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Symptoms of Sleep Deprivation | How does Sleep Deprivation Affect people

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Symptoms of Sleep Deprivation | How does Sleep Deprivation Affect people

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What Are Sleep Deprivation and Deficiency?

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Sleep deprivation and deficiency are conditions that occur when you don't get enough good quality sleep when your body needs it. This can lead to physical and mental health problems. Learn about the causes, risk factors, symptoms, and treatment for Sleep deprivation and deficiency.

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Sleep deficiency can interfere with work, school, driving, and social functioning. You might have trouble learning, focusing, and reacting. Also, you might find it hard to judge other people's emotions and reactions. Sleep deficiency also can make you feel frustrated, cranky, or worried in social situations.

Sleep deficiency is also linked to a higher chance of injury in adults, teens, and children. For example, sleepiness while driving (not related to alcohol) is responsible for serious car crash injuries and death. In older adults, sleep deficiency may be linked to a higher chance of falls and broken bones.

Sleep deficiency has also played a role in human mistakes linked to tragic accidents, such as nuclear reactor meltdowns, grounding of large ships, and plane crashes.

Sleep Deprivation can interfere with most, if not everything you do. Sleep deficiency can make it hard for you to control your emotions and affect how you perceive others emotions and reactions. It is also linked to a chance of injury. There is research that also points to it being played as a role in human errors connected to tragic accidents like plane crashes.

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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."

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Among teens, sleep deprivation an epidemic

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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.

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Sleep research suggests that teenagers need between eight and 10 hours of sleep every night.

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(1)From Article : Sleep deprivation occurs when an individual fails to get the amount of sleep that they need. Sleep deprivation can occur due to various lifestyle, work and environmental factors. Sleep disorders and other chronic medical conditions can also cause sleep deprivation. Not enough sleep or disruptions to to sleep can have a major impact on daytime functioning including poor concentration, reduced reaction times and altered mood. In children, sleep deprivation can affect behavior and school performance. Chronic sleep deprivation can have a negative impact on brain, metabolic (e.g., overweight/obesity, diabetes) and immune health.

Somewhat Paraphrase : Sleep Deprivation is when a person does not get the needed amount of sleep. They can also be caused by many things. In children it can affect academic performance and behavior. "Chronic sleep deprivation can have a negative impact on the brain, metabolic (e.g., overweight/obesity, diabetes) and immune health."

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ABSTRACT

Sleep has an important role in maintaining health and wellbeing; this relationship is becoming increasingly recognised for adolescents and young adults. Many physicians will encounter young people who present with complaints or conditions that have some relation to poor sleep. This review article looks at why sleep matters within this population group, how it can impact on longer term health consequences and discusses some tools to help enable the clinician to evaluate and address sleep within clinical practice.

KEYWORDS: Adolescents, chronic disease, fatigue, sleep, young adults

Introduction

The important role of sleep in maintaining health and wellbeing has become increasingly recognised. Sleep has many functions (including promoting growth, learning and cognitive development),1 has a role in immunity2 and studies have reported an association between poor sleep and heart disease in adults.3,4 Its relevance is now becoming increasingly recognised in adolescents and young adults, particularly with regards to our 24-hour culture of connectivity and media consumption.5,6

The 2014 Health behaviour in school-aged children report demonstrated that for 15-year-olds in England, 30% of boys and 49% of girls reported experiencing sleeping difficulties and 36% of 15-year-olds reported not having enough sleep to be able to concentrate on school work.7 Poor sleep in adolescents and young adults can result in longer-term sleep problems, which may impact on them into adulthood. In one study, adolescent sleep disturbances predicted adult sleep disturbances.8 If problems were present at age 16 years, a third still had problems at 23 years and 10% at 42 years.

Many adult physicians will encounter young people who might present with complaints or conditions that have some relation to poor sleep and/or fatigue. If sleep is not first considered by the physician, this is likely to remain unrecognised and consequently result in ineffective treatment strategies if the underlying problem is not addressed. Additionally, it may be that if further questioned, a complaint about sleep disturbance may reveal another concern, or hidden agenda. In this article we will look at sleep in the adolescent and young adult (AYA) population, why it matters and what to do about it.

The biology of adolescent sleep

Adolescents and young adults have been defined by the World Health Organization as those aged between 10 and 24 years. During this period of development and maturation, there are a number of changes taking place, with brain maturation continuing throughout this period.9 It is therefore not surprising that the biology and pattern of sleep differs within this age range.

A reduced urge to fall asleep results in adolescents staying awake later; hence, they have an overall shortened sleep duration. This factor is particularly noticeable during the school years, as the time required to rise for the school day remains constant. However, the amount of sleep required by this population group has not reduced, resulting in a period of relative sleep deprivation compared with the adult population.10

Adolescent sleep disorders

There are of course specific sleep disorders that affect AYAs, the most common being delayed sleep phase syndrome. This develops in adolescence and can continue into young adulthood; it is reported to affect 7% of adolescents. Delayed sleep phase syndrome is a pathological shift of the normal delay in the timing of sleep onset that occurs at this age, those affected will typically go to bed between 1am and 4am and wake much later in the morning.12 This results in significant sleep deprivation if the individual's daily routines do not allow for a late awakening. Treatment requires gradual adjustment of the sleep cycle and use of bright light therapy in the morning with avoidance of bright light in the evening.12,13 Other less common sleep disorders include night terrors, sleep walking, sleep-onset anxiety, restless legs and narcolepsy, but these are beyond the scope of this article.13

The relationship between sleep and health

It is important to note that there is often a bidirectional relationship between sleep and health and having an awareness of the complexity of this relationship is helpful when assessing sleep in clinical practice. An early indication of a patient developing problems with their sleep can be sleep fragmentation, where individuals have difficulty remaining asleep, resulting in them feeling unrefreshed. This sleep fragmentation may then lead onto further health consequences of poor sleep, including daytime somnolence, impaired cognition and poor mood.

Sleep fragmentation can itself occur because of an underlying health condition, such as obstructive sleep apnoea and it is this bidirectional relationship that requires consideration. Additionally, this interplay between sleep and health in AYAs can have a continuing impact into adulthood and it is therefore of importance to all physicians who encounter this patient cohort. This is particularly true of young people with long-term health conditions. Some of the important health-related associations are discussed here.

Sleep and obesity

Possible physiological reasons for this association could be explained by the fact that glucose metabolism and the hunger hormones (leptin and ghrelin) follow certain nocturnal patterns and disruption to this, by shortening the duration of sleep, has an impact on calorie intake and utilisation.18,19

Obesity in AYAs and in later life is known to be associated with chronic health problems, such as type 2 diabetes and hypertension. An additional consideration is the relationship between obesity and obstructive sleep apnoea and the resultant impairment on sleep. Therefore, the association between sleep and obesity has bidirectional importance.

Sleep and mental health

Sleep and pain

There is an established link between poor sleep and pain in healthy populations. However, it has also been demonstrated in conditions such as juvenile idiopathic arthritis, headaches or as part of a pain syndrome (such as chronic widespread pain and fibromyalgia).26 Studies focusing on pain and these clinical conditions have more often been separated into an adult or paediatric population, neglecting the fact that AYAs are a discrete population with specific developmental processes that are often overlooked.

The relationship between sleep and pain for young people with juvenile idiopathic arthritis and other rheumatological conditions has more recently been explored. Most of the reported studies use either parent-proxy questionnaires or a combination of patient and parent-proxy questionnaires and the majority of studies have a mean age of less than 13 years.31,32 As such, they are not representative of the age range included in an AYA cohort. Although an association is demonstrated between sleep and pain in these studies, there are a number of other variables to consider that may not be as easily measured, such as psychological or social factors.

For patients of all ages with chronic pain, the importance of sleep is known to be an integral part of assessment and treatment strategies although, again, there is a paucity of studies assessing the impact on the AYA cohort. One study focusing on 12-18-year-olds demonstrated that the presence of chronic pain, rather than the intensity of pain, was predictive for insomnia and that those with chronic pain had a sixfold higher risk for insomnia symptoms.33

Sleep and illness

Adolescents and young adults are well represented within the acute hospital setting, with 16-19-year-olds accounting for 20% of inpatients.34 Sleep within a hospital environment is challenging for all patients, but AYAs may encounter additional difficulties with their sleep cycle not matching the traditional ward bedtime routine. Early wakening for observations, medicines and ward rounds can contribute to sleep deprivation. Being on an adult ward may result in exposure to older patients with significant illness and even death, the impact of which may affect the AYA's own cognitive concerns about their illness and can have a detrimental effect on their sleep.

Those AYAs who have a chronic illness will have more frequent encounters with their GPs and hospital physicians and it is therefore important to recognise that these patients may be encountering problems with sleep or fatigue. Most chronic illnesses have been recognised to impact on sleep - for example, asthma, cancer, epilepsy, kidney disease and sickle cell disease.35 The impact on an individual's sleep may be related to a multitude of causes, including disease-specific factors, medication side effects, hospital admissions and psychological factors. As already highlighted, these interactions can be bi-directional and are therefore important to recognise.

Sleep and fatigue

It is worth taking some time to consider whether there is any difference between feeling sleepy or fatigued, as the complaint of tiredness may be used by someone to describe either of these symptoms. Sleepiness relates to being more likely to fall asleep, whereas fatigue is a perception of low energy after otherwise normal activities.36 Understanding which symptom is being experienced can help with managing the underlying problem although it may at times be difficult to distinguish between the two.

