Most teens don't get enough
sleep,
usually because their schedules are overloaded or they spend too much
time texting or chatting on the computer with friends until the wee
hours of the morning. Other teens try to go to sleep early, but sleep
problems prevent them from doing so.
Over time, nights of missed sleep (whether they're caused by a sleep
disorder or simply not scheduling enough time for the necessary ZZZs)
can build into a sleep deficit. Teens with a sleep deficit are unable to
concentrate, study, and work effectively. They can also experience
emotional problems, like depression.
What Happens During Sleep?
As we sleep, our brains pass through five stages of sleep. Together,
stages 1, 2, 3, 4, and REM (rapid eye movement) sleep make up a sleep
cycle. One complete sleep cycle lasts about 90 to 100 minutes. So during
an average night's sleep, a person will experience about four or five
cycles of sleep.
Stages 1 and 2 are periods of light sleep from which a person can
easily be awakened. During these stages, eye movements slow down and
eventually stop, heart and breathing rates slow down, and body
temperature decreases. Stages 3 and 4 are deep sleep stages. It's more
difficult to awaken someone during these stages, and when awakened, a
person will often feel groggy and disoriented for a few minutes. Stages 3
and 4 are the most refreshing of the sleep stages — it is this type of
sleep that we crave when we are very tired.
The final stage of the sleep cycle is known as REM sleep because of
the rapid eye movements that occur during this stage. During REM sleep,
other physical changes take place — breathing becomes rapid, the heart
beats faster, and the limb muscles don't move. This is the stage of
sleep when a person has the most vivid dreams.
What Prevents an Early Bedtime?
Research shows that teens need 8½ to 9½ hours of sleep a night. So, a
teen who wakes up for school at 6 a.m. would have to go to bed at 9
p.m. to reach the 9-hour mark. Studies have found that many teens have
trouble falling asleep that early, though. It's not because they don't
want to sleep. It's because their brains naturally work on later
schedules and aren't ready for bed.
During adolescence, the body's circadian rhythm (an internal
biological clock) is reset, telling a teen to fall asleep later at night
and wake up later in the morning. This change in the circadian rhythm
seems to be due to the fact that the brain hormone melatonin is produced
later at night in teens than it is for kids and adults, making it
harder for teens to fall asleep.
Sometimes this delay in the sleep-wake cycle is so severe that it
affects a person's daily functioning. In those cases it's called delayed
sleep phase syndrome.
Changes in the body clock aren't the only reason teens lose sleep,
though. Read on to learn about some of the biggest causes of sleep
deprivation.
Insomnia
Lots of us have insomnia (trouble falling or staying asleep). The
most common cause of insomnia is stress. But all sorts of things can
lead to insomnia, including physical discomfort (the stuffy nose of a
cold or the pain of a headache, for example), emotional troubles (like
family problems or relationship difficulties), and even an uncomfortable
sleeping environment (a room that's too hot, cold, or noisy).
It's common for teenagers to have insomnia from time to time. But if
insomnia lasts for a month or longer with no relief, doctors consider it
chronic. Chronic insomnia can be caused by a number of different
problems, including medical conditions, mental-health problems,
medication side effects, or substance abuse. Teens with chronic insomnia
can often get help for their condition from a doctor, therapist, or
other counselor.
For some, insomnia can be made worse by worrying about the insomnia
itself. A brief period of insomnia can build into something longer
lasting when someone becomes anxious about not sleeping or worried about
feeling tired the next day. Doctors call this psychophysiologic
insomnia.
Periodic Limb Movement Disorder and Restless Legs Syndrome
Teens with these conditions find their sleep is disrupted by leg (or,
less frequently, arm) movements, leaving them tired or irritable from
lack of sleep.
In the case of periodic limb movement disorder (PLMD), these
movements are involuntary twitches or jerks: They're called involuntary
because the person isn't consciously controlling them and is often
unaware of the movement.
Teens with restless legs syndrome (RLS) actually feel physical
sensations in their limbs, such as tingling, itching, cramping, or
burning. The only way they can relieve these feelings is by moving their
legs or arms to get rid of the discomfort.
Doctors can treat PLMD and RLS with medications. For some teens, treating an iron deficiency can make the conditions go away.
