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References: Sleep, Exercise, and Therapy

  1. Brain Basics: Understanding Sleep - National Institute of Neurological Disorders and Stroke (NINDS) - A clear government explainer on the brain's sleep clock (the suprachiasmatic nucleus and melatonin) and the stages of non-REM and REM sleep. Source for the sleep architecture table in Section 18.3.

  2. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine - Paruthi S, et al. Journal of Clinical Sleep Medicine, 2016 - The AASM consensus that teenagers 13 to 18 should sleep 8 to 10 hours per 24 hours. Short and readable.

  3. Sleep (Youth Health in Focus) - Centers for Disease Control and Prevention, Youth Risk Behavior Survey - Reports that in 2025 only about 1 in 4 US high school students (24%) got at least 8 hours of sleep on an average school night.

  4. About Sleep - Centers for Disease Control and Prevention (2024) - Recommended sleep by age and practical sleep habit tips. Source for the sleep hygiene list in Section 18.6.

  5. Sleep disturbance and risk of active disease in patients with Crohn's disease and ulcerative colitis - Ananthakrishnan AN, et al. Clinical Gastroenterology and Hepatology, 2013 - The study of 3,173 people with IBD that linked poor sleep to later flares in Crohn's disease (but not ulcerative colitis). A good example of a strong association that can't prove cause.

  6. Transkingdom control of microbiota diurnal oscillations promotes metabolic homeostasis - Thaiss CA, et al. Cell, 2014 - The landmark study showing gut microbes follow a daily rhythm driven by feeding times. Read the abstract carefully to see which findings come from mice and which from people.

  7. Physical Activity Guidelines for Children and Adolescents - Centers for Disease Control and Prevention (2025) - How much activity teens need: 60 minutes or more a day, with vigorous, muscle-strengthening, and bone-strengthening activity on at least 3 days a week.

  8. Effectiveness of physical activity interventions for improving depression, anxiety and distress: an overview of systematic reviews - Singh B, et al. British Journal of Sports Medicine, 2023 - An umbrella review of 97 reviews and over 1,000 trials showing medium-sized mood benefits from physical activity in adults. The abstract is open access.

  9. Efficacy of psychological therapies for irritable bowel syndrome: systematic review and network meta-analysis - Black CJ, et al. Gut, 2020 - Compares CBT, gut-directed hypnotherapy, and other therapies across 41 trials, and explains why their benefits are probably overestimated.

  10. Improvement in Gastrointestinal Symptoms After Cognitive Behavior Therapy for Refractory Irritable Bowel Syndrome - Lackner JM, et al. Gastroenterology, 2018 - Free full text of the IBSOS trial analyzed in this chapter's claim box, including a description of what each CBT session covered and the funding statement.

  11. ESPGHAN/NASPGHAN guidelines for treatment of irritable bowel syndrome and functional abdominal pain-not otherwise specified in children aged 4-18 years - Groen J, et al. Journal of Pediatric Gastroenterology and Nutrition, 2025 - The European and North American pediatric guideline that recommends hypnotherapy and CBT as treatment options for IBS in children and teens. Long and technical, but the recommendation tables are useful for families.

  12. Effects of voluntary slow breathing on heart rate and heart rate variability: A systematic review and a meta-analysis - Laborde S, et al. Neuroscience and Biobehavioral Reviews, 2022 - Meta-analysis of 223 studies showing that slow breathing raises vagally mediated heart rate variability during and after practice.