Sleep at camp: a survey.

Do your staff members get progressively tired throughout the summer? Are there more camper and staff accidents or illnesses toward the end of the camp season? Are there times when staff members appear irritable and less attentive to campers? How do a few tired staff members affect camp life? What can directors and key staff do to help?

All too often camp staff seem to burn the candle at both ends. In 1994 I developed a sleep questionnaire and conducted an informal survey of Ohio camp directors at the annual American Camping Association Ohio Section fall meeting. Forty camp directors responded to the survey, 38 from resident camps and 2 from day camps. Of the 38 resident camps, 36 held one-week camp sessions, one held two-week sessions, and one held four-week sessions.

The majority of the camps represented in the survey had wake-up time between 7:00 a.m. and 7:30 a.m. Campers' bedtimes were between 9:30 p.m. and 10:30 p.m., giving them about nine hours of sleep. The majority of camp directors responded that their campers get enough sleep at camp, but that staff members and the directors themselves do not get enough sleep.

How much sleep do people need?

Sleep is important for everyone, at all ages. Children aged 2 to about 12 years old (prepuberty) need between 9 and 10 hours of sleep. They usually fall asleep quickly, awake infrequently, and sleep almost the entire 9 to 10 bedtime hours. During sleep, the growth hormone is released and restorative actions occur, allowing for normal functioning the next day. After a good night's sleep, children feel refreshed, alert, and energetic.

Sleep needs change as people grow older. When children begin to mature into adolescents, their bodies go through rapid changes in physical growth and psychological, social, and cognitive development. Carskadon studied the sleep habits and sleep patterns of adolescents aged 10 to 20 years and found that they need more sleep than they did before puberty. Other studies Carskadon conducted conclude that the need for sleep increases across the second decade of life and that many young people this age do not get enough sleep.

In a 1981 study, Carskadon and Dement showed that college students who gave themselves eight hours of sleep were very sleepy the next day. When they got 10 hours of sleep - two additional hours - the students maintained optimal alertness throughout the next day. At camps in the Ohio survey, camp staff members averaged 6 to 7 hours of sleep at night.

What happens when staff don't get enough sleep?

Active camp life - early wake-up, 24-hour staff responsibilities, staff socializing, and late nights out - often leads to insufficient sleep. When someone complains of daytime sleepiness and associated symptoms, the individual is sleep deprived.

Daytime symptoms of chronic sleep loss include: irritability, difficulty concentrating, distractibility, fatigue, lack of coordination, loss of appetite, gastrointestinal disturbances, and muscle pains.

Severe sleepiness greatly impairs alertness, increasing the likelihood of poor performance and accidents. Camp staff should be fully alert, wide-awake, energetic, and at peak mental function for their own, and campers', safety and enjoyment.

The effects of alcohol increase with sleep deprivation. After a week of accumulating sleep debt, a person can become impaired or legally drunk after only one or two drinks.

What can directors and key staff do?

Sleep debt does not go away by itself; a sleep deprived person needs sleep. Staff don't always admit when they are tired. In fact, they often camouflage sleepy feelings with stimulation, exercise, excitement, or caffeine. Directors and key staff can help staff members realize the importance of a good night's sleep to keep them refreshed, alert, energetic, and positively functioning in their ever-demanding job.

* Start with the job interview. Inform staff members that you expect them to manage their health, which includes sufficient sleep, throughout the summer in order to maintain job effectiveness.

* Include health management as part of the staff evaluation process. Staff need to know that staying healthy is a responsibility and that insufficient sleep hinders their performance.

* Take slides or photos of your staff in action. Take random pictures the first and last day of staff orientation, the first staff meeting after the campers arrive, and then again a few weeks later. If staff members are tired, you'll notice it in the pictures. Share the pictures with staff and ask them what they see, what they're doing correctly and incorrectly, and what they should change. Discuss again how health impacts their effectiveness.

* If you notice staff becoming tired (whether it's a unit or the entire staff), meet with them to discuss your observations. Let the group problem solve and make suggestions. Ask staff members to try a suggestion, monitor it, later discuss the outcome, and, if necessary, brainstorm alternative solutions.

