A large-scale survey on teens and sleep has made a big splash in the news recently with its results: most teens are not getting enough sleep, and their lack of sufficient sleep is being associated with a whole series of risky, unhealthy behaviors, from smoking and drinking to sexual activity and over-eating. This is a landmark study, the first of its size and scope to explore the connection between sleep and health problems in adolescents.
The results come from the 2007 National Youth Risk Behavior survey, conducted by the Centers for Disease Control. This survey of more than 12,000 teenagers assessed a range of health-risk behaviors among adolescents. Regarding sleep, the survey asked teens: "On an average school night, how many hours of sleep do you get?" The responses were divided into two categories: eight hours or more per night was considered sufficient sleep, and fewer than eight hours was considered insufficient sleep.
More than two-thirds of teens surveyed -- 68.9% -- said they received fewer than 8 hours of sleep on an average school night.
And if that's not enough, here's where things really get disturbing: Of the 11 health-risk behaviors that the survey examined, 10 of them were more likely to occur in teenagers who reported insufficient sleep during the school week.
Lack of sleep in teens was associated with a greater risk of:
• Drinking soda 1 or more times per day
• NOT exercising for 60 minutes on 5 of the past 7 days before the survey
• Using computers for 3 hours or more per day
• Participating in a physical fight at least once
• Smoking cigarettes
• Drinking alcohol
• Smoking marijuana
• Engaging in sexual activity
• Feeling sad or hopeless
• Having seriously considered suicide
It's worth repeating: teenagers who reported sleeping fewer than 8 hours on school nights were more likely -- in many cases significantly more likely -- to engage in these risky behaviors than teens who slept 8 hours a night or more during the school week. These results do not prove that lack of sleep causes these behaviors to occur more frequently, but they do point out a strong association between insufficient sleep and many serious, risky behaviors. We know that sleep deprivation clouds judgment, diminishes self-control and willpower. It affects mood, energy, and outlook. And this is also true for adults! For teenagers, whose brains are still developing (and whose social and emotional skills are as well), the challenges of sleep deprivation are particularly serious.
We know that teenagers have their own special needs for sleep, and that aspects of their lifestyles make them particularly vulnerable to sleep deprivation:
• During adolescence, our circadian rhythms change, making teens biologically more inclined to stay up late at night and to wake later in the day. (Yes, your teen's determination to greet midnight wide-awake and never see noon is a biological thing!) This internal drive is at odds with the typical early-morning school schedule, which can leave teens woefully short on sleep during the week.
• Teens just need more sleep than adults do. The National Sleep Foundation recommends 8½ to 9 ¼ hours of sleep per night for teenagers. Unfortunately, not many are getting this. The NSF estimates that only 15% of teenagers are sleeping 8 ½ hours nightly.
• Their schedules -- with school, sports, and friends -- tend to be inconsistent, which makes it more difficult to establish a routine with regular bedtimes and wake times.
• Teens today are constantly wired to an array of electronic devices. This ever-present technology can interfere with pre-sleep wind-down routines, and with sleep itself.
With the stakes for teenagers' health so high, news such as this survey shouldn't be ignored. The medical profession needs to pay more attention to sleep as a health factor for young people. As parents, what can we do to help our teens sleep better and perhaps avoid some of these risks to their health?
• Talk to your teen about sleep. You've made a point to have conversations about drinking, smoking and sex, right? It's time to add sleep to the list of topics to cover.
• Give them a little time to sleep in -- but not too much. Allowing your teenager to sleep in on the weekends is okay, and can help them catch up a bit on any sleep they might have missed during the week. Just don't let them sleep more than 1 or 2 hours beyond their regular wake time.
• Encourage your teen to get regular exercise. This can be in the form of organized sports, or just free-form recreational play. Physical activity -- ideally outdoors, where they can also be exposed to sunlight--will help overall health and nightly sleep.
• Limit their exposure to technology. Let's be realistic -- cell phones, computers, video games, and PDAs are not going away. The goal here is to set reasonable limits, which should include no electronics in the bedroom.
• Make sure to include your teen's doctor in the conversation. Don't let sleep be overlooked at your teen's check up. If your child's doctor doesn't ask about their sleep, raise the topic yourself.
As parents to teenagers, we're all engaged in trying to provide them with the skills to live healthfully, happily, and well. Guiding our teens to strong sleep habits is a critical part of that mission.
Michael J. Breus, PhD
The Sleep Doctor™
Everything you do, you do better with a good night's sleep™
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