Sleep Guide For Teens
The teenage years are known to be tumultuous. During this phase of life, people go through profound physical and emotional changes along with major transitions in schooling and social relationships.
During this complicated period, sleep plays a central role in virtually all aspects of health and well-being, and lack of sleep can have far-reaching consequences. Unfortunately, numerous factors, including fundamental biological changes related to circadian rhythms, make getting adequate sleep a serious problem for teenagers.
As a result, data has shown that sleeping problems are commonplace. A survey by the National Sleep Foundation found that 59% of 6th through 8th graders and 87% of high schoolers in the United States were sleeping less than is recommended. To add insult to injury, parents dramatically underestimated the extent to which their teenage children struggled with sleep.
This guide provides the information that teenagers, parents, educators, and others who work with teens need to know about sleep during this stage of life. It explains how much sleep teenagers need, why that sleep is important, the challenges to getting enough quality sleep, and tips for getting better rest each night.
Teenagers and Sleep
It’s widely accepted that sleep is vital at all stages of life, but it can be easy to overlook how sleep needs and the impacts of sleep loss change during different points in life. The teenage years are a unique time during which the role of sleep has some notable differences than in other phases of life.
How Much Sleep Do Teens Need?
According to researchers and experts, the optimal amount of sleep for teenagers is between 8.5 and 9.5 hours per night.
For decades, it was assumed that a person’s sleep needs decreased significantly as they moved from childhood into adolescence. In the late 1970s and early 1980s, however, researchers began to discover that, in fact, teenagers still required the same amount of sleep for healthy functioning.
Multi-year studies of adolescents illustrated that though they might seem able to get by with fewer hours of rest in any given day, their lack of sleep accumulated into a sleep debt that could create myriad problems during this important time of physical, mental, and emotional development.
Why is Sleep Important for Teens?
Sleep science is still a developing field, yet the more that is learned, the greater the realization that sleep influences virtually all aspects of a person’s well-being. This is certainly true during the teenage years, and research has identified a number of specific ways in which the quality of a teen’s sleep can have huge consequences.
Sleep is a time for the brain to rest, recharge, and to consolidate thoughts and memories. When sleep is disturbed, it can harm cognitive function in a handful of ways. While this can happen at any age, the impacts can be magnified for teens whose brains are still developing and who are learning and maturing at a high rate.
Without quality sleep, teens have reduced memory and problem-solving skills, harming their ability to engage in higher-level learning. Not surprisingly, studies have found that this can have a direct effect on grades and standardized test scores.
Lack of sleep poses tremendous problems for emotional well-being. Getting sufficient sleep is important for mood regulation. Teens who suffer from poor sleep have reduced emotional resilience and a higher prevalence of anxiety as well as mood disorders like depression and bipolar disorder. Studies have also found considerably higher rates of thoughts of suicide and suicide attempts among teens with significant sleeping problems.
Unfortunately, these mental health conditions can create further complications for sleep, exacerbating symptoms and sleep disturbances. There is an indication, though, that getting good sleep can combat the initiation or severity of these mental health disorders.
The rest that the body gets during sleep is essential for physical growth and the effective recuperation and development of various systems of the body. Lack of sleep in teens has been associated with changes in appetite and metabolism that can contribute to weight gain. Poor sleep can create sluggishness and fatigue, increase acne and skin problems, and cause cardiovascular changes that elevate the risk of diabetes, high blood pressure, and heart disease. Recent research has found that adolescent insomnia may be tied to the eating disorder anorexia nervosa.
Risk of Accidents
The drowsiness and lack of concentration that can come with poor sleep increase the risk of all types of accidents. Most worrisome are auto accidents because these can be life-threatening for teen drivers and others on the road. Being sleepy behind the wheel is a problem at any age, but because many teens are new to driving and have been found to be more susceptible to distractions when driving, this can be especially dangerous.