Sleep and accidents

UK data for 2010 reported over half of all deaths in 15-19-year-olds were attributable to external causes, including injuries and poisoning, risks and behaviours. Transport accidents were responsible for 77% of the deaths for those aged between 10 and 18 years.39 Sleep deprivation is likely to have a role here as transport data for the UK demonstrate that for sleep-related crashes, 38% of drivers are aged between 16 and 30 years.40 International data have shown that traffic-related mortality is higher in males and rose with increasing age within the AYA age group.41

Assessing sleep in clinical practice

The assessment of sleep requires an understanding of the many factors that can impact upon it, some of which have been explored above. It is important to note that these factors and their interactions can change during this period of growth, development and maturation. Taking a detailed sleep history enables these factors to be established and then further assessed as indicated; key points to discuss are shown in Box ​Box1. 1 . Undertaking at least part of the consultation with only the young person (without parents or guardians present) and with the assurance of confidentiality is good clinical practice for this age group.

Box 1.

Habitual bedtime and rise time

Difficulties falling asleep (sleep-onset latency)

School day versus weekend (sleep irregularities)

A full sleep history may not always be possible and therefore shorter tools such as the BEARS (B = bedtime issues, E = excessive daytime sleepiness, A = night awakenings, R = regularity and duration of sleep, S = snoring) screening tool (Table ​(Table1) 1 ) or even the use of the HEEADSSS (home environment, education and employment, eating, peer-related activities, drugs, sexuality, suicide/depression, safety) psychosocial tool can be a useful first assessment in this age group.42,43 A more detailed history can then be taken if a specific problem is identified.

Table 1.

Categories

Example questions

Bedtime problems

Do you have any problems falling asleep at bedtime?

Excessive daytime sleepiness

Do you feel sleepy a lot during the day? At school? While driving?

Awakenings during the night

Do you wake up a lot during the night?

Regularity and duration of sleep

What time do you go to bed on a school night? At weekends? How much sleep do you usually get?

Sleep disordered breathing

Ask family members about snoring.

Sleep education is often the first step required for successful management and as such a number of studies have looked at the role of sleep education in adolescents, often in a school environment. These studies include some that were aiming to disseminate knowledge alongside those attempting to effect a change in behaviour. A review of these by Blunden and Ridgney, demonstrated the importance of including others, such as parents, as sleep is affected by both cultural and environmental factors within the home.44 Importantly, it was noted that a generic sleep programme would be unlikely to benefit all individuals. Identifying specific problems was a more useful approach and imparting knowledge alone was not enough to effect a change in behaviour.

Exploring the young person's (and where appropriate, the family's) understanding of sleep and discussing sleep hygiene is a useful first management strategy. The concept of sleep hygiene relates to establishing a set regimen that in turn encourages a regular sleep and wake pattern. Important aspects of this include avoiding daytime naps, avoiding stimulant usage (including caffeine) in the afternoon, only using the bed for sleeping, ensuring a calm and relaxing sleep environment, encouraging exposure to natural daylight and encouraging exercise. Sleep hygiene advice is easily accessed via a number of online resources, some of which are shown in Table ​Table2 2 ​2 .

The use of handheld media devices is a now a significant part of life, particularly for AYAs, and is therefore worth separate consideration. There has been increasing interest in the impact that the use of devices such as smart phones and tablets have on sleep within this population group. A 2016 systematic review has confirmed that bedtime use and access to these devices were significantly associated with inadequate sleep quality, poor sleep quality and excessive daytime sleepiness.45 Exploring usage of such devices is therefore important if a sleep problem has been identified. Good sleep hygiene advice would include not having these devices within the bedroom, thus reducing the temptation to use them.

Conclusions

Sleep has an important role to play in the health of adolescents and young adults, both in the short and longer term. A number of adverse outcomes have been shown to be associated with poor sleep within this population. Improved recognition of its importance and the assessment of sleep in routine clinical practice can help to identify and manage problems before longer-term consequences develop. The use of simple screening tools can help and there are a number of online resources that can guide both the clinician and patient.

Conflicts of interest

The authors have no conflicts of interest to declare.

References

7. Brooks F. Magnusson J. Klemera E. Spencer N. Smeeton N. HBSC England National Report: health behaviour in school-aged children (HBSC): World Health Organization Collaborative Cross National Study. Hatfield, UK: University of Hertfordshire; 2015. [ Google Scholar]

18. Leproult R. Van Cauter E. Role of sleep and sleep loss in hormonal release and metabolism. In: Loche S, editor; Cappa M, editor; Ghizzoni L, editor; Maghnie M, editor; Savage MO, editor. Paediatric neuroendocrinology. Basel: KARGER; 2009. pp. 11-21. [ Google Scholar]

38. National Institute for Health and Care Excellence Chronic fatigue syndrome/myalgic encephalomyelitis (or encephalopathy): diagnosis and management, NICE clinical guideline No 52. London: NICE; 2007. [[ PubMed] Google Scholar]

39. Wolfe I. Macfarlane A. Donkin A. Marmot M. Viner R. Why children die: death in infants, children and young people in the UK. Part A. London: Royal College of Paediatrics and Child Health; 2014. [ Google Scholar]

40. Flatley D. Reyner LA. Horne JA. Sleep-related crashes on sections of different road types in the UK (1995-2001) London: Department for Transport; 2004. [ Google Scholar]

43. Goldenring J. Rosen D. Getting into adolescent heads: an essential update. Contemp Pediatr. 2004;21:64-90. [ Google Scholar]

Articles from Clinical Medicine are provided here courtesy of Royal College of Physicians

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Sleep has an important role in maintaining health and wellbeing; this relationship is becoming increasingly recognised for adolescents and young adults. Many physicians will encounter young people who present with complaints or conditions that have some ...

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From the Article: The last decade has seen increasing interest in the relationship between sleep problems in adolescence and the development of risk-taking behaviour. Studies undertaken in American 14–18-year-olds have demonstrated an association between insufficient sleep and an increased likelihood of engaging in some health-risk behaviours, such as smoking, alcohol use, marijuana use and violence.23,24 In a Finnish study of 13–18-year-olds, 27% reported weekly sleep problems, which in turn were associated with older individuals as well as peer and alcohol problems.²⁵ One theory as to why this association might exist is that sleep deprivation affects cognition, and therefore poor choices may result from peer pressure or an inability to adequately assess the consequence of these behaviours. In this instance, it is the risk-taking behaviour that may lead to both short- and long-term health problems that can continue into adulthood.

My Paraphrase

Over the last decade there have been studies which show that sleep deprivation affects those under 18's cognitive abilities. This can result in bad decisions being made. In a study on Americans 14-18 it was found that there was an increased likelihood in participating in health-risk behaviors like smoking, consuming alcohol, marijuana use and participating in violence. A Finish study also showed that 27% of 13-18 year-olds reported having weekly sleep problems. One theory is sleep deprivation affects one's cognition.

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Learn steps you can take to improve your sleep habits. Make sure that you give yourself enough time to sleep. With enough sleep each night, you may find that you're happier and more productive during the day. Sleep is often the first thing that busy people squeeze out of their schedules.

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(2)Go to bed and wake up at the same time every day. For children, have a set bedtime and a bedtime routine. Don't use the child's bedroom for timeouts or punishment.

Try to keep the same sleep schedule on weeknights and weekends. Limit the difference to no more than about an hour. Staying up late and sleeping in late on weekends can disrupt your body clock's sleep-wake rhythm.

Use the hour before bed for quiet time. Avoid intense exercise and bright artificial light, such as from a TV or computer screen. The light may signal the brain that it's time to be awake.

Avoid heavy or large meals within a few hours of bedtime. (Having a light snack is okay.) Also, avoid alcoholic drinks before bed.

Avoid nicotine (for example, cigarettes) and caffeine (including caffeinated soda, coffee, tea, and chocolate). Nicotine and caffeine are stimulants, and both substances can interfere with sleep. The effects of caffeine can last up to 8 hours. So, a cup of coffee in the late afternoon can make it hard for you to fall asleep at night.

Spend time outside every day (when possible) and be physically active.

Keep your bedroom quiet, cool, and dark (a dim night light is fine, if needed).

Take a hot bath or use relaxation techniques before bed.

My paraphrase: The National Heart, Lung, and Blood Institute says that these are the most healthy sleep habits they are: going to bed and waking up at the same time each day, trying to keep the same sleep schedule during the week and weekends, use the hour before bed for quiet time so no screens or lots of light and noise. Don't have alcohol or large meals before bed, avoid nicotine and caffeine. If possible try to also spend time outside each day, keep your bedroom cold, quiet, and dark. You can also try to take a warm bath or try other relaxation techniques like meditation.

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Lack of adequate sleep can lead to many complications. Some of these complications can lead to further difficulty in getting sleep. Lack of sleep causes elevated cortisol, which can result in increased blood sugar, increased blood pressure, cravings for carbohydrates, and sugar, which leads to weight gain and other medical and psychiatric complications. The subjective experience of sleep loss can be distressing, which can exacerbate complications. The following is a non-comprehensive list of complications of sleep loss:

Diabetes/insulin resistance

Hypertension

Obesity

Obstructive sleep apnea

Vascular disease

Stroke

Myocardial infarct

Depression

Anxiety

Psychosis

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Some of the reasons why many teenagers regularly do not get enough sleep include:

hormonal time shift – puberty hormones shift the teenager’s body clock forward by about one or two hours, making them sleepier one to two hours later. Yet, while the teenager falls asleep later, early school starts don’t allow them to sleep in. This nightly ‘sleep debt’ leads to chronic sleep deprivation

using screen based devices – smart phones and other devices used around bed time reduce sleep time. Teens who put down their smart-phones an hour before bed gain an extra 21 minutes sleep a night, (that's one hour and 45 minutes over the school week) according to a study by Vic Health and the Sleep Health Foundation

hectic after-school schedule – homework, sport, part-time work and social commitments can cut into a teenager’s sleeping time

leisure activities – the lure of stimulating entertainment such as television, the internet and computer gaming can keep a teenager out of bed.

light exposure – light cues the brain to stay awake. In the evening, lights from televisions, mobile phones and computers can prevent adequate production of melatonin, the brain chemical (neurotransmitter) responsible for sleep

vicious circle – insufficient sleep causes a teenager’s brain to become more active. An over-aroused brain is less able to fall asleep.

social attitudes – in Western culture, keeping active is valued more than sleep

sleep disorder – sleep disorders, such as restless legs syndrome or sleep apnoea, can affect how much sleep a teenager gets.

