Sleep Deprivation in Adolescents and Children

Sleep disorders are alarmingly increasing among children and teenagers. An average teenager sleeps less than 7 hours. One in five even sleeps less than six hours at night. This is far too little and should alert us.

Many barriers can prevent a teen from getting the required sleep they need. They begin to face new pressures at home, school, part-time jobs and with their peer groups. Sometimes, they are faced with decisions they have to make for the first time in their life. And all this comes when they have other changes in their body, feelings, moods and, emotions. So getting enough sleep during this challenging period is highly crucial. Lack of sleep will only make this stage of life more difficult for them.

In this article, we will deal with the questions what are the influencing factors of sleep deprivation in adolescents and children and what impact does that have on their growth and development.

How to Define Adolescence?

This is a stage of growing up from childhood to adulthood, it can also be defined as the period of life between puberty and maturity. This period is usually between the age of 13 to 17 years in male while it is 13 to 21 years in a female. Also, adolescence is a transitional stage of psychological and physical change that occasionally occurs during the period of childhood and adulthood, its cultural expression, mental and physical change may begin earlier and ends afterward.

The three stages of adolescence:

The early stage of adolescence (12 – 14 years): this is the first stage of adolescence, a child is entering puberty for the very first time, it tends to be an uncomfortable period of physical growth and sexual development. This physical growth can have an influence on their emotional and psychological growth, especially if they are concerned about their looks among peers.

The middle stage of adolescence (15 – 17 years): this stage consists of both emotional and psychological development. At this periods will begin to assert their independence. They will start to pull away from their parents and even their family in general. Teens are searching for an identity, and they wish to spend time with new peers whom they admire. However, during this emotional and psychological development that teens go through, they are both reaching for their independence while at the same time fearing to lose the security of their parents.

Late adolescence (18 – 21 years): at this stage, teens are finding their way through social life. They will begin to gain more confidence and start to expand their own social group. They will continue to pull more and more away from their parents, find a job and form relationships with those at work.

Characteristics of adolescence are:

• Biological growth
• Quick decision making
• Undefined status
• Increased pressures
• Search for oneself
• Socialization

What are the symptoms of sleep deprivation in adolescents?

Sleep disorder in adolescence occurs when a teenager is finding it difficult to falling asleep or staying asleep at night, is unable to meet up with the hours of sleep required, or do not feel rested despite spending enough time in bed.

One in five children at the school age is plagued with difficulty sleeping or staying asleep. They often wake up in the middle of the night, have problems to wake up in the morning, experience increased nightmares, and also sleepwalking. Nearly 30 percent struggle with daytime sleepiness. Other symptoms of not getting enough sleep in adolescence are:

• Constant yawning
• Change of mood poor concentration
• Loss of interest in activities
• Experiencing sleepy grogginess

Watch this short video on Sleep Deprivation in Adolescents and Children:

How long should children sleep?

The necessary amount of sleep is individual for each child. However, the following information gives a rough guideline; it refers to a total sleeping time spread over 24 hours, including naps:

• Infants between the ages of four and twelve months should sleep 12 to 16 hours
• Children between the first and second year of life need to sleep eleven to 14 hours
• Children between the ages of three and five years ten to 13 hours
• At the age of six to twelve, it should be nine to twelve hours
• Teenagers older than twelve need 8 to 11 hours sleep

Scientific research has shown that children who have maintained these sleep times for extended periods have benefited noticeably in terms of their attention, behavior, learning, memory, emotional development, quality of life, and physical and mental health. In contrast, children with sleep problems tend to have contact problems with their classmates, are more anxious and impulsive, suffer from mood swings, feel depressed or sad, have more motivation and attention deficits, and feel stressed and inferior.

What are the main influencing factors of sleep disorders among children and teenagers?

First, it must be said that children of all ages naturally sleep well. Under normal conditions, most children start the day feeling rested. If that is not the case, it is important to clarify which type of sleep disorder causes fatigue. A possible cause could be congenital pathological fatigue (hypersomnia) or insomnia (chronic sleep disorder). The best-known form of hypersomnia is narcolepsy (excessive daytime sleepiness). It is usually triggered in the youth but also can occur in early childhood or adulthood.

However, disease-related sleep disorders like narcolepsy, nocturnal respiratory disorders or Restless Legs Syndrome are generally an exception among young people and can usually be treated effectively with medication.

