The Causes and Consequences of Teen Sleep Issues

by Martin Reed Patient Advocate

Insufficient sleep is all too common among teenagers. This is particularly concerning since sleep deprivation can have a negative effect on academic performance and even a teen’s physical and mental health. The prevalence of adolescent sleepiness was recently addressed in a special issue article in the journal Pediatric Annals.

Teen boy asleep on bed in front of laptop.

The prevalence of sleep issues among teenagers

The authors of the article highlighted research that found only 35 percent of sixth- to eighth-graders get optimal sleep of nine or more hours per night — and this drops to just nine percent of ninth- to 12th-graders. Perhaps unsurprisingly, this has led to more than half of teenagers reporting daytime drowsiness at least once a week.

Teen girl writing note to boy instead of sleeping.

Biological causes of teen sleepiness

Puberty is primarily to blame when it comes to biological processes that disrupt sleep in teens. Hormonal changes lead to a delay in the sleep-wake cycle which delays sleep by roughly two to three hours. This leads to later bedtimes and later wake times. The authors of the article also stated that exposure to artificial light suppresses melatonin production more severely in teens compared to adults, making it harder to fall asleep.

Girl having trouble falling asleep.

Delayed sleep-wake phase disorder in teenagers

This sleep disorder is characterized by a delay in the sleep-wake cycle of at least two hours after the desired bedtime. Symptoms can include daytime sleepiness, academic decline, and behavior problems. The authors of the article reported that this sleep disorder is thought to affect up to 15 percent of teens. Treatment includes sleep scheduling, light therapy, and limiting naps.

Teenage girl using cell phone at night.

Insomnia in teenagers

According to the authors of the article, insomnia affects up to 10 percent of adolescents. Symptoms include difficulty falling asleep, frequent awakenings, and daytime dysfunction. Teens may be predisposed to insomnia by genetics or other health issues, exposure to stress or trauma, and poor sleep practices and negative sleep thoughts. Treatment includes identification of any medical causes of the insomnia, good sleep hygiene, and cognitive behavioral therapy for insomnia.

Teen boy snoring.

Obstructive sleep apnea in teenagers

Although the authors cited a study which found obstructive sleep apnea (OSA) to affect only between one and five percent of teenagers, it is a potentially serious sleep disorder that requires medical attention. Symptoms include snoring, pauses in breathing, and excessive sleepiness. The most common cause of OSA in children is enlarged tonsils, although obesity is fast becoming a risk factor, too. Treatment depends on the cause of the disorder and its severity.

Teenage girl petting cat in bed, leg close-up.

Restless legs syndrome in teenagers

The article’s authors found that only two percent of adolescents experience restless legs syndrome (RLS) — but the condition may be underdiagnosed. Symptoms include an irresistible urge to move the legs and tingling sensations in the lower extremities that are only relieved by movement. Potential causes of RLS include sleep deprivation, nicotine, alcohol, and some medications. Treatment with iron therapy may help.

Teen boy throwing away fidget spinner.

Medical disorders that cause teen sleepiness

Attention-deficit/hyperactivity disorder (ADHD) shares many symptoms with sleep deprivation. Unfortunately, the medications used to treat ADHD can also disrupt sleep. The authors of the article pointed out that depressed teens and those with anxiety and severe stress reactions are more likely to report sleep problems. The best treatment for sleep issues caused by anxiety is typically cognitive behavioral therapy.

Teen girl tired at school.

The effect of school and home life

Early school start times, academic workloads, extracurricular activities, socializing with friends, and part-time jobs all combine to make sleep a real challenge for our teens. Increased teenage autonomy can also lead to fewer enforced sleep rules when it comes to bedtimes, more caffeine consumption, and a greater use of computers or electronic devices before bed. Low socioeconomic status and overcrowded or unsafe neighborhoods also lead to inconsistent sleep schedules.

Teens with good test results in school.

The academic consequences of teen sleepiness

Sleep deprivation harms academic performance. The authors of the article pointed to one study which found 80 percent of high-school students who slept for at least nine hours per night achieved As or Bs, whereas those who obtained less sleep reported lower grades. Furthermore, grade point averages of college students fell significantly when they failed to get good quality sleep.

Tired, moody teen girl sitting on bed.

The mood consequences of teen sleepiness

The authors identified studies that found sleep disorders increased rates of depression and made treatment of depression more difficult. Furthermore, college students with poor sleep quality were found to be more likely to have high levels of stress and negative moods compared to good sleepers. Studies are also beginning to suggest a link between insomnia and anxiety, and are linking short sleep duration with suicide risk.

Teen girl drinking alcohol.

Teen sleep disturbances linked with drug use

The article pointed to studies that found ninth- to 12th-graders in the United States were more likely to smoke, drink alcohol, and consume marijuana if they got less than eight hours of sleep. Sleep-deprived college students have also been found to drink significantly more alcohol and consume more over-the-counter and prescription sleep aids and stimulants compared to healthy sleepers.

Teen girl drowsy driving.

The risk of drowsy driving in sleep-deprived teens

Drowsy driving reduces attention and impairs response times — and the authors pointed to a paper that suggested drivers younger than 25 are responsible for more than half of all crashes caused by drivers falling asleep at the wheel when alcohol is not a factor. The article highlighted one study, which found that half of teens who drove reported having driven drowsy at least once in the past year — and five percent had reported nodding off or falling asleep at the wheel.

Tired teen boy in library.

Sleep is a serious health issue for teens

As this slideshow has revealed, sleep deprivation and poor sleep quality pose a serious risk to the health, academic achievement, and safety of our teenagers. Adolescent sleep issues should never be ignored and, since many sleep problems are down to environmental and behavioral issues, sleep education may go a long way in helping to address this problem.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.