Paraphrase : What are the reasons people develop sleep deprivation. It can be due to many things such as light exposure, which causes the brain to stay active for longer. Blue light devices like phones and tv's also contribute to worsened or delayed sleep. Studies have found that " Teens who put down their smartphones an hour before bed gain an extra 21 minutes sleep a night".

Paraphrase pt2 :Sleep disorders also affect how much a teenager sleeps. After school schedules can also cut into a teenagers sleep time. Many teens (especially those in high school) have to spend lots of time juggling homework, after school activities, and for some even part time jobs. There is also a "Hormonal Time Shift". Which pushes the time when teenagers will naturally tire an hour or two back. This paired with schools early starts means that many will not get the needed time to sleep in resulting in "sleep debt".

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Experts recommend that teenagers get 8 to 10 hours of sleep each night. However, most teens do not get enough sleep. Experts warn that too much screen time may be partially to blame.

The average teen uses electronic screens for more than seven hours a day. While working on a computer may be beneficial for schoolwork, spending too much time on electronics for entertainment may be detrimental to their health and can have a significant impact on sleep.
Teens are inundated with technology, and most keep media devices in their bedrooms. This may explain in part why sleep issues in teens are on the rise. It can be tricky to ease a teen off their devices, but we discuss some simple ways to reduce the impact of screen use on teen sleep, such as turning devices off an hour before bedtime.

What Is the Impact of Screen Time on Teen Sleep?

Spending unhealthy amounts of time on the internet can upset the sleep-wake cycle that controls when teens feel tired or awake. The more time a teen spends on their devices, the less time they spend doing other daily activities, such as exercising and being outdoors. This can get their body's circadian rhythm out of sync and lead to sleep problems, including insomnia.

Teens who spend a lot of time on their screens tend to go to bed later and sleep fewer hours each night. They also may have difficulty falling asleep, have fragmented, poor quality sleep, and experience tiredness during the day.

Many of these sleep issues may be due to teens having cell phones in their rooms and being awakened by phone calls and text messages. In fact, research has found that approximately 20% to 40% of teens have been woken up by their phone at least once each month.

In addition to cell phone use, experts cite other concerning statistics about teen screen behavior.

Bedroom Use: 75% of teens have at least one electronic device in their bedroom.

Bedtime Use: 60% routinely use a media device before bed.

Daily Use: On average, children and teens spend a total of 7.5 hours a day using screens for entertainment, including televisions, computers, and video games.

While both daytime and evening screen use may affect sleep patterns, research points to bedtime use as having the greatest impact on a teen's sleep. The sleep disruption may be even greater when teens use their electronic devices in the dark. Even just keeping an electronic device in a bedroom can lead to poor sleep.

One reason excessive teenage media consumption raises concerns is its potential influence on the developing teen brain. Experts aren't quite sure how screen time affects brain function and behavior. Some researchers believe that growing young brains may be more vulnerable to the effects of electronic devices than adults are.

Screen use, depressive symptoms, and sleep habits interact and perpetuate each other in a complex relationship. For example, screen time appears to contribute to both insomnia and depression. Depression may then worsen existing sleeping difficulties. Finally, insomnia may exacerbate addictive screen behavior, continuing the unhealthy cycle.

Research suggests that screens may interfere with sleep due to lost sleep time, light exposure, and stimulation from media content.

Shop the Best Mattresses for Teenagers

Lost Sleep Time Due to Screen Use

Sometimes it seems that teens just can't put their phones and other electronics down. When they choose to stay up late, either surfing the internet or watching TV, they may be cutting into valuable sleep time.

Teens sometimes try to make up for lost weeknight sleep by sleeping in on the weekends. However, research has found that teens who text and use social media at bedtime may continue to sleep fewer hours on the weekends. Therefore, sleeping late on weekends may not be enough to make an impact on sleep debt from excessive screen use.

Light Exposure Affects Sleep

The blue light emitted from electronic screens can interfere with falling and staying asleep. Bright lights suppress the hormone melatonin, which tells your body when it's time to sleep. Research suggests that children and teens may be more sensitive to blue light than adults.

Exciting and Violent Media Content

Several studies show that media content also affects sleep. In one study, people who played exciting video games before bed had elevated heart rates, difficulty falling asleep, and less time spent in rapid eye movement (REM) sleep. Loss of REM sleep is concerning for teens because it is important for learning and memory.

Other research suggests that interactive media, such as video games, seem to make sleeping more difficult than passive television viewing. And media that portrays violence seems to have a stronger impact on sleep than non-violent media.

Which Screens Affect Sleep the Most?

Experts aren't sure which types of screens affect sleep the most. Research suggests that most media devices with blue light-emitting screens are linked to poor quality sleep. However, some studies have identified differences in sleep outcomes depending on the screen type and the interactivity and intensity of the content.

For example, computer use may have a stronger effect than TV watching on length of sleep. Teens who spend more time on touch screen devices have higher rates of sleep disturbances, and, in particular, more time using tablets is linked to worse overall sleep quality and more nighttime awakenings.

The Effect of Sleep Deprivation on Teens

Excessive screen time can lead to sleep deprivation in teens, which can in turn lead to other problems. Teens need 8 to 10 hours of sleep each night. However, 6 in 10 middle schoolers and 7 in 10 high schoolers do not get the recommended amount of sleep, putting them at risk for many physical and mental health problems.

Chronic lack of sleep may increase a teen's risk for depression. Not getting enough sleep can also cause irritability, impulsiveness, and difficulty paying attention, which can cause problems in school or driving. Some sleep-deprived teens may lack motivation and have difficulty getting along with others.

Additional research suggests that lack of sleep due to too much screen time raises a teen's risk of becoming obese. This may be due to lack of physical activity and nighttime eating while engaging in online activities.

How Much Screen Time Is Too Much for Quality Sleep?

Studies have indicated that the longer a teen spends on their screen, the worse their sleep may be. Therefore, experts say that screen time should be limited to two hours a day. Teens who spend more than two hours on screen time in the evening may have non-refreshing sleep, low energy the next day, and long-term insomnia.

When Should Teens Stop Screen Time So It Doesn't Affect Sleep?

Experts suggest putting electronic devices, such as phones and tablets, away at least one hour before bedtime. They recommend that teens avoid any use of electronics at night time altogether. A healthy bedtime routine can instead include reading a book or engaging in family time.

Reducing the Effects of Screen Time on Sleep

It's important for parents and caregivers to understand that teens are naturally drawn to technology as a way to connect with others, seek excitement, and obtain information. Technology has become a part of many teens' everyday routines. However, it's also important for teens to understand that too much screen time can impact their sleep and well-being.

Parents and caregivers should consider taking a balanced approach to foster productive use of technology and minimize potentially unhealthy consequences. A few simple household media rules and changes to your teen's screen behavior can encourage healthy sleep habits.

Remove Electronic Devices From the Bedroom: Computers, tablets, and other media devices should be kept outside of the bedroom to minimize nighttime distractions.

Turn the Phone Off: If you can't keep the phone out of your teen's bedroom entirely, encourage them to switch their phone off when they go to bed to stop nighttime awakenings from phone calls and text messages.

Replace Screen Time With Physical Activity: Suggest that your teen do a physical activity after school, such as going for a walk, instead of playing video games or watching TV.

Cut Back on Social Screen Use: Explain to your teen that using a phone or tablet for more than two hours a day for social activities is considered excessive and can impair their sleep.

Decrease Screen Time During Certain Times of the Day: Keep screens off-limits during meal times and homework, unless they are needed for school.

Choose Non-Violent Media: Help your teen choose calming and non-violent media to reduce stimulation and subsequent sleep problems.

Wear Blue Light Blocking Glasses: If your teen continues to read from a tablet or other electronic device, encourage them to wear special blue light blocking glasses that filter out the artificial blue light.

Motivate Your Teen: While teens can sometimes be reluctant to change their behaviors, they may be more open to change when they fully understand the consequences. Pointing out that sleep loss may have led to fatigue or a low grade on a test may motivate them to reevaluate their habits.

Be a Role Model: Parents and caregivers can set a good example for children and teens by modeling healthy sleep routines and limiting their own screen time.

Remember, experts recommend that teens get more sleep than most adults. Talk to your teen about establishing healthy screen media behaviors that contribute to good health and good sleep.

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Cell phones and other media devices are a big part of a teen's daily life. Learn how screen time can take a toll on teen sleep and ways to reduce the impact.

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From article: Teens who spend a lot of time on their screens tend to go to bed later and sleep fewer hours each night. They also may have difficulty falling asleep, have fragmented, poor quality sleep, and experience tiredness during the day.

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Bedroom Use: 75% of teens have at least one electronic device in their bedroom.

Bedtime Use: 60% routinely use a media device before bed.

Daily Use: On average, children and teens spend a total of 7.5 hours a day using screens for entertainment, including televisions, computers, and video games.

While both daytime and evening screen use may affect sleep patterns, research points to bedtime use as having the greatest impact on a teen’s sleep. The sleep disruption may be even greater when teens use their electronic devices in the dark. Even just keeping an electronic device in a bedroom can lead to poor sleep.

One reason excessive teenage media consumption raises concerns is its potential influence on the developing teen brain. Experts aren’t quite sure how screen time affects brain function and behavior. Some researchers believe that growing young brains may be more vulnerable to the effects of electronic devices than adults are.

