self-careCENTER FORRESEARCH ON GIRLS

A SERIES OF RESEARCH AND INFORMATIONAL PUBLICATIONS BY CRG“Putting the world’s best research to work for girls.”

by Lisa Damour, Ph.D.

Research on sleep deprivation in children and adolescents demonstrates that “sleep deprivation isnot only common, but also represents a chronic problem among youths”1 with studies finding that

as many as 43% of adolescents sleep seven hours or fewer each night when at least nine hours are

typically recommended.2 Not surprisingly, sleep deprivation is associated with poor cognitive

performance, emotional health, and physical health.3, 4

Many studies have found that girls are more likely to suffer from sleep problems than boys5 with

some researchers finding that girls are three times more likely than boys to have difficulty fallingasleep or staying asleep.6 As children, boys and girls tend to sleep equally well. A dramatic rise in

sleep problems emerges with the onset of puberty for girls; a similar trend does not occur with the

onset of puberty for boys.7 While hormonal causes may play a role for the increased rate of sleep

problems in girls relative to boys,8 there are several other factors that interfere with sleep in children

and teenagers: the use of technology, adolescents’ efforts to “catch up” on sleep during weekends, and

the consumption of caffeine.

GIRLS AND SELF-CARE: SLEEP

TECHNOLOGY USE

Technology use interferes with sleep in several ways:

• using computers and cell phones in bed interferes with the habit of falling asleep in bed,• light emitted by technological devices can trick the body into thinking that it is time to wake up, and• technology use can delay sleep or interfere with the relaxation needed to fall asleep.

Psychologists have long known that the human body makes powerful associations between places and the functions thatare typically performed in those places. With portable technology, children and adolescents are able to use their beds as“offices” where they do homework, phone and text their peers, and use their computers to watch online video content.9 Theuse of the bed for a variety of activities besides sleep gradually weakens the body’s link between being in bed and fallingasleep and leads to difficulty sleeping, regardless of actual levels of fatigue. An essential part of healthy “sleep hygiene”–the term used to describe the behaviors that promote good sleep–is to restrict the use of the bed to sleep and activities thatalmost exclusively precede sleep (i.e., leisure reading).10

Research also indicates that evening technology use may disrupt thesecretion of melatonin, a hormone that naturally increases duringdarkness and helps promote sleep. Late-night light exposure is knownto suppress melatonin levels,11 and some research suggests that the useof technological devices–which involves staring directly at a lightsource from a relatively close distance–may be especially disruptive tosleep.12, 13 These effects appear to be the most harmful for teenagers.

Studies also demonstrate that the content associated with adolescenttechnology use can interrupt sleep, delay sleep, or cause stimulationthat disrupts sleep. Research has found that a majority of adolescentshave taken their phones to bed with them and been awakened by textmessages or phone calls after bedtime hours.14 Further, adolescentswho multi-task with two or more forms of digital technology havebeen found to sleep less than their peers who tune into one form oftechnology at a time.15 Finally, research demonstrates that late-nighttelevision viewing or video game playing delays sleep and that theexcitement associated with video gaming can also reduce the amountof time spent in deep, restorative sleep.16

“CATCH UP SLEEP”With the onset of puberty most adolescents begin to feel alert late intothe evening. This is due to a normal developmental process known as sleep phase delay which involves a shift in circadian rhythms andaccounts for the fact that teenagers often prefer to stay up later at night and to sleep longer in the mornings than children.17 Despite latebedtimes, teenagers wake early on school days and tend to experience a growing “sleep debt” as the week progresses. On the weekend, many

teenagers stay up late and then sleep in to “catch up” on sleep lostduring the week. Some research indicates that girls sleep later thanboys on weekend mornings; this finding is likely due to the fact that, on average, girls begin puberty two years earlier than boys.18

Weekend “catch up” sleep undermines restfulness and healthy sleephabits. When the school week begins, adolescents who have stayed upand slept late on the weekends experience the equivalent of jet lag asthey try to get their bodies to adjust back to the school week “timezone.” Further, having put themselves into a weekend “time zone,” manyadolescents find that they have difficulty falling asleep on Sunday nighteven though they need to wake early on Monday morning; as a result,many teens arrive at school on Monday morning after a particularlyshort night of sleep.19

CAFFEINE USEResearch finds that roughly 40% of adolescents consume caffeine on a daily basis, many with the express purpose of staying awake late atnight.20 The regular consumption of caffeine has been demonstrated to lead to a cycle of delayed sleep, fatigue, and ongoing caffeine use.21

