Sleep Deprivation in Kids and Teens: A Real Cause for Concern

Sleep is an absolute necessity for optimal health. I’ve written before about the risks of sleep deprivation in adults and why maximizing sleep quality is essential to achieving optimal health. However, children and adolescents are arguably even more at risk, since sleep is so crucial for proper growth and development. In this article, I’ll discuss the health impacts of too little sleep, how much sleep kids and teens really need vs. how much sleep kids in the United States are actually getting, and my tips to help your kids get better-quality sleep.

The health costs of too little sleep

In children and adolescents, insufficient sleep is associated with increased risk for:

• Obesity: a 2015 meta-analysis of longitudinal studies found that children and adolescents with shorter sleep duration had more than twice the risk of becoming overweight or obese (1).
• Diabetes: sleep deprivation adversely impacts blood glucose regulation. A 2012 study found that short sleep duration is associated with increased insulin resistance in adolescents (2).
• Hypertension: youth with short sleep duration have a 2.5-fold increased risk of having elevated blood pressure (3).
• Depression: while the connection between depression and poor sleep may be a vicious cycle, with depression leading to sleeplessness, several studies suggest that poor-quality sleep itself is a risk factor for depression (4, 5).
• Attention and behavior problems: more than a dozen studies have linked attention and behavior issues in children to poor sleep quality and short sleep duration (6, 7, 8, 9).
• Poor academic performance: sleep is unequivocally related to academic performance. Sleep loss is frequently associated with poor learning capacity and neurocognitive performance (10), while earlier bedtimes and wake times are associated with better grades (11).

How much sleep do your kids really need? It might be more than you think!

In teens, short sleep duration is also associated with increased risky behaviors (12):

• Abuse of drugs and alcohol: in a nationwide study of U.S. adolescents, getting seven or fewer hours of sleep was associated with increased use of drugs and alcohol (13).
• Motor vehicle crashes: one study found that later school start times were associated with increased sleep and fewer car crashes among teens (14).
• Suicide attempts: sleeping fewer than eight hours a night is associated with a threefold increased risk of suicidal attempts (15).

How much sleep do kids and teens really need?

To determine how much sleep children and teens need to promote optimal health and avoid all of these potential health issues, a panel of 13 experts at the American Academy of Sleep Medicine reviewed more than 864 articles in 2016 on sleep and health in children and adolescents. They came to a consensus that for every 24 hours, children ages six to 12 years old should sleep nine to 12 hours, and teens ages 13 to 18 years old should sleep eight to 10 hours (16). Therefore, fewer than nine hours in children or eight hours in teens is considered inadequate.

Too many kids getting inadequate shut-eye

Despite the fact that short sleep duration in kids has been a national health concern for a decade, the percentage of students who get sufficient sleep has substantially decreased since 2009. A recent analysis performed by the CDC attempted to determine the prevalence of short sleep duration (fewer than nine hours for middle schoolers and fewer than eight hours for high schoolers) on weekdays. They found that 73 percent of youth got inadequate hours of sleep (17). Here’s the full breakdown: For middle schoolers:

• 6 percent got four hours or less
• 6 percent got five hours
• 11 percent got six hours
• 20 percent got seven hours
• 30 percent got eight hours
• 27 percent got nine hours or more (adequate sleep)

For high schoolers:

• 7 percent got four hours or less
• 13 percent got five hours
• 23 percent got six hours
• 30 percent got seven hours
• 27 percent got eight hours or more (adequate sleep)

Put another way, a whopping 23 percent of middle schoolers and 43 percent of high schoolers get six or fewer hours of sleep per night. And this doesn’t even tell us whether the little sleep they are getting is quality sleep. When we consider these data, is it really any wonder that we have epidemics of childhood obesity, diabetes, and ADHD?

How to support healthy sleep habits

Now that we know just how crucial sleep is, let’s talk about solutions. The conventional approach to sleep difficulties is all too often pharmaceutical intervention. A 2007 study found that 81 percent of visits to the pediatrician for sleep difficulties resulted in a prescription for a sleep medication (18), many of which are not even approved or tested for use in children. In contrast, the functional approach seeks to determine the causes of poor sleep in the first place. While some kids may have more complex causes of underlying sleep abnormalities, in my experience, most sleep difficulties in children can be addressed by making a few simple lifestyle changes. Try these tips in your home to improve your kids’ sleep:

• Get kids outside during the day: Like adults, kids need exposure to bright blue light during the day to help entrain their circadian rhythms. If they attend school during the day, make sure they are getting exposure to sunlight before or after school, or ideally at lunchtime, when the sun is highest.
• Reduce bright light in your house in the evening: Even if you can’t convince your kids to wear the hip blue-blocking glasses, you can reduce the amount of blue light they are exposed to in the evening hours. Try lighting some red-bulb lamps or beeswax candles at night instead of harsh white lights.
• Eat dinner earlier in the evening: Kids may find it difficult to fall asleep with a stomach full of food after a late dinner. Try to eat dinner earlier if possible to allow time to digest, and discourage large late-night snacks.
• Set bedtimes for your kids: Parent-set bedtimes have been associated with improved sleep duration and better daytime functioning in teens (19). If your child isn’t sleepy, encourage him to at least get in bed and read or journal by red or orange light. Children thrive on routines, so having a pattern of low-key activities that repeat every night can help them relax and start to feel sleepy.
• Make the bedroom a device-free sleep sanctuary: Make a house rule that there are no devices allowed in the bedroom at nighttime and set a “media curfew” elsewhere in the house (i.e., no devices after a certain time). Evening technology use is associated with poor-quality sleep and shorter sleep duration among youth (20). If teens must use devices to complete homework in the evenings, be sure that they have blue-blocking applications like F.lux set up on their computers and/or that they wear blue-blocking glasses. Make the bedroom a dark, cool, and quiet place.
• Limit caffeine: The abuse of caffeine in teens is highly concerning. Children and adolescents are one of the fastest-growing populations of caffeine users, with an estimated 70 percent increase in the number of teens using caffeine in the past 30 years (21). There is no evidence for a benefit of caffeine in children and adolescents, and at least one animal study suggests that it could interfere with sleep and brain maturation (22).
• Explain why: Helping kids to understand why healthy sleep practices are important and the association between sleep and their health can reduce their resistance to new practices. It also makes them more likely to continue these practices into adulthood, when they become independent.
• Model good behavior: All of these principles for healthy sleep in kids also apply to adults. If you’re staying up until 12:30 a.m. on your iPad, your kids are much more likely to take after your bad habits. This is a great opportunity for you to check in with your own sleep habits, too!

As a parent, ensuring that your child gets adequate sleep is one of the most important things you can do to set them up for success and health in the future. That’s all for now! Now I’d like to hear from you. Do your kids get enough sleep? Will you incorporate some of these tips? Share your thoughts in the comments below.