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While we think of teenagers as being full of energy and not needing much sleep, many adolescents may be sleep deprived. Changing social behaviors and simple biology may all factor into sleep deprivation. Often social obligations drive teenagers to pass on sleep. Yet staying awake for extended periods and losing sleep because of anxiety can make a teenager as sleep-deprived as an adult. Understanding the causes of teen sleep deprivation and how to prevent it can help parents ensure healthy sleep for their k ids.

Sleep Deprivation - How Much Sleep Do Teens Need?

Most adolescents only get about 6.5 - 7.5 hours of sleep per night, and some get less. Sleep research suggests that a teenager needs between eight and 10 hours of sleep every night. This is more than the amount a child or an adult needs. Why do teens need so much sleep?

Teenagers need more sleep because their bodies and minds are growing quickly. Scientific research shows that many teens do not get enough sleep. Although getting enough sleep may not seem that big a deal to most teens, those who don't get enough sleep and are overtired are more likely to:

Struggle in school

Have trouble with memory, concentration, and motivation (the desire to accomplish a goal)

Be involved in car crashes and other accidents. Sleepiness (the feeling of wanting or needing to sleep in places and at times when you shouldn't) affects reaction times

Feel depressed, which can become a serious medical condition

Importance of Sleep for Teens

For Academic Appraisal

The educational development of teens is directly tied to sleep health. Poor sleep may leave teens struggling academically. Studies investigating the effects of different sleep-wake schedules on academic achievement showed that impaired sleep quality and quantity are associated with decreased learning ability and compromised daytime functioning.

Essentially poor sleep equals poor grades for teenagers. When teens are working their hardest to achieve academic excellence, sleep deprivation may be a roadblock.

Emotional Well-Being

With hormones raging, teens are already in a sensitive place emotionally at their age. But sleep deprivation makes it worse. Feelings of depression and anxiety can be amplified by sleep deprivation. Often teens may be prescribed medications to manage mental health symptoms when a good night's sleep would have sufficed.

Poor sleep affects mental health by disrupting our circadian rhythms and interfering with our normal sleep stages, thereby throwing our bodies and our brains off-kilter. A sleep-deficient brain has a decreased ability to make emotional judgments and to incorporate multiple pieces of information into a decision.

Physical Growth and Development

Sleep, especially deep sleep, is important for teens' physical and mental health. Deep sleep or slow-wave sleep is a stage in the sleep cycle that promotes the healing of the body and mind from waking life and releases essential growth hormones beneficial to teen development. The loss of good sleep may result in early poor health and a reduction of growth hormones at a time when teens need them most.

Bad Decision Making

While we may think that immaturity in teens may make them prone to poor decisions, lack of sleep may make decision-making even worse. Consistent lack of sleep can lead to impaired judgment and poor decision-making skills. Studies have shown sleep loss over an extended period can cause decreased cognitive performance, leading to the inability to make sound judgments. Teens may find it harder to recall information and crave junk foods simply from lack of sleep.

Prone to Accidents and Injuries

Most teens are just learning to drive, and inexperienced drivers make parents nervous. But a teen who is sleep deprived has an increased risk. Sleep deprivation can impair cognitive functioning just like being impaired by alcohol.

Teens with sleep deprivation may be prone to traffic accidents and more. If they are involved in athletics, they may be prone to more sports-related injuries. Lost sleep makes you less capable of responding effectively to any situation, which can result in mishaps.

Causes Sleep Deprivation in Teens

Hormonal Changes with Respect to Time

Teens are going through many hormonal changes which may disrupt normal sleep patterns. Teen sleep problems can begin long before they turn 13. The sleep habits and changing bodies of 10 to 12-year-olds have a close link to the teen years. The sleep patterns of teens are also firmly set in their lives. It is not easy for them to change the way they sleep. Thus, teen sleep problems can continue well into their years as adults.

Exposure to Blue Light

Time spent by teens watching TV and on computers and smartphones can impact healthy sleep. Blue light radiation from these electronic devices triggers the brain to stay alert as if it is daytime even in the middle of the night. Exposure to blue light can leave teens restless and sleepless and not knowing why. Blue light devices are so much a part of our lives we never realize that they affect our sleep. Teens should avoid exposure to blue light devices for at least a few hours before going to sleep.

Overuse of Electronic Gadgets

Along with the presence of blue light, electronic device use itself can impact healthy sleep. Teens can spend hours on video games trying to reach that next high score. They can surf the internet well into the night and chat with friends on their smartphones constantly. While all these habits seem normal for modern teens, these electronic gadgets are stealing precious time away from healthy sleep.

Putting a limit on electronic gadget use may seem daunting for parents but setting time aside for sleep is essential for health.

Overuse Of Social Media

Teens spend more and more time on social media. The obsession can often lead to sleepless nights. Worrying about a ping or a "like" can leave teens feeling anxious and even depressed. Overuse of social media can deprive teens of the healthy sleep they need. Limiting social media use can be a difficult ask for parents but is essential if they want teens to sleep well. Talking to your teens about social media and how it can impact sleep may make an impact on them and their decision to use social media wisely.

Sleep Disorder

Many teens may in fact may be suffering from a sleep disorder. While teen life is full of distractions and stresses including electronics school and friends, those factors may not entirely be the root of sleep deprivation. Sleep apnea and insomnia are some of the most common sleep disorders and are prevalent in teens. Diagnosing and treating sleep disorders in teens is the first step to helping them live healthy lives.

If you suspect your teen is struggling to get good enough sleep, and they're constantly waking up feeling sleep deprived or have other symptoms from lack of sleep, Sleep Care Online is the solution for you/your teen. We are a simple and convenient way for people to be tested for sleep disorders like sleep apnea from the comfort of their own homes. Have your child take a free risk assessment to get started toward a proper diagnosis of your sleep disorder.

Take a Free Risk Assessment!

Effects Of Teenage Sleep Deprivation

Sleep deprivation increases the likelihood that 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. It's a problem that knows no economic boundaries.

While studies show that both adults and teens in industrialized nations are becoming more sleep-deprived, the problem is most acute among teens. In a detailed 2014 report, the American Academy of Pediatrics called the problem of tired teens a public health epidemic.

Social and cultural factors, as well as the advent of technology, all have collided with the biology of the adolescent to prevent teens from getting enough rest. Since the early 1990s, it's been established that teens have a biological tendency to go to sleep later - as much as two hours later - than their younger counterparts.

Yet when they enter their high school years, they find themselves at schools that typically start the day at a relatively early hour. So. their time for sleep is compressed, and many are jolted out of bed before they are physically or mentally ready. In the process, they not only lose precious hours of rest but their natural rhythm is disrupted, as they are being robbed of the dream-rich, rapid-eye-movement stage of sleep, some of the deepest, most productive sleep time.

Additional Factors for Teenage Sleep Deprivation

Researchers noticed that as kids got older, they were naturally inclined to go to bed later. Teens experience a so-called sleep-phase delay. Their circadian rhythm - their internal biological clock - shifts to a later time, making it more difficult for them to fall asleep before 11 p.m.

Teens are also biologically disposed to a later sleep time because of a shift in the system that governs the natural sleep-wake cycle. Among older teens, the push to fall asleep builds more slowly during the day, signaling them to be more alert in the evening.

How Can Teenagers Sleep Better?

A consistent sleep schedule is key to healthy sleep. Make a checklist that helps you stay on track for going to bed at the same time every night. Whatever your teen's pre-bedtime routine might be, follow it to help notify your body that bedtime is near.

Maybe reading a book, listening to soothing music, or meditating can be used to help a teen prepare for sleep. That routine can help them stay aligned with a healthy sleep schedule.

While taking naps is normally not a good idea when battling sleep deprivation, for teens it is a solution. Because teens need extra hours of sleep, they can make up sleep time with naps. A nap during the day can leave a teen feeling refreshed and rejuvenated and does not interfere with their nighttime sleep schedule.

Just make sure the naps are short. Long naps that last more than 15 minutes to half an hour take too much time away from nighttime sleep and may leave a teen awake all night.

Early risers have better sleep. Whether it be adults or teens, getting up early in the morning gets your day started sooner, which means you are more prepared for sleep at night. Late risers have excess energy and may stay up well into the night. Once they fall into that cycle, it is difficult to establish a normal, healthy sleep pattern. Start early and go to bed according to your sleep schedule to feel better every day.

Activities during the day are a great way for teens to use up excess energy. Too much anxiety and energy at night keep them up. Sports or clubs at school can keep them occupied so they can sleep well when bedtime rolls around. A busy schedule is one of the best ways to help teens cope with hormonal changes and social life. Co-curricular activities help kids stay engaged with other kids in healthy activities that promote good sleep.

Social media and electronic devices these days can only make teens feel isolated and alone. They may spend more time engaging in a chat than chatting with friends. These behaviors can lead to a cycle of sleepless nights engaging with the internet rather than real people.

Encouraging teens to socialize with friends and engage in activities outside the home and away from Facebook are healthy habits that help prevent sleep deprivation from becoming a problem.

As bedtime rolls around, electronic gadgets should be put away. It can be difficult for teens to stop engaging with friends on social media or searching the internet for info about pop icons, but electronic devices deprive most teens of sleep by keeping them overly alert and awake for hours. Teens can spend hours on electronic devices, not realizing how much time is lost and how much sleep is lost. Limiting screen time is one of the best ways to promote healthy sleep in teens.

While teens are growing toward adulthood and may find a sleep schedule childish, parents can remind them that erratic sleep schedules can impact their health and life. If you question your teen about feelings of grogginess or drowsiness during the day even though they feel they have slept all night, you can help them realize that a crazy sleep schedule is not healthy or beneficial to them.

Sleep schedules do not have to be rigid. Following patterns that work well for teens and sticking to those patterns works best.

