We were talking the other day about one of the sleep disorders that occur today among the adolescent population: the 'vamping'. In the aforementioned post we introduced in passing the influence of hormones in the sleep of girls and boys between (approximately) 12 and 20 years old. Today I want to talk about sleep at these ages again, because I have a very recent recommendation from the Academy of Pediatrics of the United States, according to which adolescents suffer from sleep deprivation compared to years ago, and Even worse, they sleep fewer hours than their bodies need..
According to a study published in Pediatrics, the number of adolescent boys and girls who are sleep deprived has steadily increased. The research, titled “The Great Sleep Recession: Changes in Sleep Duration Among US Adolescents”, included hundreds of thousands of participants surveyed over a long period. Note that the researchers asked how often they were sleeping minimum of 7 hours. I find it striking that the bar is set so low, because the National Sleep Foundation establishes that they are necessary between 8 and 10 hours daily at these ages.
I imagine that if they had been asked how often do you sleep at least 8 hours?, The results would have been more shocking
For some time now, more voices have been heard from professionals in the world of pediatrics and neurology questioning the entrance times to the institutes. If at those ages they have trouble falling asleep early because the melatonin It is secreted later, and also Many teenagers have to get up very early to go to class, the circadian rhythms are altered.
Consequently, the production of morning cortisol will be insufficient and the body will have less energy when it's time to get out of bed. However, it's not just school schedules that are to blame: continuous stimulation from screens that many people use even in bed does nothing to benefit the brain, which needs periods of rest and darkness to synchronize.
Adding to the fact that we all want our daughter or son to be the best in music, sports, math, languages... We're definitely on the verge of "losing our way" (if we haven't already). Because a child of any age isn't just a student: to develop as a person, as a social being, needs more than just learning; and the solution is not to reduce sleep hours to get everything done, but assess the needs of adolescents without putting too much pressure on them.
Why teenagers sleep less than they need
During puberty, the internal clock undergoes a physiological delay: The brain releases melatonin later, so sleep occurs later and natural awakening also occurs later. This condition, when it is very pronounced and affects daily life, is called delayed sleep phase syndrome.
Added to the above are environmental factors: exposure to bright light and blue light of mobile phones, tablets and computers at night further delays the release of melatonin; irregular weekend routines misalign the internal clock; and the academic and social stress increases physiological activation, making it difficult to fall asleep.
The result is a cumulative sleep deficit which is not fully compensated by sleeping more on weekends. Evidence indicates that this partial “recovery” does not completely reverse the metabolic and immune changes associated with little sleep.
Circadian rhythms, hormones and school schedules
The sleep-wake cycle is regulated by the suprachiasmatic nucleus and external synchronizers (especially the daylight) and internal (melatonin, temperature, cortisol). In adolescence, the biological window of sleepiness shifts to later, so that going to bed early becomes difficult even if you are tired. Forcing yourself to wake up earlier than your body would program is a chronic social jet lag.
This misalignment translates into less attention, poorer academic performance, mood swings, and increased daytime sleepiness. It has been shown that slightly delaying the school start time is associated with more hours of sleep and better daytime functioning without prejudice to learning.
Common sleep disorders in adolescence
In addition to circadian delay, there are specific disorders that can prevent continuous sleep or achieve a restful sleep:
- Insomnia: difficulty falling or staying asleep, or perception of unrefreshing sleep, several nights a week for weeks. It is often associated with Stress, anxiety, bad habits, illnesses or drugs.
- Restless Leg Syndrome y periodic limb movements: an urgent need to move the legs when lying down, with tingling or burning sensations, and nocturnal jerks that fragment the dream.
- Obstructive sleep apnea: respiratory pauses with snoring, gasping, or night sweats. It is associated with daytime sleepiness and attention and behavioral problems; it may be favored by tonsillar hypertrophy or over weight.
- Nightmares: associated with Stress, fever, medications, substance use, or sleep deprivation. These can make it difficult to get back to sleep.
- Somnambulism: brief episodes in which the adolescent sleepwalks. It is usually benign; it is advisable calmly guide back to bed without trying to wake up abruptly.
