All living creatures need sleep. In people, the need for sleep decreases over time from 18 hours in newborns, to an average of 8 hours for adults. Too little sleep can dramatically affect our waking hours by 1) increasing fatigue/drowsiness 2) decreasing mental and physical performance 3) increasing negative moods such as sadness, irritability, and anger.
Adolescence is a time of life when responsibilities and commitments are increasing but the time needed for sleep does NOT decrease. Adolescents continue to need 9-10 hours of sleep each night though on average they get much less (7-8). Also, the physiologic or normal sleep pattern for adolescents changes. Research in which melatonin,
a type of “sleep hormone”, levels are measured reveal that teenagers are “programmed” to fall asleep later at night and wake later in the morning. This is at odds with a major influence in their lives - HIGH SCHOOL! In fact, high schools tend to start as early or earlier than elementary and middle schools. The tendency for teens to sleep much later on weekends is thought to be in response to the “sleep debt” they accumulate during the school week.
In 1997-98 a large study in Minneapolis examined the effect of changing high school start times from 7:15 am to 8:40 am. Over 50,000 students were affected by this. There was improved attendance, a decreased drop-out rate. Though the students did
not go to bed earlier, they got about 1 hour more sleep per night. Other studies have showed teenagers who get A’s and B’s regularly sleep more hours and do less “catch up” sleeping on weekends than those with lower grades. Students at high schools that start early report more fatigue, dozing off in class, and trouble paying attention than those at high schools with later start times. More high schools across the country have been changing high school hours in response to these findings.
Sleep disturbance can worsen or even mimic certain conditions such as ADHD. In patients with ADHD who also have “sleep disordered breathing” (aka snoring/sleep apnea) treating the breathing symptoms resulted in improved sleep and decreased or even eliminated their ADHD symptoms. The same is true for mood disorders such as
depression. Depression is associated with poor sleep; poor sleep increases depressed and other “bad” moods; the worsening mood further decreases sleep etc, etc.
The most serious consequence of teenage sleep deprivation is an increased risk of injury and death. In more than 50% of car accidents associated with falling asleep at the wheel the driver is between 16 and 25 years old. Drivers who slept 6-7 hours are almost twice as likely to be involved in a crash than those who slept 8 hours. Drivers who slept 5 hours or less are 4.5 times more likely to crash!
There are ways to promote adequate sleep for your teenager, and entire family for that matter:
1) keep a evening/bedtime routine, including on weekends if possible.
2) avoid or limit the number of hours your teenager works outside of school. Teens with part time jobs get less sleep, especially if they work 20 hours or more per week.
3) avoid stimulant use such as caffeine (coffee, soda, chocolate), nicotine, and alcohol. Alcohol can induce sleep at first and they has a “rebound” disruptive effect of sleep.
4) avoid television, computer/media use right before bedtime and do not have television sets or computers in the bedroom.
5) advocate for your high school to delay start time.
6) discuss your child’s sleep habits and concerns you have with your physician.
The mnemonic BEARS can be useful for considering your teenagers sleep habits:
B= bedtime (trouble falling asleep?)
E= excessive daytime sleepiness?
A=awakenings in night?
R=regularity (in time and amount of sleep?)
S=snoring (sleep disordered breathing)
References:
1)Excessive Sleepiness in Adolescents and Young Adults: Causes, Consequences, and Treatment Strategies. Pediatrics Vol. 115 No 6 June 2005
2)Adolescent Sleep Needs and Patterns; Research Report and Resource Guide. National Sleep Foundation 2000