Part one of this report looked at the Parkway School District switching to an earlier start time. Some students and parents believe start times before 8 a.m. are too early. Parkway officials note the school day is pinched on both ends by bus schedules, class time, after-school activities, homework and family time.

For Parkway students like Zack Becker, the school day starts early. The Parkway North High School sophomore is in marching band. During band season, the group met at 6:30 a.m. for practice, meaning Becker had to get up at 5:45 a.m. to get to school.

?I?m averaging six hours of sleep a night,? he said.

Fatigue affected Becker?s grades, which dropped from a 4.0 as a freshman to a 3.4 in his first semester.

Dr. John Spivey, a pediatricican and sleep medicine expert at Mercy Children?s Hospital said should get about nine and a half hours of sleep a night.

Early to bed?

Getting teenagers to go to sleep earlier is no easy task, explained Spivey.

?Around age 12 to 14, when a child hits puberty, there?s a natural shift in their sleep clock,? he said. ?Their circadian rhythm, their internal clock, basically skips ahead two hours. Typically, a teenager really cannot go to bed at 8 o?clock. Their internal clocks are telling them to go to bed at 10 or 11 o?clock."

To get enough sleep, teens would need to sleep until 7 a.m., he said.

?Then, you?re fighting after-school activities, sports, jobs, social time, homework, family time,? Spivey said.

• Read More: about teens and sleep from the National Sleep Foundation.

As a result, few teens get enough sleep during a school week, so they catch up on weekends, trying to repay the ?sleep debt.? However, sleeping until noon or 2 p.m. can further throw their circadian rhythm out of whack, Spivey said.

He pointed to a Stanford sleep study showing sleeping students simply did not perform well in school.

?It can affect your immune system, too,? Spivey said. ?It can affect your mood. Adolescents talk about changes in their moods. Add in hormone changes and you have mood swings.?

Katherine Wessling sends her daughter to Compton-Drew Middle School, a magnet school in the St. Louis School District. After class times moved to 7 a.m. this year, her 12-year-old daughter dropped out of all after-school activities because she was too tired.

Wessling also said that a principal told her it had nine more of its most serious disciplinary incidents after the time change.

Who?s on first?

Spivey said elementary students can and should go to bed at 8 or 8:30 a.m., and are awake and energetic at 6 a.m. after 10 hours of sleep.

 ?It really makes sense for elementary school students to go to school first,? Spivey said.

There?s not universal agreement on that. It brings up issues with younger children waiting for buses while it?s still dark out, Snider said. After-school childcare becomes an issue, too.

Then again, Snider said teenagers can get into trouble in the unsupervised period before parents get home form work. 

?The research has been accumulating. There?s evidence that it?s bad education, bad for society and bad for equity,? she said. ?Disadvantaged students suffer twice as much as other students.?

Snider said a Brookings Institute study found that even when changing start times has a high upfront cost, investing the resources to alter schedules for buses and after-school activities can pay off.

An Air Force Academy study shows that students who start school after 8 a.m. perform better. It?s the equivalent of a poor teacher with an average teacher, the study found.

 ?This isn?t just about student achievement,? Snider said. ?We?re doing long-term damage in terms of weight gain, depression and suicide.?

Attention to attendance

Despite the earlier start times, Tandy said Parkway high school attendance has basically stayed the same as last year, and three of the schools are slightly higher.

Still, Snider believes later start times are worthwhile for students and schools.

?About 70 percent of the kids in this country are seriously sleep deprived,? she said. ?Our children?s achievement should be what?s most important to us, not a bus schedule.?

What is your child's start time? Do you think it's appropriate? Please share you opinions in the comments section.

Part one of this report looked at the Parkway School District switching to an earlier start time. Some students and parents believe start times before 8 a.m. are too early. Parkway officials note the school day is pinched on both ends by bus schedules, class time, after-school activities, homework and family time.

For Parkway students like Zack Becker, the school day starts early. The Parkway North High School sophomore is in marching band. During band season, the group met at 6:30 a.m. for practice, meaning Becker had to get up at 5:45 a.m. to get to school.

