Sleep is essential for life, like food, water and the air we breathe. Unfortunately, more than 1/3rd of adults in this country and about 2/3rds of teenagers are not obtaining the sleep they need.
The Causes
U.S. teenagers are sleep deprived primarily due to early school start times which are in direct conflict with a normal developmental shift in their sleep pattern. Melatonin, a hormone signaling sleep, is secreted later for teenagers, contributing to a delay in their sleep and wake times. Less parental involvement in setting a bedtime and behavioral choices such as use of electronic devices and caffeine can further exacerbate the problem.
Teenagers sleep best between the hours of 10:45 p.m. to 8:00 a.m.
It might help to think of teenagers as sleeping in a completely different time-zone than everyone else. It is almost like their brains are in a place 2 to 4 hours to the west!
The Bad News
It turns out this lack of sleep leads to more than tiredness and typical teenage angst. Car crashes are a primary concern. Teenagers are dragging themselves out of bed before they are fully awake to drive to school. They are inexperienced drivers and are more likely to take risks as the area of the brain responsible for judgement and making good decisions, called the prefrontal cortex, is still under development. This area of the brain is negatively affected by sleep deprivation, adding further risk. The AAA recently released a report showing driving while sleep deprived can be as unsafe as driving while intoxicated with alcohol. Parents often warn their teenagers about the risk of driving under the influence, yet many students are driving to school after obtaining only 5–6 hours of sleep, jeopardizing their lives along with others on the road. In addition to car crashes, sleep loss in the teenage population leads to more sports related injuries, alcohol or drug use, obesity, depression and thoughts of suicide.
Early school start times are not unique to U.S. teenagers, with studies in Japan, Italy, Australia and Finland showing similar findings.
The Good News
The good news, is when later school start times are implemented, communities report less teen related car accidents. Teenagers also report improvement in their mood with less symptoms of depression. There is evidence for improved academic performance in core classes and on standardized tests. Teachers report a calmer start to the day with more students able to stay awake during the first hour of class.
3 Ways to Help
Learn More About the Benefits of Adjusting School Start Times
Parents and community members will often argue against school start time changes without understanding the shift in teenage sleep patterns or reviewing the positive benefits a later school start time can provide. Teenagers are not lazy and we are not coddling them by letting them sleep in. Telling them to “try harder” to fall asleep earlier is akin to telling someone to go to the bathroom when they have not urge to do so. It is not biologically possible. It is time to rethink how we are treating our teenagers. By not letting them sleep, we are robbing them of a basic need. Rather than trying to force teenagers to follow a sleep schedule designed for the convenience of adults and the convenience of school districts, our time would be better spent learning how much sleep teenagers need and at what time of the day they sleep best. The MN Sleep Society is developing a toolkit linking the biology of sleep to the research on starting school later along with providing numerous other resources for schools and parents to use as they evaluate this issue in their community.
Support Schools
It takes a village to raise a child and to adjust school start times. Parents, medical providers, school leaders and community members need to work together to overcome the barriers and obstacles that exist. Challenges schools face include cost, fear of change and ignorance about the value of sleep and the shift in teenage sleep patterns.
All of these issues can be overcome. Many schools have a tiered bus schedule in order to keep transportation costs low, with older students often picked up first and the elementary age students picked up last. School districts have been able to adjust school start times at cost neutral status when they flip these times having teenagers picked up last and elementary age students picked up first. Biologically, this makes sense as younger children wake up early. Transportation costs can also be addressed in some communities by having students take a city bus. While many schools are willing to put in the time and effort needed to adjust the transportation schedule, schools often encounter protest. People are resistant to change with “no” as the typical knee-jerk reaction. Adults hold on tight to their current schedules. Educating parents and teachers along with other key stakeholders is the first step for any school district looking at adjusting their start times. The safety of children trumps any other issue.
Be a Role Model
Value sleep for yourself and your family. Evaluate your own sleep schedule. If you are not devoting the recommended 7–9 hours a night for sleep, readjust your priorities. Sleep is as important as good nutrition and exercise. Sleep helps to rid our brain of neurotoxins and allows us to think clearly. Sleep also helps to regulate our mood and appetite. Sleep balances hormones for growth and immune function which is especially important for children who are still developing.
In addition to allowing enough time for sleep, follow a predictable schedule each day, even on the weekends. Our body functions best when we follow a rhythmic pattern, waking up at the same time and going to bed at the same time each day. Minimize your exposure to light (including that from electronic device screens) at 1–2 hours before bed as bright light delays the release of melatonin, disrupting natural sleep onset timing. Walk away from cell phones, laptops and the TV. In addition to diminishing light exposure, this has the added benefit of allowing you to disconnect from the day. It is important to have a wind-down period before bed to allow your mind and body to transition into sleep mode. Avoid sabotaging your sleep with disrupting substances like caffeine or alcohol. The latter may allow you to fall asleep faster but sleep will be more fragmented and less restful.
For children, set and enforce bedtimes. This can be more difficult during the teenage years as they exercise their autonomy. Educate your teenager about the importance of sleep, then find mutually agreeable “lights-out” time, aiming for 8–10 hours nightly depending on their sleep need. There are times to make compromises when raising a teenager. Sleep is not one of those times.
Keep in mind sleep is not a luxury. It is a necessity. Teen sleep deprivation is a public health crisis which can be resolved, if we make effort in our homes and communities to address this issue in order to improve the health and well-being of young people across the country.
Julie Dahl APRN, CNP is a nurse practitioner and is on the board of the Minnesota Sleep Society and is the Executive Director of the Teen Sleep: School Start Time Committee.
Meir Kryger MD is a professor at Yale School of Medicine and author of Mystery of Sleep.
Originally published at medium.com