Sleep plays a critical role in the physical and mental health of today’s teens. While the official recommendation calls for adolescents to receive 8-10 hours of sleep each night, many teens average much less. Insufficient sleep in teens has been associated with poor academic performance, mood disorders, anxiety and depression, substance abuse, and even suicidal thoughts. The fact that so many teens fail to get a good night’s sleep suggests that teen and parental education on this topic could significantly improve the mental health of our adolescent community.
Historically, researchers and medical professionals believed that sleep was a passive state, meaning that the brain was inactive and resting when sleeping. However, more recent research has shown that the brain is engaged and active during sleep, working to support functions that are essential for an individual’s overall health and well-being. Sleep is regulated by the body’s internal clock, or circadian rhythm, which is an indicator of the body’s sleep-wake cycle over the 24 hour day. During non-REM sleep, the first stage of sleep, the body works to regulate heart rate and breathing, restore itself, and slow down. In the latter stages of non-REM sleep, the body is in a deep sleep. Transitioning to REM (rapid eye movement) sleep, the body dreams and regulates emotions. On an average night, one can cycle multiple times through non-REM and REM sleep. While it was previously believed that REM sleep supported active brain functions like learning and memory, researchers have since determined that the restorative nature of non-REM sleep actually better supports these functions.
Overall, almost every bodily system is impacted by sleep. During the deeper stages of sleep, the brain begins to remove waste products from brain cells through what has recently become known as the glymphatic system. Similar to the lymphatic system, researchers have realized that deep sleep permits the brian to cleanse itself to a greater degree than was previously understood. Accordingly, healthy sleep habits may lead to a decreased incidence of neurological disorders later in life, such as Alzheimer’s disease and dementia. Studies have also found correlations between sleep and other neurological disorders, such as Parkinson’s Disease and strokes. In addition to neurological impacts, sleep highly affects metabolism as it alters hormone levels, such as ghrelin and leptin, which affect appetite. More specifically, lack of sleep leads to decreased leptin levels and increased ghrelin levels, which ultimately may lead to weight gain and obesity, and ultimately diabetes. Because sleep is so essential to health and well-being, it is crucial that adolescents achieve the amount of sleep that their body requires to productively perform these functions. Every individual’s body requires a different amount of sleep, which is mainly determined by age. While the exact number varies, it is estimated that teens should receive 8-10 hours of sleep each day. In addition to the amount of sleep, sleep quality is believed to have an even bigger effect on an individual’s health. Therefore, poor sleep quality, even for the recommended number of hours, can lead to negative mental health outcomes.
Leading to Mental Health Issues Due to the connection between sleep and our physical well-being, it is not surprising that sleep also affects our emotional and psychological health. A lack of sleep makes it more difficult to deal with even minor stress factors and can lead to an inability to maintain a positive outlook on life. Sleep impacts our attention span and ability to learn and digest new information. Conversely, insufficient sleep, particularly for adolescents, makes it difficult for teens to pay attention for six or more hours a day in school, participate in after-school activities, and complete what may be hours of homework each evening. A failure to do any of these things may lead to anxiety, depression, suicidal thoughts, chronic insomnia, drug or alcohol abuse, or other emotional/psychological disorders.
Anxiety is an individual’s feelings of worry or fear, often followed by physical symptoms such as an increased heart rate, sweating, and muscle tension. From a biological perspective, lack of sleep increases cortisol levels, a stress hormone that impacts anxiety and affects mood regulation, nervousness, and feelings of worry. Research has shown that sleep deprivation can trigger anxiety in individuals or worsen existing anxiety, particularly in adolescents who are less equipped to distinguish between the confusing physical and psychological symptoms of anxiety. Moreover, the relationship between sleep and anxiety is not a one way cycle, but a negative continuous circle. While lack of sleep can exacerbate anxiety, anxiety can also lead to a lack of sleep. Anxious feelings and thoughts can keep an individual up at night, which in turn can lead to restlessness and even more anxiety. Not surprisingly, insomnia is often a symptom of anxiety disorder. In order to break this circle, it is very important that teens experiencing difficulty sleeping seek help as soon as possible.
Unhealthy sleep patterns in adolescents can also lead to depression, a mental health condition characterized by extreme levels of sadness, hopelessness, and overall loss of interest. Lack of sleep decreases neurotransmitters in the brain such as serotonin and dopamine that regulate mood and emotions. Indeed, individuals with insomnia are much more likely to develop depression than those who get an appropriate amount of sleep each night. Because insufficient sleep prevents the body from healing itself emotionally or physically during the night, too little sleep causes both increased negative reactions to everyday stressors and decreased positive emotional states. Like anxiety, sleep and depression also have a cyclical relationship – while insomnia may cause depression, depressive disorders also lead to insomnia, and many individuals with depression have trouble falling and staying asleep. Serious insomnia can impair decision making and clear thinking, ultimately leading to suicidal thoughts and ideations. Therefore, the risk of suicide is important to consider when adressing adolescent sleep concerns. Treating sleep issues in teens at an early stage can significantly help alleviate depressive symptoms.
Research has also shown that insufficient sleep levels can lead to increased alcohol and drug usage, including binge drinking, drunk driving, black outs, and other dangerous behaviors. While more research is needed on the exact connection between sleep and alcohol/drug use, teens suffering from insomnia are more likely to use alcohol or drugs (marijuana) as a sleep aid, which can act as a gateway to future problems. Conversely, drug and alcohol abuse can often lead to insomnia, so it is sometimes difficult to know which is the underlying cause. Some of these teens also report engaging in risky sexual behavior, struggling in school academically, or having problems with relationships with friends and family
By all accounts, technology use among teens – social media, television, and video games – has reached epidemic proportions, and much of this use occurs in the evening before bedtime. In addition to causing teens to stay up later and get less sleep, research demonstrates that screen time in the evenings negatively affects both the duration and quality of teens’ sleep patterns. Blue light, which comes from the screen of devices, prevents the body from making melatonin, making it harder to fall asleep. Scrolling through social media before bed can also be overstimulating for young brains, causing social anxiety and stress which leads them to have more difficulty falling asleep. Social media usage has also been shown to lead to anxiety and depression, especially for adolescent females with body image issues who spend countless hours comparing themselves to others, which in turn leads to sleep loss. Notifications and checking messages and social media during the night also can cause disrupted sleep patterns or even obsessive technological behaviors. This sleep deprivation in the evenings quickly translates into increased sleepiness during the day. For parents, it is important to set boundaries. Consider having a no screen time rule prior and during sleep, beginning one hour before bedtime. Keep phones, iPads, and computers charging in the kitchen, instead of in teens’ bedrooms.
In the first instance, unhealthy sleep patterns should be addressed by lifestyle changes if possible. When sleep problems persist and begin affecting an adolescent’s daily life, it is important for them to immediately seek help. Different forms of therapy and/or medication can be appropriate, depending upon the severity, duration, and mental health impact of the sleep deprivation. For chronic insomnia or serious sleep issues that have resulted in mental health disorders such as anxiety and depression, mental health professionals and sleep specialists will often recommend CBT, or cognitive behavioral therapy, to help patients understand what is causing the sleep disorder, as well as the best way to address the problem. CBT is a type of goal-driven talk therapy that is useful in treating a myriad of mental health conditions. It can be used alone or in conjunction with medication under adult supervision. While there are a number of prescription medications that may be recommended for mental health conditions, Melatonin is a natural supplement that can be taken before bed to help reset the body’s natural sleep cycle. It is generally safe for short term use, but longer term use should be discussed with a medical provider.
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