or the end of the day also contributes to pupils’ performance.
Research by Stichting Team Alert shows that one third of young people go to bed later than planned because they still had homework to do. Spreading assignment deadlines over a longer period can therefore contribute to pupils’ sleep duration.
Pillar 5. Policy: Substance use
Caffeine intake leads to a shorter total sleep duration. Because caffeine is present not only in coffee but also in energy drinks, tea and chocolate (milk), these products should be avoided late in the day. In addition, the use of substances such as alcohol, soft and hard drugs is associated with sleep problems, as are smoking and passive smoking. School regulations concerning these substances, and especially their enforcement, are important.
Attention to a healthy sleep pattern is still relatively new for schools and municipalities. However, there is increasing clarity about the effects of unhealthy behaviour on, among other things, learning performance and lifestyle. By examining the above determinants together with the GGD and implementing interventions where necessary, schools can help improve sleep quality—and thereby the health and ultimately the learning performance—of their pupils.
This article is a summary of an article that previously appeared in the epidemiological bulletin. You can read the full article here.