# data[].attributes.body
https://www.cnn.com/2022/06/07/health/teen-sleep-deprivation-wellness/index.html

# data[].attributes.attachment_link.readable_text
Sign up for the Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep.

American teenagers aren't getting enough sleep these days, and author Lisa L. Lewis refuses to snooze on the issue anymore.

Lewis, a mother of two, helped spark the first law in the nation requiring healthy school start times for adolescents - a law that will be put into action in California later this summer.

Her new book, " The Sleep-Deprived Teen: Why Our Teenagers Are So Tired, and How Parents and Schools Can Help Them Thrive," was releasedJune 7 and details so many things parents and caregivers need to know about teenagers and sleep.

Lewis shared why sleep is so important for teenagers, how much sleep teens should be getting, and why they need to sleep more than adults. She touches on all the factors that can negatively affect teen sleep: technology, gender, sexual identity and socioeconomic status, to name a few.

CNN recently talked with Lewis to discuss her work, and to learn more about how parents and caregivers can get their children more sleep.

This conversation has been edited and condensed for clarity.

CNN: What prompted you to write a book about teens and sleep?

Lisa Lewis: The whole issue of teen sleep and school start times hit my radar when my oldest kid, who is now in college, entered high school. At that point, the school started at 7:30 a.m. And I just knew that was much too early. I was driving him to school at that point, and every morning I'd look over and see he was not very awake. Every afternoon he was coming home really worn out.

I wanted to know why school started so early. What I found was that I had tapped into a much bigger issue. That same month, the US Centers for Disease Control and Prevention released its baseline report on school start times, which came on the heels of the American Academy of Pediatrics policy statement on the same subject. Their recommendations were that middle school and high school should start no earlier than 8:30 a.m. That's what got me involved.

CNN: So why do teens need so much sleep?

Lewis: At the onset of puberty, teens have a circadian rhythm shift, and their body clocks shift to a later schedule. It also connects to the release of melatonin, which is what primes our bodies to sleep. When kids become teenagers, melatonin begins to be released later than it used to. That means teens are not ready to fall asleep until 11 p.m. Because the same melatonin does not recede until later, teens end up wanting to sleep in more than they used to.

CNN: How much sleep should teens be getting?

Lewis: Most teens should get between eight and 10 hours, according to the National Sleep Foundation. The amount of sleep we need throughout our life span does change, though. When you look at kids up to age 13 - so, tweens - they need nine to 11 hours. The recommended range for adults is seven to nine hours. There are some teens and grown-ups for whom less than the prescribed amount will be fine. There also are some teens for whom 10 hours will be what they need. Sadly, many of our teens are not getting even the minimum of eight hours. Data from the CDC indicates that in 2007, only 31% of teenagers were getting eight hours or more. By 2019, that number was down to 22%. We're in a teen sleep deprivation epidemic.

CNN: What are the ramifications of teens not getting enough sleep?

Lewis: Sleep for teens is an emotional buffer and provides emotional resiliency. Teens are going through a major phase of brain development, and sleep is where a lot of that development happens. In the classroom, students who are asleep are not learning. Students who are there and not fully awake are not learning well. Sleep deprivation limits students from acquiring information, impedes the retention of the information, and hinders the ability to retrieve that information.

Various studies have indicated that when schools shift to later start times, they see improvements in attendance and graduation rates go up. With sports, sleep enhances performance; plus teen bodies release growth hormone, which heals injury when they sleep, so being well rested is a competitive advantage. In general, well-rested teens are happier and healthier and do better in school. They are more emotionally resilient. And they are easier to live with.

CNN: Beside early start times, what are some other external factors that can disrupt teen sleep?

Lewis: Stress is a huge one. If your kids can't get to sleep before 11 p.m., you need to look at whether they are overloaded or overscheduled. Technology is another factor. If you have a teen who is up until 1 a.m. or 2 a.m. playing video games, that is cutting into their sleep time, too. There are other factors. Menstrual cramps can impact sleep. We know that sexual- and gender-minority teens sleep worse than their counterparts, as do teens of color. There are other factors, too, like living in crowded conditions, or where it's noisy or where teens don't feel safe, that can impact sleep.

CNN: How do you think the chaos of the pandemic years has impacted teen sleep?

