Building Healthy Sleep Habits in Teens


All of us have been thrown off of our routines over the past year and it’s affected just about every part of our lives at this point. One larger impact we’ve noticed—particularly in our teen patients—are sleep challenges. According to the American Academy of Sleep Medicine and the American Academy of Pediatrics, teens and pre-teens aged 13-18 should get between 8 and 10 hours of sleep each night. However, many parents are struggling to get their teens off their various devices and in bed. In fact, research from the CDC shows that a whopping 73% of teens aren’t getting enough sleep! Why can't they sleep? Why do they need so much? And, how can we break that cycle to help them form better sleep habits? Keep reading!

Why is sleep so important for teens?


Well, speaking generally, teens are developing in some BIG ways mentally, physically, socially, and emotionally. Lack of proper sleep is a catalyst for problems in each of those areas. According to the Sleep Foundation parents and guardians have five areas of focus to consider:


1. Thinking and Academic Achievement

Sleep benefits the brain and promotes attention, memory, and analytical thought. It makes thinking sharper, recognizing the most important information to consolidate learning. Sleep also facilitates expansive thinking that can spur creativity. Whether it’s studying for a test, learning an instrument, or acquiring job skills, sleep is essential for teens.


Given the importance of sleep for brain function, it’s easy to see why teens who don’t get enough sleep tend to suffer from excessive drowsiness and lack of attention that can harm their academic performance.


2. Emotional Health


Most people have experienced how sleep can affect mood, causing irritability and exaggerated emotional reactions. Over time, the consequences can be even greater for teens who are adapting to more independence, responsibility, and new social relationships.


Prolonged sleep loss may negatively affect emotional development, increasing risks for interpersonal conflict as well as more serious mental health problems.


Mental health disorders like anxiety, depression, and bipolar disorder have routinely been linked to poor sleep, and sleep deprivation in teens can increase the risk of suicide. Improving sleep in adolescents may play a role in preventing mental health disorders or reducing their symptoms.


3. Physical Health and Development


Sleep contributes to the effective function of virtually every system of the body. It empowers the immune system, helps regulate hormones, and enables muscle and tissue recovery.


Substantial physical development happens during adolescence and can be negatively affected by a lack of sleep. For example, researchers have found that adolescents who fail to get enough sleep have a troubling metabolic profile that may put them at higher risk of diabetes and long-term cardiovascular problems.


4. Decision Making and Risky Behavior

Sleep deprivation can affect the development of the frontal lobe, a part of the brain that is critical to control impulsive behavior. Not surprisingly, numerous studies have found that teens who don’t get enough sleep are more likely to engage in high-risk behaviors like drunk driving, texting while driving, riding a bicycle without a helmet, and failing to use a seatbelt. Drug and alcohol use, smoking, risky sexual behavior, fighting, and carrying a weapon have also been identified as more likely in teens who get too little sleep.


Behavioral problems can have widespread effects on a teenager’s life, harming their academic performance as well as their relationships with family and friends.


5. Accidents and Injuries


Insufficient sleep in teens can make them prone to accidental injury and even death. Of particular concern is an elevated risk of accidents as a result of drowsy driving. Studies have found that sleep deprivation can reduce reaction times with an effect similar to that of significant alcohol consumption. In teens, the impact of drowsy driving can be amplified by a lack of driving experience and a higher rate of distracted driving.

Why aren't teens sleeping enough?


Below are just a handful of reasons from the Sleep Foundation on why teens may not be getting enough sleep. If you are concerned about your teen's sleep habits, consult your pediatrician!


1. Delayed Sleep Schedule and School Start Times

During adolescence, there is a strong tendency toward being a “night owl,” staying up later at night and sleeping longer into the morning. Experts believe this is a two-fold biological impulse affecting the circadian rhythm and sleep-wake cycle of teens.


First, teens have a sleep drive that builds more slowly, which means they don’t start to feel tired until later in the evening. Second, the body waits longer to start producing melatonin, which is the hormone that helps promote sleep.


