How sleep changes during adolescence

Do you often wonder what's going on with your teenager's sleep? Does the following scenario sound familiar?

Every morning, your child struggles to get out of bed. Somehow, she manages to leave the house barely on time, or maybe she skips the first period. She begins to feel more alert towards noon, and is able to participate in all of her afternoon and evening activities: team practices, theater rehearsals, seeing friends, etc. Several days a week she comes home from these activities after the family’s dinner time. Long day, right? But somehow, when bedtime arrives, she is wide awake, chatting with friends on her phone, scrolling through social media, doing homework, and is basically as far from sleep as it gets. You tell her to turn everything off and go to sleep, so she could wake up on time the next morning. But she’s just not feeling sleepy yet, and has better things to do, anyway.

The American Academy of sleep Medicine recommends that teenagers 13-18 years of age get 8-10 hours of sleep regularly, to promote optimal health. The health outcomes associated with getting enough sleep include improved memory, attention, learning, and in general, better mental and physical health. Despite these recommendation (and the actual need for sleep), many adolescents don’t get enough sleep, especially on school nights. Why? 

A combination of factors is to blame:

1. A physiological development that occurs at this age allows teenagers to delay bedtime more easily. That doesn’t mean they need less sleep; it is just easier for them to stay awake longer.
2. During adolescence, timing of alertness and sleepiness shift to a later time of day. That means that a typical adolescent becomes fully alert a little later in the morning than a primary school student. Similarly, a typical adolescent doesn’t feel sleepy until later at night.
3. Compared with younger children, adolescents are more likely to use electronic devices later in the evening. They also have more responsibilities and interests. All of these become possible due to the reduced sleep propensity in the late evening and also due to an increase in autonomy.
4. Early school start time: since adolescents go to bed late at night (due to the reasons mentioned above) but are still required to wake up early for school, they often end up getting insufficient hours of sleep during school nights.
   

​Insufficient and ill-timed sleep in adolescence can have serious consequences, including depression and anxiety, weight gain, behavioral problems, and car accidents.
 
What can be done about this? While parents can’t control physiological maturation processes or social norms, some steps may still be taken. The following tips are meant for adolescents, their parents, and anyone who would like to adopt an earlier bedtime:

• Reduce light exposure in the evening. Artificial light in the evening can trick our brain to believe it’s earlier than it truly is.
• Similarly, stay away from phones and computers close to bedtime. Electronic devices emit light that seems to our eyes and brains as sun light. 
• Increase light exposure in the morning. Timing is everything! Natural sunlight at the right time can make it easier to start the day.
• Don’t use social media in the evening. In general, it’s better to avoid emotionally triggering content prior to bedtime, and instead focus on calm and relaxing activities.
• Advocate for later school time in your district 

Not all teenagers are affected by these factors in the same way. For some, the natural delay of bedtime may be minimal and easy to cope with. For others, it may be so significant that it leads to serious academic and emotional problems. If your teen is experiencing emotional distress, seek professional help. 

References:
 
Blake MJ, Sheeber LB, Youssef GJ, Raniti MB, Allen NB. Systematic Review and Meta-analysis of Adolescent Cognitive-Behavioral Sleep Interventions. Clin Child Fam Psychol Rev. 2017 Sep;20(3):227-249. doi: 10.1007/s10567-017-0234-5. 
  
Crowley SJ, Wolfson AR, Tarokh L, Carskadon MA. An update on adolescent sleep: New evidence informing the perfect storm model. J Adolesc. 2018 Aug;67:55-65. doi: 10.1016/j.adolescence.2018.06.001.