Lewis: I think the biggest issue is mental health. We have seen every major group sounding alarms about teen mental health. Back in December, the US Surgeon General issued a special advisory on teen mental health. The CDC released new data in April showing that mental health has worsened in teens.

CNN: How can parents and caregivers convince teenagers they need more sleep?

Lewis: Lecturing them doesn't have the desired effect. Having a conversation is more helpful, especially if it's an ongoing conversation. Model good behaviors, like no tech use within one hour of bedtime. Teach them about things like a wind-down routine. Our brains are not like computers - you don't just turn it off and hit the pillow and go to sleep. One thing that's important is not to force any of it.

CNN: At what point did your project expand to advocacy?

Lewis: They went hand in hand. After those big reports came out, I wrote an op-ed for the Los Angeles Times the following fall about why schools should start later in the morning. That piece was read by California State Sen. Anthony Portantino, who had it on his radar as well. He started looking into it and introduced a bill about school start times in February 2017. I reached out to a national nonprofit named Start School Later and I started a local chapter. As the bill advanced, I ended up testifying in front of the state (Assembly's) education committee. It was a lengthy process that culminated with Gov. Gavin Newsom signing the bill into law in 2019.

CNN: Why is this new law significant?

Lewis: The new law goes into effect July 1, and it's the first of its kind in the nation requiring healthy secondary school start times. It specifies that for public and charter middle schools, start times can be no earlier than 8 a.m., and for high schools, start times can't be earlier than 8:30 a.m. Similar laws in other places have proven to be successful. To this point, the largest city to change its start times is Seattle; they did it in 2016. The city did all these surveys before and after that change, and they learned students got an extra 34 minutes of sleep on school nights once the start times were moved back. That's huge.

CNN: What are the big questions you'll be asking next?

Lewis: As of right now, California is the only state that has enacted a law of this scope. That leaves quite a bit of room to work with other states out there. As of right now, both New York and New Jersey have active bills on this topic, but no other state has passed a law like this. There is a tremendous opportunity to look at doing this in all the other states; teen sleep deprivation is not just a California issue. This is something I will be focusing on for quite a bit.

# data[].attributes.attachment_link.keywords[]
health and health care (by demographic group)

# data[].attributes.attachment_link.title
Teens are facing a sleep deprivation epidemic. Here's why | CNN

# data[].attributes.attachment_link.description
Sign up for the Sleep, But Better newsletter series. Our seven-part guide has helpful hints to achieve better sleep. American teenagers aren't getting enough sleep these days, and author Lisa L. Lewis refuses to snooze on the issue anymore.

# data[].attributes.headline
Drill always has practice before school at my school

# data[].attributes.subject
Drill always has practice before school at my school

# data[].attributes.body
"Their results were disturbing: Almost half of the students who began school at 7:20 were "pathologically sleepy" at 8:30, falling directly into REM sleep in an average of only 3.4 minutes--a pattern similar to what is seen in patients with narcolepsy."

# data[].attributes.attachment_link.title
Sleep deprivation may be undermining teen health

# data[].attributes.attachment_link.description
Lack of sufficient sleep puts adolescents at risk for cognitive and emotional difficulties, poor school performance, accidents and psychopathology.

# data[].attributes.headline
Late start would be more advantageous for teachers too! If meetings were held before school, they would have strict end times....

# data[].attributes.subject
Late start would be more advantageous for teachers too! If meetings were held before school, they would have strict end times....

# data[].attributes.headline
Who is hurt/challenged by a switch to later start times?

# data[].attributes.subject
Who is hurt/challenged by a switch to later start times?

# data[].attributes.headline
Many jobs don't start at 8, but at 9. So why not start school at 9 if we are trying to prepare them to "real-life"?

# data[].attributes.subject
Many jobs don't start at 8, but at 9. So why not start school at 9 if we are trying to prepare them to "real-life"?

