What happens when we’re sleep deprived?

Problems from sleep deprivation are seen everywhere. I hear parents say they need more and that their kids need more. Even teens often admit that they don’t get enough. But why is it such a big deal? What problems are really caused by sleep deprivation? There are many! When we’re sleep deprived, it can lead to many problems that are often not attributed to poor sleep. This can include irritability, poor academic performance, accidents, obesity and more.

Last week we discussed why so many tweens and teens get too little sleep.

You’ll have to learn what your real sleep needs are. Too many people think they’re “used to” less than recommended amounts of sleep, so they’re okay. Once you know your needs, learn the problems with sleep deprivation so you can recognize symptoms in yourself.

Next week we’ll talk about how you can get better sleep.

How much sleep is needed?

Sleep experts recommend nine to ten hours for growing tweens and teens, with a minimum of eight and a half hours until the mid-twenties as our brains continue to mature.

Remember that when we’re sick or in a growth spurt, we need more than usual. Listen to your body!

Find your specific need.

You can estimate how much you need by experimenting over a school vacation time. Go to bed when you’re tired at night and wake on your own. Talk to your parents to let them know what you’re doing so they don’t try to wake you too soon.

Initially you will probably need a lot to catch up on sleep debt, but after a few nights of adequate sleep, see how much your body needs regularly. Don’t lay around all day watching tv or playing on your phone. Get moving! If you have too much down time, it can make your body feel tired, even when you’re not.

Count the hours you sleep naturally once your sleep debt is paid. When it’s time for school or other activities, adjust your bedtime to allow for that much sleep. If that’s impossible you’ll have to work with parents, coaches, and teachers to find solutions.

When you fall asleep within 20 minutes of going to bed and wake up without an alarm, you’re probably getting the right amount of sleep. If you fall asleep immediately upon hitting the pillow and always need an alarm to wake up, you’re probably sleep deprived.

Problems of sleep deprivation

Hormone changes

Sleep deprivation can lead to increased levels of cortisol (a stress hormone), decreased activity of human growth hormone (which is active during tissue repair), and decreased glycogen synthesis (energy). Hormones that regulate appetite are affected by sleep duration. Sleep also influences the release of insulin, which is important in our sugar metabolism

These hormone changes are all implicated in the sleep problems we recognize, and we’re still learning more effects.

Moodiness

We all associate the teen years with angst, so we can easily attribute a teen’s moodiness to just being a teen. But being chronically tired can lead to emotional dysregulation. This will look like irritability, frustration and anger.

Chronic sleep deprivation is associated with developing depression. Depression affects our ability to sleep well and poor sleep can increase the risk of depression, so it can have a snowball effect.

Growth

Growth hormone is released as we sleep. Chronic sleep deprivation can affect your overall height if you don’t get enough sleep during your rapid growth tween and teen years.

Growth hormone isn’t just needed for growing. It also stimulates muscle growth, muscle repair, bone building and fat burning. Sleep loss may affect healing time and weight due to less growth hormone.

Obesity

Obesity has been associated with sleep deprivation. Specific appetite hormones are altered by sleep. Our appetite can be increased when we fail to get enough sleep.

Sleep deprivation can lead to eating more calories than needed because of increased appetite. This increases the risk of obesity and all the health consequences of being overweight.

Diabetes

Sugar metabolism is directly affected by sleep. People who don’t get enough sleep are at increased risk of Type 2 diabetes from this direct effect as well as from carrying excess weight.

School problems

Getting proper amounts of sleep can help with focus and learning. When we fail to get enough sleep, problems with attention, memory, decision making, reaction time, and creativity start to show. As if ADHD wasn’t enough to cause these things – sleep deprivation compounds the issue!

Grades can easily fall, which leads to anxiety and depression, which in turn leads to more moodiness and trouble sleeping.

Sleep deprivation mimics ADHD. If you think the medicine to help your ADHD that’s worked for years suddenly isn’t working, think about your sleep needs and amounts. Increasing the medicine isn’t the answer!

Injuries

Teens with chronic sleep deprivation are more likely to be accidentally injured due to poor focus and slowed reaction time. Sleep deprivation also slows healing after injury.

Drowsy driving is comparable to drunk driving. Tired teens are at high risk for falling asleep at the wheel. Drowsy driving is the most likely to occur in the middle of the night (2-4 am), but also in mid-afternoon (3- 4pm) as teens drive home from school.

Athletes are more likely to be injured while playing their sport, so it is in the best interest of the team to get enough sleep. And yes, I know with the busy practice schedule and homework it’s hard. But athletes need sleep.