* Carry a pencil and paper to document staff members' behavior. Note incidents such as putting their heads on the table at breakfast, being late to flag raising, snapping at campers, visiting the health center often, or lying on the grass while their campers play. Be specific and note the day, time, and incident. Approach staff individually and use the information to help them become aware of their behavior. Focus on what you observed and how the behavior affects campers and other staff members. Help the individual problem solve how to correct or improve the situation; when staff take ownership of the problem, they become more responsible for solving it. At home, many teenagers and college students make up their sleep debt by sleeping in on weekends or taking long naps when they are tired. Encourage staff to take naps during their free time.

* Review staff health center records with the camp nurse. Monitor staff illness and injury. Develop a staff illness and injury report for every week of camp. This information will help you keep track of how sleep issues are affecting your camp. Use the information you gather to set bedtimes for campers and staff.

* Change the sleep schedule for the entire camp. For example, the camp director can announce: "Camp feels tired. We've just had our summer Olympics, which was exciting, but also tiring. I want everyone in the cabins at 9:30 tonight." It works. Campers and staff will be thankful the next day because they'll feel better.

Survey questions

What is the wake-up time for your camp?

6:30            3%
6:45            3%
7:00           55%
7:15            8%
7:30           20%
8:00            8%

When is lights out for campers?

Lights

Out               Campers          Teens          CITs

9-9:30              18%              0%            0%
10:00               40%              8%            8%
10:30               25%             10%            0%
11:00                8%             40%           33%
11:30                5%              5%            5%
12:00                0%              0%            3%
12:30                0%              0%            3%

Do you think your campers and staff members get enough sleep?

Campers

Yes                65%
No                 35%

Staff Members

Yes                25%
No                 65%
Yes/No             10%

What is your camp's staff curfew(*) time?

with campers                     5%
1.0:00 p.m.                      3%
11:00 p.m.                       8%
11:30 p.m.                      10%
12:00 midnight                  33%
12:30 a.m.                       3%
1:00 a.m.                        8%

* 70% had a staff curfew; 25% had no staff curfew.

Do you think sleep affects your staff's job performance?

Yes              98%
No                2%

What symptoms do you notice in a staff member who is tired?

  * irritable, cranky, short temper
  * less attentive to campers
  * job performance decreases
  * lacks creativity
  * decreased energy level
  * sleepy during slow times
  * more camper/staff accidents/illness

Do you (the camp director) feel you get enough sleep at camp?

Yes           5%
No           65%

What are some sleep problems at camp?

bedwetting                75%
snoring                   73%
sleep talking             50%
sleep walking             40%
nightmares                40%
insomnia                  30%

[TABULAR DATA OMITTED]

Carskadon, M.A. (1990). Adolescent sleepiness: increased risk in a high risk population. Alcohol, Drugs, Driving 5(6), 317-28.

Carskadon, M.A. (1990). Patterns of sleep and sleepiness in adolescents. Pediatrician (17), 5-12.

Carskadon, M.A. and Dement, W.C. (1981). Cumulative effects of sleep restriction on daytime sleepiness. Psychophysiology (18), 107.

Carskadon, M.A. and Dement, W.C. (1987). Sleepiness in normal adolescent. In Guilleminault, C., ed. Sleep and Its Disorders in Children. New York: Raven Press, 53-66.

Carskadon, M.A., Harvey, K., and Dement, W.C. (1981). Sleep loss in young adolescents. Sleep (4), 299-312.

Erceg, L.E. (Summer 1993). Tracking camp illness and injury: a way to monitor risks. Association of Camp Nurses Newsletter, 3-6

Sheldon, S., Spire, J., and Levy, H. (1992). Pediatric Sleep Medicine. Philadelphia: W.B. Saunders Co.

Wolfson, A.R. and Carskadon, M.A. (1986). Early school start time affects sleep and daytime functioning in adolescents. Sleep Research (25), 177.

Myra Pravda, RN, MSN, has been a camp nurse for 18 years and is a clinical nurse specialist in sleep disorders. She is a board chair of the Association of Camp Nurses and is the coauthor of Off to Camp.