In many cases, the lack of sleep among teenagers is due to physical changes during puberty coupled with extraneous confounding factors such as a busy schedule or excess of media consumption. But also stress and anxiety or even depression represent a growing problem. In the following, we look at four significant causes in more detail.

Sleep disorders due to mental and physical changes during puberty

Puberty is a period when your body begins to go through several changes. Girls see their breast develop and also have their first menstrual period; boys start to grow facial hair and change voices.

In most cases, these changes in the body are accompanied by how a person sleeps. If you are a parent you only know too well the changing sleep habits of their children: Small children are often already wide awake at dawn, but when they turn into teenagers an early start makes them often very grouchy in the morning.

This is related to a biological shift in a teens internal clock of about 2 hours. It means that a teenager who used to fall asleep at 10 pm before will not be able to fall asleep until 12 pm. It’s a simple cause and effect: If you are not tired, it does not help to go to bed at 9 or 10pm when the sleep hormones are not fully kicking in yet.

Sleep Deprivation Due to Social Jetlag

The more the length of the sleep during the week differs from that of the weekend, the more sleep problems occur. The issue of this so-called Social Jet Lag is not the fact that teenagers tend to sleep longer on weekends (that is actually recommended to anyone who accumulates a sleep deficit during the week).

The real issue is the gap between the sleep schedule during the week and that on the weekends when teenagers go to bed extremely late at night and get up very late. If your regular bedtime is at 11pm during the week, but on weekends you don’t sleep before 5 am, it is like flying over 6 time zones every weekend which we all know causes a massive strain on anybody’s mental and physical wellbeing.

Sleep Deprivation Due to Busy schedules

Often there are social causes of overwork. Like adults, young people are facing more hectic schedules and more stress these days which has a significant influence on the quality of their sleep. An average teen needs 9 hours sleep each night. If he or she needs to wake up at 6 am to catch the bus or go to school, she or he needs to fall asleep at 9 pm to meet this requirement. This works not only against the internal clock of a teenager as discussed earlier, but there also might be the need to study up late or to meet other social obligations.

Sleep Deprivation Due to Media Consumption

Not only adults often succumb to the temptation to watch television in the evening to fall asleep or to quickly check the emails again, but even children also use the offers of our digital age more and more and at an earlier age.

Several studies worldwide have addressed the risk factor of media consumption for our sleep. This refers in particular to the evening use of TV, laptops, tablet, phones or game consoles. Users are overstimulated by noise and light, which in turn can lead to inner restlessness and sleep problems.

Not only the sleep length but also the quality of sleep suffers from these media. Research has shown that many children watching television had reduced sleep efficiency, meaning less good sleep during bedtime. Similarly, the percentage in making use of the cellphones and computer can lead to lower sleep and higher waking time.

What are the effects of sleep disorder in adolescence?

It is a fact that chronic sleep deficit reduces memory and concentration naturally. Chronic sleep disorders such as insomnia and hypersomnia are also often associated with anxiety and depression as well as discontent and even suicidal thoughts. This again results into lack of sleep and the inability of young people to regulate their mood – a vicious cycle.

The amount of sleep and sleep habit also affects your body functions. The odds of being overweight are twice as high in children who use media than those who do not use media in the evening. This is related to the lack of exercise on one side but also to the fact that the shorter sleep duration by long evening media consumption affects the diet. Late in the evening children get hungry, and the focus is then not on vegetables but on hearty snacks and sweets.

Here is a summary of  the major effects of sleep disorder:

• Sleep loss results in poorer memory which tends to affect academic performance
• Chronically, sleep-deprived teenagers are most likely to be associated with a depressive disorder, increasing moodiness and troubled mind
• Inadequate rest for the body can lead to body tremors and aching muscle
• The inability of a teenager to get enough sleep will result in severe headaches
• Sleep disorder also brings about gain or loss of weight
• Lack of sleep weakens the body immune system
• Sleep problems in teenagers can bring about the increment in blood pressure
• Morning-evening effect: Children who are getting up too early might develop a melatonin deficit in the evening which increases the risk not to be able to fall asleep; this, in turn, means difficulties getting up in the morning – a vicious cycle
• Stunted growth in teenagers can also be a result of inadequate sleep; it is when you are asleep that your body produces growth hormone; growth hormone is responsible for better muscle building, rapid healing of wounds and if you are still growing – an increase in height.

