With Better Habits, Sleep-Deprived Teens Can Wake Up

Teenagers are notorious for being sleep-deprived, and unfortunately the anecdotes about teens and sleep are backed up with some serious statistics. Lynn A. D'Andrea, MD, Medical College of Wisconsin Associate Professor of Pediatrics, cites information from the 2006 Sleep in America poll conducted by The National Sleep Foundation (NSF). According to the study, only 20 percent of all teenagers get the recommended amount of sleep at night.

As a board-certified sleep specialist and the director of the Pediatric Sleep Center at Children's Hospital of Wisconsin, Dr. D'Andrea says the statistics are not surprising, but they are alarming. Adolescents and teenagers ages 11-17 were surveyed for the NSF study. Young people in that age group should get about 9 hours of sleep each night, Dr. D'Andrea says, but most are getting far less.

Why Don't Teens Get Enough Sleep?
There are a variety reasons why teenagers don't get enough sleep. Dr. D'Andrea says that often teens with insomnia, those who want to go to sleep but cannot, do not practice good 'sleep hygiene.' "They have a hard time waking up in the morning. They sleep in on the weekend. They're on the computer right up until they want to go to bed. They try to fall asleep with the television on in the room. They're text messaging and calling people late into the evening hours," she says.

Also at issue for teenagers are biological changes. The body's daily biological rhythms are controlled by the body's biological "clock," a collection of neurons in the brain that are finely tuned to regulate sleeping and waking cycles.

Dr. D'Andrea says as children mature to adolescents, sometimes their circadian rhythms are influenced by a delay in nighttime melatonin secretion. Melatonin is a natural hormone which helps regulate the body's circadian rhythm and promotes sleep. When melatonin secretion is delayed, teens naturally want to stay up later at night and sleep in later in the morning. However school start times are often early, causing teens to become sleep deprived.

Getting inadequate sleep does more than cause teens a few yawns in class. Their grades may be affected, and the NSF study found 15 percent of teen drivers drove drowsy at least once a week. "Teenagers are already high-risk drivers just by being new drivers," Dr. D'Andrea says. "Then if you put a sleepy teenager in the car, their risk of a car crash is increased."

Working Toward Better Sleep Hygiene
"Everyone needs to have a bedtime," says Dr. D'Andrea. She encourages parents to work with teens to establish a bedtime routine, but some of the key parts of it are common-sense steps to promote nighttime sleep. All electronics should be turned off at least half an hour before bedtime and caffeinated beverages should be avoided after 4 or 5 p.m. "Everyone benefits from slowing down and letting their mind and body relax before trying to fall asleep," she says.

Another key is consistency. Maintaining similar schedules on the weekends as on the weekdays can be challenging, but it's important for teenagers to try to regulate their sleeping schedule. "There's no doubt we all like to sleep in on the weekend, but there probably shouldn't be more than a one- to two-hour difference in wake time," Dr. D'Andrea says. If teenagers wake up at 6 a.m. during the week and sleep until noon on the weekend, they will most likely experience sleep problems similar to jet lag. "It's like jetting off to Europe every weekend," Dr. D'Andrea says.

"We live in a 24/7 world," Dr. D'Andrea says. "What happens is sleep is sacrificed to the detriment of our health. But teens who are sleep-deprived are late to school or absent from school and their grades start to deteriorate. They don't feel like exercising, which raises concerns about obesity. They're dangerous when they're driving."

While some teens may have other sleep issues such as sleep apnea, a common disorder where breathing becomes too shallow or stops briefly, many teen sleep issues are addressed with cognitive behavioral therapy. Cognitive behavioral therapy involves working with patients to modify behaviors and address emotional issues such as stress.

Solving sleep problems is very important for health, Dr. D'Andrea says. "When you have a sleep disorder, it's pervasive and can affect other areas of your life, including daily activities and how you function. Sleep is something we should protect."

Dr. D'Andrea works with teenagers and younger children at the Sleep Center at Children's Hospital, the only sleep disorders center in Wisconsin dedicated exclusively to the care of children. The Sleep Center is accredited by the American Academy of Sleep Medicine.

Dr. D'Andrea is Chief of the Division of Pediatric Pulmonary and Sleep Medicine and director of the Pediatric Sleep Center at Children's Hospital of Wisconsin.

Melissa Rigney Baxter
HealthLink Contributing Writer

MCW Health News presents up-to-date information on patient care and medical research by the physicians of the Medical College of Wisconsin.