A perspective article published in the New England Journal of Medicine denounced the practice of subjecting immigrant children to constant illumination in detainment facilities after forced separation from their parents at the United States-Mexico border.1

Despite an executive order issued on June 20, 2018 to end family separations, 1100 children remain at the Ursula facility in McAllen, Texas, where, according to author Charles A. Czeisler, PhD, MD, from the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital in Boston, Massachusetts, the “overhead lighting stays on around the clock.” Constant light exposure causes prolonged sleep deprivation and disrupts circadian rhythms and can be particularly harmful during the childhood stages of development. Chronic sleep deficiency in early life can have long-term consequences, including later-life obesity, hypertension, poorer memory processing, and learning ability, and increased risk for “adverse mental health outcomes.” The mental consequences of sleep deprivation for children include increased risk for anxiety disorders, substance abuse, feeling of hopelessness, depression, and suicidal ideation.

After family separations, Dr Czeisler argues, the US government becomes responsible for properly housing immigrant children; by exposing them to constant illumination, it fails to provide even basic care. Previous research conducted by Dr Czeisler and colleagues2 found that “sleep deficiency combined with… circadian disruption can induce a prediabetic state… within 2 weeks.” Additional research has shown that constant light exposure can diminish muscle and bone mass in mammals, with some study subjects showing early signs of osteoporosis. After 8 weeks of constant light exposure, mammals enter a “proinflammatory state” in which “hemoglobin, hematocrit, and lymphocyte levels [drop] while neutrophils [double].” The children in these facilities are coping with separation from their families and forced incarceration; the added burden of constant illumination is medically harmful and ethically indefensible.

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The practice of family separations has been described by the president of the American Academy of Pediatrics as a “form of child abuse.”3 Dr Czeisler argues that constant illumination is an additional measure of trauma enacted against immigrant children in these facilities and insists that, at the very least, the Department of Homeland Security (DHS) turn off the lights at the Ursula facility at appropriate times. Per statistical analyses, it costs US taxpayers $800 per person per day to support these “tent cities”: at that cost, the DHS could feasibly provide at least a more proper housing arrangement, in lieu of eliminating the detainment facilities altogether.


  1. Czeisler CA. Housing Immigrant Children — The Inhumanity of Constant Illumination [published online June 22, 2018]. N Engl J Med. doi:10.1056/NEJMp1808450
  2. Czeisler CA. Duration, timing, and quality of sleep are each vital for health, performance and safety. Sleep Health. 2015;1(1):5-8.
  3. Doctor: Family separation is child abuse. CNN. https://www.cnn.com/videos/us/2018/06/18/colleen-kraft-american-academy-of-pediatrics-family-separation-child-abuse-ath.cnn/video/playlists/at-this-hour-video/. Accessed July 9, 2018.