Lack of sleep can increase impulsive decision-making in adults and teens. This is because sleep disruptions inhibit the effective functioning of the frontal lobe, the part of the brain that powers impulse control. In teens, though, the frontal lobe is still developing, so they are already predisposed to riskier and more impulsive decisions. When combined with a lack of sleep, this can contribute to high-risk behavior related to driving, sex, and the use of drugs and alcohol.
What Are Common Sleep Problems For Teens?
A significant percentage of teenagers report sleeping less than the recommended 8.5 to 9.5 hours per night. Unfortunately, this is not a problem that occurs just every once in awhile; instead, studies have found that 23.8% of adolescents meet the diagnostic criteria of insomnia that involves more serious and persistent sleeping problems. Some researchers estimate that figure to be even higher, and for many, insomnia is chronic and can reach the more severe level of the condition known as an insomnia disorder.
For reasons that are still not fully understood, adolescent and teenage girls tend to have higher rates of insomnia than boys. As studies continue to reveal new findings about teens and sleep, researchers hope to discover ways to better address this pressing problem. In the meantime, it is known that both girls and boys confront significant sleep issues during their teenage years.
The cause or causes of sleeping problems for teenagers can be different for every individual. Despite this, research has uncovered patterns in sleep disruptions and identified some of the most prominent factors that can cause poor sleep and insomnia in teens.
Circadian Rhythm Shifts
A central issue in the sleep problems facing teens is a change in their circadian rhythm that usually begins around the start of puberty. The circadian rhythm helps align the body’s schedule to regulate all types of functions of the body, including sleep. Ideally, a person’s circadian rhythm is closely aligned with the day-night cycle as this enables easier and healthier patterns of going to bed and waking up each day.
- Delayed melatonin production: in teens, the body does not start producing melatonin until considerably later in the day. Melatonin is a naturally-produced hormone that promotes relaxation and sleep, so this shift pushes back the time when a teenager is able to fall asleep and stay asleep.
- Altered sleep drive: every person has both a drive for wakefulness and sleep. These two drives can be constantly shifting, and when the balance moves toward one or the other, you can feel much more alert or drowsy. In teens, the sleep drive builds more gradually through the day, reducing the desire and perceived need for sleep until later at night.
The combination of these two factors pushes the daily sleep schedule of most teens back by around two hours. For this reason, many teens feel like “night owls” that prefer to go to bed later and sleep longer in the morning.
Theoretically, teens could simply shift their day to accommodate this sleep phase delay in order to get the total hours of sleep that they need. The reality is that school obligations frequently make that impossible.
Most middle and high schools in the United States have early start times. Only a small percentage of schools start after 8:30 a.m., and many begin classes before 8 a.m. In order to be ready for school and arrive on time, teens have to wake up far earlier than their biological clock would dictate.
As a result, most teens get insufficient sleep during the week and suffer from the effects of sleep deprivation in school. Lack of sleep each night accumulates into a sleep debt or deficit, and many teens try to “catch up” by sleeping in on weekends. While this helps boost their total sleep hours, it furthers the disruption and inconsistency in their circadian rhythm, locking them into a cycle of consistently poor sleep.
The American Academy of Pediatrics (AAP), the leading professional organization for doctors who treat children, has decried early start times as a “critical contributor to chronic sleep deprivation among American adolescents.” Because of the consequences of sleep deprivation in teens, AAP has called on school districts nationwide to push back start times to try to reduce this fundamental misalignment between school schedules and the circadian rhythms of teens.
Teenagers face significant demands on their time, including the requirements of school assignments, extracurricular programs, work obligations, sports, community activities (including in religious organizations), and social commitments. Many teenagers are developing their academic and personal interests as well as their social relationships, and these activities take time.
These time demands can negatively impact sleep in several ways. Teens may give priority to these activities, viewing them as more important and with more tangible benefits that getting adequate sleep. Working or studying may push a teen’s bedtime even later, compounding their nightly sleep deficit.
On weekends, teens may opt for social activities that involve going to bed later or waking up earlier, circumventing the opportunity to catch up on sleep lost during the school week and further compounding circadian disruptions. Some experts have labeled this effect “social jet lag.”
