Science of Sleep (2016)

Dr. Sheryl Shook, Department of Math and Science, Kapiʻolani Community College

A 2016 SENCER Model

SENCER Model Course Logo

The Science of Sleep Course uses the unresolved public issue of sleep debt to engage students who would not likely pursue science, while at the same time serving students already committed to a science major. The classroom student population, diverse in academic focus, cultural attitude, economic status, and scientific ability, provides a foundation for vibrant exchanges that challenge students to consider connections between social inequity and disease. Civic responsibility is addressed by emphasizing that students are empowered with knowledge that can help a community member increase sleep wellness. Students do community outreach in a poster session where they teach about sleep disorders and their sleep research projects. In addition, students perform service learning by visiting elder care facilities, elementary schools, low-income housing centers, high schools and more. There, they conduct educational activities they create to teach community members, in a culturally relevant context, how to improve their sleep. In fall 2016, this course will gain the sustainability designation through addressing environmental implications of individuals and their sleep habits.

Instructor’s Goals
This course is designed to encourage students who have felt excluded from science, or have not been interested in science, to see they can be a part of scientific discovery and can immediately apply sleep science knowledge to improve the lives of those around them. At the same time, students who are committed to focusing on science are challenged to further develop their critical thinking skills and expand their ability to see the power of the application of scientific knowledge in the community.

Students become familiar with contested topics in sleep science, as well as topic history, learning about errors in science that created myths around the purpose of sleep and what constitutes sleep. They also study contemporary, competing scientific views about topics such as why we dream. By becoming acquainted with contested topics, students see they can question findings in science, think critically about what they read, and be courageous and creative about proposing their ideas. Students have opportunities to share their thoughts through written and oral presentation assignments that include open-ended questions.

Another aim of the course is to motivate students to care more deeply about social and economic injustices, and understand how the power of scientific knowledge can be limited by inequities in society. For example, although there is a benefit in understanding the science behind the necessity of adequate sleep to manage diabetes, this benefit may not be manifested if someone has to work excessive hours to make enough money to pay for basic needs, therefore making it impossible to get enough sleep.

Students evaluate their study habits and exam performance through gaining insight into how they learn and their test-taking strategies. There are mini-lessons and activities such as “lecture and exam wrappers” woven into the course to increase student metacognition and study skills.

Student Learning Objectives

  • Recognize the signs of sleep debt and appreciate the significance of its impacts on the individual and the community.
  • Contrast theories about why we dream and be able to conduct a dream group, including describing steps to lucid dreaming.
  • Apply principles of human and animal sleep physiology to theories about what sleep is, why we do it, and how diverse cultural attitudes about sleep have developed.
  • Concisely communicate about healthy sleep habits, incorporating nutrition and holistic approaches to sleep wellness.
  • Describe sleep disorders and other sleep disruptive considerations such as post-traumatic stress disorder, drugs, and environment.
  • Integrate an understanding of the scientific method into the design of an experiment, written assignments, oral presentations, and critical reading of articles.
  • Build confidence about understanding science and participating in scientific courses, activities, and careers…”Science is for me! I can do it!”
  • Use laboratory techniques and instruments to apply the scientific method to test hypotheses.
  • Critically review scientific literature.
  • Design procedures for acquiring information from experimentation.
  • Record, analyze, and extract information from data acquired.
  • Communicate research results orally and in writing.

Linking Science and Social Issues

  • Brain anatomy taught through insomnia research on techniques such as meditation
  • Molecules and synapses taught through the use of herbal medicines and drugs on sleep
  • Social justice taught through demographics about sleep debt-related health issues
  • Animal behavior taught through phylogeny of sleep
  • Scientific method taught through designing and conducting sleep science experiments that examine the effect sleep has on a variable (e.g. cognition, mood) or the effect a variable (e.g. food quality, exercise) has on sleep
  • Critical thinking taught through contradictory scientific theories about why we dream and sleep
  • Cultural humility taught through diverse cultural attitudes about sleep
  • Sustainability taught through sleepless society’s carbon footprint
  • Hormones taught through sleep debt effects on the endocrine system
  • Homeostasis taught through sleep debt physiology
  • Autonomic nervous system taught through post-traumatic stress disorder related sleep issues