Tips For Parents To Prevent Sleep Deprivation In Teenagers

Take their cellphone away before bed

Limit their caffeine intake

Do not let them eat junk food a few hours before bed

Make sure all their homework is completed

Encourage a bedtime routine

Additional Tips on Managing Teenage Sleep Deprivation

Most teens are focused on social life and may not see sleep as a big deal in their lives. It's important to help teens realize that sleep is affecting them. Let them know that any symptoms of sleep deprivation are not a joke and can be impacting their health. Ask them to simply try out a sleep schedule for a few days and see if they feel better in the morning. They may thank you for it.

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Teens And Sleep: What Is Teenage Sleep Deprivation? - Sleep Care Online

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Teens and their sleep facts are detailed in this blog along with other tips. Check out the relationship between teens and sleep and learn the causes, effects, and preventive measures of sleep deprivation on teenagers.

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Most adolescents only get about 6.5 – 7.5 hours of sleep per night, and some get less. Sleep research suggests that a teenager needs between eight and 10 hours of sleep every night. This is more than the amount a child or an adult needs. Why do teens need so much sleep?

Teenagers need more sleep because their bodies and minds are growing quickly. Scientific research shows that many teens do not get enough sleep. Although getting enough sleep may not seem that big a deal to most teens, those who don’t get enough sleep and are overtired are more likely to:

Struggle in school

Have trouble with memory, concentration, and motivation (the desire to accomplish a goal)

Be involved in car crashes and other accidents. Sleepiness (the feeling of wanting or needing to sleep in places and at times when you shouldn’t) affects reaction times

Feel depressed, which can become a serious medical condition

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Why Sleep is needed may be another category.

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Why Sleep is needed may be another category.

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Sleep, especially deep sleep, is important for teens’ physical and mental health. Deep sleep or slow-wave sleep is a stage in the sleep cycle that promotes the healing of the body and mind from waking life and releases essential growth hormones beneficial to teen development. The loss of good sleep may result in early poor health and a reduction of growth hormones at a time when teens need them most.(7)

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Today, many people - teens especially - suffer from sleep deprivation.

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Sleep Disord. 2020; 2020: 5316364.

Abstract

Background. Disparities in sleep disturbances have been described in adults; nevertheless, among adolescents, data have yielded conflicting results. Therefore, analyses of our cohort study of 500 urban, normally developed Hispanic adolescents (10-18 years), aim to determine if rates of sleep debt differ between: (a) male and female adolescents, (b) US-born Hispanics and first-generation immigrant ethnic counterparts, and (c) specific activities that these teens trade for sleep. Participants' weekday and weekend sleep patterns, along with the reasons for sleeping less than the recommended hours were recorded. Standardized surveys were used to gather information regarding sociodemographics, migration, acculturation, and medical history. Using the criteria set forth by the National Sleep Foundation, analyses indicated that sleep deprivation is a pervasive problem, with 75% in the preadolescents and 45% of the late adolescents exhibiting sleep problems. Females slept on average at least one hour less per day than their male counterparts (7 vs. 8 hours). The sleep problems were rooted in several overlapping causes, including use of technology, video games, studying, and employment. Nevertheless, reasons for sleep loss differed by gender and by immigrant status. Multivariable adjusted logistic regression analyses showed that females, US-born teens, and preadolescents had higher odds of being sleep deprived. Pediatricians and sleep experts should be aware of gender-specific causes and responses of sleep problems. Cultural ecological frameworks need to be considered, and clearly indicate that findings may not generalize to youth from other cultural backgrounds.

1. Introduction

According to the Center for Disease Control (CDC), up to 70% of U.S. adolescents regularly sleep less than eight hours [ 1]. This equates to approximately 42 million adolescents suffering sleep deficiencies. The potential impact on society is considerable, given the host of deleterious sequelae due to sleep loss that are common in this age group, including poor school performance, and in extreme cases, death [ 2, 3].

Gender-specific medicine has gained relevance, as the scientific community continues to recognize gender differences in normal human functioning, pathophysiology, treatment response, and disease manifestation [ 4]. Nevertheless, most studies focusing on sleep disorders have avoided enrolling females, overlooked sex and gender effects, or applied suboptimal methodology [ 4]. In addition, sleep research has previously applied findings from adults to adolescents, disregarding the discrete developmental processes of adolescence, and ignoring etiological and behavioral differences [ 5]. For instance, for most adults, sleep length highly depends on demand of work, accomplishing the tasks needed to keep a household functioning, and fulfilling parental obligations, which are not largely applicable to adolescents. Therefore, it is important to identify which activities they are trading for sleep, so they can be targeted by future interventions.

Analogous pediatric studies have shown mixed results, with some researchers indicating that sex/gender has no influence on sleep, while others argue for significant disparities in prevalence and outcomes [ 5- 8]. Discordance could be due to over reporting in national surveys, (representative of the national population, but lacking objective measures), or convenience sampling (recruiting patients in sleep centers). These conflicting findings and design shortcomings underscore the need for additional research. Consequently, it is important for pediatric medicine to verify the existence of gender differences, and facilitate the development of treatment modalities or adjustments tailored to patient gender.

Several reasons motivated our decision to focus on Hispanic adolescents: First, national surveys indicated that minorities are more likely to be affected. Nevertheless, it seems that risks are different depending on nation of origin. Compared to Mexicans, "other" Hispanic groups had higher risks of sleep debt (<5 hours per night). Second, Hispanics represent a sizable and rapidly growing subgroup of the U.S. population that has been understudied. Third, from the public health perspective, it is imperative to confirm if prior findings apply to this minority group of adolescents, as they are a rapid expanding population. Therefore, there is a need to understand which factors impact healthy sleep habits to integrate these unique issues (e.g., psychosocial) into preventive programs. Our a priori hypothesis was that Hispanic females would have a less favorable sleep profile, particularly if they were recent immigrants.

2. Methods

2.1. Study Design and Inclusion Criteria

ROBIM is a 5-year longitudinal study based in South Florida. This article focuses on the responses of the 500 Hispanic adolescents, which the American Academy of Pediatrics defines as minors 11-18 years old.

Youths were recruited through direct outreach in centers and health care facilities that provide recreational, social, and educational services for Hispanics. Adolescents were eligible if they did not have a history of a major neurological/psychiatric disorders (i.e., autism, severe developmental problems, mental retardation, schizophrenia), or clinical disease (i.e., cancer, renal, or heart disease) that prevented their participation in the study. Adolescents were ineligible if they received any neuro-pharmacological intervention or were taking bodybuilding substances (i.e. steroids, growth hormones).

After a complete description of the study to the adolescent and his/her legal guardian, written, informed consent was obtained from both parties. Only 25 adolescents were invited to participate, but were not enrolled because of schedule conflicts.

2.2. Assessments

ROBIM's baseline visit was conducted by trained interviewers, and consisted of a brief medical exam, structured survey questionnaires to obtain sociodemographic information, health behaviors (diet, exercise, sleep, drug use), and medical information (e.g., medical history, and medication use). As part of the protocol approved by the Florida International University and the University of Miami IRBs, parents completed brief questionnaires regarding sociodemographics, adolescent's health, including exposure to alcohol or drugs during pregnancy, and to provide a blood sample to test their BDNF levels.

2.3. Sleep

To assess sleep duration, teens were asked to indicate the time they go to sleep on regular school nights (Monday to Thursday night), and the time they get up in the morning on regular school days (Monday to Friday morning). Time in bed (TIB) was calculated by subtracting bedtime from rise time. Difficulties initiating sleep were rated on a three-point Likert scale, with response options of "not true", "somewhat true" and "certainly true". If a positive response was given (2 or 3 on the scale), the participants were asked about frequency in the past month (yes/no DSM-IV criteria).

According to national guidelines, teens <12 years old need 10-11 hours of sleep, while adolescents ages 12-18 need between 8:30 and 9:30 hours each night [ 9]. Based on this criterion, adolescents were classified as sleep deprived or not.

2.4. Independent Variables

Sociodemographic information was collected using both adolescent and parent self-report questionnaires. Participants were asked both their age and their date of birth. Since gathering information on physical, sexual, cognitive, and social development is complex, for pragmatic reasons, we used chronological age to define development boundaries. Children ≤12 years old were classified as preadolescents, with adolescents classified as 13-18 years old. Ethnicity was determined using participants' self-identification, country of origin, and the ethnicity of their parents and grandparents.

Adolescents were also asked about the place of birth (City and Country) and followed with a question about when they arrived to Florida if they indicated that they were born outside Florida. Based on their responses, the participants were classified as an international immigrant, US-born in Florida, and US-born in another state (internal migration).

Self-reported gender, ethnicity, number of years living in the US, and number of family members were obtained using standardized surveys. The surveys also enquire whether a male or a female was the head of the household and then about parent's income, employment, and education.

2.4.1. Control Variables

We gathered information on variables known for affecting sleep, such as sociodemographics, neighborhood, and acculturation (measured by the Marin acculturation short scale) [ 10]. We also included indices of general health (medical history, medication intake, and body mass index), and health behaviors (e.g., caffeine consumption, drug use, and exercise via Stanford 7-day survey) [ 11].

2.4.2. Statistical Analyses

Descriptive statistics were used to summarize the data. Group comparisons were assessed using the chi-square test for categorical variables, ANOVA for normally distributed variables, and the Wilcoxon rank sum test for nonparametrically distributed, continuous variables. Logistic regression modeling was used to evaluate the relationship between the main variables of interest (gender, migration, and development stage) and sleep outcome. Models included adjustments for other sociodemographic variables of the adolescents and the parent, country of origin, health behaviors, neighborhood stressors (environment), and acculturation.

3. Results

3.1. Sleep and Sociodemographic

The demographic characteristics of the adolescents currently enrolled in ROBIM are shown in Table 1 . The age of the respondents ranged from 11 to 18 years, and the mean was 14.7 ± 2.0. The majority was either in middle or high school (35% and 50%, respectively), with the remaining participants being either in elementary school (14%) or in university (1%).

