During the summer holidays, the rhythm changes for many people
Traveling, going to bed later, away from the usual environment. During the summer holidays, we often deviate from our daily rhythm. But it is less good for our brains. Pediatric neurologist Jolanda Schieving from Radboudumc explains the importance of regularity in our summer series ‘Healthy through the summer’. This applies to children with a brain disease, but actually everyone benefits from it.
During the summer holidays, the rhythm changes for many people. It’s longer daylight, warmer weather, we have more free time and go on vacation. This causes us to go to bed later and our normal rhythm changes. “Our brains don’t like that at all,” says Jolanda Schieving, pediatric neurologist at the Radboudumc Amalia Children’s Hospital. ‘Our brain thrives best with rest, cleanliness and regularity. So go to bed at the same time and get up in the morning.’
Your brain works hard during sleep. Schieving: ‘Many people think that sleep is something passive, but this is absolutely not the case. Our brain must work actively to ensure sleep. If it doesn’t work, we sleep worse. The consequences are immediately noticeable: you can concentrate less and have more difficulty remembering things.’ Fatigue can lead to less good motor skills, and Schieving and her colleagues notice this in the summer: ‘In the summer, we see more trauma, children who come to hospital with brain injuries. They fell out of a tree or down a slide.’
Stick to the normal rhythm
The importance of regularity is especially important for children and adults with a neurological disorder. Jolanda Schieving specializes in children with movement disorders, such as ataxia. “As summer approaches, I get many parents in my office hours asking for tips for the holidays with their child who has a neurological disorder,” she says. ‘They benefit even more from sticking to the daily rhythm. Children with epilepsy are more likely to suffer from seizures if rest, cleanliness and regularity are released.’
From research, we know that in the month of December, full of changes due to holidays and Christmas vacation, more epileptic seizures occur. This has never been investigated before the summer, but according to Schieving it is plausible that it is also the case: ‘It is common knowledge that lack of sleep and deviation from the rhythm, typical of the holiday period, leads to more seizures.’
‘An epileptic seizure is like a marathon for your brain. Most seizures stop on their own within two minutes, after which your brain needs to recover. Lack of sleep increases the likelihood of a longer seizure. The longer the attack lasts, the harder it is to regain control. We call that status epilepticus.’ Prolonged seizures can cause brain damage. There is also the possibility that you will fall during an attack and hit your head on something, possibly resulting in brain damage.
Young people under eighteen
Jolanda Schieving focuses specifically on young people under the age of eighteen with a brain disease. “You have to be extra careful if, for example, you have epilepsy. If you go to a festival, be careful about drinking alcohol. It increases the chance of having an epileptic seizure. Also make sure there is someone nearby who knows you have epilepsy and can respond appropriately to an epileptic fit.’ But Schieving also realizes that young people want to go out: ‘Young people want to do what their peers do: to go out, discover who they are and where their interests lie. I try to show them the possible consequences of activities as best I can, but in the end they make their own choice’.
The importance of medicine
Another thing that Jolanda Schieving notices is that medicine is taken worse in the summer. Schieving: ‘We call this adherence to therapy. We know that the more medicine people have to take, the less well they do. And this applies to an even greater extent in the summer, when the regular rhythm disappears’. And that comes with risks. The combination of changes in combination with fewer drugs leads to more seizures. ‘You sometimes feel that after a few days of reduced medication intake,’ says Schieving.
She tries to think with her patients as much as possible. “It helps if we involve children in the decision about a particular medicine. Then a tablet or a drink, how many times a day, the side effects. And how would you like to be reminded that you take your medicine? Through an app, your watch or an alarm clock? The involvement of the patients is of great importance here.’ This increases compliance and reduces the risk of epileptic seizures.
Five pieces of advice for children and young people with a brain disease
Jolanda Schieving has the following advice for children with a neurological disorder and their parents:
- Keep peace, cleanliness and regularity intact as much as possible. Then the children and with it the whole family have the most fun. Organize separate activities for siblings with one parent, so that the child with a brain disease gets enough rest with the other parent or adults.
- Do not change sleeping times too much. It’s tempting to go to bed later on vacation, but try to stick to your own rhythm as much as possible and don’t shift the schedule by more than an hour.
- Contact your own doctor if complaints such as an epileptic seizure occur while on holiday. We think along and can refer you to a hospital in your area if necessary. Always let the doctor contact us there.
- A medical statement explaining the condition is useful for some conditions to contribute. Request this at the hospital.
- Take medicine properly and on time, especially if your rhythm and your own environment are lost during the holidays. Also remember the Schengen declaration when you take certain types of medicine abroad.
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