- Narcolepsy (rare): extreme daytime sleepiness, irresistible naps, sleep paralysis, hypnagogic hallucinations, and sometimes cataplexy. Requires specialist evaluation.
Insomnia in adolescents: signs, causes, and when to consult
We can all have bad nights, but if insomnia appears several nights a week for weeks or months, it's time to consult. Common triggers include:
- Unfavorable environment: heat, cold, noise, excessive light or screens on.
- Dysfunctional habits: irregular schedules, late naps, stimulating activities at night.
- Stress or emotional problems: anxiety, depression, family or academic conflicts.
- Medical problems or drugs: pain, nasal congestion, thyroid disorders, stimulants.
- Substance use: caffeine, nicotine, alcohol or other drugs.
It should be evaluated by the doctor if there is habitual snoring, respiratory pauses, disabling daytime sleepiness, major mood swings, decreased performance, or if sleep difficulties persist despite improved sleep hygiene.
Consequences of chronically insufficient sleep
Lack of sleep is harmful to mental and physical health. Sleeping less than necessary increases the risk of sleep problems. atención, the memory y learning; irritability and negative mood; anxiety and depression; and risky behaviors such as increased alcohol consumption Stimulants, alcohol and other substances.
On the physical plane, it is associated with hormonal imbalance (cortisol, leptin and ghrelin), increased appetite and weight, increased insulin resistance, risk of diabetes and cardiovascular disorders (blood pressure and autonomic variability). daytime sleepiness increases the likelihood of accidents, especially while driving.
Insufficient sleep also impacts the immune system; links have been described between deprivation and inflammatory changes that could promote chronic diseases. Associations have even been observed between short and poor quality sleep in adolescence and a greater likelihood of suffering from some autoimmune diseases in later stages, without this implying direct causality.
Can we help you?
In addition to raising our voices and trying to fight so that competitiveness is not the constant that guides our lives; to give back a little common sense to this 'crazy' world…:
- Promotes and enables physical activityYou encourage them when you set an example and invite them to join you on a hiking or biking trail; you allow them when you don't, by signing them up for three different academies that will keep them busy four afternoons a day. A little freedom makes it easier for them to move wherever and whenever they want.
- The bedroom is the 'cave' for resting... no screensDon't inhibit their online socializing, but do seriously set time limits. The fewer distractions, the better.
- Resting is not just sleeping: They may be awake but thinking, writing, drawing... Don't bother them by checking in every five minutes to see if they've closed their eyes.
- In the late afternoon No stimulant drinks or alcohol are taken; It is rare that he says this, but he expects that from an age they will experiment with legal and illegal drugs, however they should not be part of everyday life.
- Give exampleDon't assume that just because you're a parent means your kids are okay watching you on a Tuesday night, mesmerized by the TV. Same with the drinks we talked about.
- Even in adolescence, routines can be good; we skip them when they're 16 and going to a concert on Saturday night, but the exception also makes the rule.
- Light and early dinners: Don't eat foods that are difficult to digest for dinner, and remember that approximately two hours should have passed between dinner and bedtime.
- Bedrooms are more comfortable when they have been ventilated and at a suitable temperature; It may be difficult for them to understand that even in 'their space' it is good to open the window from time to time, let's not get overwhelmed by it.
- Live the day with a certain intensity: the day is for moving and exposing yourself to daylight; helps synchronize the internal clock.
- Disconnection routine The last hour: Turn off screens, take a warm shower, read, or listen to relaxing music. Blue light slows the release of melatonin.
- Regular hours going to bed and getting up, even on weekends, with small differences so as not to upset the clock.
- Short nap only if it is essential and early (less than 30-45 minutes) so as not to rob you of your night's sleep.
- Detects signals: Frequent snoring, pauses in breathing, marked drowsiness, worsening mood or academic performance warrant consultation.
I literally transcribe the conclusions of the aforementioned study: "Lack of sleep is detrimental to mental and physical health. People who don't get enough sleep are at risk for developing diseases and health problems. These include weight gain, heart attacks, heart failure, high blood pressure, stroke, diabetes, and depression.". The message is clear: More and better sleep protects present and future health.
And the main conclusion is that the decrease in the hours of sleep in adolescents (according to the own perception of the participants in the study) it's worrisome.
