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Help For Teens With Insomnia

It's tough to get teens to do anything, let alone get to sleep when they are supposed to. With the advent of electronic devices ruling their every waking moment, many teens spend their last few minutes of the day texting friends or playing video games instead of winding down. It turns out this is one factor in a list of issues that could be contributing to teen insomnia.

What is insomnia?

Signs and causes of teenage insomniaInsomnia is a sleeping disorder, defined as difficulty falling asleep, staying asleep, or having non-restorative sleep. The difference between adult insomnia and teen insomnia is that there is a unique set of issues that affect teens; they have changing physiology that is out of their control (i.e. hormones), and ongoing emotional stress. Persistent periods of lack of sleep have a detrimental affect on a teen's ability to function at school, work, with friends and at home.

How common is teen insomnia?

In a study of over 1,000 teens, ages 13 to 16 years old, 11% met the criteria for having insomnia and 88% of teens with a history of insomnia reported having current insomnia. The average age of onset was 11, and it was determined that the onset of menses was associated with a 2.75-fold increased risk for insomnia.

The researchers concluded that insomnia is common and chronic among adolescents. They determined that there was no obvious increase in insomnia for boys at pubertal development, but that there was a significant increase in insomnia for girls after their first period.

Causes of insomnia

It's important to understand the difference between a teen who goes to bed late and wants to get up late (delayed sleep phase syndrome) versus insomnia. Delayed sleep phase is when a person's sleep/wake cycle, the circadian rhythm, is delayed from the normal sleep/wake cycle. This happens to teens because melatonin (a hormone that promotes sleep) production occurs later in the day for teens compared to children and adults, affecting their ability to fall asleep at an ideal time. When this happens, your teen wants to stay up late and sleep late.

The problem begins because most teens have to get up early for school. Getting up early cuts down on the time they need to sleep, about 8 full hours. According to a 2006 poll by the National Sleep Foundation, 45% of adolescents get an insufficient amount of sleep on school nights (less than 8 hours). Late bed times due to their shifting circadian rhythm combined with the demands of early school mornings, can ultimately lead to insomnia.

Other causes of insomnia in teens:

  • Substance Abuse - Many recreational drugs, i.e. heroin, cocaine and methamphetamine, can cause insomnia. Chronic insomnia can also create substance abuse; if your teen takes something to help with insomnia he/she can become addicted to sleeping pills or other drugs.
  • Behavioral issues - Anxiety and stress can affect sleep. Talk to your teen. Is he/she experiencing stress of any kind in relation to relationships, school work, college decisions or just general life anxiety? Behavioral issues like anxiety or depression can also lead teens to self medicate, experimenting with recreational drugs.
  • Bedtime routine that doesn't promote healthy sleep (i.e. using electronic devices which have a higher concentration of blue light, affecting melatonin production).
  • Obstructive sleep apnea - Breath becomes shallow and can even stop because something is blocking the upper airway. The lungs and diaphragm have to work harder, often causing a snort or jerk which in turn causes non-restorative sleep.
  • Medications - Is your teen on any medicine for physical pain or psychological issues? Check the label and see if insomnia is a side effect.
  • Caffeine use - Does your teen drink soft drinks, sports drinks with sugar/caffeine or tea or coffee? Caffeine use, even earlier in the day, can affect sleep.
  • Restless legs syndrome - aching, twitching and the urge to move the legs.
  • Sleep environment - Is there too much light in your teen's room? Is it too loud?
Insomnia in Teens

Symptoms of insomnia

  • Difficulty falling asleep at night, can't stay asleep or wake in the early morning hours
  • Prolonged daytime sleepiness or tiredness
  • Often irritable or very moody
  • Unable to concentrate or focus on tasks or studies
  • Sleep anxiety
  • Depression, suicidal thoughts

How to determine if your teen has insomnia

  • Encourage your teen to keep a sleep diary for approximately two weeks, which will help a doctor understand his/her sleep patterns and determine a diagnosis.
  • A doctor may prescribe a sleep study, in which your teen is given a polysomnogram, in which dozens of electrical wires are attached to the body to determine patterns while he/she sleeps.
  • Your teen may take an Epworth Sleepiness Scale, a questionnaire that is used to assess daytime sleepiness, which in turn can help determine if there are any sleep disorders. 
  • Actigraphy (actimetry sensors) are small, wrist-worn devices about the size of a wristwatch that measure movement during sleep over time. 
  • If you believe your teen is depressed or has anxiety, a psychological evaluation may be helpful to determine if that is one root cause of his/her insomnia.

