I can’t remember where I came across this cartoon, but it’s one that irritates me. The teenage bird with the cool-dude-backwards-cap assumes the stance of a seasoned raconteur. With one deliberate wing gesture, he begins: “Actually” (proclaiming absolute authority on the matter), “my species is not nocturnal: I’m just a teenager”. Of course I’m just assuming he’s a he-bird, but even if he’s a she-bird, it doesn’t matter. The cartoon sends the wrong message. It labels all teenagers as being rebellious on the matter of sleep.
The higher authority, the owl, listens intently, but has no wise offerings.
Let me be a human ‘owl’ for a moment. ‘Sleep’ is my job. Sleep is my passion. I’m a child health sleep researcher, and naturally I sleep. My species is diurnal and I have some wise offerings on the matter of teenage sleep.
Sleep is emerging as an important public health issue. This is in sharp contrast to traditional sleep medicine, which focussed primarily on the identification and treatment of sleep pathologies. The term ‘sleep health’, with accompanying metrics, had its first airing in an article, written by renowned sleep specialist Daniel Buysse in the journal Sleep, as recently as 2014. This shift in focus places sleep at the forefront of health. Sleep impacts on every aspect of our physical and mental well-being. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes, including improvements in attention, behaviour, learning, memory, emotional regulation, quality of life, and mental and physical health.
Regularly sleeping fewer than the number of recommended hours is associated with problems in attention, behavior, and learning. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. Sleep recommendations for the number of hours children should sleep are based on research showing these associations. Obviously the quality of their sleep is also important, but less is known about health outcomes related to sleep quality per se.
Post-pubertal teenagers are nocturnal. Well, that’s a bit of a stretch, but they do undergo biological changes at puberty, whereby secretion of melatonin (a hormone released 1 to 2 hours before sleep to increase sleep pressure) becomes delayed. This is part of the circadian system that drives the sleep-wake cycle. Added to this, sleep becomes a low priority for teenagers compared to the many external influences, particularly social, that dominate their lives. Consequently, and compared to their pre-pubescent and adult counterparts, a teenager’s preferred fall-asleep time falls much later in the evening. The good news is that the human teenage species is not alone. A delay in circadian phase around the time of puberty has been observed in several mammalian species. But they do not have to contend with school start times. School start times put a brake on teenagers getting adequate sleep, causing many to become sleep-deprived, and in some cases, chronically sleep-deprived.
I recall dropping my teenage son off at school one morning when we were running a tad late. A ‘higher authority’ was standing outside, personally greeting each pupil one by one as they scampered through the school gate. I’d never seen this before and on witnessing this act of graciousness, the ‘higher authority’ was immediately elevated to the top of my list of ‘men who I want my son to grow up to be like’. But when I told my son this, he said, “Mu-um! He was only there to catch the late ones. They get detention or rubbish duty”.
Needless to say, the higher authority’s ranking plummeted. Undoubtedly a school has a responsibility to grow good students who will become responsible citizens and know the value of being on time, but my unspoken message to you, Mr Higher Authority, was: “Actually, those kids, like all other teenagers, should still be in bed asleep at that hour, not singled out as naughty latecomers!“
Five out of seven days a week, our New Zealand teenagers are required to arrive at school by about 8:45 am. This equates to just over 70% of their term time. It’s not until approximately age 21 that their sleep patterns shift to become more adult-like and they can ‘actually’ handle early starts.
Accommodating the sleep needs of teenagers, whether at an individual or societal level is crucial for their health and well-being. It also makes for healthy, happier experiences living with teenagers. We will never know if our teenagers are reaching their full social, emotional, or academic potential if we continue to deprive them of sleep. The bottom line is their sleep timing is different, it’s delayed, they simply can’t ‘fall sleep’ at the same time as the rest of us, yet they need more sleep than adults. So… “actually”, I believe we fail our teenagers miserably on the sleep health front.
Those are my wise offerings on the matter of teenage sleep.
Dr Barbara Galland is a researcher in the Department of Women’s and Children’s Health at the Dunedin School of Medicine, New Zealand. Her research interests include Sudden Unexpected Death in Infancy, sleep disordered breathing in children, adolescent sleep, and the sleep-obesity relationship across all age groups.
- Buysse DJ. Sleep health: can we define it? Does it matter? Sleep. 2014;37:9-17.
- Hagenauer MH, Perryman JI, Lee TM, Carskadon MA. Adolescent changes in the homeostatic and circadian regulation of sleep. Dev Neurosci. 2009;31:276-284.
- Paruthi S, Brooks LJ, D’Ambrosio C, et al. Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion. J Clin Sleep Med. 2016;12:1549-156