Adolescents who consume high levels of caffeine experience moreinterruptions to their sleep than peers who consume less caffeine22 andthose who fall asleep in class have been found to consume nearly twiceas much caffeine as their peers who stay awake throughout the schoolday.23 While adolescents typically consume caffeine in the form of softdrinks, the last decade has been marked by the widespread availabilityand marketing of “boutique” coffee and energy drinks that contain highlevels of caffeine.24

self-care:GIRLS AND SELF-CARE: SLEEP

Product Serving Size Caffeine

COFFEES

• Brewed 8 oz 80-135 mg

• Instant 8 oz 40-108 mg

• Drip 7 oz 115-175 mg

• Espresso 2 oz 100 mg

• Starbucks regular 16 oz 259 mg

• Decaffeinated 8 oz 5-6 mg

SOFT DRINKS

• Mountain Dew 12 oz 58 mg

• Coca-Cola 12 oz 45 mg

• Dr. Pepper 12 oz 41 mg

• Pepsi Cola 12 oz 37 mg

ENERGY DRINKS

• SoBe No Fear 16 oz 141 mg

• Red Bull 8.3 oz 67 mg

GIRLS AND SELF-CARE: SLEEP [endnotes]

1 Roberts, R., Roberts, C., & Duong, H. (2009). Sleepless in adolescence: prospective data on sleep deprivation, health and functioning. Journal Of Adolescence, 32(5), 1045-1057.2 Roberts (2009), 1055.3 Hamilton, N. A., Nelson, C. A., Stevens, N., & Kitzman, H. (2007). Sleep and psychological well-being. Social Indicators Research, 82(1), 147-163.

Fredriksen, K., Rhodes, J., Reddy, R., & Way, N. (2004). Sleepless in Chicago: tracking the effects of adolescent sleep loss during the middle school years. Child Development, 75(1), 84-95.Shin, C., Kim, J., Lee, S., Ahn, Y., & Joo, S. (2003). Sleep habits, excessive daytime sleepiness and school performance in high school students. Psychiatry And Clinical Neurosciences,57(4), 451-453.

4 Steinsbekk, S. & Wichstrøm, L. (2015). Stability of sleep disorders from preschool to first grade and their bidirectional relationship with psychiatric symptoms. Journal of Developmental and Behavioral Pediatrics, 36(4), 243-251.

5 Kirmil-Gray, K., Eagleston, J. R., Gibson, E., & Thoresen, C. E. (1984). Sleep disturbance in adolescents: Sleep quality, sleep habits, beliefs about sleep, and daytime functioning.Journal of Youth and Adolescence, 13(5), 375-384.Price, V., Coates, T., Thoresen, C., & Grinstead, O. (1978). Prevalence and correlates of poor sleep among adolescents. American Journal Of Diseases Of Children (1960), 132(6), 583-586.

6 Johnson, E., Roth, T., Schultz, L., & Breslau, N. (2006). Epidemiology of DSM-IV insomnia in adolescence: lifetime prevalence, chronicity, and an emergent gender difference. Pediatrics, 117(2), 247-256.

7 Johnson (2006), 247.8 Johnson (2006), 254.9 Van den Bulck, J. (2007). Adolescent use of mobile phones for calling and for sending text messages after lights out: results from a prospective cohort study with a one-year

follow-up. Sleep, 30(9), 1220-1223.10 Mindell, J., Meltzer, L., Carskadon, M., & Chervin, R. (2009). Developmental aspects of sleep hygiene: findings from the 2004 National Sleep Foundation Sleep in America Poll.

Sleep Medicine, 10(7), 771-779.11 Kozaki, T., Koga, S., Toda, N., Noguchi, H., & Yasukouchi, A. (2008). Effects of short wavelength control in polychromatic light sources on nocturnal melatonin secretion. Neuroscience

Letters, 439(3), 256-259.12 Higuchi, S., Motohashi, Y., Liu, Y., Ahara, M., & Kaneko, Y. (2003). Effects of VDT tasks with a bright display at night on melatonin, core temperature, heart rate, and sleepiness.

Journal Of Applied Physiology (Bethesda, Md.: 1985), 94(5), 1773-1776.Figueiro, M. & Overington, D. (2015). Self-luminous devices and melatonin suppression on adolescents. Lighting Research and Technology, 0, 1-10.

