Back to Life, Back to Reality: High School and Adolescent Sleep

Teen Sleep PatternsIt’s official: there is about one month left of summer before school starts up for most adolescents.  While there’s a lot to talk about at this time of year – everything from insect repellent for those nasty mosquitoes to the high rates of underage drinking at summer music festivals – I’m going to focus on a conversation that I find myself in with many of my teenage patients at this time of year:

Me: “I see that you wrote down that you get about 6 to 7 hours of sleep most nights.”

Teen: “Yeah… Well, actually, that’s only when I am in school.  During the summer I sleep a lot more… Like 8 or 10 hours per night.”

Me: “What is it like to get only 6 or 7 hours of sleep when you’re in school?”

Teen: “It’s hard… I’m really tired in the morning.”

Me: “What makes it hard to get more sleep during the school year?”

Teen (99% of the time): “Homework.”

There’s often a big difference between adolescent sleep habits during the school year and during the summer. Some of this difference has to do with schedules and how schedules can fill up during the school year, but some of it also has to do with teenage biology.

The Rumors are True: Adolescents’ Sleep Patterns Are Different

I’m sure that you’ve heard this, as research and recommendations for adolescent sleep pop up in the news every so often.  But here’s your confirmation that the rumors are true: adolescents have different sleep patterns than the rest of us.

There are two main factors that are thought to influence this. The first has to do with something called melatonin, which is a messenger released by a person’s brain that helps signal the body that it’s time to sleep. Starting as early as middle childhood (defined as ages 6 to 12), the brain starts to release melatonin later and later in the evening, shifting the circadian rhythm (or sleep/wake patterns) so that preteens and adolescents may actually have trouble falling asleep at their previous 8pm bedtime and may be groggy early in the morning when their melatonin levels are still high.  Studies estimate that most teenagers would go to bed at 11pm, according to this natural sleep/wake rhythm.

And there’s another difference between teens and younger kids as well: while a 5-year-old might collapse into their dessert bowl when they are really tired, adolescents don’t have the same “sleep drive,” and actually take longer to fall asleep (even when sleep-deprived) than their younger counterparts.

The real kicker, however, is that even though it’s normal for adolescents to have unique sleeping patterns (with their whole sleep/wake cycle shifted later), they still need as much sleep as they did when they were younger.  Optimal sleep times for adolescents are 8.5 to 9.5 hours per night, but hitting that target can get pretty difficult if a person’s body doesn’t feel like going to sleep until 11pm and school starts at 7:45am.  In a national survey of high school students in 2013, only 31.7 percent got at least 8 hours of sleep per night.

And the consequences of our nationwide teen sleep deprivation? There are many.  Inadequate sleep is associated with increased rates of car accidents when drivers are sleep deprived as well as increased rates of depression. Some studies link poor sleep to increased appetite and risk for obesity. And while many teens stay up because of school work, it’s well demonstrated that sleep is actually an important part of forming memories, so staying up for that extra hour might be counterproductive.

Because of the importance of sleep in health and learning, there is a shift to start middle and high school in recognition of the normal adolescent sleep/wake cycle.  The American Academy of Pediatrics released a statement in 2014 encouraging school districts to start middle and high school at 8:30am or later to help encourage adequate sleep in their teen and preteen students.  If you’re into advocacy and your (or your teen’s) school starts earlier than 8:30am, bringing the science about later school starts to the school board’s attention is one way to promote teen health in your community.

Sleep Training

So, there are about four weeks to go before school starts, and you feel great… but are getting up at 11am every day.  How can teens and their families prep for the transition to the school schedules?

  1. Get a sleep schedule going now… and keep it going during the school year
    One of the most important elements of sleep is consistency, meaning that a person goes to sleep and wakes up at roughly the same time every day.  If you’ve shifted your summer schedule to go to bed at midnight and you know that you’ll have to wake up at 6am when school starts, it’s a good idea to start moving your nightly bedtime back slowly (15 minutes earlier every few days) to prepare for the school year.  And if you’re bedtime is currently not consistent, start working on going to sleep and waking up at a consistent time.
  2. Prioritize sleep
    This sounds silly and obvious, but it’s a critical piece of the puzzle. If sleep is a priority, that means that school work and other activities have to fit around it, which requires some planning. Parents, teachers, and guidance counselors can be great resources in thinking about how to plan ahead to avoid frequent late nights.  There might be a rare exception to this for a huge project or a paper that was assigned on short notice, but if the importance of sleep is recognized, sometimes work will just have to wait.
  3. Have a bedtime routine
    Doing the same thing every night before going to sleep creates a signal for your body to wind down, which can be really helpful if you’re trying to relax after cramming for an exam. There should be a few steps to your sleep routine (things like brushing your teeth, turning down the lights, changing into pajamas, writing in a journal, even meditating!) and it should be screen-free (see #4).
  4. Dude, seriously
    We’ve discussed this before when chatting about cell phones, but I’ll say it again: screens can make it hard to fall asleep. Small studies have shown that electronic devices that are lit with blue light interfere with the release of melatonin (remember? That message that tells our bodies to sleep?), so turning off all screens – computers, tablets, televisions, and cell phones – is key to healthy sleep.
  5. Nap when you need to
    Taking a short nap can recharge you and be good for memory and energy; just make sure that you don’t nap too close to bedtime, as that can make it hard to fall asleep later.
  6. Avoid caffeine after 2pm
    This one’s pretty self-explanatory: caffeine late in the day can make it hard to fall asleep later.  Don’t forget that there are lots of things that contain caffeine:

    • Soda, of course
    • Tea, including many iced teas and sweetened teas
    • Coffee, including some brews labeled as decaf!
    • Some energy drinks
    • Some gum and breath-fresheners
    • Chocolate: the darker the chocolate, the more caffeine it has
    • Some medications, like Excedrin Migraine

Getting in the swing of healthy sleep habits is like training for a sport, so get your sleep schedule on track now to set yourself up for success during the school year. Your body and mind will thank you!