# data[].attributes.headline
Do students see device as learning devices or entertainment?

# data[].attributes.subject
Do students see device as learning devices or entertainment?

# data[].attributes.attachment_link.description
Teens don’t get enough sleep, and it’s not because of Snapchat, social lives or hormones -- it’s because of public policy, says Wendy Troxel. Drawing from her experience as a sleep researcher, clinician and mother of a teenager, Troxel discusses how early school start times deprive adolescents of sl…

# data[].attributes.attachment_link.readable_text
At the same time, today's teens are maturing in an era of ubiquitous electronic media, and they are fervent participants. Some 92 percent of U.S. teens have smartphones, and 24 percent report being online "constantly," according to a 2015 report by the Pew Research Center. Teens have access to multiple electronic devices they use simultaneously, often at night. Some 72 percent bring cellphones into their bedrooms and use them when they are trying to go to sleep, and 28 percent leave their phones on while sleeping, only to be awakened at night by texts, calls or emails, according to a 2011 National Sleep Foundation poll on electronic use. In addition, some 64 percent use electronic music devices, 60 percent use laptops and 23 percent play video games in the hour before they went to sleep, the poll found. More than half reported texting in the hour before they went to sleep, and these media fans were less likely to report getting a good night's sleep and feeling refreshed in the morning. They were also more likely to drive when drowsy, the poll found.

The problem of sleep-phase delay is exacerbated when teens are exposed late at night to lit screens, which send a message via the retina to the portion of the brain that controls the body's circadian clock. The message: It's not nighttime yet.

Yuan, a clinical associate professor of pediatrics, said she routinely sees young patients in her clinic who fall asleep at night with cellphones in hand.

"With academic demands and extracurricular activities, the kids are going nonstop until they fall asleep exhausted at night. There is not an emphasis on the importance of sleep, as there is with nutrition and exercise," she said. "They say they are tired, but they don't realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity."

The role of parents

Adolescents are also entering a period in which they are striving for autonomy and want to make their own decisions, including when to go to sleep. But studies suggest adolescents do better in terms of mood and fatigue levels if parents set the bedtime - and choose a time that is realistic for the child's needs. According to a 2010 study published in the journal Sleep, children are more likely to be depressed and to entertain thoughts of suicide if a parent sets a late bedtime of midnight or beyond.

In families where parents set the time for sleep, the teens' happier, better-rested state "may be a sign of an organized family life, not simply a matter of bedtime," Carskadon said. "On the other hand, the growing child and growing teens still benefit from someone who will help set the structure for their lives. And they aren't good at making good decisions."

They say they are tired, but they don't realize they are actually sleep-deprived. And if you ask kids to remove an activity, they would rather not. They would rather give up sleep than an activity.

According to the 2011 sleep poll, by the time U.S. students reach their senior year in high school, they are sleeping an average of 6.9 hours a night, down from an average of 8.4 hours in the sixth grade. The poll included teens from across the country from diverse ethnic backgrounds.

American teens aren't the worst off when it comes to sleep, however; South Korean adolescents have that distinction, sleeping on average 4.9 hours a night, according to a 2012 study in Sleep by South Korean researchers. These Asian teens routinely begin school between 7 and 8:30 a.m., and most sign up for additional evening classes that may keep them up as late as midnight. South Korean adolescents also have relatively high suicide rates (10.7 per 100,000 a year), and the researchers speculate that chronic sleep deprivation is a contributor to this disturbing phenomenon.

By contrast, Australian teens are among those who do particularly well when it comes to sleep time, averaging about nine hours a night, possibly because schools there usually start later.

Regardless of where they live, most teens follow a pattern of sleeping less during the week and sleeping in on the weekends to compensate. But many accumulate such a backlog of sleep debt that they don't sufficiently recover on the weekend and still wake up fatigued when Monday comes around.

Moreover, the shifting sleep patterns on the weekend - late nights with friends, followed by late mornings in bed - are out of sync with their weekday rhythm. Carskadon refers to this as "social jet lag."

"Every day we teach our internal circadian timing system what time it is - is it day or night? - and if that message is substantially different every day, then the clock isn't able to set things appropriately in motion," she said. "In the last few years, we have learned there is a master clock in the brain, but there are other clocks in other organs, like liver or kidneys or lungs, so the master clock is the coxswain, trying to get everybody to work together to improve efficiency and health. So if the coxswain is changing the pace, all the crew become disorganized and don't function well."

This disrupted rhythm, as well as the shortage of sleep, can have far-reaching effects on adolescent health and well-being, she said.

"It certainly plays into learning and memory. It plays into appetite and metabolism and weight gain. It plays into mood and emotion, which are already heightened at that age. It also plays into risk behaviors - taking risks while driving, taking risks with substances, taking risks maybe with sexual activity. So the more we look outside, the more we're learning about the core role that sleep plays," Carskadon said.

