Even on vacation, the brain benefits from rest, regularity and rest

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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 that is less good for our brains. Pediatric neurologist Jolanda Schieving of Radboudumc explains the importance of regularity in our summer series ‘Healthy through the summer’. That applies to children with a brain disorder, but actually everyone benefits from it.

During the summer holidays, the rhythm changes for many people. It is longer light, warmer weather, we have more free time and go on holiday. This makes us 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 that is absolutely not the case. Our brain has to work actively to ensure sleep. If that doesn’t work, we sleep worse. The consequences are immediately noticeable: you can concentrate less and have more trouble 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 the 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. ‘With summer approaching, I get a lot of parents at my office hours asking for tips for the holiday 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 the Christmas holidays, more epileptic seizures occur. This has never been investigated before the summer, but according to Schieving it is plausible that this is also the case: ‘It is generally known that sleep deprivation and deviation from the rhythm, typical for the holiday period, lead to more attacks.’

‘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. With sleep deprivation, the likelihood of a longer attack increases. 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 a chance 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 disorder. ‘You have to be extra careful if you have epilepsy, for example. If you go to a festival, be careful with drinking alcohol. It increases the chance of having an epileptic fit. Also make sure that there is someone nearby who knows that you have epilepsy and who can respond appropriately to an epileptic attack.’ But Schieving also realizes that young people want to go out: ‘Adolescents want to do what their peers do: going out, discovering 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.’

Importance of medication
Another thing that Jolanda Schieving notices is that medication is taken less well in the summer. Schieving: ‘We call this adherence to therapy. We know that the more medicines people have to take, the less well this goes. And that applies even more in the summer, when the fixed rhythm disappears.’ And that comes with risks. The combination of changes in combination with fewer drugs leads to more seizures. ‘You sometimes notice that after a few days of reduced medication intake,’ says Schieving.

She tries to think along with her patients as much as possible. ‘It helps if we include children in the decision for a certain medicine. So a tablet or a drink, how many times a day, the side effects. And how do you want to be reminded that you are taking your medication? Through an app, your watch or an alarm clock? The involvement of patients is of great importance in this.’ This increases compliance and reduces the risk of epileptic seizures.

Five advice for children and young people with a brain disorder
Jolanda Schieving has the following advice for children with a neurological disorder and their parents:

  1. Keep calm, 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 disorder gets enough rest with the other parent or adult.
  2. Don’t change the 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 move the schedule more than an hour.
  3. Contact your own doctor if complaints, such as an epileptic attack, arise 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.
  4. A doctor’s statement explaining the condition is useful for some conditions to contribute. Request this at the hospital.
  5. Take medication properly and on time, especially if your rhythm and your own environment are lost during vacation. Also remember the Schengen statement when taking certain types of medication abroad.

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