The science of lost sleep in teens
Studies by Brown, Lifespan scientists are at cutting edge of sleep researchProvidence, RI -- A new poll of teenagers across the US finds that many of them are losing out on quality of life because of a lack of sleep. The results, announced today by the National Sleep Foundation (NSF), cite sleeping in class, lack of energy to exercise, feelings of depression, and driving while drowsy as only some of the consequences for insufficient sleep.
The poll data support previous work by three Rhode Island researchers who are at the forefront of sleep research. Previous studies from Brown Medical School, and Lifespan affiliates Bradley Hospital and Hasbro Children's Hospital, have found that adolescents are not getting enough sleep, and suggest that this can lead to a number of physical and emotional impairments.
Mary A. Carskadon, PhD, with Bradley Hospital and Brown Medical School, chaired the National Sleep Foundation poll taskforce and has been a leading authority on teen sleep for more than a decade. Her research on adolescent circadian rhythms indicates that the internal clocks of adolescents undergo maturational changes making them different from those of children or adults. Nevertheless, teens must adhere to increasingly earlier school start times that make it nearly impossible for them to get enough sleep.
"Our results show that the adage 'early to bed, early to rise' presents a real challenge for adolescents," says Carskadon, who directs the Bradley Hospital Sleep and Chronobiology Sleep Laboratory and is a professor of psychiatry and human behavior at Brown Medical School.
Carskadon's work has been instrumental in influencing school start times across the country. Regionally, the North Kingstown School Department in Rhode Island, North Reading Public Schools in Massachusetts, and West Hartford Public Schools in Connecticut are considering school start time changes due, in part, to research on teens and sleep.
In a study published in the November 2005 issue of the journal Sleep, Carskadon found that the "sleep pressure" rate – the biological trigger that causes sleepiness – slows down in adolescence and is one more explanation for why teens can't fall asleep until later at night. Carskadon's newest finding indicates that, in addition to the changes in their internal clocks, adolescents experience slower sleep pressure, which may contribute to an overall shift in teen sleep cycles to later hours.
Judy Owens, MD, a national authority on children and sleep, is the director of the pediatric sleep disorders center at Hasbro Children's Hospital and an associate professor of pediatrics at Brown Medical School. Her latest book, "Take Charge of Your Child's Sleep: The All-in-One Resource for Solving Sleep Problems in Children and Teens," is especially important in light of the fact that 90% of the parents polled believed that their adolescents were getting enough sleep during the week.
"This poll sends a clear message to parents: Teens are tired," says Owens. "Parents can help get a handle on the problem by eliminating sleep stealers such as caffeinated drinks in the fridge or a TV or computer in the teen's bedroom as well as enforcing reasonable bed times."
Last June, a major report in the journal Pediatrics merged a review of more than two decades of basic research with clinical advice for physicians. Rhode Island authors included Carskadon, Owens, and lead author, Richard Millman, MD, professor of medicine at Brown Medical School and director of the Sleep Disorders Center of Lifespan Hospitals, a Rhode Island sleep research and treatment center that is one of the largest in the country.
The report indicated that adolescents aged 13 to 22 need nine to 10 hours of sleep each night. It also discussed the hormonal changes that conspire against them. When puberty hits, the body's production of sleep-inducing melatonin is delayed, making an early bedtime biologically impossible for most teens. At the same time, the report notes, external forces such as after-school sports and jobs and early school start times put the squeeze on a full night's sleep.
The result: A "profound negative effect" on mood, school performance and cognitive function. Studies also show that young people between 16 and 29 years of age were the most likely to be involved in crashes caused by the driver falling asleep.
"Some of our kids are literally sleep-walking through life, with some potentially serious consequences," Millman said. "As clinicians and researchers, we know more now than ever about the biological and behavioral issues that prevent kids from getting enough sleep. But the National Sleep Foundation did something powerful: They asked teens themselves about their sleep. The results are startling and should be a wake-up call to any parent or pediatrician."
Brown Medical School is Rhode Island's only school of medicine and the hub of the state's academic medical enterprise. As part of an Ivy League university, the medical school attracts leaders in teaching and clinical care and, with its seven affiliated hospitals, brings in more than $120 million in external research funding each year. Brown Medical School's Department of Community Health, ranked 6th in the nation by US News and World Report, offers comprehensive graduate programs in epidemiology, biostatistics as well as a master of public health degree.
Founded in 1931, Bradley Hospital (www.bradleyhospital.org) was the nation's first psychiatric hospital operating exclusively for children. Today, it remains a premier medical institution devoted to the research and treatment of childhood psychiatric illnesses. Bradley Hospital, located in East Providence, is a teaching hospital for Brown Medical School and ranks in the top third of private hospitals receiving funding from the National Institutes of Health. Its research arm, the Bradley Hasbro Children's Research Center (BHCRC), brings together leading researchers in such topics as: autism, colic, childhood sleep patterns, HIV prevention, infant development, obesity, eating disorders, depression, obsessive-compulsive disorder (OCD) and juvenile firesetting. Bradley is a private, not-for-profit hospital and operates the Bradley School, a fully certified special education school. Bradley is a member of the Lifespan health system.
Hasbro Children's Hospital (www.hasbrochildrenshospital.org) in Providence, RI, is the pediatric division of Rhode Island Hospital, the largest teaching hospital of Brown Medical School. A private, not-for-profit hospital, Hasbro has been named as a top children's hospital by Child magazine, ranking 9th in orthopedics. It is nationally recognized for its child protection program and Draw-A-Breath asthma and allergy initiative. It is also the home of the Injury Prevention Center, which aims to reduce accidental injuries in children. The hospital has pioneered numerous procedures and is at the forefront of fetal surgery, orthopedics and pediatric neurosurgery. Hasbro Children's Hospital is a member of the Lifespan health system.
Last reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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