Delayed Sleep Phase Syndrome (DSPS) and Teenagers

The scenario of the late-night teenager being dragged out of bed in order to go to school is classic. Up until recently, such behavior was blamed on poor sleep hygiene, laziness, and maybe the side effects of hormone imbalances. 

Now we know better. Research shows our kids are more likely to become night owls during their teens, and that this is a normal part of growing up. 

What's unfortunate is that some of our teens develop delayed sleep phase syndrome or DSPS, which exaggerates this late rhythm shift. Add other influences like cell phone use, caffeine as self-medication, and the demands of school, sports, and job schedules, and it's easy to see how our young people have become dangerously sleep deprived.

 

Reasons why teenagers are sleep deprived

Bad habits and behaviors may still be part of the bigger picture. However, there are physiological changes going on in the adolescent brain which also account for these late-night leanings. 

DSPS and the teenaged brain

The brains of teenagers undergo one final developmental phase that includes the loss of volume in the cortex, the headquarters for executive function, sensory processing, and memory. The decline in cortex volume is normal, a sign that late-stage brain maturation is taking place.

Changes in the way the brain regulates sleep result in teens staying up late. This normal delay in the circadian system is joined by a slower buildup of "sleep drive," also considered normal during puberty.

Parents, take comfort: your kids' desire to burn the midnight oil is perfectly normal, if inconvenient. You might say that it's just a "phase." In up to 16 percent of teens, it truly has to do with phasing.

Delayed sleep phase disorder, or DSPS, is common among teens; it reflects a mismatch between sleep drive and social obligations. 

Kids with bona fide DSPS struggle with:

Meanwhile, they have no other sleep or medical problems or apparent sleep hygiene issues to explain their sleep delays.

The challenge with teenagers and DSPS comes at the crack of dawn. Most teens are not ready to awaken at the hours society requires.

Nor are they ready to go to bed, even if they wanted to: social time (live or online) keeps them awake, as does the demands of homework, jpbs, social lives, even late-night team practices.

If teens go to bed at 1 am, and they need to be somewhere by 8 am—what seems to be a reasonable time to start the day to most adults—that's only 7 hours of sleep, not factoring in the time it takes to fall asleep, and the time it takes to get ready and go. This is far less than the 8 to 10 hours of sleep recommended by the National Sleep Foundation. 

Imagine what it must be like for those teens who must rise even earlier... bell times for "zero period" at high school or early-morning team practices (sometimes as early as 5 am).

Studies show: most teens do not get enough sleep—as few as 15 percent achieve 8 or more hours of sleep on school nights.

The demands placed on teens force them into patterns of sleep deprivation during the week, followed by Saturday sleep ins, which only partially recover sleep debt, but disrupt circadian rhythms. Then Monday morning rolls around, and they return to an early schedule for another week of sleep deprivation.

It's no wonder our kids are falling asleep in class.

Research shows they are paying a price: they experience fewer stages of critical REM sleep during weeknights which may be blamed for behavioral and educational difficulties.

Also on the increase for sleep-deprived teens are rates of absenteeism and risk-taking behaviors like drinking alcohol, smoking, drug use. Sleep-deprived teens are more likely to become obese. Academic performance can decline as well.

School start times

The Start School Later movement began as a response to this inequitable arrangement. With conclusive scientific evidence to support them, activists began entering into dialog with school boards nationwide to raise awareness about sleep deprivation among teens, much of it caused by the systems that exist to serve their educational needs.

The statistics are alarming. While the American Academy of Pediatrics recommends that middle and high school students start class 8:30 am or later: 

Seattle Public Schools was one of the biggest systems to come on board in 2015; its system is mutilayered and the restructuring of hours and transportation schedules required exhaustive strategizing before a later bell time schedule was finally approved and instituted. 

The problem with coffee

Many adults think the notion of sleepy kids is nothing new, and that if they can get by with a cup of coffee in the morning, so can these kids. 

It's a problematic attitude, especially in communities like Seattle where swigging espresso shots is an iconic pastime. 

However, teens don't just drink a morning cup of joe these days. They use caffeine to bolster alertness... not just in the morning, but all day long and into the evening.

Caffeine use, according to the American Academy of Pediatrics, can "lead to insomnia or subconscious sleep disruption and subsequent daytime drowsiness, which in turn may lead to an increased need for caffeine the next day. Excessive use of caffeine... under conditions of sleepiness may provide apparent short-term gain but long-term negative consequences on sleep and circadian health."

This is why coffee can be a problem: Late-night teen consumers of caffeine drinks may or may not have DSPS. Instead, their caffeine habit may be the key reason why they can't fall asleep at night. Caffeine is not, and has never been, a tenable solution to the problem of sleep deprivation.

Teens and screens

An issue most adults also don't think about relates to the ubiquitous use of backlit devices into the evening hours (by all people, regardless of age). 

For teens, the practice of staring at some kind of screen—whether it is a cell phone, laptop, gaming device, or tablet—means they are engaging in the delay of their own sleep chemistry. 

Blue spectrum light emissions from all handheld devices can be blamed to insomnia for anyone who stares at their screens during the evening hours. The brightest light on the spectrum is blue, and when the eyes perceive it, they send signals to the brain to shut down the release of the hormone, melatonin, which facilitates sleep.

If a teen has been engaged with his screen for several hours, putting it down to sleep is almost a guarantee of self-imposed insomnia, as hisbrain, confused by the bright light interruption, may required added time to restart the pineal gland so it can produce melatonin. 

Drowsy driving: teens at high risk

The problems of daytime fatigue, compromised impulse control, and poor attention spans among teens may easily be due to sleep deprivation.

Drowsy driving rates among teenagers are on the increase for this reason. Even teens with good driving skills and a few years of experience can easily make mistakes behind the wheel due to insufficient sleep.

 

Check out these statistics:

Veteran sleep researcher Mary Caskardon captures the reality of our sleep-deprived teenagers best: 

 "... we see the teenager who falls asleep driving home late at night; in another teen, the problem emerges with titanic struggles to wake up in the morning, often failing and resulting in late or missed school; another may simply feel sad and moody and blue, lacking initiative or motivation; in other teens, grades begin to suffer as the teen struggles to keep awake during class and while doing homework; another may turn to heavier drugs to get some positive and arousing sensations; many just struggle along in a kind of haze, never knowing how to feel or do their best."


 Sources: 

American Academy of Pediatrics
American Academy of Sleep Medicine
BMC Public Health
Centers for Disease Control
Cleveland Clinic 
Journal of Adolescent Health Care
National Highway Traffic Safety Administration
National Institute of Mental Health
National Sleep Foundation
Start School Later

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