Table 1

Demographic variable

Percent

Gender

Male

47%

Female

53%

Age

In years

14.7 ± 2

Body mass index

14-25

30%

25-30

61%

>30

9%

Current education

Elementary

14%

Middle school

35%

High school

50%

University

1%

Income

Low/poverty

42%

Middle

26%

High class

32%

Migration status

Immigrant

27%

Born in Florida

64%

Migrate from another US state

9%

In this relatively large sample of healthy, typically developing adolescents, the average total sleep time during weekdays was 8.0 ± 1.6 hours (3-15 hours). Only 25% reported sleeping over 8.0 hours on school nights, and this rate increased to 35% each weekend. On workdays, the average bedtime was 10:55 PM compared to 1 AM during weekends.

In 15% of the adolescents, insomnia was the cause for suboptimal hours of sleep (6 vs. 8.5 hours/night), with all teens reporting difficulty initiating sleep (DIS) subtype.

We further sought to understand whether different patterns were the result of disparities in sociodemographic, language acculturation, and/or sleep environmental factors such as number of siblings (overcrowded environment) or neighborhood conditions. All analyses performed demonstrated that they were not significantly different.

3.2. Sleep Deprivation and Development Stage

The prevalence of sleep problems was age dependent, with 65% of the preadolescents reporting less than the recommended sleep time. An additional 5% reported sleeping more than 11 hours, suggesting a deteriorated quality of nightly sleep. When analyzing the older group, almost half had sleep deficits (45%, <7 hours nightly).

Participants seemed to try compensating for weekday sleep debt by oversleeping 1-2 hours on the weekend. Up to 34% of adolescents had a weekend bedtime delay of 2 hours or more, which can indicate a Delayed Sleep Phase disorder.

Since prior analyses suggested that overweight and obese children sleep less, we pursued such analyses. As depicted in Table 1 , over half of the sample was overweight. Nevertheless, in normal-weight, overweight, and obese groups, comparisons of sleep values showed no significant differences either for weekdays or weekends. On the contrary, preadolescents who were obese slept more hours during weekdays (10.3 ± 1.9 vs. 8.5 ± 1.4 vs. 8.3 ± 1.3 hours, p = 0.03). Hours of sleep were very similar among all adolescents (7.8 ± 1.7 vs. 8.0 ± 2.0 vs. 7.7 ± 1.7 hours, p = 0.88).

3.3. Sleep Gender Differences

The male to female ratio was nearly 1 : 1. Of convenience for these analyses, females at baseline had normal menstrual cycles, and consumption of coffee, alcohol, or drugs was minimal (10%). Gender differences in sleep deprivation and insomnia rates, according to DSM-IV criteria, were explored. At first glance, we did not observe significant gender differences in sleep measurements (8.7 ± 1.5 vs. 7.6 ± 1.7 hours, p = 0.2). Yet it needs to be acknowledged that females were sleeping less than 8 hours, which heightens the risk of chronically insufficient sleep. Since lack of differences may be a function of the pubertal status of the females sampled, which can be affected by the age ranges studied, we performed additional analyses. As depicted in Figure 1 , males slept on average at least one more hour per day than their female counterparts, and when accounting for age, ANOVA became significant. Nevertheless, when teens reached the last year of high school, or the first year of college, they returned to sleeping a similar number of hours. Findings probably reflect the more intense pace of social life for older males.

Gender differences were evident, with 10% of males reporting insomnia versus 16% of females, with the risk of having insomnia nearly twice as high among females (OR = 1.8, 95% CI: 1-3.6, p = 0.05). No gender difference in circadian disorders was observed.

3.4. Sleep Deprivation, Family, and Environment

The study successfully recruited a sample of both high (34% < 80,000) and middle/low-income participants. Although sleep deprivation has been related to overcrowded environments and poverty, there were no statistically significant differences in the number of siblings between the groups. No relationship was observed between greater risk of insufficient sleep and being part of a family with low income and lower educational attainment in our study. Moreover, a tendency was observed for sleep deprived teens to be wealthy and not working at baseline.

With regard to the environment, the relationship between neighborhood stressors and weeknight and weekend sleep schedules was only marginally related ( p = 0.08). Although total neighborhood scores were similar, prior data indicate that concerns for safety cause a state of chronic hyperarousal, so we pursued additional analyses. Indeed, we found that presence of gangs and hearing gunshots were associated with going to sleep late (12.20 ± 2 vs. 10.20 PM ± 2, p = 0.005).

3.5. Reported Causes by Gender

The sleep problems were rooted in several overlapping causes. The most common reason (40%) for sleep loss was electronic media use in the bedroom, (i.e., surfing the Internet, looking at TV/Netflix movies, or playing video games). Gender differences were evident in the proportion of males reportedly using a game console in the bedroom (11% vs. 1% females), and all males said they made at least one friend through online gaming, compared to none of the females. Socializing was second on the list (28% via cellular phone). Some identified (14%) striving for good grades or greater reliance on long work hours as a cause. A higher proportion of females than males (20.5% vs. 15%) reported sleeping less because of work. Others (10%) reported problems decreasing vigilance and arousal, due to anxiety and ruminative thinking about stressors.

3.6. Reported Causes by Gender and Migration Status

Most adolescents were native-born Americans, and 27% were born abroad. Of those born abroad, almost half were Cubans (43%), followed by Colombians (13%), Central Americans (Panama, Honduras, Guatemala, Nicaragua) (14%), Argentinians (9%), other South American (6% Uruguay, Peru, Ecuador, Venezuela), and Dominican Republic (6%).

Based on prior studies suggesting that immigrants sleep more hours than US born Hispanics, we contrasted their sleep hours during weekdays and weekends and did not find any significant differences. We also examined the impact of place of origin and found no significant differences. Yet, additional analyses provided a new perspective to these findings. For instance, Hispanic males born in the US reported going to sleep later during weekdays than females (12.0 ± 2 vs. 10.0 ± 1, p = 0.05), but differences disappeared during the weekends (11.5 ± 1 vs. 12.5 ± 1, p = 0.4).

On the contrary, female immigrants tended to go to sleep later during weekdays than their male counterparts (11.0 ± 2 vs. 9.0 ± 1 PM, p = 0.09), but woke up later during the weekends (11.0 ± 2 vs. 10 ± 1 AM, p = 0.03). As depicted in Table 2 , when exploring the reasons driving sleep debt, more differences emerged. The males born in the US were the group most frequently citing playing video game as the primary reason for sleeping fewer hours than recommended. They were also more likely to report playing games online with friends, while none of the females reported this trend.

Table 2

Socializing

TV/computer

Video games

Work

Insomnia

US born

Males

33%

34%

14%

9%

10%

0.02

Immigrant

Males

20%

27%

3%

27%

24%

0.03

Two main reasons drove sleep debt in this group of females, having to work and insomnia. Notably, quite the opposite occurred among immigrants, males were more likely to report working as a cause. In contrast to females born in the US, only one female immigrant reported insomnia as a cause of sleep deficiencies.

3.7. Final Analyses

In order to clarify potential influences of social, cultural, acculturation, stress, and other behavioral risk factors on sleep, we performed a multivariate analysis. As depicted in Table 3 , multivariable adjusted logistic regression analyses showed that females, US-born, and preadolescents had higher odds of being sleep deprived.

Table 3

Coefficientsa

Model

Unstandardized coefficients

Standardized coefficients

t

Sig.

B

Std. error

Beta

1

(Constant)

10.557

1.016

10.391

.000

In Table 4 we show the results of the analyses for insomnia, in which the only significant predictor was the number of years since immigration to the US. Yet, acculturation was not a predictor. Age and gender were significant, but once immigration was included in the model, they were no longer significant.

Table 4

Coefficientsa

Model

Unstandardized coefficients

Standardized coefficients

t

Sig.

B

Std. error

Beta

1

(Constant)

1.901

.144

13.188

.000

4. Discussion

Although it is well established that adolescents in the United States have poor sleep habits, the vast majority of the studies are based on nonHispanic whites and to lesser extent African Americans. Limited research has been done in US Hispanics, and those available are mostly based on adults, which prevent making or extrapolating accurate conclusions [ 14- 16]. Our analyses confirmed that these adolescents obtained less than the recommended hours of sleep for their age on school days. Our data discovered that our pre-adolescent Hispanics exhibited excessively high rates of sleep deprivation [ 1, 17]. Pre-adolescence seems to be a particularly risky developmental period for inadequate sleep patterns. Sleep hygiene practices were moderately poor among adolescents. Emphasizing good sleep hygiene practices and integrating sleep promotion programs into daily routines should be considered in order to improve the health of these adolescents.

4.1. Contribution to the Extant Literature

The obvious question is whether these excessive rates are due to factors amenable to change with target interventions. For example, is this due to increasing use of technology? While nearly all American adolescents have and use the computer, the internet, console games, and cellular phones, males and females use them at different rates as indicated by our analyses. Data are in line with prior surveys indicating that males playing video games do experience reduced subjective sleepiness, and experience slight sleep onset latency [ 12]. Based on these outcomes, additional studies are clearly justified.

Findings complement prior studies by examining immigration status, since family background can distinctively impact sleep behaviors. Indeed, female adolescents were more likely to report working as a cause for sleep deprivation. For immigrants, expectations of male gender roles may explain why more male immigrants reported working as a reason for sleeping fewer hours. Findings are in line with cultural ecological frameworks that recognize that behaviors need to be appreciated within a larger sociocultural context [ 10]. These results highlight the importance of not generalizing results to youth from other cultural backgrounds, even if they are from the same race. Notably, differences were driven by length of US residency, and not by the country of origin or the phenomenon of acculturation, as they do not modify the results of these analyses, whereas a prior analysis of sleep patterns in adults found that acculturation accounted for differences in sleep duration [ 14, 15].