Sports Performance

It’s not just injuries that increase among sleep deprived athletes. Performance also falls when we fail to get sleep.

Less sleep increases fatigue, lowers energy, and leads to poor focus. It may also slow recovery as mentioned above.

In short, sleep helps your sports performance.

Study of 18-27 year old males

Eve Van Cauter, Ph.D., from the University of Chicago Medical School, studied the effects of three different durations of sleep in eleven 18-27 year old men. For the first 3 nights of the study, the men slept 8 hours per night. Over the next 6 nights, they slept 4 hours per night. For the last 7 nights, they slept 12 hours per night.

After 4 hours of sleep per night, participants metabolized glucose least efficiently. Levels of cortisol were also higher during sleep deprivation periods. This can lead to memory impairment, insulin resistance, and impaired recovery.

After only 1 week of sleep restriction the previously young, healthy males had glucose levels that were no longer normal. They showed a  reduced ability to manage glucose, similar to the way elderly people metabolize it.

Study of female university athletes

Cheri Mah of the Stanford Sleep Disorders Clinic and Research Laboratory has studied college level athletes for many years. Her research shows that getting more sleep leads to better sports performance for all types of athletes.

One study of the Stanford University women’s tennis team focused on increasing sleep to 10 hours per night. Those who increased their sleep time ran faster sprints and hit more accurate tennis shots than while getting their usual amount of sleep.

Illnesses

Too little sleep increases the risk of getting sick. Your immune system needs sleep to perform at its best.

Risky behaviors

Teens with chronic sleep deprivation have been shown to participate in more risk taking behaviors. These behaviors, such as driving without a seatbelt, drinking alcohol, skipping the bike helmet and tobacco use, add to the problems of sleep deprivation.

Next Up:

Now that you understand the many problems with sleep deprivation, come back next week to learn how to get more sleep.

Why don’t teens get enough sleep?

Teens often do not get enough sleep. Most teens need 8.5-10 hours of sleep each night. Not 6 hours. Not even 8 hours. Most don’t get even close to meeting their needs and that’s a bigger deal than many realize. You don’t just “get used to” too little sleep. Sleep is very undervalued, but we need to prioritize it. Sleep deprived teens suffer from many physical and emotional problems. Add ADHD or anxiety into the mix, and it’s even worse!

This is part 1 of a 3 part sleep series. It will focus on what makes it hard to get enough sleep. Next up will be why it’s so important to get sleep, then the big topic of how to get more.

So… why don’t teens get enough sleep?

Body clock.

One of the most common reasons is that their biological clock (AKA circadian rhythm) makes it hard to fall asleep before 11 pm and school starts too early to allow them to sleep until 8 am, which would allow for a reasonable 9 hours. Nine hours are on the low end of sleep need for many adolescents. If teens are still growing, they will need even more!

Research shows that tween and teen sleep patterns are hormonally influenced. Your parents probably get frustrated with your late nights, thinking you’re in control of your bedtime, but you’re not. This isn’t an act of rebellion.

Research shows that the hormonal response to the 24-hour daily light/dark exposure that influences circadian rhythm is altered in the adolescent years. Adolescents physiologically stay awake later at night and therefore need to remain asleep later in the day.

It’s not your fault!

But sadly, it is your problem because you suffer the consequences.

Screens.

Melatonin is a hormone that is released from our pineal gland. We need it to feel tired. During the day the pineal is inactive. When the sun goes down and it gets dark, the pineal gland starts to produce melatonin. It’s released into the blood and helps us feel tired and sleep. Melatonin levels in the blood stay elevated through the night until the light of a new day helps to lower the levels again.

The light from smart phones, tablets, and computers interferes with our natural melatonin rising. This keeps us from feeling tired and falling to sleep.

It’s best to limit screen use for at least an hour before bedtime. I know that for many teens this is difficult because they have to finish their homework at that time. Today’s teens need their computer or tablet to do homework.

If you have any time during the day to work on homework, do it. This is even more important for kids who take stimulant medicines for their ADHD. This medicine is out of your system close to bedtime, so it will be harder to sustain attention, making homework more frustrating and less efficient. Homework will take longer to do after medicine wears off, which decreases the time for sleep and fun activities.

If you can’t turn off the screen, at least use a program that limits the blue light that prevents the rise of melatonin. I personally use f.lux. It’s free and works on PC, Mac, ipad, android, and Linux. I find that it really helps. Try it!

Phones.

On a similar note, phones distract us all from what we’re doing, including getting to sleep. They also can wake us if we forget to put it on silent when we sleep.

