Is it a mental health disorder, a physical disorder or simply a lack of SLEEP?

February 19, 2020

Happy Wednesday! Today I wanted to share with you an article I read in Pediatric News written by Tara Haelle. The Title is A Good Night’s Sleep. 

In the article, Tara quotes Dr. Spinks-Franklin, a pediatrician in Texas Children’s Hospital  in Houston as explaining that “social media and electronics are not the only barriers to a good night’s sleep for teens.”

Lets review what is the recommended hours of sleep for children:

infants – 12-16 hours (Oh to be a baby!) including naps (for those ages 4-12 months).     Kids 1-2 years old need 11-14 hours and kids ages 3-5 years old need 10-13 hours  including naps. By the ages of 6-12 years the amount drops to 9-12 hours/night.

Most of us can control how many hours of sleep our little ones get (there are exceptions!), however, the teen years can sometimes pose a challenge when it comes to sleep! Many parents fall asleep before their teens do! Did you know that teens actually need 8-10 hours of sleep? Yet, statistics show that 75 % of seniors get less than 8 hours of sleep!

It’s true that social media, TV and computers contribute to this lack of sleep but a rigorous academic load with extracurricular activities can also play a large role. Some teens work after school and this too feeds into their hours of homework and other responsibilities. Another factor is drinking caffeine in the afternoons. Many teens quickly learn that drinking caffeinated drinks will help keep them up to study but what they don’t realize is how it affects them the following day!

I will also note that sleep apnea can also result in the symptoms discussed below. If you notice that your teen is snoring loudly or has pauses in their breathing during sleep discuss this with your doctor and consider a referral to an ENT (Ears, Nose and Throat specialist). This is a treatable disorder than can truly change a child’s life.

I for one believe in later start times for teens. Enforcing early start times in schools leads to a decrease in sleep overall and as a result increases the levels of irritability and other problems as I will explain.

According the Dr. Spinks-Franklin, there are 2 kinds of sleep problems in teens: insomnia and delayed sleep phase syndrome. Both are very important since they can lead to short  and long term physical and mental health issues.

In the short term, a lack of sleep leads to poor judgment, poor executive functioning and even depression.

The interesting part of the article addresses the similarity in symptoms between ADHD and a lack of sleep:

  1. Depression, feeling sad, or emotional hypersensitivity.
  2. Mood swings, crankiness (this happens to parents too!)
  3. Difficulty concentrating, fidgeting in one’s seat or daydreaming
  4. Unable to complete tasks or stay on task. Problems with memory
  5. Difficulty in social situations, such as with others in school or friends
  6. Daytime sleepiness
  7. Behavioral issues like impulsivity, aggression or hyperactivity
  8. Frequent careless mistakes
  9. Feeling lethargic or lack of motivation
  10. Easily distracted

The problem with insomnia is that once it starts it is difficult to break the cycle as anxiety and school or social stressors seem worse with the lack of sleep. What can be small hills can feel like mountains impossible to climb.

The second issue mentioned is that of delayed sleep phase syndrome. This is when someone has a delay in the secretion of melatonin and just can’t seem to fall asleep when they want to. In teens this is made worse by sleeping in on the weekends (to catch up on sleep) since this interferes with the body’s circadian rhythm (our body’s physical, mental and behavioral daily cycles) making the problem worse!

So what can we do???

  1. No screen time 1 hour before bed! I try to tell patients to leave reading or project based learning for right before bed and encourage them to do their computer work as soon as they get home from school or activities
  2. No caffeine at least 5 hours before bedtime.
  3. Consistent schedule for sleep (including weekends!)

While all of these can seem difficult to implement, if you are noticing any of the above symptoms with your teen, sit them down and have a discussion about it. If your teen is struggling they may consider your advice. It is worth a try!

Making small changes can have big impacts. Instead of treating the symptoms, let’s try to focus on the why of how we feel instead.

I hope you’re having a wonderful week!

Happy zzzzzzz’s 🙂

Elizabeth Vainder, M.D.

“Good Night:Common Problems seen in teens are insomnia and Delayed Sleep Phase Syndrome.” Pediatric News Volume 54, No.2 February 2020., Tara Haelle, expert analysis from AAP 2019.

** If you suspect that insomnia is affecting your child’s ability to function in school or their day to day life, speak to your pediatrician. Consider cognitive behavioral therapy which can also help with insomnia.

Published by

drvcares

I am a board certified pediatrician with 20 years of clinical experience. I am writing this blog to provide support to parents on their parenting journey. This is not intended for medical advice. My goal is to help parents understand that they are not alone and that many other parents have the same concerns and questions that they do. I will cover different topics related the mental wellness of parents and kids. I hope you will join me and subscribe to website so that you can receive my weekly posts. Remember: Being the best parent you can be is unique to you and your family. This can only happen when you understand that you need to take care of yourself too!

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