Dangers of not addressing insomnia/negative effects

It's important to address insomnia in your teen because of the detrimental physical and emotional affect it can have on them. Sleep deprivation is a serious matter, contributing to a multitude of issues. Chronic sleep deprivation affects the teenage brain by diminishing the brain's ability to learn new information. It can also lead to emotional issues like depression and anxiety, which in turn could lead teens to try recreational drugs. A Columbia University study of 16,000 teenagers in grades 7 to 12 found that with bedtimes of midnight or later teens were 24 percents more likely to suffer depression than those with bedtimes of 10 p.m. or earlier. In fact, teens with later bedtimes were 20 percent more likely to have suicidal thoughts.

Insomnia in teens

Types of treatment

  • Establish a consistent sleep routine - remind your teen get in bed at the same time every night and early enough to get the recommended 8 hours of sleep, have your teen turn off electronics an hour before bed, advise him/her to take a warm shower, read a book or even meditate.
  • Sleep remedies - sleep medications (which may have a negative effect on the teen's developing brain and have their own side effects) whether over the counter or herbal/natural, should be used only under the supervision of a physician.
  • Dietary changes and eating habits - remind your teen to avoid large meals, caffeine and sugar at bedtime.
  • Exercise - insomnia is often associated with depression and anxiety, and exercise is known to help alleviate those feelings. It's best to avoid vigorous exercise too close to bed.
  • Weighted Blanket - has small pellets that apply input to pressure points, which aids in relaxation.
  • Assess the sleep environment - perhaps your teen needs blackout curtains or a white noise machine. Also remind him/her to turn off all electronic devices, or at least put his/her cell phone in airplane mode and turn off the wi-fi. Even the light on a bedside clock can disrupt sleep.
  • Relaxation therapy - includes breathing techniques and visualizations for sleep.
  • Drug or rehab therapy - if your teen suffers from substance abuse because of insomnia, or has insomnia because of drug abuse, a rehab therapy program may be necessary.

Benefits of insomnia treatment

Sleep is a very important, productive time for the developing, adolescent brain. Teens who get the recommended amount of sleep experience better learning and greater physical and mental health. Teens who sleep well are more focused and have less likelihood of depressed moods. Insomnia treatment can help restore you teen's ability to function and focus every day. A well rested, happy teen equals a happy family!

REFERENCES:

  • https://www.ncbi.nlm.nih.gov/pubmed/16452333
  • https://www.sleepassociation.org/patients-general-public/delayed-sleep-phase-syndrome/
  • https://sleepfoundation.org/sites/default/files/2006_summary_of_findings.pdf
  • https://www.ncbi.nlm.nih.gov/pubmed/16452333
  • http://www.webmd.com/sleep-disorders/news/20040610/sleepless-nights-common-among-teens#1
  • http://www.cumc.columbia.edu/publications/press_releases/sleep_depression.html
  • http://msue.anr.msu.edu/news/teen_sleep_cycles_affect_school_success_habits_that_help
  • http://www.cumc.columbia.edu/publications/press_releases/sleep_depression.html
  • https://www.verywell.com/what-is-actigraphy-3015130
  • http://epworthsleepinessscale.com/about-the-ess/
  • http://www.sleepdisordersguide.com/article/sleep-solutions/polysomnogram-polysomnogram-test-diagnosis-of-sleep-disorders
  • https://sleep.org/articles/melatonin/
  • https://www.sleepassociation.org/patients-general-public/delayed-sleep-phase-syndrome/
  • https://www.rls.org/understanding-rls/symptoms-diagnosis
  • http://www.webmd.com/sleep-disorders/guide/understanding-obstructive-sleep-apnea-syndrome#1
  • http://www.jscimedcentral.com/SleepMedicine/sleepmedicine-2-1022.pdf
  • http://www.insomnia-free.com/relaxation-therapy-techniques.html

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