Image - Mc Quinn.
Sleep is part of a circadian rhythm between two states: wakefulness/sleep. It can be defined as a regular, recurring, and easily reversible state of the body, characterized by relative tranquility and a significantly increased threshold or response to external stimuli compared to the waking state. Sleep is a necessary physiological process, during which the subject is not readily in contact with the environment, at a conscious level. Plays a critical role both in early brain development, in learning and in memory consolidation. During puberty, the brain experiences a second period of synaptic exuberance and creation of neural networks; for this process to develop properly, it is a good sleep is necessary.
Several studies have examined the prevalence of complaints of sleep disorders in parents and adolescents; many associate fragmented dream with behavioral problems. Sleep problems are more prevalent in adolescents with chronic illnesses, neurodevelopmental disorders, and psychiatric disorders. Defining normal sleep patterns at these ages requires considering maturational changes, social and environmental influences, and using, when appropriate, objective tools such as actigraphy or polysomnography.
All living beings present periodic oscillations in their physiology and behavior. Circadian rhythms, such as sleep/wake cycle, are repeated approximately every 24 hours and synchronize processes such as body temperature, cortisol, and growth hormone. The suprachiasmatic nucleus of the hypothalamus acts as a biological clock and requires external (especially light) and internal (melatonin, temperature, cortisol) synchronizers.
In adolescence, current hypotheses confirm a rhythm delay, so the need for sleep appears later. In addition, the irregularity between school days and weekends increases the discrepancy and deregulates the pattern. Sleep architecture also changes: from 50% REM/non-REM sleep in childhood to around 20% REM sleep in adolescents/adults.
Among the external synchronizers, the teenager's current environment plays a key role: own room with devices, privacy and poorly supervised schedules. The disdain of sleep (considering it a “waste of time”) and the exposure to toxics (alcohol, caffeine, nicotine) make the problem worse. In fact, many teens need about nine hours of sleep per night, yet they sleep considerably less on weekdays.
As for internal synchronizers, melatonin levels tend to peak later in the evening, and adolescents' ideal waking time is also later. The result is that Many schoolchildren arrive to class sleep deprived.. Sleeping well after learning something is critical for consolidate memory and stabilize what has been learned.
A particularly relevant consequence of chronic deprivation is the accident rate due to drowsiness, including traffic accidents in young drivers. Prolonged deprivation also increases the risk of cortisol, alters glucose homeostasis (favoring obesity y diabetes type 2), reduces emotional control, increases anxious or depressive behaviors, decreases academic performance and memory capacity, and can simulate attention deficit type symptoms, with increased abuse of Stimulants, alcohol and other substances.
When we talk about insomnia, its central characteristic is persistent difficulty initiating or maintaining sleep, or the perception of unrefreshing sleep with daytime impact. It is advisable to explore medical causes, interfering pre-sleep habits, erroneous beliefs, awakenings conditioned to staying in bed, and other behaviors that fragment sleep. Sleep diaries for one or two weeks provide objective information and guide management. Melatonin may be useful in insomnia of falling asleep In selected cases, always accompanied by sleep hygiene and chronotherapy.
At the delayed sleep phase syndrome, the diagnosis is based on a sleep calendar, actigraphy, and a detailed clinical history. Treatment combines chronotherapy (progressive schedule adjustments), light therapy morning, strict hygiene and, occasionally, melatonin in the evening. Maintain stable social routines It is essential to avoid relapses.
La narcolepsyAlthough uncommon, it usually begins in adolescence or early adulthood. It requires confirmation with polysomnography and multiple sleep latency testing. Treatment combines sleep hygiene, scheduled micro-naps and drugs that promote wakefulness under specialized supervision.
The vast majority of sleep difficulties in adolescents are due to habits and schedule organization that can be improved with education and support. The role of the pediatrician and the school is key to detect and facilitate adjustments that protect rest. Taking care of your sleep isn't a luxury: it's a pillar of health as important as diet or physical activity.
Consistent habits, reducing screen time before bed, regular schedules and a family culture that prioritize rest can make a difference in the emotional, cognitive, and physical well-being of adolescents today and their health tomorrow.