The immigrant health advantage was also observed for insomnia [ 15]. Although we expect that stressors, work, and the familism typical of Hispanics may exert an effect on sleep, the lack of significance in the logistic models reflects that the underlying sources of the association between immigrant status and sleep are mediated by other variables and require further investigation.

To note in our final model, neither overweight nor obesity predicted the duration of sleep, although obese preadolescents seem to be sleeping more. These results suggest that the heterogeneity of published results regarding the relationship between sleep duration and obesity probably reflects sampling bias, or lack of consideration for the development stage [ 17]. On the other hand, our analyses confirmed the trend to sleep more during weekends, possibly as a compensatory mechanism to mitigate the adverse effects of a poor weekday-sleep pattern.

4.2. Limitations

Our findings need to be analyzed in the context of some study limitations. First, our study was limited to subjective sleep measures. We also recognize that the sample size although large ( n = 500), may be insufficient to conduct statistical analyses by country of origin.

The strengths of our study are the use of a diverse sample of Hispanic adolescents, with a sizable proportion of females, and controlling for important demographic and clinical confounding factors.

In summary, while the widespread use of technology is a pervasive factor impacting adolescents' sleep, their impact differs by gender and immigration status. On the other hand, we are less clear about other factors that may affect sleep, such as job and neighborhood safety.

Acknowledgments

We are indebted to all participants in this study for their cooperation. Also, we thank the University of Miami Research Center for their support during the survey. The Research Project was fully sponsored by the Nursing Research Institute NIH with grant number (R01 NR13378-01-MJM).

Abbreviations

DSM-IV:

Diagnostic statistical manual 4

CDC:

Center for disease control

ROBIM:

The role of brain derived neurotrophic factor in decision making participants

TIB:

Time in bed

ANOVA:

Analyses of variance

DSPD:

Delayed sleep phase disorder.

Data Availability

The data used to support the findings of this study may be released upon application to the Florida International University IRB who can be contacted at: Maria Melendez-Vargas, ude.uif@nelemedm, (305) 348-8311.

Conflicts of Interest

The authors declare that they have no conflicts of interest.

Authors' Contributions

All authors of this research paper have directly participated in the planning, execution, or analysis of this study. More specifically, this was the contribution of the authors as mentioned below with their responsibility in the research.

References

2. Walsh J. K., Engelhardt C. L. The direct economic costs of insomnia in the United States for 1995. [[ PubMed] Google Scholar]

10. Marin G., Sabogal F., Marin B. V., Otero-Sabogal R., Perez-Stable E. J. Development of a short acculturation scale for hispanics. [[ CrossRef] Google Scholar]

Articles from Sleep Disorders are provided here courtesy of Hindawi Limited

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Disparities in Sleep Health among Adolescents: The Role of Sex, Age, and Migration

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Background. Disparities in sleep disturbances have been described in adults; nevertheless, among adolescents, data have yielded conflicting results. Therefore, analyses of our cohort study of 500 urban, normally developed Hispanic adolescents (10-18 ...

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Has sleep deprivation affected your academics? If so how so.

Has it impacted your life outside of school?

Do you have any techniques to fall asleep or stay asleep?

Do Electronics affect your sleep?

How does it impact your energy, cognitive ability, and willpower?

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This disorder can make it hard to fall asleep, hard to stay asleep or both, even though you have the chance for enough sleep. It can drain your energy.

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What is sleep deprivation?

Sleep deprivation is when a person doesn't get enough sleep. This can be a short-term issue, affecting one or a few nights, or it can be a chronic concern that lasts weeks or even months. Sleep deprivation can happen for countless reasons, many of them harmless, but it's also a key symptom of certain health conditions.

Sleep is something that everyone needs, and most people need a similar amount, depending on their age. That amount also changes with age. However, some people need more sleep to feel well-rested, while others need less, but these exceptions aren't common. A change in your sleep patterns, gradual or sudden, is a reason to talk to a healthcare provider.

The average daily amount of sleep needed, by age, is:

Newborns (up to 3 months old): 14 to 17 hours.

Infants (4 to 12 months old): 12 to 16 hours, including naptime.

Young children (1 to 5 years old): 10 to 14 hours, including naptime.

School-aged children (6 to 12 years old): 9 to 12 hours.

Teenagers (13 to 18 years old): 8 to 10 hours.

Adults (18 years and up): 7 to 9 hours.

Sleep deprivation can also take different forms. For some people, sleep deprivation happens because they stay awake instead of sleeping. For others, they're still sleeping, but they aren't getting quality sleep, so they still wake up feeling tired.

Sleep deprivation usually isn't a major problem in limited, isolated amounts. However, research shows that chronic sleep deprivation can cause or contribute to a variety of health issues.

What is the difference between sleep deprivation and insomnia?

Insomnia and sleep deprivation are closely related but aren't the same thing. Insomnia is when you're unable to sleep when you try. Sleep deprivation is what happens when you don't give yourself enough time to sleep don't get enough sleep or both.

Who does it affect?

Sleep deprivation can happen to everyone at any point in their life.

How common is this condition?

Sleep deprivation is very common. Experts estimate between 50 million to 70 million adults in the U.S. meet the medical criteria for sleep deprivation at any point in time. Virtually every human being experiences sleep deprivation at some point in their life. For some people, it's simply a greater or longer-lasting issue, or it happens for a more serious reason.

How does this condition affect my body?

Your body needs sleep to regenerate certain systems and carry out certain processes. To understand more about that, it helps to know a little more about the human sleep cycle. That cycle involves different stages of sleep. Those are:

Stage 1: Light sleep. This is a short stage, usually no more than 5% of your total sleep, which begins right after you fall asleep.

Stage 2: Deeper sleep. This stage is deeper and makes up about 45% of all the time you spend sleeping (this number goes up as you get older). Research indicates this stage is key in memory storage and learning.

Stage 3: Deepest sleep. This stage makes up about 25% of the time you spend sleeping (this number goes down with age). There's evidence that this stage is the most important to how your body recovers and maintains itself because the brain prioritizes this stage in people with sleep deprivation. It's very hard to wake someone up from this stage, and they'll usually feel foggy or confused for up to 30 minutes after waking up.

REM sleep: REM stands for "rapid eye movement." This stage is when you dream. When a person is in REM sleep, you can see their eyes moving beneath their eyelids.

When you fall asleep, you typically enter stage 1 and then move in and out of stages 2 and 3. After that, you go into REM sleep and start dreaming. After the first REM cycle, you start a new sleep cycle and go back into stage 1 or 2. One cycle normally takes about 90 to 120 minutes before another begins. Most people go through four or five cycles per night (assuming they get a full eight hours).

Systems affected

Sleep deprivation has negative effects in multiple ways throughout your body. Those can affect the following body systems, organs and processes:

Heart and circulatory systems: Sleep deprivation has long-term damaging effects on your heart and circulatory health. People with chronic sleep deprivation are more likely to develop high blood pressure (hypertension) and high cholesterol (hyperlipidemia).

Metabolic systems: People with chronic sleep deprivation are at a much higher risk of developing Type 2 diabetes.

Immune system: Your body's natural defenses against infections can't work properly if you aren't getting enough sleep.

Nervous system: It's common for people who aren't sleeping enough to have higher pain sensitivity, which means they feel pain more easily, the pain is more intense or both.

Brain: Sleep deprivation has very negative effects on how your brain works. While experts don't fully understand sleep's role in brain function, they do know it's a key part of how people learn and remember. There's also some evidence that sleep deprivation could play a role in the development of Alzheimer's disease.

Mental health: Sleep deprivation also negatively affects your mental health, making it harder for you to manage and process your emotions. People with sleep deprivation are more likely to feel symptoms of depression and anxiety.

The effects of sleep deprivation depend on why it happens and how long it lasts. The longer a person has sleep deprivation, the greater - and more severe - the effects.

Conditions that can get worse or happen because of sleep deprivation

Sleep deprivation also increases your risk of developing certain conditions or making them worse if you have them. These conditions include:

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Sleep Deprivation: What It Is, Symptoms, Treatment & Stages

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Sleep deprivation is when you aren't getting enough sleep, or your sleep is of poor quality. When severe, it can disrupt all activities and parts of your life.

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📖 MyBib – A New FREE APA, Harvard, & MLA Citation Generator

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Automatically create bibliographies, references, and citations in APA, MLA, Chicago, Harvard, and more with our fast and free citation generator.

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Girls Take Lessons, Join Clubs More Often Than Boys But Boys Play More Sports

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New U.S. Census Bureau historical tables show both girls and boys are taking more lessons and playing more sports than in 1998.

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Getting enough quality sleep at the right times can help protect your mental health, physical health, quality of life, and safety. Learn how to figure out if you're getting enough sleep, what symptoms children show, and sleep and your health in this topic.

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National Institute of Diabetes and Digestive and Kidney Diseases

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Defining Overweight and Obesity

A person whose weight is higher than what is considered to be a normal weight for a given height is described as being overweight or having obesity. ¹

Fast Facts

According to 2017-2018 data from the National Health and Nutrition Examination Survey (NHANES)

Nearly 1 in 3 adults (30.7%) are overweight.²

More than 2 in 5 adults (42.4%) have obesity.²

About 1 in 11 adults (9.2%) have severe obesity.²

According to 2017-2018 NHANES data

About 1 in 6 children and adolescents ages 2 to 19 (16.1%) are overweight.³

Almost 1 in 5 children and adolescents ages 2 to 19 (19.3%) have obesity.³

About 1 in 16 children and adolescents ages 2 to 19 (6.1%) have severe obesity.³

Using Body Mass Index (BMI) to Estimate Overweight and Obesity

BMI is a tool to estimate and screen for overweight and obesity in adults and children. BMI is defined as weight in kilograms divided by height in meters squared. BMI is related to the amount of fat in the body. A high amount of fat can raise the risk of many health problems. A health care professional can determine if a person's health may be at risk because of his or her weight.

