Puberty is a complex physiological, cognitive and psycho-social cascade of changes. Sleep disturbances can arise during this essential time, which may adversely affect growth, health and development. Most of you who have adolescents at home are well aware of these complex changes; well so am I. My great sleeper, who used to fall asleep the minute his head would hit the pillow around 9, now walks the hallways till 11 or midnight at times, unable to fall asleep. I have decided to look deeper into this common phenomenon that affects so many teens to see what suggestions I can find in literature.
To start off, we need to dive into basic physiology of sleep. Sleep is regulated by two body systems: sleep/wake homeostasis and the circadian rhythm. The sleep/wake homeostasis lets our body know when it needs to rest. The circadian rhythm, regulate the time period of sleepiness and wakefulness. Changes in the circadian rhythm occur during adolescence as part of physiological process. This natural shift is called sleep phase delay. Teen who used to go sleep around 8-9 pm at night before puberty, now won’t be able to fall asleep till 10 or 11 pm. Since most adolescents have early school start, this sleep phase delay can make it difficult for the teenagers to get recommended 9 hours of sleep. For adolescents the strongest circadian “dips” tend to occur between 3-7 am and 2-5 pm.
The biological clock is controlled by the brain that responds to light and dark signals. In the morning, light travels from the optic nerve of the eye to the brain, it signals the internal clock that it time to awake and to the body to produce cortisol hormone. In the evening, different hormone, melatonin, gets produced. Melatonin promotes sleep. It’s postulated, that since adolescents have difficulty going to bed early, it can help to keep light dim at night as bedtime approaches. Using the same rational, it would be helpful to get into bright light as soon as possible in the morning.
As I mentioned before, though delayed sleep onset is normal physiological change that occurs during puberty, the amount of sleep required to restore normal day to day ability to function does not change significantly from pre-adolescence. Teens still need solid 9-10 hours of sleep. Otherwise, there are cognitive and behavior consequences, such as poor judgement, lack of motivation, and inattention to name just few. Lack of sleep may cause depressive symptoms in some teenagers. There is some evidence from studies that suggests direct relation between lack of sleep and obesity. Risk of injuries exponentially increases with inadequate amount of sleep.
Most teens will sleep much better if they simply develop the habits of good sleep hygiene. Because teens are in a stage of life that is very unique, the tips listed below are even more important for them:
- Teens should have a consistent regular routine just before bedtime.
- They need a chance to unwind at night. To help them relax, teens should avoid activities that will excite their senses late in the evening. They should find another time for computer games, action movies, intense reading or heavy studying.
- Adolescents should avoid anything with caffeine (including soda and chocolate) after 4:00 pm.
- A regular exercise routine and a healthy diet will help them sleep better at night.
- Keep the lights dim in the evening. Upon awakening open curtains to get maximum amount of light. This helps keep body clock set at the right time.
- If they must take a nap, they should keep it to under an hour. It can be hard for teens to get enough sleep during the week. They may need to wake up later on weekends. But they should not wake up more than two hours later than the time when they normally rise on a weekday. Sleeping in longer than that will severely disrupt a teen’s body clock that in turn create pathological sleeping disorder.
Thanks, as always!