2 out of 3 high school students maintain only sleep for 7 hours or less during school nights. What does that mean for their mental health?
For millions of adolescents across the world, sleep deprivation has become a far too common lifestyle. Our team created a guide to discuss the mental health ramifications of sleep loss in teens, and the factors that make it so hard for them to unwind at bedtime.
The Teen Insomnia Epidemic
Although everyone has experienced the inability to sleep at some point, occasionally, transient insomnia can last for a night or two and may be caused by such factors as stress or changes in sleeping habits. For those of us where these sleep symptoms persist, chronic insomnia may last for months or even years and can have a profound impact on your quality of life. Teens are at risk for both transient and chronic insomnia – here’s what parents need to know.
How Much Sleep Do Teens Need?
You may be surprised to learn how common it is for teens to survive on less sleep than they actually need. While every child is unique, and some require less sleep than others, researchers have identified some tell-tale trends. Studies conducted in the United States show that:
- On average, teens need approximately nine hours of sleep on a nightly basis.
- 60% of middle school students (grades 6-8) do not get adequate sleep on school nights.
- More than 70% of high school students (grades 9-12) do not get the recommended hours of sleep each night.
- A whopping 2/3 of high school students report seven hours or less of sleep on school nights.
- Close to 17% of teens clinically classified as insomnia sufferers, meaning that they are unable to fall or stay asleep at least two nights per week for a period of a month or longer.
Below are some possible factors to take into consideration when helping your teen get a more quality sleep.
School schedules generally conflict with the natural bodily rhythms of most growing teenagers. During and after puberty, kids naturally fall asleep later than younger children and older adults. Sending teens to bed early doesn’t usually turn out as expected, as they will lie awake until midnight or later, despite their best efforts at sleep. Considering that most schools in the United States rarely start later than 8 a.m., it’s easy to see how the pubescent years be the first to usher in insomnia symptoms for youngsters.
Approximately 17% of school districts have begun to get the message, moving their start times to 8:30 a.m. or later for middle school and high school students. Experts note that these experiments have been successful, leading to more sleep, fewer car accidents, and even better graduation rates.
Stress is also powerfully linked with insomnia, and most teens are under a large variety of academic and social pressures. Research indicates that 27% of teens report high-stress levels. The most commonly reported source of teen stress is school, at 83%, while 69% of teens are stressed out about getting into college or choosing a life path after high school.
Puberty and gender
Puberty takes its toll on the mind and body, and sleep cycles are a common target during these times of change. In fact, the entire sleep-wake pattern tends to reorient itself, delaying the natural sleep onset and rising times, and shortening the length of time spent in deep sleep. This leads to sleepiness during the day, as well as irregular sleep patterns in which kids may attempt to “catch up” on sleep during the weekend.
Also, the growth spurts associated with puberty can cause “growing pains”, which tend to worsen around bedtime. In extreme cases, some teens may even wake up in the middle of the night from the discomfort. Although they are not dangerous, these pains can contribute to poor sleep quality.
Gender may also play in role in teen sleep deprivation. Girls are more likely than boys to report short sleep duration. This could be due, in part, to sexually unique biological and social factors during puberty. For example, girls tend to have higher overall stress levels and greater reactivity to stress.
Other neurodevelopmental disorders
Research shows that teens with neurodevelopmental disorders may be at increased risk for sleep problems. Disorders such as autism, attention deficit hyperactivity disorder (ADHD), Down syndrome, cerebral palsy and even fetal alcohol syndrome can increase anxiety and make it more difficult for kids to settle into sleep. They can also make it more difficult to maintain sleep throughout the night.
A note on COVID
The COVID-19 pandemic has wreaked havoc on the mental health of citizens across the globe, and teens are no exception. According to a June 2020 Harris Poll, approximately 70% of teens report that the crisis has negatively impacted their mental health. Stress, anxiety and depression, combined with a shift in daily school routines and an associated increase in screen time, make matters worse for teens. Parents need to carve out quality non-screen time with kids, as well as to help them craft unique routines.
The Effect of Insomnia on Teens
Missing an occasional night’s sleep rarely has serious consequences, but chronic insomnia can have a major impact on both physical and mental health in teenagers. Physically, researchers have found that poor sleep can increase teens’ risk for diabetes, obesity and even injuries.
Psychologically, even sleep-deprived kids who do not meet any clinical definitions for mental health problems are likely to suffer from behavior problems and reduced academic performance. They are also at risk for anxiety, depression and feelings of hopelessness. They are more likely to engage in dangerous behaviors like drinking and driving, not using seatbelts, and unprotected sex.
