By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

CHANGES IN BODY CLOCK AFFECT TEEN SLEEP PATTERNS

Question: My 16-year-old son won’t go to bed at bedtime. My husband and I turn in around 9 p.m., but our son is up until after midnight. During the week, we all get up at about the same time, 6 a.m., but on weekends we don’t see him until after noon. What can I do to stop this behavior? I think he is resisting going to bed to be “cool.” He seems tired all the time. This worries me, as well, since he has just started to drive.

Answer: Mom, your concern is well-founded. However, your son’s problem of not getting to sleep before midnight may be primarily due to his age rather than any conscious effort on his part to be cool or trendy. Adolescents have physiologically different sleep patterns than younger children or adults.

A lot of research has been done recently into adolescent sleep patterns. On average, children need 10 hours of sleep nightly, adults 8.25 hours and adolescents 9.25 hours of sleep every night.

As a result, many concerned parents want high school starting times changed. A number of school districts across the country have already done this. These include schools in Arlington, Va.; Lexington, Ky.; and Minneapolis, Minn. These districts report that after the change, students get more sleep and show reductions in absences and tardiness.

Another important benefit of this change is that it should lead to a decrease in car accidents. In fact, research reported by the National Highway Transportation Safety Administration shows that young drivers (25 or under) are involved in more than one-half of fall-asleep crashes.

Why is it that people in this age group don’t have the same sleep patterns as their younger siblings or their parents?

During the middle teenage years, our biological clocks undergo a change that makes it hard to fall asleep until later in the evening. This could be as late as 10 p.m. or even 11 p.m. The problem results from a “time shift” in the secretion of melatonin, one of the hormones that helps regulate sleeping and waking patterns. After age 16, the nightly release of melatonin takes place later than it does in early adolescence, making it harder to fall asleep until later in the night.

It is not clear why this change in our body clock -- or circadian rhythm -- occurs. Some feel this is due to the hormonal and physical changes taking place during this developmental period. Teenagers’ erratic schedules -- up early during the week and sleeping in on weekends -- can also cause sleep phase circadian rhythm problems.

So what can be done? Understanding that this is a developmental phase can help. At the same time, talk with your son about how he can get better sleep. Here are some tips.

• Get about 9 hours of sleep nightly.
• Stay on the same sleep/wake schedule, even on weekends.
• Avoid bright lights, which signal the body to wake up, in the evening.
• Get into bright lights as soon as possible upon awakening.
• Avoid caffeine and nicotine after noon.
• Avoid alcohol.
• Relax before going to bed -- but NO computer games.

This is one of the phases he will outgrow, but it’s a good idea to promote good sleep habits at any age.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.