If allowed to sleep on their own schedule, many teens would get eight hours or more per night, sleeping from 11 p.m. or midnight until 8 or 9 a.m., but school start times in most school districts force teens to wake up much earlier in the morning. Because of the biological delay in their sleep-wake cycle, many teens simply aren’t able to fall asleep early enough to get eight or more hours of sleep and still arrive at school on time.


With reduced sleep on weekdays, teens may try to catch up by sleeping in on the weekend, but this may exacerbate their delayed sleep schedule and inconsistent nightly rest.


2. Time Pressure


Teens often have their hands full. School assignments, work obligations, household chores, social life, community activities, and sports are just some of the things that can require their time and attention.


With so much to try to fit into each day, many teens don’t allocate sufficient time for sleep. They may stay up late during the week to finish homework or during the weekend when hanging out with friends, both of which can reinforce their night owl schedule.


Pressure to succeed while managing these extensive commitments can be stressful, and excess stress has been known to contribute to sleeping problems and insomnia.


3. Use of Electronic Devices

Electronic devices like cell phones and tablets are ubiquitous among teens, and research, such as the 2014 Sleep in America Poll, finds that 89% or more of teens keep at least one device in their bedroom at night.


Screen time late into the evening can contribute to sleeping problems. Using these devices can keep teens’ brains wired, and incoming notifications can cause disrupted and fragmented sleep. Evidence also points to suppressed melatonin production from exposure to the light from cell phones.


4. Sleep Disorders


Some teens have poor sleep because of an underlying sleep disorder. Adolescents can be affected by obstructive sleep apnea (OSA), which causes repeated pauses in breathing during sleep. OSA frequently causes fragmented sleep and excessive daytime sleepiness.


Though less common, teens can have sleep disorders like Restless Leg Syndrome (RLS), which involves a strong urge to move the limbs when lying down, and narcolepsy, which is a disorder affecting the sleep-wake cycle.


5. Mental Health Problems


Mental health conditions like anxiety and depression can be a challenge to quality sleep in teens as well as adults. Insufficient sleep can contribute to these conditions as well, creating a bidirectional relationship that can worsen both sleep and emotional wellness.


6. Neurodevelopmental Disorders


Neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), can make it harder for teens to sleep well. Lack of sleep may also contribute to more pronounced symptoms of these conditions.

How can I help?


According to the Child Mind Institute, there are 9 techniques to apply to help guide your teen to the quality sleep they REALLY need.


1. Be Consistent with Teenage Sleeping Habits

“Consistency is really, really crucial in terms of building healthy sleep habits,” says Dr. Alison Baker, a child, and adolescent psychiatrist at the Child Mind Institute. That means it’s important for your teen to go to bed as close as possible to the same time every night, and get as close to 8 hours of sleep as possible. But it’s also important for him to stick to the same schedule—within reason—on the weekends.


If a kid’s sleep schedule shifts dramatically on the weekends—staying up most of the night and sleeping until midafternoon Saturday and Sunday—the chances of getting back to normal Sunday night are slim. It’s not easy for kids to resist—no one wants to be the first to leave the party—but the academic, athletic, and social demands of the week have no time for the weekend.


2. Screens Off an Hour Before Bed


Most clinicians, and everyone we talked to, emphasize the importance of turning off all electronic devices a minimum of an hour before the time young people are trying to go to sleep. And it’s more than just excitement. Electronic screens emit a glow called “blue light” at a particular frequency that sends “a signal to the brain which suppresses the production of melatonin and keeps kids from feeling tired,” says Dr. Max Van Gilder, a pediatrician in practice for 40 years. He suggests planning ahead so that homework that needs to be done on a screen is completed by early evening and “off-screen” work is saved for later at night. That also means no “unwinding” by going on Facebook or YouTube.


What’s more, social media is a great place to find new sources of anxiety. Good luck getting to sleep if you’ve just read something socially stressful from your best frenemy.


Dr. Van Gilder also recommends f.lux, a free app that automatically adjusts the light on your computer screen to coincide with the time of day. F.lux automatically removes the stimulating blue light from your computer screen at night so that you’re able to sleep better even if you’ve been up late working on a paper.