The Course

Science of Sleep 2016 Syllabus

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Science of Sleep Schedule

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Science of Sleep Lab

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Science of Sleep Lab Schedule

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Students participate in lessons and activities to gain an understanding of healthy and disordered sleep. In several contexts, students examine the impacts of sleep debt on the individual and the community, while being mindful of diverse cultural attitudes about sleep. Physiology of sleep homeostasis, circadian rhythms, and pharmacology are integrated into the teachings and include findings from current research. There is instruction on dream analysis, dream-group facilitation, lucid dreaming, and theories about why we dream. Civic responsibility is emphasized as students are empowered with ample knowledge and concern to engage community members in conversations about sleep debt and sleep wellness. Further community outreach is achieved through a sleep disorders poster and information session.

The laboratory portion of the course provides hands-on experience using the scientific method to address theories and questions in sleep science. As a part of the research projects, students conduct experiments utilizing a variety of equipment used by sleep researchers and sleep disorder clinicians. The students participate in a community-based poster session where they present the results of their research projects. The research topics range from an examination of factors that can affect sleep—for example, nighttime foods or daytime exercise—to how sleep quality itself can affect cognition, mood, food cravings, and a host of other concerns. In additional community outreach and service learning work, laboratory students visit sites such as elder care facilities, elementary schools, low-income housing centers, and high schools. During these visits, they conduct educational activities they have created themselves, to teach community members, in a culturally relevant context, how to improve their sleep.

There is no prerequisite for The Science of Sleep, with the intention that this course will be a bridge to scientific discovery for students. The course fills the requirement for diversification in biological sciences.

Evaluating Learning

Student grades for lecture are awarded based on three unit exams, a cumulative final exam, the sleep disorders poster session, in-class activities, quizzes, and assignments.
Student grades for laboratory are awarded based on research projects, community outreach, quizzes, the student research poster session, quizzes, and lab participation.

The course evaluation and student learning assessment uses a modified SALG instrument developed by the SENCER project (SALG Site) that is specific to The Science of Sleep course.

Background and Context

Former U.S. Surgeon General Dr. Richard Carmona, in a statement to the National Institutes of Health, referred to the public’s lack of understanding about sleep disorders and their impact as “health literacy in our society at its worst.” Students of The Science of Sleep course increase their level of concern and understanding about sleep debt and enter their communities with strategies to promote sleep debt awareness and teach people how to improve sleep habits.

The consequences of sleep debt—the difference between the hours of sleep you need and what you actually get—are far more harmful than feeling drowsy. There is substantial research linking sleep debt to diabetes, obesity, depression, cardiovascular disease, neurologic disorders, automobile accidents, and industrial catastrophes. Hawaiʻi is the state with the lowest rate of healthy sleep time and the highest rates of diabetes, obesity, and death from heart disease and stroke, giving this national public issue local significance.

The economic cost, of sleep debt to the United States begins with the insomnia-associated, direct cost estimates that range from tens of billions to over one hundred billion dollars annually. The totals increase greatly when indirect costs such as sleep debt-related illness, loss of productivity, accidents, and absenteeism are factored in, resulting in estimates of hundreds of billions of dollars each year. The ultimate tragedies of sleep debt are the preventable deaths due to accidents and illness. The impact on the community is clear when we look at the health issues, accidents, economic impact, and deaths and trace them back to sleep debt. Because of its immediacy and personal relevance (every student sleeps!), it is almost effortless to engage students on various levels with this information and use it as a foundation for teaching a range of scientific concepts and processes.

The Science of Sleep lecture course (PHYL 160) was developed and first taught by John Rand, PhD, in fall 2002 using a standard lecture format (non-SENCERized). It fills the general education requirement for diversification in biological science. Initial development funding came from a National Institutes of Health – IDeA Networks for Biomedical Research Excellence (INBRE) grant intended to expand and develop Hawaiʻi’s competitive biomedical research capacity. The INBRE grant provided funds for faculty reassigned time to development the course and for the purchase of course materials, including actigraphy watches.

