Obstacles to Quality Adolescent Sleep

By: Kate Sheppard

Sleep has been on the decline among adolescents since the 1990s with no signs of stopping anytime soon. Recent surveys conducted by the CDC found that 77% of adolescents receive less than 8 hours of sleep a night, a leap up from 68% in 2013. High-quality sleep is associated with a wide array of benefits, including improved academic performance, emotional regulation, memory, and attention. Sleep nevertheless remains an overlooked aspect of student wellness, and a variety of obstacles remain in place for teens looking to get a good night’s rest. 

1. School Start Times

One common barrier for teen’s sleep is school start times. The onset of puberty delays melatonin production, causing teens to grow tired later in the night. They also experience changes in their daily body temperature rhythms. While sleeping, the body’s core becomes cooler, which is why taking a warm bath or sleeping under heavy blankets can act as a sleep aid: when the skin becomes warm, the core cools in response. This natural cooling is delayed among teens, postponing their biological clocks even further. These changes combined with social pressure from peers causes teens’ sleep schedules to shift later and later. School start times, however, tend to creep earlier in middle and high school, imposing a chronic mismatch between a teen’s natural sleep schedule and their student life. When students have trouble falling asleep before 11 PM but are expected to be awake and attending school by 7:30 AM or earlier, they must face the unsolvable quandary of being late or sleep deprived, neither of which contributes to their academic readiness. 

2. Diagnosing Sleep Disorders

The misdiagnosis of sleep disorders is another obstacle to adequate sleep among adolescents. Insomnia—unexplained difficulty falling asleep or staying asleep despite adequate opportunity to do so—is well-documented in adolescents, especially older teens and girls. Insomnia tends to appear with other psychological issues; half of teens with insomnia report having a psychiatric disorder, suggesting that effective diagnosis and treatment of insomnia may improve mental health outcomes. However, the Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5) criteria for insomnia requires that an individual has “adequate opportunity to sleep”, which is not often the case with teens, especially those with early school start times. Proper diagnosis therefore requires analyzing not just a teen’s standard school-year sleep schedule, but also their sleep on weekends and vacations. This obstacle means that doctors may be hesitant to diagnose insomnia in teens, or, if only part of a teens’ schedule is examined, they may incorrectly identify causes of sleeplessness. Even if a teen does get a diagnosis, options for adolescent insomnia are under-researched, meaning they may have ill-fitting choices for treatment. 

3. Teens and Screens

Screen use is often cited as an obstacle to sleep among teens, but this requires some nuance. Many researchers cite light exposure as the reason that screen use delays sleep, but Gradisor et al.’s 2011 study on sleep and screens found that ‘passive’ devices, like TV and music players, do not have a strong correlation with sleep difficulty, while ‘interactive’ technology (video games, etc.) led to delays in bedtime and unrefreshing sleep. This suggests that what teens do on screens matters more than whether or not teens use screens at all. 

4. Sleep Miseducation

Finally, a lack of information on how to improve sleep may be contributing to teen sleep loss. To fill this gap, some schools have introduced sleep education programs, with varying degrees of success. A 2011 review by Blunden et al. found that sleep programs conducted in schools are effective in increasing student knowledge, but do not appear not appear to consistently improve sleep quality and duration, student mood, or levels of physical activity. This suggests that a more holistic approach, including changes to student attitude and feelings of control over sleep, are needed for success.

5. Everyday Strategies

There are a number of habits which teens can implement to improve their sleep quality and duration. These habits include: 

• constructive worrying (helpful especially for teens struggling with insomnia)

• a mindfulness meditation practice

• regular exercise (including team sports, daily walks, and/or going to the gym—whatever is most enjoyable!)

• bright light therapy

• including certain nutrients in daily meals, like:

  • magnesium (found in soy products like tofu, nuts) which is associated with longer sleep times and less tiredness during the day

  • fiber (fruits and vegetables, beans, lentils) which is associated with deeper, more restorative sleep

  • vitamin B6 (poultry, oats, bananas) which helps produce melatonin and serotonin, both of which are critical for sleep

  •  vitamin D (fatty fish like trout, salmon, and tuna) which supports the sleep-wake cycle, also called the circadian rhythm

  • complex carbs (whole grains, starchy vegetables) which are correlated with higher-quality sleep compared with simple carbs like white breads and pastas

It’s important to emphasize that while these tips can be helpful, they are not a cure-all for teen sleep deprivation. Combating the recent surge in sleeplessness will take efforts on all fronts. Without accurate diagnostic processes for sleep disorders, reasonable school start times, and sleep education efforts, we can’t hope for better results. If we try to move forward without these changes, there’s no reason for us to be surprised when kids fall asleep in class, struggle with emotional outbursts, or perform poorly in school. Educators, parents, and policymakers each have a role to play in ensuring teens get the 8 hours a night that makes the 16 hours of the rest of their lives worthwhile.