And the family can help, too, by altering the home environment. It can be useful to start gradually dimming lights around the house to signal when it’s time to quiet down and start moving towards sleep.


3. Watch the Snacking

Adolescents, many of whom control over their diet for the first time, are prone to eating and drinking on an ersatz schedule, as a means to self-regulate, or to stay awake, or just because they can. But the bag of chips, or the cookies at 1 am, or caffeine any time after dinner—whether or not they help get the essay written—can postpone sleep, and harmfully.


4. Boost the Biological Clock


One of the most significant physiological changes to occur in adolescence is a shift in the production of melatonin, the sleep hormone. Effectively, teens are living in a different time zone than the rest of us. But “that is the normal circadian rhythm for 15-22 year-olds, ” says Dr. Van Gilder. He frequently recommends that teens who have trouble sleeping try taking a low dose (2-3 mg) of melatonin (a non-prescription vitamin that can be purchased at the drugstore) one to two hours before it’s time to go to bed to help jumpstart melatonin production.


5. Simplify


“Overscheduling” and the pressure to build a college resume have pushed many teens beyond what they can reasonably accomplish in the space of a day or a week. “We need to get colleges to revise the message they’re sending,” Dr. Carskadon says. “But the family really is the core. You have to help your child understand that they can’t do a hundred percent of everything.” Kids need you to help them set realistic expectations for their time, and your support and acceptance when approaching the college process.


6. Set a Good Example


“Parents need to model good sleep habits for their teens,” Dr. Baker says. “Staying up all night with your kid to edit his paper or pulling an all-nighter for work yourself isn’t really sending the right message.” Parents who make sleep a priority for themselves show their kids that it’s part of living a healthy lifestyle—like eating right and exercising regularly.


7. Streamline Mornings

While there’s not much you can do about your school’s start time, Dr. Van Gilder says teens should organize their mornings so that they can sleep in “as long as is humanly possible.” Consider showering, picking out clothes, and packing up books before bed so you don’t have to spend time doing it in the morning. “Ask mom or dad to make you an egg sandwich to eat on the bus. Whatever it takes to squeeze in as much sleep as possible and arrive one minute before school starts.”


8. Pump Up Productivity


For the first two years of high school Gabriel Levine, now 19, bought into the pervasive attitude at Hunter College High School that he describes as ” basically, it’s cool to do really well on as little sleep as possible.” Then at the beginning of junior year, he got very interested in the topic of productivity and started reading a lot of studies. “I discovered that a lot of my academic performance could be better by sleeping a full 8 hours than by staying up all night studying. Cognitive functioning is just better with sleep and without it, you sacrifice that.”


Since then, Levine, who just finished his first year at the University of Chicago, has been committed to getting a minimum of 7-8 hours of sleep every night. He managed this in high school, he says, by using the odd bits of time during the day he’d been inclined to blow off as too short to be fruitful. “I’d even work during rehearsals when I wasn’t needed on stage,” he says.


Levine also found that he worked most productively in 45-minute blocks separated by 10-minute breaks to clear his head. “If you break it down into bite-size pieces and use the time you have during the day, you can get a lot done and be a lot more relaxed about the whole thing.”


9. The Bed is For Sleep


Experts agree that it’s easier to fall asleep and stay asleep if you associate the bed with sleeping. That means working in another room you associate with getting work done might get you to the finish line faster, as well as allowing you to shift gears when it’s time for sleep. “Once a place has been unproductive for me, it’s tainted,” says Levine, who doesn’t study in any room that has a bed. “If I’ve gotten really good work done somewhere then I keep going back and the association reinforces the reality.”

Cutting down on distractions also gets one closer to potential sleep time. Kids shouldn’t be logged in to Instagram while they do their chemistry homework. Amazingly, the phone might be a better way to collaborate on homework projects—more direct, less time to dither and chat, more time to get things done.


As always, if you have any concerns about your child's sleep health or any other issues you feel may be related to lack of sleep, please don't hesitate to reach out to your AP pediatrician!

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