?I?m averaging six hours of sleep a night,? he said.

Fatigue affected Becker?s grades, which dropped from a 4.0 as a freshman to a 3.4 in his first semester.

Dr. John Spivey, a pediatricican and sleep medicine expert at Mercy Children?s Hospital said should get about nine and a half hours of sleep a night.

Early to bed?

Getting teenagers to go to sleep earlier is no easy task, explained Spivey.

?Around age 12 to 14, when a child hits puberty, there?s a natural shift in their sleep clock,? he said. ?Their circadian rhythm, their internal clock, basically skips ahead two hours. Typically, a teenager really cannot go to bed at 8 o?clock. Their internal clocks are telling them to go to bed at 10 or 11 o?clock."

To get enough sleep, teens would need to sleep until 7 a.m., he said.

?Then, you?re fighting after-school activities, sports, jobs, social time, homework, family time,? Spivey said.

• Read More: about teens and sleep from the National Sleep Foundation.

As a result, few teens get enough sleep during a school week, so they catch up on weekends, trying to repay the ?sleep debt.? However, sleeping until noon or 2 p.m. can further throw their circadian rhythm out of whack, Spivey said.

He pointed to a Stanford sleep study showing sleeping students simply did not perform well in school.

?It can affect your immune system, too,? Spivey said. ?It can affect your mood. Adolescents talk about changes in their moods. Add in hormone changes and you have mood swings.?

Katherine Wessling sends her daughter to Compton-Drew Middle School, a magnet school in the St. Louis School District. After class times moved to 7 a.m. this year, her 12-year-old daughter dropped out of all after-school activities because she was too tired.

Wessling also said that a principal told her it had nine more of its most serious disciplinary incidents after the time change.

Who?s on first?

Spivey said elementary students can and should go to bed at 8 or 8:30 a.m., and are awake and energetic at 6 a.m. after 10 hours of sleep.

 ?It really makes sense for elementary school students to go to school first,? Spivey said.

There?s not universal agreement on that. It brings up issues with younger children waiting for buses while it?s still dark out, Snider said. After-school childcare becomes an issue, too.

Then again, Snider said teenagers can get into trouble in the unsupervised period before parents get home form work. 

?The research has been accumulating. There?s evidence that it?s bad education, bad for society and bad for equity,? she said. ?Disadvantaged students suffer twice as much as other students.?

Snider said a Brookings Institute study found that even when changing start times has a high upfront cost, investing the resources to alter schedules for buses and after-school activities can pay off.

An Air Force Academy study shows that students who start school after 8 a.m. perform better. It?s the equivalent of a poor teacher with an average teacher, the study found.

 ?This isn?t just about student achievement,? Snider said. ?We?re doing long-term damage in terms of weight gain, depression and suicide.?

Attention to attendance

Despite the earlier start times, Tandy said Parkway high school attendance has basically stayed the same as last year, and three of the schools are slightly higher.

Still, Snider believes later start times are worthwhile for students and schools.

?About 70 percent of the kids in this country are seriously sleep deprived,? she said. ?Our children?s achievement should be what?s most important to us, not a bus schedule.?

What is your child's start time? Do you think it's appropriate? Please share you opinions in the comments section.

DEAR DR. ROSENBERG: I have heard that there may be some type of implantable device being developed for the treatment of sleep apnea. Is this true?

A: Yes, that is true. There are now clinical trials being performed in the United States for an implantable electrical device. The device emits a current that stimulates the muscles at the base of the tongue. Theoretically by doing this, it prevents the tongue from collapsing into the airway. I and other sleep specialists are awaiting the results of these trials in the next few years.

DEAR DR. ROSENBERG: I was diagnosed with sleep apnea a month ago. I have been having trouble sleeping with my CPAP, especially when I'm falling asleep. I was wondering, could a sleep aid help or is that dangerous with sleep apnea?

A: This is a great question. Actually several studies have shown that the use of a sleep aide for the first two weeks of CPAP therapy improved long-term usage. Those that used the sleep aid Eszopiclone (Lunesta) during the first two weeks were much more likely to still be using CPAP at six months. So if this continues, you might want to speak to your health care provider.

