Teens Are Sleep-Deprived, And Screens Are Why, Study Suggests

American Council on Science and Health

So often when we take a closer look at a particular concern, inevitably we conclude that the biggest influencer at play is the smartphone. Whether it’s to assign blame, dispense praise or explain any range of human behaviors, so frequently this ubiquitous device finds its way into the center of the discussion.

And given the wide range of services the device can perform – web access, photography, voice communications, and more – that’s understandable.

Distracted driving? Yes. We examine the role that texting plays when we’re behind the wheel.

Teenage anxiety? Bullying? Self-worth? Yes, yes and yes. The talk becomes how social media interaction – and access to it on a tiny machine that nearly every kid in America carries everywhere – affects the psyche and human development of teenagers. The list of issues goes on and on.

In fact, this dynamic has become so prevalent that when we even suspect the smartphone as being a major source of a particular problem, we’re now almost inclined to react the opposite way. We’re starting to reject the knee-jerk reaction that the phone is always the cause of the problem, since, surely, not every problem can be traced back to the device, right?

Yet, sometimes, the smartphone may actually be responsible.

That’s the conclusion drawn by researchers at San Diego State University studying sleep-deprived American teenagers. After conducting a meta-analysis surveying more than 360,000 subjects, they concluded that decreasing sleep time comes at the expense of increasing screen time.

“Teens’ sleep began to shorten just as the majority started using smartphones,” states Jean Twenge, Professor of Psychology at SDSU. “It’s a very suspicious pattern.”

As we wrote earlier this year, the National Sleep Foundation recommends teenagers get between 8 and 10 hours of sleep nightly. Contrast that to the findings by researchers, who say that beginning in 2009 when smartphone use became widespread, there was a 17 percent increase of students reporting sleeping 7 hours or less per night, which sleep experts term as insufficient.

The research team used data from two “long-running, nationally representative, government-funded surveys,” one called Monitoring the Future, and another called the Youth Risk Behavior Surveillance System and determined that “about 40% of adolescents in 2015 slept less than 7 hours a night, which is 58% more than in 1991 and 17% more than in 2009.”

Meanwhile, those who spent 5 hours daily on their devices had a 50 percent greater chance of not getting the adequate amount of sleep that other teenagers got who were online for just an hour.

“Portable media devices are of special importance for insufficient sleep as they not only directly displace or delay sleep time by increasing arousal that interferes with sleep,” the authors wrote in their paper titled, “Decreases in self-reported sleep duration among U.S. adolescents 2009-2015 and links to new media screen time,” published in the journal Sleep Medicine, “but are also easily carried into the bedroom and used in bed before sleep while emitting light that can affect sleep-wake rhythms.”

The Science of Adolescent Sleep

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Why do children wake up early when they are young but want to stay in bed till noon as teenagers?

Experts say it’s biology. Adolescents’ bodies want to stay up late and sleep late, putting them out of sync with what their school schedules demand of them. So kids have trouble waking up, and they often find themselves feeling drowsy in morning algebra class.

But that chronic sleepiness can affect their health and well-being, their behavior, and even their safety; it becomes genuinely dangerous when sleepy teenagers get behind the wheel.

At a recent conference on adolescent sleep, health and school start times, at which I gave a brief keynote, several experts made compelling arguments supporting the idea that middle and high school start times should shift to 8:30 a.m. or later, as recommended by the American Academy of Pediatrics and the American Academy of Sleep Medicine.

Brian Tefft, a senior researcher with the AAA Foundation for Traffic Safety, talked about “drowsy driving.” He cited an annual study that asks, “In the past 30 days how often have you driven when you were so tired that you had a hard time keeping your eyes open?” Over the past five years, on average, a quarter of the 16- to 18-year-old licensed drivers reported driving in that condition at least once, and 2 percent said fairly often or regularly.

The argument is that teenagers who face very early school start times are at risk of regular sleep deprivation. Driving after sleeping only four to five hours a night is associated with a similar crash risk as driving with an alcohol level at the legal limit. Sleeping less than four hours puts you at the same risk as driving with double the legal alcohol limit. (This is not only true for adolescents, but for all of us.)

Drowsy driving may not be the only risk that tired teenagers take. Wendy Troxel, a clinical psychologist and senior behavioral and social scientist at RAND, talked about the “adolescent health paradox,” that teenagers, who are in a developmental period of physical strength and resilience, face disproportionately high mortality rates. Unintentional injury (especially car crashes) is high on the list of causes, followed by homicide and suicide.

