My Teenager’s Sleep is all over the Place!

Adolescence is a huge time of change – physical, and emotional.  To cope with this, teenagers need at least 8 – 10 hours of sleep per night.  However, most Australian teenagers are only getting 6.5 – 7.5 hours of sleep per night.  So, why is this and what impact is it likely to have?

Firstly, after puberty there is a shift in a teenager’s internal clock meaning that they no longer feel tired early in the evening.  They feel tired much later; usually around 11pm so even if they go to bed at 9pm, they are unlikely to fall asleep until much later.  School, however, still starts at 8:30 am, often earlier if they do sport or are in a club which makes achieving 8 - 10 hours’ of sleep very difficult.

There is often sport or other school activities after school as well, which means eating dinner later and then a significant amount of homework or socialising leading to later and later bedtimes.

This is then compounded on the weekend when they can finally sleep in and will often sleep in until late in the day.  This will completely throw their sleep-wake cycle out of kilter.

On top of this, more and more teenagers are drinking caffeine which increases stimulation, making it more difficult to fall asleep and reducing the quality of their sleep.

In Australia, we are also seeing alcohol and cannabis play more of a role in sleep dysfunction in adolescents with teenagers experimenting more with these socially as well as then using them to help them sleep.  This in turn, exacerbates exhaustion the next day causing them to sleep later and worsen the disruption of the sleep-wake cycle.

A significant issue facing today’s teens which the parents of today did not face as teenagers, is the internet, smart phones and the impact of screen time.  The need to feel connected to their friends 24 hours a day is very real for a lot of teens. Many teens feel that they will be excluded from an event if they are not able to respond straight away or that they are being a bad friend if one of their friends’ “needs” them in the middle of the night and they do not answer a text.  This is a serious problem as the light from the screen has been shown to suppress melatonin levels, a natural hormone we release to help us sleep.  Cyberbullying can also occur at night meaning that even a teenager’s bedroom is no longer a safe place for them.

The result of all this is an accumulation of insufficient sleep, daytime sleepiness, impaired cognition, irritability, low mood, reduced school performance, increased risk-taking behaviour, and increased levels of anxiety and depression. 

We are also seeing a rise in obesity in Australian children and adolescents.  A new term has been coined called “social jetlag.”  This is where teenagers are more likely to eat more, feel hungrier and make unhealthier food choices as they have higher levels of obesogenic hormones such as leptin and ghrelin as they have simulated jetlag in their body with the disruption of their sleep-wake cycle.  This contributes to the obesity epidemic in our country.

If you have a teenager who drives, chronic sleep insufficiency is also a serious consideration for their safety on the road.  This is not just early in the morning around 2am but also in the mid-afternoon around 3pm.

So, what should parents do? Here are a few tips to optimise sleep hygiene!

• Try and encourage an appropriate bedtime that allows 8 hours sleep per night

• Encourage your teenager not to sleep in on the weekend (good luck!!)

• Dim the lights in the evening

• Stop technology 1 hour before bedtime

• Keep devices out of the bedroom overnight – the risk to check Instagram or snapchat overnight is just too great!

• Open the curtains in the morning so they wake up with natural morning sunlight

• Encourage regular mealtimes – do not skip breakfast.  Regular mealtimes encourage a routine and the sleep -wake cycle

• Encourage daily exercise

• Encourage your teen to avoid stimulant drinks, alcohol and cannabis.

• If your teenager needs an antihistamine, make sure it isn’t a sedating one

• Sometimes a 15 – 30 min nap in the early afternoon can be beneficial

If the above isn’t working, consider seeing your doctor to see if something else is going on.  Some adolescents, particularly girls suffer insomnia and occasionally this is associated with a depressive disorder that requires treatment.  Other chronic health conditions that may adversely affect sleep include asthma, chronic allergic rhinitis, sleep apnoea or pain.  All of these conditions require assessment and treatment.

References

1.    Mindell JA & Owens JA (2003). A Clinical Guide to Paediatric Sleep: Diagnosis and Management of Sleep Problems. Philadelphia: Lippincott Williams & Wilkins.

2.    Better Health Channel [https://www.betterhealth.vic.gov.au/health/healthyliving/teenagers-and-sleep] (07/07/2024)

3.    Chawla, J et al. Optimising sleep in adolescents: The challenges: Australian Journal of General Practice; Vol 53 (6), June 2024