Wondering How Lack of Sleep is Affecting your Teen?
By Dr. Eleanor McGlinchey
Not getting enough sleep for school
Picture yourself in this scenario: you are juggling multiple jobs. The first is a “desk” job that you are required to attend every day from about 7:30am to 3:30pm. Your other jobs occur before or after your “desk” job and include working as a competitive musician and as a cashier at your local grocery store. On a good day, you return home at around 5:30pm but then have to do 2-3 hours of additional work for that desk job. All the while, you are still attempting to have a social life, but it happens to be in a high pressure social context where you are expected to be connected 24/7 over social media. Finally, let’s imagine that you are doing all this while severely jet-lagged. You try to fall asleep at night when you “should” but your body is not yet sleepy. However, you then need to wake up for your desk job at what feels like 4:00am. You begin every busy day on very little sleep. Unfortunately, this scenario is not uncommon for many people in our modern society, but even more unfortunate, this is the norm expected for adolescents today.
I was interviewed recently by a high school freshman, Kevin, who was beginning his academic pursuits at a competitive private school in New York City. Kevin was writing an article for his school newspaper on the negative effects of sleep deprivation for adolescent health. He was interested in the topic, but was not hopeful that the article would have any effect on the culture of sleep deprivation in his school. He told me that the principal had warned a group of intelligent and impressionable 8th graders that should they decide to attend this school, they would need to determine how they would succeed by giving up one of three things: grades, friends or sleep.
The culture of this particular private school is not unique (except perhaps in the blatant declaration that students should expect to skimp on sleep). The CDC had previously investigated a few high schools across the country, in light of suicide clusters that have occurred in some competitive high schools over the last few years. The focus of media investigations has largely been on academic demands and mental health problems among the students. Clearly these are important issues; however, a potential missing link to these tragedies may be the lack of sleep that students “must” adhere to in order to succeed.
How sleep affects mental health
Tragically, there has been a sharp rise in suicide rates in the United States population and it is now the second leading cause of death for adolescents ages 15-24. A study, led by Pittsburgh researcher Tina Goldstein in 2008, found that adolescents who had died by suicide had recently reported increased sleep disturbance relative to a group of teens that had not attempted suicide. Similarly, multiple epidemiological studies have found associations between lack of sleep and suicidal ideation and attempts among teens (e.g., McKnight-Eily et al., 2011). Unfortunately, this is not the only potentially fatal trend associated with teenage sleep deprivation. Lack of sleep has also been associated with increased odds of motor vehicle accidents; cigarette, drug, and alcohol abuse; and increased mental and physical health difficulties. We must remind ourselves that “correlation is not causation” (meaning sleep deprivation does not automatically lead to these outcomes). However, these findings highlight the mental, physical, and emotional effects of sleep deprivation and therefore sleep is an underestimated risk factor among adolescents. So, why are teenagers so vulnerable to sleep deprivation?
Is your teen sleep deprived?
One often-overlooked reason for sleep deprivation in teens is the adolescent biology working against middle and high school schedules. Around puberty, adolescents experience a delay in their biological clock that sets sleep timing. They also experience suppression in melatonin, the hormone that helps to signal sleepiness in the body. Evolutionarily speaking, this made sense— There needed to be a strong and relatively fearless group of clan members who could stay up at night to protect the rest of the community. Today, we no longer need our teens to stay awake at night to protect us from wild animals; but their biological tendencies remain and our communities are now forcing adult schedules on adolescents.
The jet-lagged exhaustion that adolescents experience each day is more than what most adults would tolerate. There is now a great deal of evidence suggesting that sleep deprivation sets off a brain-to-body signal that it is sick. This increases your body’s production of proteins designed to fight off infection. These proteins also signal your body that you actually need MORE sleep (hence your body’s desire to sleep more when you have a cold). When you are chronically sleep deprived, the proteins start attacking everything, including healthy cells and neurons, leaving you more susceptible to medical and mental illness.
Keeping tech out of the bedroom - until the morning
The teens I see in my clinical practice are often burnt out. I remember being a teenager and wondering why I couldn’t just adopt an adult sleep and wake schedule. I was fearful that I would never be able to easily wake at 6:30am or 7:00am to get to work. Graciously though, my biology (and every other teenagers) knows that and gradually changes to “adult” sleep patterns between ages 25–35. In the meantime, how can teens achieve better sleep? In the absence of an international mandate for less homework and later school start times, teens can adopt practices that help them sleep soundly. This can include keeping “sleep stealers” like phones and ambient light out of the bedroom. It also means trying to wake at the same time every day, even on the weekends. I know this is an unpopular idea but it can really help to reduce the jet-lagged feeling on Monday mornings. And, go ahead and use those phones or other bright light devices first thing in the morning if it helps the wake-up routine in the morning. Additionally, if parents and others in the household can also follow some of these bedtime and wake-up practices, then everyone reaps the benefits of more and better quality sleep.
As I finished my interview with Kevin, I told him that I believed his school was asking him to put his health and career at risk. He sweetly agreed with me. Two weekdays later, he emailed me a copy of his beautifully written article on sleep deprivation in teens. Sent at 1:30am.
About the Therapist: Dr. Eleanor McGlinchey is a NYS licensed psychologist who believes adolescents deserve the chance for good quality sleep. She advocates for later school start times both locally and nationally. She hopes that teens who choose to work with her on their sleep will feel better rested and ready to take on the day.
Citations:
Goldstein, T. R., Bridge, J. A., & Brent, D. A. (2008). Sleep disturbance preceding completed suicide in adolescents. Journal of consulting and clinical psychology, 76(1), 84.
McKnight-Eily, L. R., Eaton, D. K., Lowry, R., Croft, J. B., Presley-Cantrell, L., & Perry, G. S. (2011). Relationships between hours of sleep and health-risk behaviors in US adolescent students. Preventive medicine, 53(4-5), 271-273.