14 Van den Bulck (2007).15 Calamaro, C., Mason, T., & Ratcliffe, S. (2009). Adolescents living the 24/7 lifestyle: Effects of caffeine and technology on sleep duration and daytime functioning. Pediatrics, 123(6),

1005-1010.16 Van den Bulck, J. (2004). Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children. Sleep, 27(1),

101-104.Higuchi, S., Motohashi, Y., Liu, Y., & Maeda, A. (2005). Effects of playing a computer game using a bright display on presleep physiological variables, sleep latency, slow wave sleepand REM sleep. Journal Of Sleep Research, 14(3), 267-273.

17 Crowley, S. J., & Carskadon, M. A. (2010). Modifications to weekend recovery sleep delay circadian phase in older adolescents. Chronobiology International: The Journal of Biological& Medical Rhythm Research, 27(7), 1469-1492.

18 Laberge, L. L., Petit, D. D., Simard, C. C., Vitaro, F. F., & Tremblay, R. E. (2001). Development of sleep patterns in early adolescence. Journal of Sleep Research, 10(1), 59-67.19 Pollak, C. P., & Bright, D. (2003). Caffeine Consumption and Weekly Sleep Patterns in US Seventh-, Eighth-, and Ninth-Graders. Pediatrics, 111(1), 42.20 Calamaro (2009).21 Temple, J. (2009). Caffeine use in children: what we know, what we have left to learn, and why we should worry. Neuroscience And Biobehavioral Reviews, 33(6), 793-806.22 Pollack (2003).23 Calamaro (2009).24 Roehrs, T., & Roth, T. (2008). Caffeine: Sleep and daytime sleepiness. Sleep Medicine Reviews, 12(2), 153-162.25 Brand, S., Gerber, M., Beck, J., Hatzinger, M., Phse, U., & Holsboer-Trachsler, E. (2010). High exercise levels are related to favorable sleep patterns and psychological functioning in

adolescents: A comparison of athletes and controls. Journal of Adolescent Health, 46(2), 133-141.26 Kurcinka, M. S. (2006). Sleepless in America. New York, NY: HarperCollins.

A dramatic rise in sleep problems emerges with theonset of puberty for girls; a similar trend does notoccur with the onset of puberty for boys.

FACTORS THAT IMPROVE SLEEP

To improve sleep duration and quality, children andadolescents should:

• Treat the bed and bedroom as a “sleep sanctuary”used exclusively for sleep or leisure activities–suchas light reading–that usually precede sleep.

• Turn off all forms of technology at least a half hourbefore bed to help the mind relax and to reducelight exposure.

• Aim to fall asleep and wake on weekends at roughlythe same times as the weekdays.

• Limit caffeine use, especially late in the day.

• Exercise: research consistently finds that aerobic exerciseis associated with falling asleep faster, waking fewertimes once asleep, sleeping more deeply, and feelingmore rested and able to concentrate during the day.25

/CRGLaurelSchool @CRGLaurelSchool

CENTER FOR RESEARCH ON GIRLSPutting the world’s best research to work for girls.

RESOURCES FOR TEACHERS

Online ResourceSLEEP AND ADOLESCENTSThis article–made available by the National Association of School Psychologists–provides educators with important information aboutsleep and highlights the school’s role in minimizing sleep-deprivation among students.LINK: www.nasponline.org/resources/principals/sleep%20disorders%20web.pdf

Dowloadable PowerPoint®HEALTHY SLEEP HABITSTeach students about healthy sleep habits with this engaging PowerPoint presentation developed by Laurel’s Center for Research on Girls (CRG). A handout to accompany this PowerPoint presentation is also available.LINK: LaurelSchool.org/CRGcurricula

Dowloadable DocumentWHY SLEEP?This handout, developed by CRG, summarizes the role of sleep in promoting mental, emotional, and physical health and can be usedalone or as a supplement to the Healthy Sleep Habits PowerPoint presentation.LINK: LaurelSchool.org/CRGcurricula

RESOURCES FOR PARENTS

BookSLEEPLESS IN AMERICA26

Sleepless in America addresses the important connections between sleep and childhood behavior.Author and well-known psychologist Mary Sheedy Kurcinka offers practical advice to help parentsestablish good sleeping habits for the whole family.

Online ResourceSNOOZE OR LOSEWritten for New York Magazine by Po Bronson–an award-winning author of books and articles onthe science of parenting–this article focuses on the “large academic consequences of small sleepdifferences” for children and adolescents. LINK: http://nymag.com/news/features/38951/

self-care: GIRLS AND SELF-CARE: SLEEP

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