Having worked with adolescents for the past twenty years, it’s been impossible not to notice an epidemic of disrupted sleep patterns in recent years. While many students attending treatment programs are sleep deprived due to depression or anxiety, many also seem to have increased depression and anxiety due to inadequate or poor quality sleep. Regardless of whether, in chicken and egg terms, the sleep disorder came first or the emotional disorder came first, the two can create a self-reinforcing cycle with severe consequences. Other causes of sleep deprivation may be environmental or behavioral rather than emotional. But whatever the cause, recent studies link sleep deprivation not only to daytime grumpiness, but to adolescent obesity, drug use, depression, school failure and even suicide.
Some adolescents are prescribed medications to address sleeplessness, which can be a viable therapeutic solution for short-term sleeplessness caused by emotional disturbance or to reset poor sleep habits formed over time. But medication can also carry with it side effects including nightmares, daytime grogginess, abuse and dependency. When practicable, alternatives or complements to medication—described at the end of this article—can be a more effective long-term solution than medication. Understanding the root cause, or causes, of your teen’s sleep deprivations can help you, your doctor and your psychologist make informed decisions about what strategies to employ to help your child get the sleep she needs.
What Causes Teen Sleep Deprivation?
Technology and Social Networks
Many teens stay up late to meet with peers online for gaming, chat rooms, texting sessions and other phone or computer based activities. Studies indicate that the timing of these sessions is a socially contagious phenomenon and the trend in many social circles is toward late-night interaction. Adolescents may also be more inclined to late-night technology use when it includes topics or behaviors they wish to hide from their parents, such as talking to a forbidden boyfriend, communicating with a negative peer group, discussing drug and alcohol use, engaging in mature gaming, or viewing pornography.
Depression and Anxiety
While depression is sometimes the cause of extreme drowsiness and excessive sleeping, it can also lead to poor quality of sleep and/or the inability to fall asleep or to stay asleep. Anxiety, which is often directly linked with depression, also can severely disrupt the quality and duration of sleep. This resultant lack of sleep can exacerbate the depression and/or anxiety, leading to a downward emotional spiral.
Drug use can itself cause sleeplessness or sleep disruption. At the same time, sleep deprivation—whether caused by an emotional disturbance, computer use or another issue—is sometimes addressed by adolescents through self-medication. Many of the social networks that teens engage late at night encourage the use of drugs—especially marijuana—as a sleep aid, according to a study out of UCSD and Harvard University. Because of the socially contagious nature of such behaviors adolescents are much more vulnerable to self-medication when they participate in a social network that encourages it. Regardless of which comes first, the cycle of insomnia and drug abuse is self perpetuating.
A field study of middle school and high school students published in the scholarly journal, Neuroendocrinology Letters, found that inadequate or poorly timed exposure to natural light in the morning can also lead to insomnia. Improper sunlight exposure (specifically blue light) delays the production of melatonin which in turn delays the onset of sleep. The phenomenon, called “night owl syndrome” by researchers, is associated with lower academic performance and other problems. Schools are using this data to inform changes in school schedules and building design in order to ensure that students get more exposure to sunlight at the right times.
Some adolescents are exhausted in the morning and throughout the day because they have been out for much of the night. Young people who have been forbidden to see a certain peer group, boyfriend or friend may routinely slip out at night if inadequately supervised. This can go on for days, weeks or months without being detected by parents.
What to Do?
In general, a short-term medication regimen is recommended primarily for sleeplessness caused by anxiety or depression. Even in these cases, medication alone is seldom the entire solution; therapy to address the root causes of the anxiety or depression is generally recommended in conjunction with medication. Other causes of sleeplessness tend to be behavioral in nature and are best addressed through a strategy designed to address the root behavior. Often—as in the case of late night computer use or sneaking out—this means reclaiming a level of parental oversight and benevolent control that may not be welcome!
In some situations this may mean putting parameters around telephone and computer use, and physically controlling those items after hours if agreements are violated. Some parents may even install computer programs to help them monitor their child’s computer use and sites visited. In the case of sneaking-out behavior, window and door sensors or sporadic bedroom checks may be the only way to monitor behavior so that violations can be addressed through a combination of discussion, consequences and possibly therapeutic intervention. In the case of poorly timed light exposure, new family habits involving different waking times and early morning walks might be a smart strategy.
Whatever the cause of adolescent sleep deprivation, it’s important to know that it can have much more serious and far-reaching consequences than previously imagined. Adolescent obesity, drug abuse, depression, school failure, anxiety, and suicidal thinking are all linked to inadequate or poor-quality sleep. It’s also important to engage the appropriate resources to help you understand the nature of your child’s sleep deprivation and to provide the proper support and intervention. Making your own careful observations, talking to your child, and engaging the services of both a physician and psychologist are great places to start if your adolescent shows signs of sleep deprivation.