Written By Terese Amble, PsyD, DBSM, LP
Pediatric Psychologist, Children's Minnesota
Chronic sleep deprivation among teenagers is increasingly common and an important public health issue. The recommended sleep amount for teenagers is between 8-10 hours with 8.5-9.25 hours being optimal for most. However, according to the 2006 National Sleep Foundation’s Sleep in America Poll, the organization’s most recent nationwide survey that focused exclusively on adolescent sleep, teenagers get an average of only 7.6 hours of sleep on school nights with notable differences by grade (about 8 ½ hours for 6thgraders and just shy of 7 hours for 12th graders). More recently, the Centers for Disease Control and Prevention (CDC) analyzed data from the 2015 Youth Risk Behavior Survey and found that nationwide 58% of middle schoolers and 73% of high schoolers reported getting less than the bare minimum recommendation of 8 hours of sleep on school nights.
So, unarguably teenagers are not getting enough sleep. But, why?
A number of complex and interrelated factors contribute to the late to bed and early to rise pattern we see in adolescent sleep. Although many would believe teenagers are losing out on sleep simply because they are up late on electronics and socializing with friends, the reality is that biologically driven changes strongly contribute to the later sleep schedule we see during adolescence.
At about the time of puberty onset, adolescents begin to experience about a 2 hour physiologically based “phase delay” in their circadian rhythm (their internal biological sleep clock) both due to delayed timing of nightly melatonin secretion (the hormone that helps promote sleep) and a slowed accumulation of sleep pressure throughout the day. Sleep pressure builds more slowly during the day for teens, which means they don’t start to feel sleepy until later in the evening making falling asleep at an earlier time difficult. Most teens are not ready to fall asleep before 10:30/11:00 p.m. These biological changes then collide with other factors that contribute to sleep loss for teens, including increased media use (both for social and academic reasons), more autonomy and less parental awareness of sleep schedules/habits, the seemingly ever increasing academic, social and extracurricular demands placed on teens, increasing mental health concerns and, importantly, school start times that are often much too early given what we know about adolescent sleep. Early school start times contribute to sleep loss and a disruption to an adolescent’s natural sleep rhythm with teens disproportionately losing out on the important dream-rich, rapid eye movement (REM) stage of sleep that dominates in the early morning hours. Notably, REM sleep plays an important role in memory consolidation and learning, both of which are critical for academic success.
In combination, all of these factors contribute to a “perfect storm” with our teenagers chronically getting far less than the recommended sleep they need to support their physical and mental health and academic success. In 2014, the American Academy of Pediatrics rightfully declared chronic sleep deprivation among teenagers a public health epidemic and recommended that middle and high schools start no earlier than 8:30 a.m. for the sake of adolescent’s sleep, health, learning, safety and quality of life.
Chronic sleep deprivation affects every aspect of a teenager’s functioning. Sleep deprivation increases the likelihood that teens will suffer a wide range of negative consequences including lower academic achievement, poorer school attendance, increased dropout rates, neurocognitive deficits (increased problems with focus/attention, memory and executive functioning), increased behavior problems (poorer impulse control and increased risk taking behaviors), increased rates of “drowsy-driving” accidents, increased rates of anxiety, depression and suicidality, lower levels of physical activity, increased obesity, decreased motivation and increased vulnerability to stress. Without a question our teenager’s mental and physical health are suffering from chronic insufficient sleep.
Although a number of factors negatively impact middle and high school students’ ability to obtain sufficient sleep, the evidence strongly implicates earlier school start times (i.e. before 8:30am) as a key modifiable contributor to insufficient sleep, as well as circadian rhythm disruption in this population. Furthermore, a substantial body of research has now demonstrated that delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety and academic achievement.
Multiple studies have demonstrated the numerous benefits of changing to a later school start time including (but not limited to) increased sleep (countering skeptics who argued that students would respond to later school start times by just going to bed later and getting the same amount of sleep), decreased daytime sleepiness/fatigue, improved academic outcomes, reduced tardiness, increased attendance, higher graduation rates, decreased rates of depression, less frequent drowsy driving and fewer motor vehicle accidents.
We all want the very best for our students. Joining together as a district to implement healthier school start times in our middle schools and high school can have far-reaching, significant positive benefits for our teenage students, from increased academic engagement and success to improved physical and mental health.
