When we see adolescents for counselling, friendship or family issues, study skills or a range of other problems, it is unsurprising that many of them also report some kind of sleep difficulty.
Sleep problems often affect kids’ ability to concentrate in the classroom, to get up and get moving in the morning and to regulate moods.
It can sometimes be hard to understand where this is coming from and why so many teenagers have trouble controlling their sleep patterns. This post aims to shed some light on the subject for both parents and teenagers.
Some facts about sleep:
- Approximately 9% of Australians have a diagnosed sleep disorder
- Sleep disorders are almost ALWAYS associated with either Anxiety or Depression (or both)
- For 12 to 18 year olds, the recommended amount of sleep is 9.25 hours a night! (How many teenagers do you know that go to sleep at 9.45pm and wake up at 7am?). This recommendation is based on analyses from a large group of studies. It takes into account how much sleep is needed for a person to achieve “optimal” performance in a range of areas including attention, reaction-time, and cognitive tests.
Does my teenager have a sleep disorder?
The most commonly complained-of problem for teenagers is that they can’t get to sleep before midnight but then still have to get up in time for school, resulting in lack of sleep during the week. They sometimes nap in the afternoons or use the weekends to catch up. In addition, they are irritable in the mornings and lack concentration at school. But, it is hard for parents to know whether an adolescent’s sleep patterns are based on lifestyle choices or whether they represent an actual sleep “disorder”. Let’s consider some different types of sleep disorder.
In the adolescent years, “circadian rhythm” problems are the most common type of sleep disorder. In particular, Delayed Sleep Phase Syndrome is a type of circadian rhythm problem which occurs in approximately 10% of adolescents and young adults compared to only 1% of people in middle age.
Delayed Sleep Phase Syndrome (DSPD) is defined by the International Classification of Sleep as being:
“characterised by habitual sleep-wake times that are delayed usually more than two hours, relative to conventional or socially acceptable times. Affected individuals complain of difficulty falling asleep at a socially acceptable time, but once sleep ensues…is reported to be normal”
Generally, individuals with DSPD have:
- sleep onset times that are consistent across days;
- little or no difficulty in maintaining sleep;
- extreme difficulty in waking up;
- severe to absolute inability to advance sleep onset to an earlier time by enforcing conventional sleep and wake times.
Basically their timing is off. If given the opportunity, a person with DSPD wants to move through the same sleep cycles as a typical person but this is out of line with what is expected of them for school, work and other activities. For example, the average adult sleep cycle might go from 11pm until 7am, whereas someone with a Delayed Sleep Phase Disorder might (want to) sleep from 3am until 11am.
Another common sleep disorder is Insomnia. This is characterised by the following:
- the individual has adequate opportunity to sleep the required number of hours;
- the person complains of sleeping badly;
- the person takes more than 30 minutes to fall asleep or wakes up in the middle of the night and is awake for more than 30 minutes;
- the problems with sleep have been ongoing for a considerable amount of time (months rather than days);
- the person is suffering impairment in their ability to socialise or perform their daily duties at school or home due to lack of sleep.
How do sleep disorders affect our functioning?
Looking at a person’s brainwaves with an EEG has enabled us to identify particular stages that we move through while we are asleep. Each stage has a different pattern of brainwaves and appears to be responsible for different functions. For example, Stage 3 and Stage 4 are deep sleep phases and are important to maintain good functioning of our lungs and heart. REM (Rapid Eye Movement) sleep is a distinct phase and appears to be important for us in regulating our moods and for cognitions, such as attention, concentration and memory. This is also the phase in which we do our dreaming.
Experts have found that, at the start of our sleep, we tend to have more non-REM (Stages 1 to 4) sleep and we progressively have more REM sleep after we have been asleep for longer. Therefore, if we are waking up too soon or having interrupted sleep, the biggest issue is that our REM sleep is most likely to suffer. This can explain the difficulties we have with maintaining a cheery outlook, a balanced mood, good attention and having the ability to recall things properly when we haven’t been sleeping very well.
Apart from sleep disorders, what else can contribute to sleep problems?
There are a variety of things that might be affecting an adolescent’s ability to sleep. Here are some things to think about…
Are lifestyle factors contributing to your adolescents sleep difficulties?
- Is your adolescent forcing themselves to stay up late in order to complete homework or chat online with friends?
- Does your adolescent indulge in caffeine or sugar late at night?
- Does your adolescent have a part-time job that makes them work late at night? Do they participate in sport late at night?
Are there stresses in your adolescent’s life that are affecting them?
- Work, school, friends or family stresses may be keeping your adolescent awake at night for worry.
- Oftentimes, a patch of bad sleep can turn into a long-term problem because the person then begins to worry about not sleeping.
- The secretion of adrenalin that happens when we worry keeps us awake. In order to help a person who is stressing (about a particular issue) or stressing about not sleeping, we need to help them learn to reduce their anxiety.
Are there environmental issues that might be contributing to difficulty sleeping?
- Consider how much light is in the room, whether there are noise factors, how comfortable the bed is and anything else that might be preventing them from falling asleep.
What can I do to get them back on track?
Below are some tips to help your adolescent manage their sleep patterns better….
- Experts recommend at least two hours without screens before bedtime in order to help our brains unwind. There is also some evidence to suggest that the light from screens can affect our sleep patterns (especially the level of the hormone, melatonin). Although turning off TVs and computer for TWO hours before bed can be a little unrealistic, see if your teenager can manage 30 – 60 minutes without them and can take it on as a bit of a challenge.
- Encourage your teenager to keep regular sleep/wake times, even on the weekends and on school holidays (within reason!). This doesn’t necessarily mean getting up at 6.30am on a Sunday, but an 8am wake time would be better than sleeping in until midday.
- Having sunlight in the eyes first thing in the morning will also help with melatonin levels (the hormone that regulates sleep/wake times) and should help teenagers get out of bed more easily. It is recommended by experts that we sit outside for 15 – 30 minutes in the morning straight after waking. Your teenager could try sitting outside to have breakfast in summer and even sitting near a window or opening the blinds in their room can be an alternative in wintertime. Sitting outside, even on a cloudy day, is much better than turning on an artificial light when it comes to the levels of blue light, which helps our bodies know what time it is.
- Consider whether your teenager has been feeling stressed recently or is experiencing anxiety that may be contributing to sleep problems. Do they need help with time-management to ensure they are not finishing off homework late at night? Could they use assistance in learning relaxation strategies or other techniques to manage stress or anxiety? If you think such issues may be related to their sleep problems, consider seeking help from a psychologist.
- Lastly, if your teenager continues to have difficulty with sleeping that is affecting their ability to function on a daily basis, it may be worthwhile talking to your GP or taking your teenager to a Sleep Clinic.
Australiasian Sleep Association: http://www.sleep.org.au/
Melbourne Sleep Disorders Centre: http://msdc.com.au/MSDC/Home.html
If you would like some help managing your child’s sleep difficulties – particularly in relation to underlying emotional issues such as anxiety – please get in touch.