Adolescents are at higher risk of experiencing negative symptoms from poor sleep quality due to the profound developmental changes that occur during this time. They may have struggle with learning and retaining new information, successfully completing tests and assignments, and moderating their emotions in times of heightened stress during the day.
Even younger children who are sleep deprived tend to show large performance gaps when compared to their peers. Losing even one hour of sleep per night can reduce a teen’s school performance to that of a fully rested child two grades below.
Executive function is the ability to process and organize incoming data, focus the mind and filter out extraneous thoughts to prioritize and accomplish tasks. It is an essential skill for success in all aspects of life. Executive functioning begins to develop in early childhood, and it becomes more sophisticated throughout the adolescent years. Unfortunately, sleep problems can interfere with this developmental process, potentially priming kids for difficulties in their future careers or relationships.
Negative mental health outcomes associated with poor sleep
Although you might assume that a minor reduction in sleep carries minimal risks, this is not necessarily true. Even a single hour of lost sleep can have a major impact on kids, and as sleep problems worsen, so do the risks. Every hour of lost sleep raises the likelihood of feeling sad or hopeless by 38%. It also increases the risk of substance abuse by 23%, suicidal thoughts by 42% and suicide attempts by 58%.
Even after researchers accounted for demographics, substance abuse, suicidal ideation and symptoms of depression at the beginning, those who suffered from sleep problems for a year were 20% more likely to have thoughts of suicide, as well as more likely to actually make a suicide attempt.
Of course, not everyone who is sleep deprived becomes suicidal. But in tandem with all the changes of puberty and the intense pressures that many teens feel, a lack of sleep could be enough to heavily offset the balance in teenagers.
Insomnia and depression: a special case
Insomnia and depression are often linked in complicated ways. Here is what you need to know about these linked disorders.
Insomnia and depression comorbidity
Comorbidity the combination of having two or more disorders which occur at the same time. Depression is one of the most common mental health issues among teenagers, and the link between depression and sleep problems are often associated. Studies indicate that more than 70% of children and teens diagnosed with depression also have insomnia or another sleep disorder. For these kids, the cycle of negatively-reinforcing symptoms tend to leave children more severely depressed than those without sleep difficulties.
Insomnia and risk for depression
Additionally, insomnia seems to be a risk factor for developing depression. Kids with chronic trouble sleeping are more likely than their peers who sleep normally to report symptoms of both anxiety and depression. Interestingly, depression does not seem to be a risk factor for insomnia. Kids who report trouble sleeping are more likely to develop depression and even attempt suicide in the future, but thankfully, those with depression are not more likely to develop future insomnia.
Insomnia interferes with depression treatment
Cognitive behavior therapy, or CBT, is an extremely popular and highly effective treatment for many forms of depression. The idea behind it is that our thoughts create our reality, and distorted thought patterns are responsible for our moods. Cognitive behavior therapy focuses on changing both thoughts and behaviors, replacing them with healthier responses to the stresses of daily life.
Unfortunately, insomnia can make CBT less effective, possibly due to the impact of sleep disorders on logical thinking and executive function, as previously mentioned. Kids with chronic trouble sleeping are more likely than those who sleep normally to have their depression recur after completing treatment.
If your teenager has been diagnosed with depression, let their therapist know about any symptoms of insomnia. Mental health professionals are used to dealing with comorbid disorders and may be able to tweak the course of treatment to address both the depression and insomnia simultaneously. This can increase the likelihood of a successful outcome.
Sleep loss can take its toll on even the most logical and thoughtful teenagers. Kids reporting seven hours of sleep or less on school nights are also more likely to report carrying weapons, using marijuana or tobacco, binge drinking, drunk driving, fighting or a myriad of other potentially dangerous behaviors.
The reverse is also true for school districts that have shifted to later morning start times. Students tend to sleep more, have better rates of enrollment and attendance, are less likely to fall asleep in class, show fewer symptoms of depression, and have fewer car accidents. A well-rested teenager is a much more effective, productive and thoughtful human.
Parents are the key
Even in adolescence, parents can still help their children unwind for bed. Everyone is different, but sleep recommendations for the majority of middle school students state they should be sleeping at least nine hours per night, while high school students need a minimum of eight. Setting a bedtime for a high school student may be difficult, but the CDC reports that “adolescents whose parents set bedtimes are more likely to get enough sleep,” suggesting that parents can have an impact on their child’s sleep by lightly enforcing it.
Even if unsuccessfully able to implement a strict bedtime routine, you can still help your child wind down in the evenings by setting a good example. By reducing noise and lowering lights as the evening progresses, avoiding late-night battles over homework or chores, and instead promoting a relaxed environment, parents can find indirect ways to support their child’s healthy sleep hygiene.
