Pathway Pediatrics

Teenagers are more sleep deprived than ever before— about 85% don’t get enough sleep at night. There are lots of reasons for this: excessive homework, too early school start times, and the intrusion of the internet into the bedroom. Here are some of my best teen sleep tips which I suspect you haven’t heard before.

I’m sympathetic— I see a lot of tired teenagers in my clinic. I know it isn’t easy for either teens are parents. I also know that some advice is easy to give, but hard to follow (like “GO TO BED EARLIER”) when teenagers are hardwired to stay up later and get up later. (Young people naturally want to sleep from midnight to 9 AM— if school started at 10 AM, teens would be a lot healthier and happier).

Here are the tips I have found that work, and you can realistically accomplish.

1. Get extra sleep in the morning by avoiding the snooze button

Do you like hammering away at that snooze button? Me too. But here’s the thing— it feels great to get those extra ten minutes of sleep, but you are really cheating yourself. If you set your alarm at 6 AM but never get out of bed before 6:45 AM, just set the alarm to 6:45 and get out of bed. Even if you need 45 minutes to wake up at 6AM, that does not mean it will take you that long to get up at 6:45. Why? Because you have had an extra 45 minutes of uninterrupted sleep.

2. Tactical napping (and caffeine if necessary)

The dogma in the sleep hygiene field is that both napping and caffeine should be avoided— for the reason that they can interfere with the ability to fall asleep at night. However, if you can’t keep your eyes open, you need to do something, especially if, say, you need to finish your history paper or drive somewhere. (Driving drowsy is like driving drunk— please don’t do it). Instead, take a tactical nap. I define this as a short nap (15-20 minutes) preferably in the afternoon. Here’s the key to tactical napping: don’t do it in your super comfortable couch or bed. Do it with your head down on a desk or reclining in your car— someplace you are unlikely to fall asleep for prolonged periods.

Sleep experts have actually studied small doses of caffeine— say, a cup of tea or small coffee— prior to a short nap. (this is sometimes called a napuccino–I can’t decide if I find this adorable or horrifying) It turns out that it is a pretty great way to wake up in a short period of time. I would experiment with short tactical naps first as that is often equivalent to having a cup of coffee.

3. Keep an eye on the homework

In college, I only pulled an all-nighter once— to get a lousy B- on my Biochemistry final. I should have known better. Research has actually shown that getting sleep will help you perform better on a test than staying up all night studying. If you can’t finish your homework at night, go to bed. Trust me. It will be there in the morning. If this happens a lot, please talk to your parents and your teachers. Believe it or not, there’s not a lot of evidence that homework helps kids learn.

4. Digital liberation:

Ok. I don’t win a lot of popularity contests here. But cell phones are totally corrosive to a good nights’ sleep. Why is this?

• They emit light that keeps you awake at night by suppressing melatonin secretion in your brain, which keeps you from falling asleep.
• They are powerfully addictive. You know how you want to scroll down Instagram just a few more photos or read a few more tweets? Guess what? Social media sites and apps have been engineered by people richer and smarter than you or I to keep you checking in, commenting, posting, liking, etc. That is how they get paid.
• They fragment sleep by emitting alerts during the night Just the other night, my wife and I woke up because I received a text message. Here’s the thing— my phone was silenced and in the bathroom, but the light was still sufficient to wake up two sleep deprived adults at 1 AM.
• They can generate anxiety and frustration right before bedtime.  Anxiety and stress are contagious, and if you are an anxious or stressed teen, your peers probably are too. Trust me, those Instagram posts will be there in the morning.

There’s a couple of things you can do so you can control your phone, instead of it controlling you.

1. Keep it out of your room. Give it to Mom and Dad and ask them to charge if for you. Tell them to lock it in their car if you are worried you can’t resist the temptation.
2. Turn on “Do Not Disturb” and “Night Shift” (on Apple Devices). These options limit interruptions from your apps and lower the color temperature on your phone. These means there is less blue white light, which is the kind of light that suppresses melatonin. (Note that this is not as good as avowing light altogether. 

5. Less light at night, more in the morning

So, light at night is bad for sleep— but in the morning it’s great. There was a recent study showing that teenagers camping out without electronic devices rapidly reset their body clock by going camping:

End all artificial lights at night for at least a weekend and drench your eyes in natural morning light, says a professor of integrative physiology at the University of Colorado, Boulder and senior author on a study on resetting sleep cycles. The most straightforward way of doing this is to forbid any electronics on a camping trip.

One easy way to do this is get an alarm clock that uses light to wake you up. I got one of these, and it is shockingly effective. (It also does not wake up my six year old, who is out of bed like a shot when my alarm goes off).

The clock starts increasing lightly slowly for 30 minutes prior to a more conventional (read noisy) alarm goes off. Since starting with this I am falling asleep more easily at night and getting up more easily in the morning. I highly recommend this model.

5. On weekends and vacations, stay on the “Plus Two” Schedule

Here’s where I differ a little bit from the traditional sleep dogma. In a perfect world, you should sleep on the same schedule every day. However, most teenagers are so sleep deprived that I don’t think that this is fair.

For my patients, I generally advocate for a “plus two” schedule. What this means is getting up two hours later than you get up for school. This lets you catch up a bit on weekends but should not throw your schedule out of whack. I also recommend keeping this schedule on school vacations.

7. Consider melatonin— if your doctor thinks it is a good idea.

Melatonin is a frequently misunderstood medication. (I wrote more on melatonin here if you want the details). In a nutshell, it has two effects. It can alter sleep schedules, and it can make you sleepy.

Most of my teenage patients actually need help with their schedule. Thus, the most effective way to use it is 0.5 mg at dinner time, as this will help move your sleep schedule a bit earlier. Sometimes I may add a small dose at bedtime (1-3 mg as well).

Note that melatonin is a medication and I’m not recommending that you take it. I recommend you discuss it with your pediatrician.

8. Have someplace besides your bed to relax

One of the principles of managing insomnia is called stimulus control. This is a fancy way of saying, if you are having problems sleeping, stop doing stuff in your bed besides sleeping. If you do your homework, watch TV, eat fried chicken, etc. in your bed, tell your parents to take you to Ikea and get you a nice chair for you to relax in. Trust me, this will help.