In 2005, Herve Collin, PhD, began teaching the course and, with the help of Dr. Rand, reintroduced the course using the SENCER model. Dr. Rand’s original idea of having students keep a sleep journal during the semester was built upon and expanded to provide to students the opportunity to analyze their own qualitative (sleep survey) and quantitative (actigraphy) sleep measurements and expose their results in a scientific format.

In spring of 2011, Sheryl Shook, PhD, LSP, took over the lecture course and began further incorporating several SENCER ideals and weaving social justice issues into the course fabric. For example, the power of scientific knowledge to resolve a public issue, such as sleep debt, is constrained by socioeconomic injustices. Students are challenged to consider how they can use an understanding of sleep physiology and healthy sleep habits to address sleep debt-related health issues such as diabetes, depression, and obesity. They then take this information and develop strategies for how to serve community members with, for example, socioeconomic limitations—having to do shift-work, care for family members, or balance other life challenges—that prevent them from easily practicing healthy sleep habits.

With a doctorate in neuroscience and certification in both herbal healing and mindfulness practices, Dr. Shook enjoyed incorporating scientific content in each of these disciplines that allows students to apply scientific knowledge regularly to areas that are immediately of interest, especially surrounding their own health and sleep habits. With a focus on current research, students may read a paper about brain areas activated during a meditation practice used to treat insomnia. Following this, brain models are used in class where students, working in small groups, learn brain anatomy in the context of the article. During class, students learn the particular mindfulness practice used in the research and can try it themselves and share it with others. Research discussed in laboratory
[PHYL 160L laboratory began in 2014; see below], such as the use of guided imagery or cognitive behavioral therapy for insomnia, is taken to a more meaningful and applicable level with students participating in these activities during lab. They learn the techniques themselves and how to role play those techniques—for example counseling a person using cognitive behavioral therapy for insomnia.

The hope is to engage students to see how they can immediately apply scientific knowledge in ways that are satisfying and at the same time promote their curiosity to further explore the research behind these practices. Incorporating holistic and herbal healing into the course has made it much easier to interest students in topics such as chemistry and molecular mechanisms of activation, as many students come to class with questions about different products, herbs, drugs, and nutrients, each promising a better night’s sleep. Human physiology lessons for this course now include research about many of these constituents, and their mechanisms of action, in teaching concepts such as synaptic activity or hormonal regulation.

The lecture course now has an increased emphasis on the responsibility of sharing the scientific knowledge through helping community members. Students are given assignments that challenge them to consider how to share sleep wellness education with individuals from diverse cultural backgrounds and with varied socioeconomic status. At the semester’s end, students conduct community outreach with a sleep disorders poster session that has been fully attended and provides students an opportunity to dialogue with individuals about sleep disorders and also sleep wellness habits in general. One goal of this activity is to increase conversations in the community about sleep debt and improve the likelihood that people in need will get treatment. Students have also written articles about sleep, including myths about sleep and healthy sleep habits, for the college newspaper.

One of the changes in the course was a shift away from predominately lecture and slides format to an increase in problem-based learning and small group activities—something Dr. Shook incorporated many years ago into her Human Anatomy and Physiology course at the college. In that setting she noticed an increase in the number and diversity of individuals speaking up in class in addition to a stronger sense of community in the classroom. There are still lectures with slides, but they are broken into smaller segments where students do “think-pair-share” activities or lengthy activities working on handouts, research articles, or human anatomy models as they answer more involved open-ended questions. Most of this work includes students sharing their findings and thoughts with the class and challenges to their classmates to consider what they are proposing.

While this course serves students already committed to a science major, an additional priority from the revision is to reach out to students not typically engaged in science. With this in mind, the “Recommended Preparation: BIOL 130, BIO 170, or ZOOL 142” that was previously listed with the course has been removed. The foundational biological concepts are now brought into the course with the instructor facilitating small-group activities with students of varied backgrounds and abilities working together, after which they are assessed with group and individual quizzes. The lecture and lab courses fill, respectively, the general education requirements for Diversification-Biological Science and Diversification Laboratory (Science).