Childhood sleep problems into adulthood
It’s never too early to start promoting good sleep habits. Many kids develop chronic sleep problems early in childhood, which may continue throughout life. In fact, early childhood sleep issues may indicate more risk-taking behavior in adolescence, including early use of marijuana, which can in turn lead to insomnia as an adult. Likewise, adolescent sleep issues are linked with a higher risk of depression in adulthood.
There is a bit of a chicken and egg conundrum in the research. Are some people genetically predisposed to sleep problems, depression and substance use? Or does one lead to another? The answers are not so cut and dry. However, the links between these three issues are strong, and the message is clear: Parents should intervene early to help children overcome sleep problems as soon as they’re recognized.
Help your teen cope with stress
Stress reactivity is a response pattern in which a person has a low threshold for stress, notably in situations perceived as threatening. High stress reactivity patterns can produce a strong stress reaction to any perceived discomfort. It makes it harder to think clearly, and switches the brain to self-preservation rather than higher-order emotions such as compassion or empathy. Stress reactivity can develop after traumatic events, but many kids show a natural predisposition to it early on.
We now know that stress reactivity is highly correlated with insomnia, and some experts suggest having younger children assessed for these patterns, if persistent. Theoretically, both stress and insomnia become more pervasive in adolescence, so identifying and intervening early with stress reactive kids could be the first step in preventing sleep disorders into adulthood.
Even in teens without high stress reactivity, worrying right before falling asleep can impact the quality and quantity of sleep. Therefore, parents should try to help kids learn to process stress and worry in healthier ways early in life. Work with them to name their feelings and develop assertive, proactive responses. Encourage them to participate in extracurricular activities. Help them break large tasks into smaller chunks and teach them to reframe negative thoughts. Promote downtime and help them practice for intimidating events such as public speaking.
Create the right environment for sleep
While some people are blessed with the ability to fall asleep anywhere, anytime, the vast majority do better in an environment intentionally designed to support healthy sleep. You generally won’t need to invest in costly room modification, just work with your teenager to make some intelligent tweaks to their routines.
Practice and preach “good sleep hygiene”
Good sleep hygiene is a collection of healthy habits that encourage sleep. Kids are incredibly well-versed as mimicking their parents’ behaviors, so be sure to model these behaviors rather than just telling your teenager what to do. Examples of good sleep hygiene include:
- Exercise regularly, but not right before bed.
- Eat a healthy diet, but limit late-night eating to a light snack.
- Lower fluid intake right before bed
- Go to bed and get up at the same time every day, even on weekends and vacations.
- Create a relaxing bedtime routine such as a hot shower or 30 minutes of reading for pleasure.
- If you don’t fall asleep right away, get out of bed after 20 minutes and do a quiet activity until you feel sleepy.
- Keep your bedroom cool and dark.
Create a comfortable, stress-free space for your child
Help your child create a comfortable and relaxing bedroom space. This can be done in limitless ways, from calming paint colors to soothing essential oils. The internet is filled with easy and inexpensive bedroom ideas — see our 101 Tips for Better Sleep for more ideas. One of the most important investments you can make, though, is a good mattress. Research shows that sleeping on a new, high-quality mattress can reduce nighttime pain, decrease stress and promote better sleep. Mattresses are available in a vast array of types and firmness levels, and comfort is highly subjective, so let your teen choose the mattress that feels right to her.
Get serious about screen time
Screen time is an inevitable part of life in the modern era. Unbelievably, 72% of teens use a cell phone before bed, 64% use an electronic music device, 60% use a laptop and 23% play video games. And 18% report being awakened several nights per week by their cell phone. It’s evident that teens are operating in a highly technological world with new normals, and these nighttime temptations do no favors for teens and adults, alike.
It’s vital to set limits on blue light exposure and screen each evening, as nighttime screen usage can make it more difficult to sleep for several reasons. Exposure to the blue light emitted by these devices hinders the production of the sleep-inducing hormone, melatonin. Tablets, phones, game consoles and other interactive devices tend to increase arousal as well, making it difficult to quiet the mind and drift off into sleep. The short sleep-wake cycles caused by incoming calls or messages can lead to chronic sleep deprivation, even in kids who otherwise have no natural issues sleeping.
It can’t be overstated: model responsible screen-related behavior by turning off your electronic devices before going to bed, and encourage your kids to follow along and prioritize their rest and health. Analog activities such as reading a book or drawing are much more conducive to falling asleep, without the blue light or hormonal interference.