In addition, the pressure to meet an abundance of school, work, family, social, and community obligations can lead to anxiety and stress that further complicates getting quality sleep.
A shifting biological clock provides a significant challenge for sleep, but that challenge is amplified by the near-constant presence of electronic devices in the lives of most American teens.
In 2015, the Pew Research Center estimated that 92% of teens in the U.S. have smartphones. The use of these devices may be non-stop, including in bed. Over 70% of teens keep their smartphone with them in their bedrooms. Other devices like tablets, music players, video game consoles, and laptops are popular and often used in the hours leading up to bedtime.
This pervasive use of electronic devices can have perilous effects on sleep. Many such devices emit blue light that can suppress the production of melatonin. The mental stimulation from using these devices before bed can make it harder for the mind to relax and be ready for sleep, pushing bedtime back even further. Having a mobile phone nearby at night can also lead to being awoken by an incoming call, message, or other notification.
The extensive obligations that teens encounter in numerous aspects of their lives can create significant stress that interferes with sleep. In a 2014 survey, 27% of teens described having high levels of stress that was most often caused by school and worries about college and what to do after high school.
Stress can contribute to sleeping problems, and in adults, it has been found that the perceived lack of control over stress makes a person at a higher risk of insomnia. A similar effect may occur in teens, especially since they may have less developed skills for coping with stress. This connection between stress and insomnia may be of particular concern for teenage girls who face some unique stressors and challenges to emotional resilience.
Anxiety and Depression
Anxiety and depression have a bidirectional relationship with sleep in both adolescents and adults. Not getting enough sleep can make people more prone to developing these mental health conditions, and at the same time, these conditions can make it harder to get quality sleep.
In many teens, anxiety and depression occur alongside sleeping problems. While it is not always possible to identify which developed first, the presence of these coexisting issues creates an additional barrier to good sleep for many teenagers.
In order to combat the sleepiness that can occur because of reduced total sleep time during the week, many teens, like adults, turn to caffeine for a boost of energy and alertness. While coffee is the most well-known caffeinated beverage, a growing number of teens -- reportedly over 30% -- are turning to energy drinks.
Energy drinks are frequently marketed to teenagers and are a rapidly expanding product category. These beverages can have extremely high levels of caffeine, including in relation to coffee or tea, and their increased consumption, especially later in the day, may further contribute to abnormal sleep schedules among teens.
ADHD and Neurodevelopmental Disorders
Neurodevelopmental disorders affect a person’s ability to acquire or apply skills or types of information. A number of these disorders can create challenges for teens when it comes to getting quality sleep.
One of the most well-known neurodevelopmental disorders is attention-deficit/hyperactivity disorder (ADHD). People with ADHD exhibit reduced attention span, heightened activity levels, and increased impulsivity. ADHD affects 11% of school-aged children. It is frequently diagnosed before age 12 but can last into teenage years and adulthood.
ADHD has a complex connection to sleep people with ADHD frequently report sleeping problems, and lack of sleep appears to contribute to ADHD symptoms.
Autism spectrum disorder (ASD) is another type of neurodevelopmental disorder that affects about 2 million people in the United States. It also has a well-established negative effect on sleep, with 44 to 83 percent of children with the condition experiencing sleep issues. As with ADHD, reduced sleep can lead to more pronounced symptoms for people with ASD.
Other Sleep Disorders
Some sleep disorders are typically thought of as affecting adults but can cause consistent problems for children and adolescents as well.
Obstructive Sleep Apnea
Obstructive sleep apnea (OSA) is a sleep disorder that is caused when the airway in the back of the throat becomes repeatedly blocked at night. Those blockages cause a person to suffer temporary lapses in breathing, known as apneas, each night. These pauses in breathing can cause multiple awakenings, worsened sleep quality, and excessive daytime sleepiness. OSA has also been associated with other health complications including depression and cardiovascular disease.