DEAR DR. ROSENBERG: I have been trying to get used to my CPAP for two months. I'm on Medicare and I know that three months is the time limit for demonstrating regular usage. I find the pressure is too high. Any ideas as to what I might do? I'm running out of time.

A: Yes, first you should speak to your health care provider about changing to either an autotitratable CPAP or a BIPAP. Both types of machines can usually do the job with less pressure. Finally, there are some new dental devices available that combine a mandibular advancement appliance with an attached nasal CPAP mask. By bringing the jaw forward, less pressure is required from the CPAP. One in particular is called the TAP-PAP, which was just recently developed.

Dr. Robert Rosenberg, Board Certified Sleep Medicine Specialist, will answer readers' questions by incorporating them into future columns. Contact him at askthesleepdoc@yahoo.com or via mail at the Sleep Disorders Center of Flagstaff, (newly Accredited by the American Academy of Sleep Medicine), 1110 E. Route 66, Suite 202, Flagstaff, AZ 86001.

Breathing Pauses During Sleep Tied to Brain Lesions

Feb. 1, 2012 -- A common sleep disorder is associated with an increased risk of symptomless but serious strokes called ?silent strokes,? German researchers report.

Sleep apnea, a condition marked by periodic interruptions in breathing during sleep, has been linked to an increased risk of strokes. But there hasn't been much research exploring the relationship between sleep apnea and silent strokes, says researcher Jessica Kepplinger, MD, of Dresden University Stroke Center at the University of Technology in Dresden, Germany.

So, Kepplinger and colleagues studied 56 men and women, aged 44 to 75 years, who?d had a stroke or mini-stroke known as a transient ischemic attack. All were given a screening tool that picks up changes in breathing during sleep.

Ninety-one percent periodically stopped breathing while they slept.

Then the men and women underwent brain imaging scans. Just over half had little areas of tissue death in the brain that had occurred in the past without a history of corresponding stroke symptoms -- evidence, Kepplinger tells WebMD, of silent stroke.

The more times a person stopped breathing during the night, the greater the likelihood of silent stroke, she says.

There was no comparison group, so researchers don't know how many people of the same ages and health status who don't have sleep apnea have had silent strokes.

Link Between Breathing and Stroke

MRI brain imaging studies suggest about 20% to 25% of people over age 60 have had a silent stroke, according to Harvard Medical School neurologist Steven Greenberg, MD, PhD. They have been linked to memory loss in some people, he says.

The study offers "good evidence linking" sleep apnea to silent stroke, Greenberg tells WebMD. But this is just an observation of an association between the two that needs further study, he says.

Greenberg moderated a news briefing to discuss the findings at the American Stroke Association's International Stroke Conference.

The study is small and preliminary. But it poses a number of questions that deserve further research, says Harvard neurologist Lee Schwamm, MD.

"I think what we can say is that breathing problems are more common in stroke patients than suspected," he tells WebMD.

"But is abnormal breathing during sleep a long-term problem in these patients? Or will it go away? And is abnormal breathing a risk factor that leads to stroke? Or is it a consequence of stroke?" Schwamm asks.

Kepplinger plans further study. In the meantime, she says, all stroke patients should be screened for sleep apnea. 

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

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From Our Store: Essays in Apologetics, Volume I (eBook)

"In effect, the president is saying we have a year to figure out how to violate our consciences," said New York?s Archbishop Timothy Dolan about the Obama administration?s new mandate for contraceptive coverage in health-care policies.

Sad to say, we Catholics have done it before. We have found ways to violate our consciences?or at a minimum, to still their cries. We?ve learned how to make peace with immoral policies, to accept the unacceptable.

Will we do it again? Will American Catholics put their consciences to sleep? Will we discover excuses for begging out of the political battle that our bishops have now joined? Count on it: some of the best liberal minds at dozens of Jesuit-run universities are working on that project right now. Given a year, they will produce plenty of arguments in favor of the Obama administration, and against the Catholic hierarchy.