Obstructive Sleep Apnea
This sleep disorder causes a person to stop breathing temporarily during sleep. One common cause of obstructive sleep
apnea
is enlarged tonsils or adenoids (tissues located in the passage that
connects the nose and throat). Being overweight or obese also can lead
someone to develop obstructive sleep apnea.
Teens with obstructive sleep apnea might snore, have difficulty
breathing, and even sweat heavily during sleep. Because it disrupts
sleep, someone with sleep apnea may feel extremely sleepy or irritable
during the day.
Treatment is available for teens with sleep apnea. Those who show
signs of the condition, such as loud snoring or excessive daytime
sleepiness, should be evaluated by a doctor.
Reflux
Gastroesophageal reflux disease (GERD)
is another common culprit of sleep loss. With GERD, stomach acids move
backward up into the esophagus, producing the uncomfortable, burning
sensation known as heartburn.
GERD symptoms can be worse when a person is lying down. Even if
someone doesn't notice the feelings of heartburn during sleep, the
discomfort it causes can still interfere with the sleep cycle. Some
people find they are better able to sleep by lying in an elevated
position or by taking medications.
If your teen suffers from GERD, it could be interfering with his or
her sleep. Talk to a doctor about treatment options or lifestyle
changes, such as changes in diet.
Nightmares
Most teens have
nightmares on occasion. But frequent nightmares can disrupt sleep patterns by waking someone during the night.
Some things can trigger more frequent nightmares, including certain
medications, drugs, or alcohol. Ironically, sleep deprivation also can
be a cause. The most common triggers for more frequent nightmares are
emotional, such as stress or anxiety.
If nightmares are interfering with your teen's sleep, consider consulting a doctor, therapist, or other counselor.
Narcolepsy
Teens with narcolepsy are often very sleepy during the day and have
sleep "attacks" that may make them suddenly fall asleep, lose muscle
control, or see vivid dreamlike images while dozing off or waking up.
Nighttime sleep may be disrupted, with frequent awakenings throughout
the night.
Narcolepsy can be disturbing because teens fall asleep without
warning, making it hazardous to do things like ride a bike or drive. A
teens's schooling, work, or social life can be affected by the unusual
sleep patterns.
Narcolepsy is not commonly diagnosed in teens, although many cases go
unrecognized. People usually begin to have symptoms between the ages of
10 and 25, but might not be properly diagnosed until 10-15 years later.
Doctors usually treat narcolepsy with medications and lifestyle
changes.
Sleepwalking
It's rare for teens to walk in their sleep; most sleepwalkers are children.
Sleepwalking
may run in families. It tends to happen most often when a person is
sick, has a fever, is not getting enough sleep, or is feeling stress.
Because most sleepwalkers don't sleepwalk often, it's not usually a
serious problem. Sleepwalkers tend to go back to bed on their own and
don't usually remember sleepwalking. (Sleepwalking often happens during
the deeper sleep that takes place during stages 3 and 4 of the sleep
cycle.)
Sometimes, though, a sleepwalker will need help moving around
obstacles and getting back to bed. It's also true that waking
sleepwalkers can startle them (but it isn't harmful), so try to guide a
sleepwalker back to bed gently.
How to Help
If your teen seems to be getting enough rest at night but is still
feeling tired during the day, it's a good idea to visit the doctor.
Excessive tiredness can be caused by all sorts of health problems, not
just difficulties with sleep.
If a sleep problem is suspected, the doctor will evaluate your teen's
overall health and sleep habits. In addition to doing a physical
examination, the doctor will take a medical history by asking about any
concerns and symptoms your teen has, and about his or her past health,
your family's health, and any medications your teen is taking. The
doctor may also do tests to find out whether any conditions — such as
obstructive sleep apnea — might be interfering with sleep.
Different sleep problems are treated differently. Some can be treated
with medications, whereas others can be helped by special techniques
such as light therapy (where someone sits in front of a lightbox for a
certain amount of time each day) or other practices that can help reset a
person's body clock.
When teens have sleep problems, doctors often encourage them to make
lifestyle changes — like turning off the cell phone or computer before
bed, cutting down on caffeine, or avoiding violent video games or movies
at night — to promote good sleeping habits.
