Insomnia Help!

 By Kellie B. Gormly
TRIBUNE-REVIEW
Monday, February 23, 2009

Nicole DeSantis, 19, often relies on the caffeine of Red Bull to keep her awake and alert during the day, which is a challenge.

Ever since DeSantis was a pre-teen, she often struggled with daytime sleepiness. When she reached high-school age, her problems magnified: On some nights, the restless, night-owl teen barely slept at all.

"It would be like 6 o’clock in the morning, and I’d say, ‘OK, I have to go to bed now’," says the Greensburg native and Bloomfield resident. "I would lay in the dark for 3 hours. … On my days off, all I wanted to do was sleep and catch up."

Now, DeSantis — a student at Point Park University — says she needs to buckle down about getting good sleep, although it’s a struggle: "School has become such a big deal that in my spare time, I don’t want to be sleeping," she says.

For teenagers, a typical, natural sleep pattern often is staying up late, and sleeping in late — even until noon or later on weekends. Yet, on school days, teens have to get up very early, which can cause sleep deprivation if they didn’t go to bed early enough, experts say. Combine that with the often-demanding schedule of school, sports and play practices, other extracurricular activities and after-school jobs, and the world has some pretty sleepy teens, experts say.

Parents often complain to Dr. Bharay Jain — a physician for Westmoreland Sleep Medicine in Greensburg — that their teens won’t get up in the morning, even though they might gently shake them to wake them up, he says. Many children miss school from sleeping in too late and fatigue, and take long naps in the afternoon.

The body’s biological clock often conflicts with demands on teenagers’ time and their lifestyles, says Dr. Sangeeta Chakravorty. She is a doctor who specializes in pediatric sleep problems at Children’s Hospital of Pittsburgh.

"The outcome is that the child is sleepy when he does not expect to be sleepy or does not want to be sleepy," she says.

"They need more sleep, even if they were getting by with 7 to 8 hours of sleep in grade school," Chakravorty says. "With all the demands … they sleep even less. Not only do they have insufficient sleep, but their rhythms are off. They are expected to perform."

Although it might seem like a lot, teens need nine to nine-and-a-half hours of sleep to function optimally, Chakravorty and Jain say, compared to an average adult’s need for about eight hours. Yet, few adolescents actually get the needed amount of shut-eye.

"I think they’re lucky if they get six or seven," Chakravorty says. "That’s average for what we see in the clinic."

Donny Haney, 15, of Harmar, can relate. He plays varsity football for Springdale High School, and is now rehearsing for his role as Genghis Khan Schmitz in the play "Seussical." Sometimes, school and activities can take up nearly 12 hours of his day, and he typically only gets about six hours of slumber on a school night. He has to get up at 6:15 a.m., but often doesn’t fall asleep until around midnight.

"I’m really fine … (but) I should probably start getting more sleep," Donny says.

Don Haney, Donny’s father, says that his son and daughter — Stephanie, 18 — usually get catch decent Z’s during the school year. Otherwise, like most teens, the kids are night owls.

"I think it’s really common knowledge that they are very definitely nocturnal," says Haney, 49. "Given the choice, they would definitely be up all night."

During the summer, he says, the kids routinely may stay up until the wee hours, and sleep until noon or later.

"We let it go, unless there’s something going on the next day," Haney says. "I don’t think there’s much parents can do to change that; it’s about picking your own battles."

Getting nine hours of sleep means that teens starting school in the 7 a.m. hour should get to bed in the 9 p.m. hour, Chakravorty says. They should get up at the same time — yes, even on weekends, when the tendency is to sleep late after staying up later. Unrealistic, yes, and few teens do it; but that’s the healthiest habit, she says. A 10-minute power nap in the afternoon should be fine, Jain says, but a longer nap can make nappers groggy later on, and they will have a hard time getting to sleep at night.

Lack of sleep in teens can have many consequences, say Chakravorty and Jain. Insufficient sleep in teenagers can contribute to behavioral problems, poor grades, lack of concentration, and other health issues like obesity and depression. Adolescents who are hurting for sleep also tend to have impaired judgment and show more risk-taking behaviors, such as experimenting with alcohol, Chakravorty says.

One way for people to know if they’re getting enough sleep is to note how quickly they fall asleep once in bed, Jain says. It should take about 10-15 minutes for slumber to kick in, Jain says; people who fall asleep as soon as they hit the pillow often are sleep-deprived, he says.

Starting high school in the 7 a.m. hour is problematic and incompatible with a teen’s biological clock, Jain and Chakravorty say. Some school districts in a few states have moved the high-school start time to an hour or two later, but neither the doctors, nor a spokesperson for the Pennsylvania Department of Education, are aware of any such districts or movements in Pennsylvania.

"I wish schools would be educated more about sleep so that they can understand how these teens are," Chakravorty says.

ABCs of ZZZs

The National Sleep Foundation, along with Drs. Bharay Jain and Sangeeta Chakravorty, say that sleep is as important to a teen’s well-being as air, food and water. Consider these tips for better sleep for teens.

• Make sleep a priority.

• If you must take a nap, don’t take a long nap, or a nap too close to bedtime. That can interfere with getting a good night’s sleep.

• Keep your room cool, quiet and dark at bedtime, but let in bright light in the morning.

• Avoid coffee, tea, soda and chocolate late in the day.

• Establish bed and wake-up times, and stick to them.

• Don’t eat, drink or exercise within a few hours of your bedtime. Avoid the television, phone and computer in the hour before bedtime.

• Try taking a shower or reading a book at night, as a signal to your body that it’s time to go to bed.

• Keep a diary or to-do lists. If you jot down notes before you go to sleep, you’ll be less likely to stay awake worrying or stressing.

Sources: www.sleepfoundation.org; Tribune-Review research

Kellie B. Gormly can be reached at kgormly@tribweb.com or 412-320-7824.

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