The exact rate of OSA in teens is unknown, but it is known to be a factor that can contribute to poor sleep in children as it does in adults. Obesity, which has become more common in young people, increases the risk of OSA in both adults and children.
Restless Leg Syndrome
Restless Leg Syndrome (RLS) is a condition that is identified by a strong urge to move the limbs, especially the legs, when at rest. It is believed to affect about 2% of teenagers, and it frequently causes sleeping problems. Nearly 70% of children and adolescents with RLS report sleep disturbances.
Narcolepsy is a sleep disorder in which a person suffers from sudden bouts of extreme drowsiness and may fall asleep without warning or in inappropriate places. Other symptoms can include vivid dreams or temporary paralysis when first getting to sleep, fragmented sleep, and loss of muscle function in response to emotional stimuli. It is estimated that one third of people with narcolepsy are diagnosed before age 15.
Parasomnias are abnormal behaviors that occur during sleep. Examples include sleepwalking, extreme nightmares, hallucinations, sleep paralysis, and many others. Parasomnias can lead to sleep disruptions and less restful sleep and can affect children and teenagers.
How Can Teens Get Better Sleep?
Given the multifaceted challenges that can complicate teenagers’ sleep, it’s impossible to say that there’s one clear-cut strategy to improve sleep that works for everyone. In this section, we discuss a number of approaches to sleep improvement, and these can be tried out and adapted to best fit any specific person’s situation.
Work With a Doctor
A family doctor or pediatrician can play a helpful role in improving sleep in teens. If sleep problems are tied to an underlying health issue or disorder, the doctor can help devise a treatment plan that can bring relief. In some cases, medications may be prescribed to help with sleep problems, although many medications, including prescription drugs and supplements like melatonin, have not been studied as extensively in youth as in adults.
Consulting with a pediatrician can help reinforce the importance of sleep for many teenagers who may otherwise be inclined to sacrifice sleep or view it as a low priority. This can work hand-in-hand with efforts by parents and educators.
When appropriate, a doctor can make a referral to other specialists who may be able to assist with sleep problems. For example, if OSA is suspected, more advanced testing can be conducted in a sleep lab. Or a doctor can make a referral to a psychiatrist if mental health issues are a cause or consequence of sleep disturbances.
Cognitive behavioral therapy for insomnia (CBT-I) is a specialized type of talk therapy that focuses on recalibrating the way that a person thinks about sleep. By eliminating negative thoughts around sleep and encouraging healthier sleep habits, CBT-I can be a part of improving sleep over the long-term. CBT-I has shown promise in teens and has been tailored to help people who have sleep problems that coexist with other problems like depression or anxiety.
Work With People at School
Parents and teens can both work to lobby school officials to change start times to better suit the needs of teenagers. While this type of change does not happen overnight, the fact that the American Academy of Pediatrics has promoted change can influence leaders at the school district level.
When school start times cannot be changed, parents can coordinate with teachers, coaches, and other educators to try to make them aware of the sleep needs of teens. Schedules for activities can take these needs into account, and educators may be able to further emphasize the message that teens should make sleep a priority.
Improve Sleep Hygiene
Teenagers can’t change their biological clock, but they can modify their sleep hygiene, which has to do with their sleep setting and their habits. Sleep hygiene improvements are one of the easiest and most effective ways to remove barriers to quality sleep.
A Better Sleep Environment
To make the most of their sleep environment, there are several steps that teens should consider:
- Make the bedroom an electronics-free zone: use of devices like mobile phones, laptops, and tablets interferes with sleep in multiple ways, and keeping these devices out of the bedroom can eliminate one of the biggest disruptors of teen sleep.
- Keep your bedroom dark: beyond just electronic devices, consider the light levels in the bedroom. For bedside lamps and night lights, use low-wattage bulbs. Blackout curtains can block exterior light, and an eye mask can be used to keep out all types of light.
- Reduce bedroom noise: falling asleep is more difficult if there is loud or distracting noise. Try to reduce external noise pollution, and when that isn’t possible, consider the use of earplugs or a white noise machine.
