Stanford Medicine Newsletter Updates For the Local Community


Spreading the word on shut-eye

Rafael Pelayo, MD, a pediatric sleep specialist, meets with high school students to encourage healthy sleep habits.


In his senior year of high school, one of James Underwood’s friends left a Friday-night party around 12:30 am and nodded off at the wheel in a remote stretch of rural Arkansas. Exhausted after a long week, including early-morning commutes to school, he careened off the road and struck a tree about a mile from home.

“It was kind of a shock to everyone,” said Underwood, now a sophomore at Stanford University.

Fortunately, his friend suffered no major injuries, but Underwood realized that the consequences could have been catastrophic. The experience motivated him to volunteer in the Sleep Ambassadors program, designed to teach high school students about the importance of sleep — and the dangers that loom when they don’t get enough.

Reaching out

Through the program, which has won awards from the California School Boards Association and the National Sleep Foundation, Stanford students and faculty in the undergraduate-level “Sleep and Dreams” class reach out to freshmen at Menlo-Atherton High School in Menlo Park to give them a primer on the value of sleep. The college students pair up with juniors from the high school, who continue to spread the gospel among their peers as part of an ongoing educational campaign.

It’s a unique program among high schools nationwide, where sleep is rarely part of the curriculum, said Stanford sleep expert William Dement, MD, PhD, who helped start the project. “It’s still true that sleep is not addressed in the educational system,” he said. “It’s a huge problem all over the country.”

This winter the program will be expanded to Palo Alto’s two high schools — Gunn High School and Palo Alto High School — where student stress has been a concern, said Rafael Pelayo, MD, a pediatric sleep specialist at the Stanford Sleep Disorders Clinic and one of the professors in the program. Pelayo also has done presentations to parents, teachers and students at local schools in an effort to encourage healthy sleep habits among the teens.

Impact on accidents

As an expert witness in many tragic car accidents, Dement said he was primarily concerned about drowsy driving among teens. Some two-thirds of all sleepiness-related crashes involve adolescents and young adults, who don’t always perceive that they are fatigued and may be prone to risk-taking, studies show.

“A lot of people have the mindset, ‘I’ll be fine. I can make myself stay awake. I’m invincible,’” Underwood said. “But if you’re not surrounded by a stimulus, you can crash very suddenly. It can be incredibly problematic.”

In addition to lessons on the consequences of driving while drowsy, the program teaches students about the basics of teen sleep and the many ways in which sleep deprivation can impact their lives. “We try to give them what they need to know going into high school at a time when sleep deprivation is so common,” said Stanford sophomore Marleyna Mohler, one of the teaching assistants. “Sleep is seen as a kind of joke and not a serious topic. There’s definitely a stigma that people who sleep a lot aren’t having fun. Pulling an all-nighter is like a badge of honor, a diehard commitment.”

Follow-up surveys with students have shown a significant increase in their knowledge about sleep and greater awareness of their own need for more sleep.

“We have a sense that it works. I get feedback from students who say, ‘I do remember what you said, and I do try to get more sleep,’” said volunteer coordinator Maggie Betsock. “If I can prevent one drowsy-driving accident a year, I’ll be happy.”

Later start times

Around the time the program was introduced, a group of Menlo-Atherton parents pressured the school board to change the bell schedule as part of the campaign to improve students’ sleep habits.

The school’s 7:45 am start time was pushed back one hour, with classes starting at 9:30 am twice a week. The schedule gives students a midweek respite to catch up on sleep, rather than relying on the weekend to recover from their accumulated sleep debt, said outgoing principal Matthew Zito. He believes these changes, together with other innovations, such as a ban on AP summer classes and a homework-free winter break, have helped improve student well-being.

“Student behavior is greatly improved. The number of disciplinary actions of a serious nature is dramatically reduced,” he said. “This isn’t all related to student sleep. But I think sleep is a factor in having a healthier academic and socio-emotional climate on the campus.”

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