Positive Health Online

Teenagers and Sleep

In the evening, modern teenagers now face a host of challenges: balancing ever-increasing amounts of homework, real life and online social demands, which is all on top of their natural changing body clock. These challenges encourage teenagers to go to bed later. The natural shift in a teen's circadian rhythms, ‘sleep phase delay’, delays their need to sleep for about two hours. Before puberty, the body becomes naturally sleepy around 8:00pm or 9:00pm. As puberty begins this rhythm shifts a couple of hours later, and as a result, teenagers tend to want to go to sleep around 10:00pm or 11:00pm. This change is often a hard adjustment for a teenager; consequently, the image of a parent struggling to wake their teenager in time for school has become a familiar representation of modern day family life.   

What’s more, with the rise of technology, parents now face an ongoing battle with teenagers using technology late into the night. Persuading teenagers to put appropriate boundaries around their technology is a growing problem. Teenagers typically need on average between 8 and 10 hours sleep; this is now far from the norm during school days.

Indeed, research is showing that teenagers are getting far less than the recommended minimum level. The American National sleep foundation study[1]  found that only 15% of teenagers enjoy 8 ½ hours sleep on school nights; a study from 2013 in the Journal of Sleep Research by Orzech et al[2] showed that only half of teenagers get 9 ½ hours. This study also showed that teenagers who slept less than 7 ½ hours had more illness than those who slept more than this amount. Sleep deprivation increases anxiety, depression and accidents in teens as well as leading to an inability to concentrate at school. Furthermore a report in 2014 by the American Academy of Pediatrics[3] called the problem of teenage sleep a public health epidemic, and recommended that schools started later in the day to help rectify the problem.

The lack of sleep means that teenagers in particular have a reduced amount of REM sleep which is when we dream and process memories according to Dr R Pelayo from the Stanford Sleep Disorders Clinic. This is backed up Shashank Joshi MD (associate Professor of Psychiatry and Behavioral Sciences at Stanford). “Sleep is like a balm for the brain. The better your sleep, the more clearly you can think while awake.”

It seems like technology is at the centre in this crises in Teenagers sleep. In 2008/2009 University of Montreal[4] conducted a study on electronic usage and sleep habits. The conclusions were clear showing that kids who used computers and videogames for more than two hours per day less than youths who used screens for less time. Also that 1/3 of teens were using computers for more than two hours a day with these children twice as likely as the others to sleep less than 8 hours per night. Similarly, teens who talked on the phone for two hours or more a day were three times more likely to sleep less than 8 hours. The result was that these teens reported more sleepiness during the day.

In terms of technology in the bedroom, according to a 2015 report by the Pew Research Centre,[5] 72% of teens bring mobile phones into the bedrooms and use them whilst sleeping, and 28% even leave them on when asleep. A 2011 Poll[6] by the National sleep federation also reported that half of teenagers texted in the hour before bed, and these tech fans reported that they were less refreshed in the morning.

A further study of 10,000 teenagers in Norway in 2015[7] showed that those who used a computer in the hour before bed were three times more likely to get less than 5 hours sleep. In addition, the study showed the use of a computer, smartphone, or Mp3 player in the hour before bedtime was significantly associated with taking longer to fall asleep.

The study also showed that more than four hours of daytime screen time use meant a 49% greater risk of taking longer than 60 minutes to fall asleep.

 The result of this lack of sleep in the weekdays, is that teenagers are out of sync with their biological clocks. In a 1998 survey of more than 3,000 high-school students,[8] for example, psychologists Amy R Wolfson PhD, of the College of the Holy Cross, and Mary A. Carskadon PhD of Brown University Medical School showed that students with higher Grades reported sleeping more in the week. Carskadon also cites sleeps role in appetite, metabolism and weight gain. It affects mood and emotion, and leads to risk behaviours, such as risks in driving, sexual behaviours and drug taking.

Apart from being mentally stimulating and delaying bed time, a major problem of display screens is the specific wavelength of ‘Blue light’ emitted tricks our brain into thinking it’s time to get up. ‘Blue light’ acts like the morning sunlight, which wakes us up by switching off the Melatonin (the sleep hormone) production in the brain. This is the opposite desired effect for the evening time, as to help us sleep Melatonin needs to be switched on in the dark. 

It is disappointing therefore, that recent research from Oxford University [9] (“Quantifying the relations between digital screens and the mental well-being of adolescents”) has shown that hours of screen time can be good for teenagers' brains. What’s more, the study shows that if youngsters spend 4 hours and 17 minutes on computers and online activity this is the perfect amount of time to develop social connections and skills. It is only past this point that screen time begins to affect children’s brain development. The focus of the study is to insist that parents may be over concerned about computers harming their children.

Sadly, from my point of view, this study totally ignores all previous research, which shows that time spent on screens, especially at night, has a detrimental effect on teenagers’ sleep. 

Here are some practical Tips To Help Your Teen Sleep Better

1.  Set a device curfew for all the family
   - Put all devices to bed at least one hour before you go to bed – this includes your mobile phone!
2. Take phones out of the bedroom before bedtime
   In an ideal world we would have no technology (including mobile phones) in the bedroom what so ever. This would reduce the impact of blue light and over stimulation from screens just before sleep. However, this is not practical for modern teenagers who want to talk to friends on their phone after school in their room, and often study in their room in the evening. Parents could set the tone for the household and keep technology out of their room including phones. This then makes it easier to enforce a boundary with teenagers that all phones are removed from the bedroom overnight in order to avoid the temptation to use them (and that technology is switched off early).
3. Reduce blue light
   Dim your computer screen or even better wear glasses that block out blue light
   Install a blue light filtering system such as flux (justgetflux.com) on your computer and electronic devices to reduce blue light Always use the nighttime mode on your devices.
   
   
4. Establish a regular relaxing bedtime routine
   Avoid stimulation close to bedtime
   Ensure all computer games and heavy studying finish early in the evening
   Set a relaxing routine such as reading a novel or having a bath.
5. Exercise and healthy diet
   Avoid caffeine after lunch, as it is a stimulant
   Exercise and a healthy diet will help to support a good night’s sleep.
6. Weekend Lie-ins: Maximum 2 hours
   You can allow your teen to sleep in on the weekend to catch up with sleep
   Don’t let their lie in to be longer than two hours, as this will disrupt the teenage body clock, making it harder to wake up for school on Monday morning.
7. Educate teenagers on how screen usage affects sleep
   Give your teenagers the facts about how screen time stimulation and blue light late at night will both prevent getting to sleep easily and reduce the amount of overall sleep.

References

1. Sleepfoundation.org ‘’Sleep-in-America-poll ‘ Teens-and-sleep. 2006.
2.  Sleep patterns are associated with common illness in adolescents. Orzech et al Journal of sleep research. 2013  
3. Let the sleep. AAP recommends delaying start times of middle and high schools to combat teen sleep deprivation. American Academy of Pediatrics. 2014.
4. Screen and nonscreen sedentary behavior and sleep in adolescents. Jennifer O’Loughlin et al journal Sleep Health. 2012
5. Teens and Technology. Pew Research Centre. 2015
6. National Sleep federation. Commuincations Technology in the Bedroom.  2011.
7. Sleep and the use of electronic devices in adolescence; results from a large population based study. Hysing et al . BMJ 2015
8. Large scale test of the Goldilocks hypothesis: Quantifying the relations between digital screens and the mental well-being of adolescents.
9. Understanding adolescents’ sleep patterns and school performance a critical appraisal. Wolfson et al. Sleep medicine review. Vol 7 no 6. P491-506. 2003