This is the story of the past 40 years, isn?t it? Church leaders take a clear stand on a controversial issue, and then dozens of dissenting Catholics?priests and pundits and theologians and even the occasional bishop?examine the argument minutely, finding difficulties and loopholes and exceptions and objections and nuances, and conclude that the Church is not teaching with authority and Catholics can safely ignore the official statements.

Through all those years of dissent Catholics have grown accustomed to backpedaling, ceding ground to more determined advocates of liberal ideology. We have found, to our shame, that we can live comfortable lives in a society that allows legalized bloodshed and mocks marriage. We disapprove of abortion and euthanasia and homosexuality and sterilization, and we state our disapproval occasionally for the record. But we have reasoned that as long as we are not participating directly in those actions, we need not hold ourselves responsible.

Now we can no longer fall back on those half-hearted arguments about our own ritual purity. With the new HHS mandate, Catholic institutions will be ordered to do something that Catholic institutions cannot do. Unless the mandate is reversed, Catholic institutions will face a fateful choice between the authority of the Church and that of the government.

The many American bishops who have spoken out against the mandate (and God bless them for it!) have framed this argument as a religious-freedom issue. So it is. But this issue poses the question of religious freedom in a particularly acute fashion. We Catholics are not asking simply to be let alone on Sunday mornings to worship in peace; we are asking not to be compelled to do something that is gravely wrong. We are not merely asking the government to remain neutral on religious issues; we are asking the government not to intervene aggressively on one side (the wrong side) of a moral debate.

Some pundits have suggested that the HHS mandate, in its effect on Catholic institutions, is tantamount to a policy that would require Orthodox Jewish institutions to buy pork for their employees. Not so. My Orthodox Jewish friends do not object if I eat pork. Eating pork is morally objectionable for them, because of the laws of their faith.

Contraception, on the other hand, is inherently wrong. The Church directs Catholics to shun the use of contraceptives not because of some private in-house rule, but because contraception violates the natural law and degrades the marital act. Americans today think of birth control as a ?Catholic issue,? but the natural-law argument applies with equal force to everyone, Catholic or not.

Why is it, then, that so many people think the prohibition on contraception applies only to Catholics? Is it because so many other religious groups, once united with the Church on the subject, have come to embrace the contraceptive culture? No doubt. But we should be honest enough to recognize another important factor. Catholics have compromised for years on this issue. Rather than fighting against the acceptance of birth control, and protesting the use of our tax dollars to fund contraceptive campaigns, we have retreated into our denominational shell, and pretended that we can tolerate the problem as long as we are not expected to buy the Pill.

Worse than that, Church leaders have tacitly accepted the fact that a huge majority of Catholic couples use contraception. The Church?s teaching is tough to accept, and the peddlers of exceptions and compromises have won the day. Looking out over their congregations on Sunday mornings, Catholic priests can be reasonably sure that at least 80% of the couples of child-bearing age are using some form of artificial contraceptive. But the priests do not preach on that topic, and the young couples do not repent. Yes, we can certainly learn to put our consciences to sleep.

For our bishops, this routine acceptance of contraception?the product of two generations of timidity and dissent?poses an immense practical problem for this year?s battle against the HHS mandate. How can we persuade the great majority of Catholics that it is morally reprehensible to pay for contraceptives, when so many Catholics pay for contraceptives out of their own family budgets?

If the bishops will have trouble mobilizing 70 million American Catholics, they will face equally difficult challenge in persuading Catholic politicians to support them in this battle. Dozens of prominent Catholic politicians have already defied the Church to vote for legal abortion, same-sex marriage, embryonic stem-cell research and assisted suicide. Here too the problem is the result of many years of compromise. Having failed to exercise ecclesiastical discipline on public officials who support the ?culture of death,? our bishops have no reason to expect that Catholic politicians will suddenly fall into line with their statements on the HHS mandate.

Like any successful politician, President Obama knows how to count votes. He announced the HHS mandate because he is confident that the bishops cannot block his plans. No doubt he anticipated a strong backlash from the American hierarchy, but he also counted on strong support from his ideological allies. And I feel sure he believed that the Catholic opposition would eventually fade?as Catholic opposition has faded so often in past years.