Adults

The table below shows BMI ranges for overweight and obesity in adults 20 and older.

BMI of Adults Ages 20 and Older

Use this online tool from the Centers for Disease Control and Prevention (CDC) to gauge BMI for adults.

Children and Teens

A child's body composition changes during growth from infancy into adulthood, and it differs by sex. Therefore, a young person's weight status is calculated based on a comparison with other same-age and same-sex children or teens using CDC's age- and sex-specific growth charts. The comparison results in a percentile placement. For example, a boy whose weight in relation to his height is greater than 75% of other same-aged boys places in the 75th percentile for BMI and is considered to be of normal or healthy weight.

Children grow at different rates at different times, so it is not always easy to tell if a child is overweight. A child's health care professional should evaluate the child's BMI, growth, and potential health risks due to excess body weight.

BMI for Children and Teens

Weight Status Category

Percentile Range

Underweight

Less than 5th percentile

Normal or healthy weight

5th percentile to less than 85th percentile

Overweight

85th to less than 95th percentile

Obesity

95th percentile or greater

Severe obesity

120% of the 95th percentile

Use this online tool from the CDC to calculate BMI and the corresponding BMI-for-age percentile based on CDC growth charts, for children and teens.

Causes and Health Consequences of Overweight and Obesity

Factors that may contribute to excess weight gain among adults and youth include genetics; types and amounts of food and drinks consumed; level of physical activity; degree of time spent on sedentary behaviors, such as watching TV, engaging with a computer, or talking and texting on the phone; sleep habits; medical conditions or medicines; and where and how people live, including their access to and ability to afford healthy foods and safe places to be active. 4,5

Overweight and obesity increase the risk for many health problems, such as type 2 diabetes, high blood pressure, heart disease, stroke, joint problems, liver disease, gallstones, some types of cancer, and sleep and breathing problems, among other conditions. 5,6 Learn more about the causes and health consequences of overweight and obesity.

Prevalence of Overweight and Obesity

Adults
Age-adjusted percentage of US adults with overweight, obesity, and severe obesity by sex, 2017-2018 NHANES Data ²
As shown in the above table
Age-adjusted prevalence of obesity among adults ages 20 and over, by sex and age: United States, 2017-2018 ⁷

Nearly 1 in 3 adults (30.7%) are overweight.

More than 1 in 3 men (34.1%) and more than 1 in 4 women (27.5%) are overweight.

More than 2 in 5 adults (42.4%) have obesity (including severe obesity).

About 1 in 11 adults (9.2%) have severe obesity.

The percentage of men who are overweight (34.1%) is higher than the percentage of women who are overweight (27.5%).

The percentage of women who have severe obesity (11.5%) is higher than the percentage of men who have severe obesity (6.9%).

Age-adjusted prevalence of obesity among adults ages 20 and over, by sex, race, and Hispanic origin: United States, 2017-2018 ⁷
As shown in the above bar graph

Among adults ages 20 and over, there are no significant differences in prevalence of obesity by sex or age group
Age-adjusted prevalence of severe obesity among adults ages 20 and over, by sex, age, and race and Hispanic origin: United States, 2017-2018 ⁷

Prevalence of overweight, obesity, and severe obesity among children and adolescents ages 2 to 19 years: United States, 2017-2018 NHANES data ³ Prevalence of obesity among children and adolescents ages 2 to 19 years: United States, 2017-2018 NHANES data ³ Prevalence of obesity among children and adolescents ages 2 to 19 years, by sex and race and Hispanic origin: United States, 2017-2018 NHANES data ³
As shown in the above bar graph

More than 2 in 5 non-Hispanic white adults (42.2%) have obesity.

Nearly 1 in 2 non-Hispanic Black adults (49.6%) have obesity.

More than 1 in 6 non-Hispanic Asian adults (17.4%) have obesity.

Nearly 1 in 2 Hispanic adults (44.8%) have obesity.

Obesity affects more than 2 in 5 non-Hispanic white men (44.7%), more than 2 in 5 non-Hispanic Black men (41.1%), more than 1 in 6 non-Hispanic Asian men (17.5%), and more than 2 in 5 Hispanic men (45.7%).

Nearly 2 in 5 non-Hispanic white women (39.8%), more than half of non-Hispanic Black women (56.9%), more than 1 in 6 non-Hispanic Asian women (17.2%), and more than 2 in 5 Hispanic women (43.7%), have obesity.

As shown in the above bar graph, men and women differ in their rates of obesity and severe obesity.

More women (11.5%) than men (6.9%) have severe obesity.

Severe obesity was highest among people ages 40 to 59 (11.5%), followed by people ages 20 to 39 (9.1%) and people ages 60 and older (5.8%).

About 1 in 11 non-Hispanic white adults (9.3%) have severe obesity.

More than 1 in 8 non-Hispanic Black adults (13.8%) have severe obesity.

About 1 in 50 non-Hispanic Asian adults (2.0%) have severe obesity.

About 1 in 13 Hispanic adults (7.9%) have severe obesity.

Severe obesity was highest among non-Hispanic Black adults (13.8%), followed by non-Hispanic white adults (9.3%), Hispanic adults (7.9%), and non-Hispanic Asian adults (2.0%).

Trends in age-adjusted (PDF, 97.2 KB) obesity and severe obesity prevalence among adults ages 20 and over: United States, 1999-2000 through 2017-2018 ⁷
Youth
Trends in obesity among children and adolescents ages 2-19 years, by age: United States, 1963-1965 through 2017-2018 ³
According to the 2017-2018 NHANES data

Among children and adolescents ages 2 to 19, about 1 in 6 (16.1%) are overweight, more than 1 in 6 (19.3%) have obesity, and about 1 in 18 (6.1%) have severe obesity.

According to the 2017-2018 NHANES data

Among children ages 2 to 5, more than 1 in 8 (13.4%) have obesity.

Among children and youth ages 6 to 11, more than 1 in 5 (20.3%) have obesity.

Among adolescents ages 12 to 19, more than 1 in 5 (21.2%) have obesity.

According to the 2017-2018 NHANES data

More than 1 in 6 non-Hispanic white boys (17.4%) have obesity and more than 1 in 7 non-Hispanic white girls (14.8%) have obesity.

Nearly 1 in 5 non-Hispanic Black boys (19.4%) and more than 2 in 7 non-Hispanic Black girls (29.1%) have obesity.

About 1 in 8 non-Hispanic Asian boys (12.4%) and about 1 in 20 non-Hispanic Asian girls (5.1%*) have obesity.

About 2 in 7 Hispanic boys (28.1%) and nearly 1 in 4 Hispanic girls (23.0%) have obesity.

More than 2 in 7 Mexican American boys (29.2%) and 1 in 4 of Mexican American girls (24.9%) have obesity.

* See asterisked note in the figure above.

Trends in Obesity among Adults and Youth in the United States

Adults

As shown in the figure above

The prevalence of obesity and severe obesity increased significantly among adult men and women between 1999-2000 and 2017-2018.

Youth

As shown in the above line graph

The prevalence of obesity among children and adolescents ages 2 to 19 years roughly doubled between 1988-1994 and 2017-2018.

Among children ages 2 to 5, the prevalence of obesity increased between 1988-1994 and 2003-2004, decreased between 2003-2004 and 2011-2012, and then increased again.

Among children ages 6 to 11, the prevalence of obesity increased between 1988-1994 and 2003-2004, fluctuated over the next several years, and most recently (2013-2014 to 2017-2018) increased.

Among adolescents, ages 12 to 19, the prevalence of obesity has increased between 1988-1994 and 2017-2018.

References

[1] Defining adult obesity. Centers for Disease Control and Prevention. Updated June 7, 2021. Accessed January 29, 2021. www.cdc.gov/obesity/basics/adult-defining.html

[2] Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among adults aged 20 and over: United States, 1960-1962 through 2017-2018. NCHS Health E-Stats, Centers for Disease Control and Prevention. 2020. Updated February 8, 2021. Accessed January 29, 2021. www.cdc.gov/nchs/data/hestat/obesity-adult-17-18/obesity-adult.htm

[3] Fryar CD, Carroll MD, Afful J. Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2-19 years: United States, 1963-1965 through 2017-2018. NCHS Health E-Stats, Centers for Disease Control and Prevention. Updated January 29, 2021. Accessed April 22, 2021. www.cdc.gov/nchs/data/hestat/obesity-child-17-18/overweight-obesity-child-H.pdf (PDF, 352 KB)

[4] What causes obesity and overweight? National Institute of Child Health and Human Development, National Institutes of Health. Updated July 28, 2021. Accessed January 29, 2021. www.nichd.nih.gov/health/topics/obesity/conditioninfo/cause

[5] Adult overweight causes and consequences. Centers for Disease Control and Prevention. Updated March 22, 2021. Accessed January 29, 2021. www.cdc.gov/obesity/basics/causes.html

[6] Cotter TG, Rinella M. Nonalcoholic fatty liver disease 2020: the state of the disease. Gastroenterology. 2020;158(7):1851-1864. doi:10.1053/j.gastro.2020.01.052

[7] Hales CM, Carroll MD, Fryar CD, Ogden CL. Prevalence of obesity and severe obesity among adults: United States, 2017-2018. National Center for Health Statistics Data Brief 360. Centers for Disease Control and Prevention. Updated February 27, 2020. Accessed January 29, 2021. www.cdc.gov/nchs/products/databriefs/db360.htm

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Trends in overweight, obesity, and severe obesity for children, adolescents, and adults.