Many studies show students who sleep less suffer academically, as chronic sleep loss impairs the ability to remember, concentrate, think abstractly and solve problems. In one of many studies on sleep and academic performance, Carskadon and her colleagues surveyed 3,000 high school students and found that those with higher grades reported sleeping more, going to bed earlier on school nights and sleeping in less on weekends than students who had lower grades.

Sleep is believed to reinforce learning and memory, with studies showing that people perform better on mental tasks when they are well-rested. "We hypothesize that when teens sleep, the brain is going through processes of consolidation - learning of experiences or making memories," Yuan said. "It's like your brain is filtering itself - consolidating the important things and filtering out those unimportant things." When the brain is deprived of that opportunity, cognitive function suffers, along with the capacity to learn.

"It impacts academic performance. It's harder to take tests and answer questions if you are sleep-deprived," she said.

That's why cramming, at the expense of sleep, is counterproductive, said Pelayo, who advises students: Don't lose sleep to study, or you'll lose out in the end.

The panic attack

Chloe Mauvais, 16, hit her breaking point at the end of a very challenging sophomore year when she reached "the depths of frustration and anxiety." After months of late nights spent studying to keep up with academic demands, she suffered a panic attack one evening at home.

"I sat in the living room in our house on the ground, crying and having horrible breathing problems," said the senior at Menlo-Atherton High School. "It was so scary. I think it was from the accumulated stress, the fear over my grades, the lack of sleep and the crushing sense of responsibility. High school is a very hard place to be."

We hypothesize that when teens sleep, the brain is going through processes of consolidation - learning of experiences or making memories. It's like your brain is filtering itself.

Where she once had good sleep habits, she had drifted into an unhealthy pattern of staying up late, sometimes until 3 a.m., researching and writing papers for her AP European history class and prepping for tests.

"I have difficulty remembering events of that year, and I think it's because I didn't get enough sleep," she said. "The lack of sleep rendered me emotionally useless. I couldn't address the stress because I had no coherent thoughts. I couldn't step back and have perspective. ... You could probably talk to any teen and find they reach their breaking point. You've pushed yourself so much and not slept enough and you just lose it."

The experience was a kind of wake-up call, as she recognized the need to return to a more balanced life and a better sleep pattern, she said. But for some teens, this toxic mix of sleep deprivation, stress and anxiety, together with other external pressures, can tip their thinking toward dire solutions.

Research has shown that sleep problems among adolescents are a major risk factor for suicidal thoughts and death by suicide, which ranks as the third-leading cause of fatalities among 15- to 24-year-olds. And this link between sleep and suicidal thoughts remains strong, independent of whether the teen is depressed or has drug and alcohol issues, according to some studies.

"Sleep, especially deep sleep, is like a balm for the brain," said Shashank Joshi, MD, associate professor of psychiatry and behavioral sciences at Stanford. "The better your sleep, the more clearly you can think while awake, and it may enable you to seek help when a problem arises. You have your faculties with you. You may think, 'I have 16 things to do, but I know where to start.' Sleep deprivation can make it hard to remember what you need to do for your busy teen life. It takes away the support, the infrastructure."

Sleep is believed to help regulate emotions, and its deprivation is an underlying component of many mood disorders, such as anxiety, depression and bipolar disorder. For students who are prone to these disorders, better sleep can help serve as a buffer and help prevent a downhill slide, Joshi said.

Rebecca Bernert, PhD, who directs the Suicide Prevention Research Lab at Stanford, said sleep may affect the way in which teens process emotions. Her work with civilians and military veterans indicates that lack of sleep can make people more receptive to negative emotional information, which they might shrug off if they were fully rested, she said.

"Based on prior research, we have theorized that sleep disturbances may result in difficulty regulating emotional information, and this may lower the threshold for suicidal behaviors among at-risk individuals," said Bernert, an instructor of psychiatry and behavioral sciences. Now she's studying whether a brief nondrug treatment for insomnia reduces depression and risk for suicide.