But this time President Obama may have miscalculated. This year?s battle could be different; Catholics may be ready to take a firm stand. Our bishops have responded to the challenge with a vigor, passion, and determination that I have never before witnessed. They seem to understand that on this issue a political defeat would be devastating, yet a unilateral surrender would be even worse. That sort of leadership could energize Catholics in the pews, and produce a groundswell of unabashed Catholic activism. The American Catholic conscience has been dozing for years; arouse it, and who knows what might happen?

To win this battle, we must be confident?confident not only that our cause is just and arguments are persuasive, but also that our allies are firmly committed, and there will be no retreat this time. There is no more ground that can safely be ceded, no more room for compromise. We cannot accept the HHS mandate. If that means preaching unpopular truths, so be it. If it requires sacrifices, we must make them. If the mandate goes into effect despite our best efforts, Catholic institutions must resist.

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If you think the oil spill from BP?s Deepwater Horizon in the Gulf of Mexico is old news, think again. The drama is not over ? oil is still leaking and hazardous chemicals are still being used to dissipate it, putting the health of our bodies and the planet is at risk.

Whitney Lauritsen of Good Gossip got the lowdown from actor Tim Robbins and filmmakers Josh and Rebecca Harrell Tickell at a press conference in Los Angeles for ?The Big Fix?. Their documentary exposes everything you haven?t heard from the media about the disaster, revealing frightening facts that the government has been trying to keep under wraps. In this video, Robbins, the executive producer, offers up his political perspective, along with a panel of experts and Louisiana residents who have been suffering through the effects of the spill. You may recognize Josh and Rebecca from their award winning film ?FUEL? and other projects such as the book/upcoming movie ?Hot, Rich and Green?.
?The Big Fix? began its one-week engagement at AMC Santa Monica on November 11 and opens in New York at the AMC Village on December 2. Check out our video from the press conference below and then vote with your dollar at the closest theater.

Occupy D.C. protesters spent Monday night huddled under the celestial sweep of a blue tarp they had erected in McPherson Square, talking, singing and, yes, sleeping ? in defiance of rules that prohibit overnight camping in the park.

As morning dawned Tuesday, a contingent of Park Police arrived to ask the protesters to remove the ?Tent of Dreams? they had draped over the park?s statue of Civil War Maj. Gen. James B. McPherson in an act of civil disobedience, marking their displeasure over the National Park Service?s new crackdown against camping on federal land.

By late Tuesday, the Tent of Dreams had ripped and slipped in the wind but remained mostly in place. The protesters spent hours debating whether to take it down and finally told police they would ? if officers allowed them to continue sleeping in the park.

As dusk arrived, both sides were at a peaceful standoff, and no camping arrests had been made.

At a court hearing Tuesday morning, U.S. District Judge James E. Boasberg said he would issue a ruling in the next two days saying the National Park Service must notify the protesters before moving in to clear the encampment in McPherson Square, except in the case of an emergency.

Boasberg noted that a 1984 Supreme Court ruling allows protesters to set up tents in federal parks as part of a vigil as long as they don?t sleep in them. His ruling means that if the Park Service decides to clear the encampment of these legal ?vigil? tents, the agency must provide a written notice with justification first and give the protesters a chance to respond.

?The main thing I was concerned about was them coming in and shutting the place down and kicking everybody out,? Jeffrey Light, a lawyer for two of the protesters, said after the hearing. ?That?s not going to happen now without notice.?

Assistant U.S. Attorney Marina U. Braswell, representing the Park Service, said the agency has no plan to close down the camp. Protesters have been living there since October, seeking economic justice in solidarity with the Occupy Wall Street movement.

The Park Service has long supported the protesters? right to conduct a 24-hour vigil in McPherson Square and at a similar encampment at Freedom Plaza. But last week, officials said that camping ? which had raised health, sanitation and safety concerns ? had to stop. Many protesters scrambled to remove their bedding and personal belongings before Monday?s noon deadline and found other places to sleep.

But others handled the crackdown differently. Two McPherson Square protesters began a ?sleep strike,? vowing to stay awake until the Park Service backs off.

