“To sleep: perchance (my teen): ay, there’s the rub”
There is the rub indeed. If Shakespeare had teenagers, he might have had Hamlet say these words. For what parent has not struggled with the adolescent who wants to burn the candle at both ends?
Approximately 1/3 of our lives are spent in this strange state we call sleep. Humans have long mused in literature and philosophy about the meaning and purpose of sleep. We now know a great deal about sleep and our knowledge is increasing exponentially about what it is, what can go wrong with it, what happens if you don’t get the right amount of it, physical and mental problems associated with it, and how it changes through the lifespan.
As parents watch their teens return for yet another year of schooling, they may have many things on their minds, such as how they will do with their studies, how they will fit in with their peers, and how happy they will be. The role of sleep in affecting all of these, though, is not likely to be a foremost concern. Sleep is one of those things that we all do and take for granted. We have a general appreciation that what happens during the state of sleep can affect our children when they are awake, and vice versa. But science is showing us that the effects are more ubiquitous than we think, and just as we understand the importance of good dental hygiene for the health of our teeth, we are coming to understand the importance of good sleep hygiene for the health of our minds.
According to the National Sleep Foundation:
- Just 1 in 5 adolescents get an optimal 9 hours of sleep on school nights; nearly half (45%) sleep less than 8 hours on school nights.
- More than half of adolescents report feeling too tired or sleepy during the day.
- More than half of adolescents say they know they get less sleep than they need to feel their best.
- 9 out of 10 parents believe their adolescent is getting enough sleep at least a few nights during the school week, leaving an “awareness gap” between parents and teens.
There are a variety of disorders of sleep that can affect children and teens, such as sleep disordered breathing and obstructive sleep apnea. We know that many of these are found with increased frequency in children and teens with various developmental disorders, such as ADHD and autism, as well as neurological conditions, such as epilepsy. While not causing these conditions, in many cases the interruptions of sleep can exacerbate behavioral and emotional symptoms. So, for parents of children and teens with such conditions, sleep may be a very important contributing factor for the child’s functioning in school, at home and with peers, and can affect the quality of the parent-child relationship.
According to the Centers for Disease Control and Prevention, nearly 1 in 5 (17.6%) 12 to 19-year-olds in the U.S. are overweight, defined as a body mass index (BMI) at or above the 95 percentile. Among African Americans and Mexican Americans, it is even higher. There is also growing evidence that what has been called the “epidemic in obesity” contributes to the sleep problems of teens. In a study published in 2010 in the journal Sleep, led by my colleague and sleep expert, Dean Beebe, at Cincinnati Children’s Hospital Medical Center, we found that overweight youth with sleep disordered breathing (ranging from obstructive sleep apnea to loud snoring) had more attention and learning problems. These concerns potentially apply to many youth, since 13-39% of overweight children have sleep disordered breathing.
But what about youth who do not have a sleep disorder or high risk condition, such as obesity? Sleep habits and needs change with age. Preschool and school-aged children need 10-12 hours of sleep per night while teens need at least 9 hours. Teens in particular may be a cause for concern because they tend to reduce their sleep more during the school year. They also can be less cooperative, asserting their independence, with parents’ attempts to encourage good sleep habits. Teens may also be more exposed to caffeine and other substances that can interfere with sleep. But, as has been found in adults, there is increasing evidence leading to the conclusion that sleep restriction has significant negative consequences for teens. Research suggests that too little sleep is related to inattentive behavior, poorer school performance, negative mood, daytime sleepiness, increased risk-taking behavior and increased risk of driving accidents. Some studies have shown that when you let teens sleep longer in the morning, they are more alert, attentive and feel better and that this has positive consequences for school attendance and performance.
In tomorrow’s blog post, I will discuss the importance of good sleep hygiene for teens.