Have you ever fallen asleep in class and the more you tried to stay awake, the sleepier you felt? Suddenly, something startled you (like your teacher's voice!) and you woke up. You felt groggy and embarrassed, wondering what you missed while you slept.
Luke (not his real name) had a hard time staying awake in his classes. He thought it was because math and science weren't his favorite courses. But there was something more serious going on.
Luke had obstructive sleep apnea, a sleep disorder that causes periods when breathing stops (apneas), and interrupts deep sleep. Luke's doctor recommended that he have his tonsils and adenoids removed. Within several weeks of having the outpatient surgery, Luke was sleeping soundly at night and feeling alert and productive at school during the day.
You never think about needing more sleep ... until you start to feel exhausted like Luke did. Even if they don't have sleep disorders, most teens are sleep-deprived. They may stay up late surfing the Internet, watching favorite late-night shows, or just tossing and turning for hours with eyes wide open. Sleep is also often disrupted during stressful times like exams or when you're having relationship problems. Your mind goes into overdrive, making it impossible to relax.
How Much Sleep Is Enough for Teens?
On average, teens need about 8 1/2 to 9 1/2 hours of sleep each night. If you fall asleep at 10 p.m., you'd need to sleep until 7 a.m. to meet this requirement. That's not always possible, especially if you have to be up before dawn to catch the bus or make swim team practice.
Many teens suffer with chronic insomnia. That means difficulty falling asleep or staying asleep, or not feeling rested despite spending enough time in bed.
Problem is, missing sleep repeatedly affects every part of your life -- from relationships with friends, to your ability to concentrate at school, to your mood. Many teens who miss sleep suffer with irritability, mood swings, and even depression.
Sleep deprivation also affects your complexion, your health, and your weight. (Some studies link sleeping less with an increased risk of obesity.) Too little sleep can also make young people more likely to suffer injuries and have auto accidents. That's why it's so important to deal with sleep disorders when they occur.
How Sleep Works
Everyone needs restful sleep to be energetic and alert, and to stay healthy. To help you understand how sleep affects you personally, let's look at how sleep works.
- REM (rapid eye movement) sleep, when you may recall vivid dreams.
- NREM (nonrapid eye movement) sleep.
NREM sleep has four levels or stages. Stage 1 sleep, the lightest stage, is the transition from being awake to deeper sleep. Stage 2, intermediate sleep, accounts for 40% to 50% percent of your sleep time. Stages 3 and 4, called slow wave or delta sleep, are the deepest levels and occur mostly in the first third of the night. It is during delta sleep when your body heals itself. It is also difficult to awaken from delta sleep, as most of us feel dazed or groggy.
Sleep stages cycle every 90 to 120 minutes. During a normal night, there are about four to five sleep cycles.
Our circadian cycles -- that is, our internal "body clocks" -- determine our daily sleep cycles, performance, alertness, moods, and even our gastrointestinal functions and metabolism. Melatonin, a hormone made by the pineal gland in the base of the brain, is linked to the circadian system. Along with sunlight, melatonin helps to set the brain's biological clock. At night, melatonin is secreted, causing the body temperature to lower, and helping us sleep.
What's Keeping You From Getting Good Sleep?
Often, getting to bed an hour earlier can resolve sleep issues and help you feel alert and productive. But sometimes there are other reasons for disturbed sleep. Here are some medical conditions that cause sleep problems:
- Snoring and Obstructive Sleep Apnea. Snoring occurs when airflow is limited and the soft tissues in the back of the throat vibrate. While snoring is annoying and causes poor sleep, it can be a symptom of a more serious sleep disorder called Obstructive Sleep Apnea (OSA). OSA involves severe narrowing of your airway. Your lungs do not get enough fresh air, so the brain wakes you up just enough to catch your breath and unlock the air passage. If you snore loudly or have excessive sleepiness, talk to your doctor.
- GERD. Some teens suffer with gastroesophageal reflux disease (GERD), which generally occurs at night when you are lying down and interrupts your sleep. Normally, a muscular valve between the esophagus and the gastric system prevents stomach acids from backing up into the esophagus. In GERD, this valve does not work properly. The stomach acids "reflux" or back up into the esophagus. This causes irritation and inflammation, and it can interfere with the sleep cycle.
- Restless Legs Syndrome. Restless legs syndrome is a creeping, crawling sensation in the legs that creates an irresistible urge to move. It sometimes starts between ages 11 and 20. Not only does it disturb sleep, it is also linked with involuntary jerking movements of the legs during sleep, called periodic leg movements of sleep (PLMS).
Get Better Sleep
If you try to relax and follow good bedtime "hygiene" yet still cannot get enough restful sleep, talk with your doctor. If your doctor suspects you might have a sleep disorder, you might be referred for a sleep study, called a polysomnography. The sleep study will help determine if you have apnea, restless legs syndrome, or some other problem. All of these disorders require specific therapy that your doctor can prescribe.
If you have no physical problem, check out the following "E-ZZZ sleep tips" to guarantee more restful sleep:
- Establish a regular bedtime routine and stick with it, even on weekends.
- Tone down loud music or flashing computer screens as you prepare for bed. Experts advise you to shut down devices like laptops and cell phones so you are not interrupted by text messages and alerts. One recent study, of almost 10,000 teens (ages 16-19), found that the use of electronic devices before bedtime resulted in less sleep.
- Eat less sugar, which can cause sudden rises in your blood sugar. This may then cause you to wake up in the middle of the night when your blood sugar drops low.
- While regular exercise helps you sleep more soundly, you should avoid exercise right before bedtime.
- When you get up in the morning, get into bright light as soon as possible. Avoid bright light in the evening. Light signals to the brain when it should "wake up" and "go to sleep."
- Reduce noise in your bedroom, Wear earplugs if you're bothered by noises while sleeping. Some people find that "white noise" -- from a fan, radio static, or a white noise machine -- can help.
- Eat foods for a calming effect. Studies at the Massachusetts Institute of Technology found that foods high in carbohydrates, like breads, cereal, or pasta, raise the level of serotonin in the brain (serotonin is a mood-elevating brain chemical). When serotonin levels rise, we feel a calming effect and sleep more soundly.
- Take a warm bath before bedtime. Sleep usually follows the cooling phase of your body's temperature cycle. After your warm bath, keep the temperature in your bedroom cool to see if you can influence this phase.
- If you're taking any medication, your sleep-wake cycle may be affected. If you use an inhaler or take Ritalin or Adderall (used in treating ADD and ADHD), be aware that these medications sometimes cause insomnia.
- Have peace of mind. Anxieties and worries can interfere with healthful sleep. Try relaxation therapies, such as meditation, prayer, or yoga before bedtime.
If you think you are having any of the medical problems discussed above, or if you are stressed or depressed and the simple suggestions above are not helping, see your primary health care provider. Good sleep is essential for health. If you are not getting it, seek help.