Sleep deprivation also has been shown to lower inhibitions among both adults and teens. In the teen brain, the frontal lobe, which helps restrain impulsivity, isn't fully developed, so teens are naturally prone to impulsive behavior. "When you throw into the mix sleep deprivation, which can also be disinhibiting, mood problems and the normal impulsivity of adolescence, then you have a potentially dangerous situation," Joshi said.

Some schools shift

Given the health risks associated with sleep problems, school districts around the country have been looking at one issue over which they have some control: when school starts in the morning. The trend was set by the town of Edina, Minnesota, a well-to-do suburb of Minneapolis, which conducted a landmark experiment in student sleep in the late 1990s. It shifted the high school's start time from 7:20 a.m. to 8:30 a.m. and then asked University of Minnesota researchers to look at the impact of the change. The researchers found some surprising results: Students reported feeling less depressed and less sleepy during the day and more empowered to succeed. There was no comparable improvement in student well-being in surrounding school districts where start times remained the same.

With these findings in hand, the entire Minneapolis Public School District shifted start times for 57,000 students at all of its schools in 1997 and found similarly positive results. Attendance rates rose, and students reported getting an hour's more sleep each school night - or a total of five more hours of sleep a week - countering skeptics who argued that the students would respond by just going to bed later.

For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth.

Other studies have reinforced the link between later start times and positive health benefits. One 2010 study at an independent high school in Rhode Island found that after delaying the start time by just 30 minutes, students slept more and showed significant improvements in alertness and mood. And a 2014 study in two counties in Virginia found that teens were much less likely to be involved in car crashes in a county where start times were later, compared with a county with an earlier start time.

Bolstered by the evidence, the American Academy of Pediatrics in 2014 issued a strong policy statement encouraging middle and high school districts across the country to start school no earlier than 8:30 a.m. to help preserve the health of the nation's youth. Some districts have heeded the call, though the decisions have been hugely contentious, as many consider school schedules sacrosanct and cite practical issues, such as bus schedules, as obstacles.

In Fairfax County, Virginia, it took a decade of debate before the school board voted in 2014 to push back the opening school bell for its 57,000 students. And in Palo Alto, where a recent cluster of suicides has caused much communitywide soul-searching, the district superintendent issued a decision in the spring, over the strenuous objections of some teachers, students and administrators, to eliminate "zero period" for academic classes - an optional period that begins at 7:20 a.m. and is generally offered for advanced studies.

Certainly, changing school start times is only part of the solution, experts say. More widespread education about sleep and more resources for students are needed. Parents and teachers need to trim back their expectations and minimize pressures that interfere with teen sleep. And there needs to be a cultural shift, including a move to discourage late-night use of electronic devices, to help youngsters gain much-needed rest.

"At some point, we are going to have to confront this as a society," Carskadon said. "For the health and well-being of the nation, we should all be taking better care of our sleep, and we certainly should be taking better care of the sleep of our youth."

# data[].attributes.attachment_link.title
Among teens, sleep deprivation an epidemic

# data[].attributes.attachment_link.description
Sleep deprivation increases the likelihood teens will suffer myriad negative consequences, including an inability to concentrate, poor grades, drowsy-driving incidents, anxiety, depression, thoughts of suicide and even suicide attempts.

# data[].attributes.headline
How has social media effected teens sleep habits?

# data[].attributes.subject
How has social media effected teens sleep habits?

# data[].attributes.headline
Maybe if we shortened the school day, more kids would feel more compelled to do extra-curriculars since they would now have the time.

# data[].attributes.subject
Maybe if we shortened the school day, more kids would feel more compelled to do extra-curriculars since they would now have the time.

# data[].attributes.body
Where can we find the sources for this articles data?

# data[].attributes.body
In the text, the author said that we haven’t made the switch because we want to “toughen” up the teenagers for the real world. What could be some of the other reasons we haven’t changed school start time?

# data[].attributes.body
Why can't kids have a bedtime more suitable for proper sleep?

# data[].attributes.headline
What would "lose" as an administrative team if we delayed our school's start time by 30 minutes?

# data[].attributes.subject
What would "lose" as an administrative team if we delayed our school's start time by 30 minutes?

# data[].attributes.headline
If school started later, how would this benefit teens?

# data[].attributes.subject
If school started later, how would this benefit teens?

# data[].attributes.headline
What happens to you when you are deprived of sleep?

# data[].attributes.subject
What happens to you when you are deprived of sleep?