The Effect of Sleep Disorder on the Sexual Maturation Process

In adolescents, healthy sleep is vital for the sexual maturation process and sex hormones especially. The nocturnal release of the luteotropic hormone is a hallmark of the onset of puberty. It increases during sleep and is crucial for the maturity process in puberty especially of young men because it stimulates the production of testosterone. Later, the nocturnal increase decreases significantly and is no longer detectable in adult men.

If the duration of sleep of a young man is reduced to 5 hours, the testosterone level decreases significantly. This decrease not only triggers losing muscle mass and fat storage but also sperm production. Sleep is as vital for the testosterone production of juveniles as it is for the growth hormone. Anyone who sleeps poorly during puberty or for a short time endangers his body growth and sexual potency.

How Can I Tell if My Child Has a Sleep Disorder?

It can be hard to determine the exact cause of a teen’s sleep disorder. However, if you experience some of the following irregularities frequently, it can be an indication that a sleep disorder exists:

• if the child regularly takes more than 20 to 30 minutes to fall asleep
• if he or she does not want to go to bed regularly
• when the child is awake at night and can not sleep on his or her own anymore
• if the child snores and has breathless respiratory problems making him or her respond only at night through the mouth
• often falls asleep at school and suffer from poor performance

If one or more of these sleep problems persist for more than two weeks and if lack of sleep continues to affect the daily life of the child, there will be the need to see the family doctor or even a sleep specialist. A sleep specialist has the skill to find the source of sleep disorder in teens and also knows what is needed to get the sleep required.

How to Treat Sleep Disorder in Adolescents?

We have learned that there are generally two ways to look at the problem of lack of sleep and the effects among teenagers. Firstly, there are natural changes associated with adolescence. The natural shift in the internal clock of a teenager which we discussed previously is why many sleep doctors, parents, and teachers are promoting a later start of school. School starting at 8 o’clock or even earlier is nonsensical against the background that teenagers require an extra one or two hours in the morning to be at their best and enjoy life.

It has been proven that one hour of additional sleep in the morning reduced the likelihood by almost 30 percent, that the child feels unhappy, sad or depressed during the day. Issues like lack of attention and bad performance are massively reduced. Simply put, students would be much fitter if they could sleep an hour longer in the morning.

Check out this article by the RAND Corporation if you want to learn more about the benefits of shifting school start times.

How to Develop a Good Sleep Hygiene for Children?

The other way to look at the sleep disorders in adolescence is to focus on sleep hygiene. Most teens need to develop the habits of good sleep hygiene to sleep better. This starts with placing a higher value on sleep within the family. Parent or guardians should try to help their teen have enough sleep. Sleep cannot be avoided or fight off.

Therefore, parents should create a calm and relaxed atmosphere in the home at bedtime. Children of all ages should have a regular, relaxing routine just before bedtime, and when getting up. In the evening 20 minutes before bedtime the light in the bedroom is already muted, and the room temperature is pleasantly cool.

In the morning, the alarm clock should go off about five to ten minutes before getting up. Best is to use a light alarm clock, which wakes you up gently with light. Should this be insufficient, a conventional alarm clock with sound signal or music can be used additionally.

How to Control Media Consumption Before Sleeping?

Electronic devices should be banished from the bedroom of their children and parents should arrange with their offspring a daily age-dependent screen time limit that limits the use of mobile phone, laptop, tablet, and TV.

The American Academy of Pediatrics has developed new guidelines in 2016. Accordingly, the screen time of children between 2 and 5 years should be limited to one hour. Children aged 6 and over the screen time should be defined individually by the parents who should also monitor the type of digital media their children use. Infants up to an age of 18 months should not be exposed to digital media at all, and Pediatrics are advising nursing mothers to refrain from doing so in front of the TV.

Meanwhile, there are several child protection software which can help parents to control the media consumption of their children. One of it is Screentime for smartphones and tablets.

But more importantly, adults themselves should be advised to apply self-imposed screentime as part of their sleep hygiene. It should end no later than 30 minutes before bedtime.

Be Cautious with Medication

One more advice to parents: Please refrain from giving your child sleeping pills without visiting medical consultants. First-line treatment should always be natural or herbal remedies such as chamomile tea. Also if you notice one or more of the signs of sleep disturbance described above, do not hesitate to go with your child to see a sleep specialist. He can and should decide on further measures for the improvement of sleep.

Making sleep a priority can stand as a great benefit. The children feel more alert and have more energy or power. They tend to think more clearly and make better decisions. They will become happier and enjoy life more.