Ask The Expert: Sleep and Teens

Image
NSF

Dr. Daniel Lewin

My 17-year-old daughter will not get out of bed in the morning. I try and try to wake her but it is near impossible. I don't want her to be late for school but clearly she is too tired to get out of bed. What should I do?

Total sleep need, even for a 17-year-old, is greater than adults, between 8.5 and 9.5 hours. If she is not sleeping at least 8 hours a night on average during the week, then the first step is to find a way to increase her NIGHT TIME sleep period. If she cannot fall asleep at night then she should, for at least two weeks, cut out television, video games and internet access within two hours of a bedtime to allow her to sleep a total of 8 hours a night. She should also cut out all caffeine after lunch. This is only a start and often more assessment and changes in sleep schedules and sleep habits are required.

My son is a freshman in high school and he wants to join the wrestling team, but they practice early in the morning and I'm concerned that he won't get enough sleep. What do you recommend?

Your concern is important. Sports practices and other extracurricular activities are very important, but participation in them may result in reduced total sleep time. Sleep experts recommend that sleep should be a priority. Make his participation in wrestling contingent upon his grades, and sleep for at least 9 hours a night. It may mean that he'll have to give up another activity. Help him prioritize his activities and weigh his desire for short-term highly rewarding activities, like watching television and playing video games, against his desire to be on the wrestling team.

I have a 16-year-old who comes home every day and collapses on the couch. Is that a problem? Should I let her nap? If so, for how long?

There are individual differences in the need for napping. Some adults and children need to nap. However, the majority of teenagers probably nap in the afternoon because they are not sleeping enough at night. Long afternoon naps are problematic because they occur during time when adolescents should be engaging in social, academic and extracurricular activities. Long naps also rob an individual of his or her ability to fall asleep at night. So, if your daughter is having difficulty falling asleep at night, she should cut out her afternoon nap. A power or cat nap of 15–20 minutes is fine.

How can I get my kids to go to sleep at a normal hour?

A regular bedtime routine, a regular sleep schedule, and clear and consistent limit setting are the key factors that help a child fall asleep at night. Most children up to age 6 should be able to fall asleep between 7 pm and 8:30 pm. Six-to eleven-year-olds may fall asleep between 7:30 pm and 9 pm, and teenagers should be able to fall asleep between 9 pm and 10:30 pm. Anxious and depressed children sometimes need special support to fall asleep at night, and teenagers have a biological propensity to fall asleep later and wake up later. There are also several sleep disorders that may interfere with a child's ability to fall asleep at a normal hour.

I set my child's bedtime for 11 pm but he just isn't tired. What should I do? What should I allow him to do until he gets sleepy?

Unless it is a vacation or weekend, 11 pm is a very late bedtime for any child. Begin by averaging how long your child sleeps during the night throughout a whole week and then figure out how much he or she sleeps during the day. Begin by eliminating or shortening daytime naps to 20 minutes. Cut out all caffeinated beverages and drinks. Only allow the child to engage in quiet, relaxing activities during the 1 to 2 hours leading up to bedtime. During this 1 to 2 hour period, there should be no television, video games or internet access. Reading, board games, writing, drawing and art projects are all good activities that require some mental effort, but are not overly stimulating.

--Dr. Daniel Lewin is a licensed clinical psychologist and specializes in pediatric sleep medicine and pediatric psychology. He is an Assistant Professor of Pediatrics and Behavioral Medicine at the George Washington University School of Medicine and Health Sciences and Director of the Children's National Medical Center(CNMC), Pediatirc Neurobehavioral Sleep Medicine Program. He also serves as the director of training and research in the CNMC, Pediatric Sleep Medicine Program. Dr. Lewin is board certified in sleep medicine by the American Academy of Sleep Medicine.

This article originally appeared in the Summer 2005 issue of sleepmatters.