Playing that one last game or checking Instagram one last time gives our brain a dopamine hit. Dopamine is a neurochemical known as the “reward molecule” that’s released after certain behaviors, such as eating, exercising or reaching a goal. While physical activity is most commonly linked to dopamine’s release, social media and online gaming are now shown to give a dopamine rush. This is why these behaviors are so addictive. It’s hard to stop the habit. One of the easiest ways is to just not use it except specific times of the day.

Take charge of your phone use ~

If you don’t want your parents restricting phone use, set your own reasonable limits.

Maybe check for messages before you leave for school after you’ve gotten ready. This can let you know of any needs or changes for the day.

Check messages again after school for the same reasons. Allow a 30 minute period to play a game or look at social media after homework is done. Then put it away and do something else.

It’s important to do things other than online games and social media. Find things to do that you enjoy. This article’s about sleep, but there are many negatives to spending too much time on screens. If you can’t limit yourself, talk to your parents or your doctor.

Indirect effects of phone use ~

It’s not just the direct issue of using our phone when it’s bedtime that interferes with sleep. There are indirect things as well.

It takes longer to finish homework when there are distractions from the phone. Putting your phone in another room when doing homework will help you finish more quickly, allowing you to get to other things more quickly.

Think of the extra time you can have to hang out with friends, getting exercise and getting to bed on time if you limit your screen time!

School starts too early.

Most school districts around the country start school well before the recommended 8:30 earliest start time.

School districts that have started later start times have shown improved test scores, fewer absences and tardies, less depression, improved athletic performance, and better graduation rates.

Unfortunately, those schools are still in the minority.

Activities are too late.

It’s not uncommon to have regularly scheduled activities too late in the evening. Many activities in my area are scheduled to run until 9:30 or 10 on school nights for middle and high school aged kids.

When kids finally get home, they’re hungry, need a shower, and are ramped up so not ready for sleep. It can be well past 11 pm when they finally hit the pillow, so they need be able to sleep until at least 8 am to sleep 9 hours, but school’s already started by that time. It’s impossible for them to get sufficient sleep. After school naps might help, but not if there’s not enough time to fit it in between homework and the activity.

There’s no easy solution for this other than reviewing what’s really important and cutting back on whatever can be cut back. This might mean one less activity. Or maybe not taking every AP class or working fewer hours. All of these are important, but sleep is more important to your health and well being.

It will also take the adults in the community to recognize the benefits of sleep. Studies support later school start times, but there are many reasons schools haven’t adopted these. If you’re a real go-getter, get active in later start times movements.

Activities start too early.

I know many kids who must be at school before school actually starts. Whether it’s band practice, church study groups, sports, or taking a missed test before school, they all interfere with sleeping in, which is what teens need.

Again, this will take the adults in the community to recognize the importance of adolescents getting enough sleep. And for most teens, this means sleeping in because that’s when they’re physiologically able to sleep.

Medical causes of sleep deprivation.

If you suspect any of the following conditions are affecting your sleep, you should work with your doctor. Even if you aren’t sure why you’re always tired, talk to your doctor.

  1. Anxiety – recurrent thoughts keep popping up
  2. Restless leg syndrome – if your legs just need to move when you lay down
  3. Sleep apnea – pausing of breath, often associated with snoring
  4. Medications that affect sleep cycles – stimulants are commonly used for ADHD and can affect sleep
  5. Heartburn or acid reflux
  6. Hormone imbalances, such as thyroid problems – you might sleep a lot but still feel tired and have other symptoms
  7. Anemia, or low red blood cell counts
  8. Depression – every teen should have a depression screen yearly, but if you think you might be depressed, talk to your doctor now!
  9. Nutrition – if you’re not eating enough, or eating foods that are not nutritious, you could feel more tired. If you eat foods that cause spikes in your blood sugar, as those sugars drop you feel fatigued.
  10. Infections – we all need more sleep when sick!
  11. Celiac disease – talk to your doctor if you have chronic abdominal issues, such as diarrhea, vomiting, pain, or weight loss
  12. Chronic pain conditions – if it hurts, you can’t get comfortable enough to sleep
  13. Chronic sleep deprivation – I know this is counter-intuitive, but being tired can make it harder to sleep.
  14. ADHD – that race car brain just won’t wind down!

What difference does it make?

If you’ve read this far, you’re probably not surprised that so many teens (and adults) don’t get enough sleep.

What difference does it make if we’re sleep deprived? It turns out, there are a lot of consequences. Some you may know, some you may be unaware are related to sleep deprivation. Tune in next week to learn why we care so much about sleep deprivation!