Another, Camilo Brokaw, a 24-year-old former coffee-shop barista from Albuquerque, said he slept in the park Monday night in defiance of the ban and will continue to do so, even if he risks arrest.

?Sleeping is a right,? he said. ?We?re trying to stand up for what we believe in.?

gowena@washpost.com

Staff researcher Magda Jean-Louis contributed to this report.

Breathing Pauses During Sleep Tied to Brain Lesions

Feb. 1, 2012 -- A common sleep disorder is associated with an increased risk of symptomless but serious strokes called ?silent strokes,? German researchers report.

Sleep apnea, a condition marked by periodic interruptions in breathing during sleep, has been linked to an increased risk of strokes. But there hasn't been much research exploring the relationship between sleep apnea and silent strokes, says researcher Jessica Kepplinger, MD, of Dresden University Stroke Center at the University of Technology in Dresden, Germany.

So, Kepplinger and colleagues studied 56 men and women, aged 44 to 75 years, who?d had a stroke or mini-stroke known as a transient ischemic attack. All were given a screening tool that picks up changes in breathing during sleep.

Ninety-one percent periodically stopped breathing while they slept.

Then the men and women underwent brain imaging scans. Just over half had little areas of tissue death in the brain that had occurred in the past without a history of corresponding stroke symptoms -- evidence, Kepplinger tells WebMD, of silent stroke.

The more times a person stopped breathing during the night, the greater the likelihood of silent stroke, she says.

There was no comparison group, so researchers don't know how many people of the same ages and health status who don't have sleep apnea have had silent strokes.

Link Between Breathing and Stroke

MRI brain imaging studies suggest about 20% to 25% of people over age 60 have had a silent stroke, according to Harvard Medical School neurologist Steven Greenberg, MD, PhD. They have been linked to memory loss in some people, he says.

The study offers "good evidence linking" sleep apnea to silent stroke, Greenberg tells WebMD. But this is just an observation of an association between the two that needs further study, he says.

Greenberg moderated a news briefing to discuss the findings at the American Stroke Association's International Stroke Conference.

The study is small and preliminary. But it poses a number of questions that deserve further research, says Harvard neurologist Lee Schwamm, MD.

"I think what we can say is that breathing problems are more common in stroke patients than suspected," he tells WebMD.

"But is abnormal breathing during sleep a long-term problem in these patients? Or will it go away? And is abnormal breathing a risk factor that leads to stroke? Or is it a consequence of stroke?" Schwamm asks.

Kepplinger plans further study. In the meantime, she says, all stroke patients should be screened for sleep apnea. 

These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.

New research now suggests not getting enough kip at night, whether booze-related or not, costs the nation billions - and potentially robs you of that promotion.

The research, commissioned by the Sleep Health Foundation and carried out by Deloitte Access Economics, says sleep disorders such as sleep apnoea, and basic lack of sleep, cost the economy $5.1 billion a year.

Even worse, the cost associated with loss of quality of life from not catching enough zeds is $31.4 billion, the research says.

"Picture yourself after a big night, you get to work and you're kind of functioning but you don't have your usual sharp edge ... we've all been there," Professor David Hillman, chairman of the Sleep Health Foundation, said.

"It does convert into dollars."

Treating sleep disorders makes up a relatively small chunk of the $5.1 billion direct cost to the economy.

The research found $270 million a year is spent on directly caring for those with sleep problems and a further $540 million on treating knock-on effects such as high blood pressure.

By far the biggest chunk - $4.3 billion - comes from lost productivity, caused by absenteeism and poor work performance.

A further $650 million is lost through indirect costs such as workplace and car accidents.

Prof Hillman, who is head of pulmonary physiology and sleep medicine at Perth's Sir Charles Gairdner Hospital and a director of the WA Sleep Disorders Research Institute, urged politicians and businesses to pay more attention to the problem.

"At the moment there is a concentration on healthy diet, regular exercise, alcohol moderation and smoking," he said.

"But a good night's sleep isn't there (on the agenda) and it's got to be."

For more information on sleep disorders visit sleephealthfoundation.org.au.