Why Teens don’t get enough Sleep! Navin Jain, MD (originally published Healthy Living 2006) My 17-year-old daughter will not get out of bed in the morning. I try and try to wake her but it is near impossible. I don't want her to be late for school but clearly she is too tired to get out of bed. What should I do? My son is a freshman in high school and he wants to join the wrestling team, but they practice early in the morning and I'm concerned that he won't get enough sleep. What do you recommend? I have a 16-year-old who comes home every day and collapses on the couch. Is that a problem? Should I let her nap? If so, for how long? How can I get my kids to go to sleep at a normal hour? I set my child's bedtime for 11 pm but he just isn't tired. What should I do? What should I allow him to do until he gets sleepy? My teenager daughter sleeps about 7 hours every night and still falls asleep during school classes.  What can I do? If you feel you are or one of these parents or one of the teenager, you are not alone.  Many of nations’s teenagers are falling asleep in class, arriving late to school, feeling down and driving drowsy.  National Sleep Foundation recently conducted a survey of 1,602 households across U.S., and released it as Sleep in America poll for 2006 during National Sleep Awareness Week.  The highlights and findings include: ·        Only 20% of adolescents report that they get optimal nine hours of sleep on school nights ·        About 50% adolescents say they actually sleep less than eight hours on school nights ·        More than 28% high school students reported falling asleep in school at least once a week in past two weeks; 22% fall asleep while doing homework ·        14% high school students arrived late or missed school because they overslept ·        Only 7% caregivers think their adolescent may have a sleep problem but 16% adolescents think that they may have one ·        More than one half (51%) of adolescent drivers have driven drowsy during the past year. ·        Adolescents who get insufficient amount of sleep are more likely than their peers to get lower grades ·        Among those adolescents who report being unhappy, tense and nervous, 73% feel that they don’t get enough sleep at night, and 59% are excessively sleepy during the day This poll identifies that there is progressive reduction in adolescent’s sleep as students transition from middle school to high school.  This happens at a critical period of development and growth and is very troublesome. As children reach adolescence, their internal clock (circadian rhythm) tends to shift (Phase Delay) and causes teen to feel more alert later at night and wake up later in the morning.  This trick of nature can make it difficult for them to fall asleep before 11:00 pm.  The natural tendency for teenagers is to stay up late at night and wake up later in the morning. However, many teenagers wake up around 6:30 am in order to go school and have to function without the sleep they need. Ben Franklin said,” Early to bed, early to rise makes a man healthy, wealthy, and wise”.  However, I do not think this applies well to teenagers.  Sleep serves restorative function for adolescent’s bodies and brains.   When students go to school without sufficient sleep, they can not process what they’ve learned during the day. Minneapolis Public School District changed starting times of several high schools from 7:15 am to 8:40 am. The results of impact of later start times on start times are encouraging.  Improvement in attendance, daytime alertness, and reduced student reported depression is noted with later start times of schools.  Most adolescents agree that adolescents require 81/2 to 91/4 hours of sleep but very few actually get that much sleep. WARNING SIGNS YOUR CHILD MAY NOT BE GETTING ENOUGH SLEEP ·        You have to wake your child for school.  It is difficult to do so. ·        Teacher has mentioned that your child is sleepy or tired during the day or falls asleep during classes at school. ·        You find your child falling asleep while doing homework ·        Your child sleeping two hours later or more on weekends than during school nights ·        Your child’s behavior is different on days that he/she gets good night’s sleep versus days he/she doesn’t ·        Your child rely on a caffeinated drink in the morning to wake up ·        Your child drinks two or more caffeinated drinks a day ·        Your child routinely naps for more than 45 minutes TIPS FOR TEENAGERS TO GET BETTER SLEEP ·        Set a consistent bed time and wake time schedule (even on weekends); Don’t sleep more than one hour later on weekends than usual wake up time during school nights ·        Allow yourself to sleep about nine hours every night.  Sleep is food for the brain: Get enough of it and get it when you need it.  You should awaken refreshed and not tired. ·        Have a relaxing bedtime routine – reading, warm bath or shower ·        Keep bedroom dark, comfortable, and quiet ·        Avoid bright light in the evening (exposure to bright light in evening will cause further phase delay of internal clock) ·        Get into bright light as soon as possible in the morning (this will advance sleep phase and one may be able to shift internal clock to help sleep at earlier time) ·        Avoid caffeine after lunchtime ·        Avoid heavy exercise in evening hours ·        Avoid prolonged naps (Naps should be a complement to good night’s sleep and not substitute for sleep at night) ·        Say no to all-nighters – all nighters or late night study sessions might seem to give you more time to cram for exams, but they are also likely to drain your brainpower TIPS FOR PARENTS / CAREGIVERS ·        Look for warning signs that your teenager may not be getting enough sleep ·        Help them set up regular sleep wake schedule ·        Unwire your teenagers: Many teenagers have a technical playground in their bedrooms: television, computer with 24/7 internet access, telephone, video games, MP3 players and so forth.   Sleep in America poll found that by 12th grade 39% children had more than 4 electronic items in their bedroom.   Removing several of these items from bedroom will make bedroom a quit place and will help to sleep better. CONSEQUENCES OF NOT GETTING ENOUGH SLEEP ·        Poor performance – in school, sports, video games ·        Missed school, late for school ·        Falling asleep in classes ·        Drowsy driving and accidents ·        Feel depressed ·        Metabolic and nutritional deficits including obesity If you feel your teenager is excessively sleepy during the day time, try some of the tips mentioned above and make sure that they are getting approximately nine hours of sleep.  If they continue to have problem with excessive sleepiness and tiredness during awake hours, they may have underlying sleep disorder like sleep apnea or narcolepsy.  You may consider evaluation by a Sleep Disorder Specialist if problem of tiredness and sleepiness persist. Any sleep related questions can be directed to him by e-mail at toledosleepdoc@gmail.com.