Keeping with the theme of increased student access, as of 2016 this course is listed as “Textbook Cost $0.” Course content is from current and classic research articles, online medical websites—Mayo Clinic and Harvard Medical School, for example—and online academic websites such as Stanford Center for Sleep Sciences and Medicine.

One of the course revisions includes facilitating metacognition through the use of various techniques such as lecture- and exam-wrappers. Mini-lessons on awareness of learning are incorporated, including assignments for students to gain insight into the success of their current study strategies.

In fall 2016 this course will also receive the sustainability designation. This is a way for students to increase awareness and critical thinking about sustainability in novel disciplines. Students will be challenged to consider how sleep habits and sleep debt affect our planet. For example, if the members of a household increase their average nightly sleep time from six hours to eight hours, what impacts might that have on the household energy usage due to two hours less of power consumption by computers, televisions, and lights? An objective of this designation is for students to discover how sustainability can be woven into diverse aspects of living.

Soon after taking over the course, Dr. Shook began receiving regular requests from students for a laboratory component for The Science of Sleep. With unwavering support from Dr. Collins and other faculty and administrators at Kapiʻolani Community College, Dr. Shook created the laboratory course (PHYL 160L) and began offering it in fall of 2014. The laboratory course fills the general education requirement for diversification with a laboratory. Students use medical-grade polysomnography equipment and actigraphy watches to conduct experiments on their sleep. Using a problem-based approach, students create and conduct a one-week experiment using actigraphy before their lesson about the scientific method. The following week, when they return with their data, they use that class meeting for a scientific method lesson where they critique their experimental design and begin work on their next research project with a practical understanding of the scientific method. Over the weeks, students learn about various equipment and techniques used for assessing sleep, how to critique—in a journal club format—research articles, explore various data analysis techniques, including basic statistics, and more. Students also conduct in-class experiments using the electroencephalography equipment. And, yes, students sleep in class on purpose: one of the classes includes every student participating in a modified version of the Multiple Sleep Latency Test, which allows quantification of sleep debt. The lab course concludes with students conducting, in the community, a poster session showing the results of their final research projects.

Another component of the laboratory course is community outreach, with students selecting their group of interest, such as elders, elementary school children, low-income housing residents, or high school students. In small groups, they create an educational program, including activities, games, and handouts and then travel to their site to conduct their program. The community sites served by PHYL 160L students continually ask to have students return, and we have had additional sites requesting visits from our “sleep wellness educators.” The instructor does not accompany the students to these sites, allowing students the full benefit of being the sleep wellness experts serving their community. When students return from their community outreach and share in-class presentations about their experiences, their level of empowerment is noticeably increased.

Related Resources

An article titled “Good Sleep Hygiene” written by Sean Fujimoto was published in the college newspaper in spring 2008.

A poster titled “Exploring Sleep, Engaging Minds” was presented at the EPSCOR conference in 2007.

A poster titled “Early Birds and Night Owls: Analyzing Sleep in Society” was presented at SENCER in 2007.

A poster titled “Sleep and Society” was presented at SENCER in 2006.

An article titled “Sleeping Myths Debunked at KCC” written by the students of PHYL 160, was published in the college newspaper in fall 2011.

Every semester since spring 2011 and ongoing, all students in the PHYL 160 lecture and lab courses present, to the community, a sleep science information poster session, including posters on sleep disorders and the students’ sleep science research projects.

Regarding resulting projects and research, every semester students request sleep science research projects beyond the lab class, but currently there is no support at Kapiʻolani Community College for a lecturer to support students in undergraduate research projects.

Dr. Shook gave a presentation about The Science of Sleep course at the SENCER Institute at the University of Hawaiʻi, February 2015

Joy Oehlers, Information Literacy Librarian, created an online Research Guide for the course in fall 2014.

Since fall 2014 and ongoing, every semester The Science of Sleep laboratory students visit sites such as elder care facilities, high schools, elementary schools, and low-income housing residents to complete community outreach by providing sleep wellness education activities.