“The onset of new cases of depression skyrockets when kids become teens,” Dr. Troxel said. And we spend a great deal of time, money and energy on programs to prevent adolescent violence and suicide, to counsel against substance abuse and unsafe sex — and not always successfully. Given the vulnerability, and the dramatic changes happening with development, researchers are looking for other ways to support adolescent brains and general well-being. “Sleep loss problems are linked with brain areas that control emotional processes and risk taking,” she said. “Sleep problems and behavioral and mental health problems are linked.” (She recently gave a TED talk on why school should start later for teens.)

The vision of those who organized the conference, led by Dr. Judith Owens, director of sleep medicine at Boston Children’s Hospital and Jim Healy, a retired investment banker who is a parent activist in Greenwich, Conn., on this issue, was to bring together scientists, doctors and community members and address an audience that included school officials and legislators.

Dr. Daniel Buysse, professor of sleep medicine at the University of Pittsburgh Medical Center and the author of a 2014 article on sleep health, spoke about what regulates sleep. There’s a sleep drive that builds up according to how long you’ve been awake, he said, and then dissipates as you sleep. Your 24-hour rhythm and your level of arousal and engagement from moment to moment also regulate sleep.

“How are these things affected in adolescents?” he asked. Their sleep drive takes longer to build up than it did in childhood, he said. “They don’t reach that critical level of sleepiness till a later time at night.”

A student who could handle elementary school starting at 9 a.m. may have to contend with middle school starting at 8 a.m. just as social demands and his or her own sleep cycle shift later, putting development, biology, social connections and academic expectations into conflict.

The brain needs sleep to replenish energy sources, said Dr. Charles A. Czeisler, a professor of sleep medicine at Harvard Medical School. “Sleep is critical to maintain focus and alertness, to repair and maintain brain cells, to clear out toxic metabolites,” he said.

Dr. Mary Carskadon, a professor of psychiatry and human behavior at Alpert Medical School of Brown University, spoke about the variety of developmental alterations that take place in adolescence, from changes in the brain to different patterns in metabolism, and the ways that sleep patterns are affected. Those same children who were once eager early risers, she said, begin staying up later and become, as many parents know, hard to rouse in the morning.

“Some people don’t get it, that this is biology,” she told me. “Adolescent sleep delay is not just in human teenagers; it’s seen in other juvenile mammals.”

And when they do wake up and get to school, their brain function is not at its best. Amy R. Wolfson, a professor of psychology at Loyola University in Maryland, and the co-editor of The Oxford Handbook of Infant, Child, and Adolescent Sleep and Behavior, said that high school students tend to perform better in courses that meet later in the day, and perform better on cognitive tests when they are given in the afternoon.

The adolescent response to chronic sleep loss may be to consume a great deal of caffeine, Dr. Troxel said, leading to a “tired but wired” state in which risk-taking becomes more likely, in a setting where adolescent biology is in conflict with academic expectations and school schedules.

How much sleep do kids and teens really need? New recommendations from experts.

The Washington Post

By Valerie Strauss June 15, 2016
Anyone who has ever watched children get on a school bus before the sun is up in the morning or teens walk into their first class clutching a jug of coffee knows that too many young people aren’t getting enough sleep. In fact, experts say that more than a third of the U.S. population doesn’t. Now, the American Academy of Sleep Medicine has just released, for the first time, its recommendations for how much sleep children and teens should get to avoid health risks.

The academy also said that children and teens who do not sleep the recommended amount put themselves at risk for obesity, diabetes, depression, behavior and learning problems, hypertension and more. For teens, there’s more: an increased risk of suicidal thoughts, suicide attempts and self-harm, the panel said.

The recommendations are:

Infants 4 to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health.
Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health.
Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health.
Children 6 to 12 years of age should sleep nine to 12 hours per 24 hours on a regular basis to promote optimal health.
Teenagers 13 to 18 years of age should sleep eight to 10 hours per 24 hours on a regular basis to promote optimal health.
Teens getting up to 10 hours of sleep? Remember that teens, because of unique sleep patterns driven by their circadian rhythms, have a hard time falling asleep before 11 p.m., and their brains stay in sleep mode until at least 8 a.m. With school often starting very early in the morning, teens can’t get eight to 10 hours of sleep. That’s why in 2014, the American Academy of Pediatrics issued a policy statement recommending that middle and high schools start class no earlier than 8:30 a.m. Some school districts have moved their start times, but most haven’t, meaning that most teens who go to school are likely to carry on without the recommended sleep.

The American Academy of Sleep Medicine says it is the only professional society dedicated exclusively to the medical sub-specialty of sleep medicine. Its release of the sleep recommendations came after a 10-month study conducted by a panel of 13 leading sleep experts that reviewed 864 published scientific articles about the relationship between sleep and children’s health and evaluated the evidence. These recommendations are endorsed by the American Academy of Pediatrics, the Sleep Research Society and the American Association of Sleep Technologists.