- Establish a comfortable temperature: most studies have found that a cool temperature is best for the bedroom, but teens can try out different thermostat settings to find what makes them most comfortable and able to drift to sleep.
- Pick a good mattress and pillow: when you lie down in bed, you’re counting on your mattress to be comfortable. It also needs to support your body to avoid problems with back pain. For that reason, choose a quality mattress and a pillow that can keep you sleeping soundly.
- Complement your mattress with quality bedding: it’s important to choose a good mattress and pillow, but good bedding -- including sheets and a comforter -- can make a bed more inviting.
Better Sleep-Related Habits
Building up sleep hygiene requires thinking about habits and routines both during the day and closer to bedtime. Some ways to improve these habits to facilitate sleep include:
- Set a time for going to bed and waking up: a consistent schedule can contribute to positive sleep hygiene. It may be tempting to operate without a bedtime, but this can make it hard for your body to get accustomed to regular sleep. Try to pick a stable bedtime and wake-up time, and ideally, stick with those times even on weekends. Even though many teens may find that it goes against their desire for independence, there is evidence that bedtimes set by parents have the best outcomes for sleep.
- Have a routine to get ready for bed: just like an athlete gets ready for a game by following the same routine, you can do the same with bedtime. Steps might include brushing your teeth, stretching, or preparing your backpack for the morning, but it’s really up to you. The key is to follow the same steps every night as a signal to your mind and body that bedtime is approaching.
- Get some sun every day: light exposure plays a role in our biological clock, and getting daily sunlight can be beneficial in regulating the circadian rhythm.
- Reduce caffeine intake: as tempting as it is to drink coffee or energy drinks throughout the day, this can backfire and make it harder to get to sleep. Keep caffeine consumption moderate and long before bed.
- Don’t smoke or drink: nicotine and alcohol can both have negative effects on sleep and can contribute to numerous other health problems as well.
- Don’t do homework or watch TV in bed: it can help to fall asleep if your bed triggers thoughts of rest. For this reason, experts advise that no activities besides sleep -- including schoolwork, watching TV, or playing video games -- be done in bed.
- Exercise every day: not only is exercise healthy, it also promotes better sleep.
- Be judicious with naps: naps may help you feel refreshed, but they can create circadian rhythm disruptions. If you need to nap, keep it short and as early in the day as possible.
Learn More About Teens and Sleep
For more resources about teen health, sleep, and the conditions that can influence sleep in teens, check out the following links.
Information and Support
- MedlinePlus: Teens’ Page. This portal for information from MedlinePlus, a service of the U.S. National Library of Medicine, has links to extensive resources related to teen health.
- UCLA Sleep Disorders Center: Sleep and Teens. This page from UCLA Health goes into detail about different factors that can affect teen sleep.
- TeensHealth: How to Talk to Your Doctor. A pediatrician can be a huge help in managing sleeping problems and other health concerns, and this page gives tips for getting the most out of conversations with the doctor.
- American Academy of Family Physicians (AAFP): Teenagers: How to Stay Healthy. This page from AAFP provides useful information about how teens can improve all aspects of their health.
Other Conditions That Can Affect Sleep
- Anxiety and Depression Association of America (ADAA): Support Groups: This page helps people with anxiety and depression find information and get support. It includes useful tips for finding or starting a support group.
- Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD). CHADD offers various types of information and support services to people with ADHD. Services are available online and from their telephone helpline at 1-800-233-4050.
- National Autism Society. This is a U.K.-based group that has resources for parents, caregivers, and others who work with people who have ASD. Online forums can be especially helpful for support and information.
- Restless Legs Syndrome Foundation (RLSF): This foundation is a nonprofit that works to enhance understanding of RLS and continue research into its causes and treatments.
- American Sleep Apnea Association (ASAA): The ASAA strives to reduce the burden of sleep apnea on patients and their loved ones. ASAA supports research, offers information, and tries to assist those who cannot afford equipment for sleep apnea treatment.