Ask the Pediatrician: How can parents help teens get enough rest?

Q: My teenager is having a lot of trouble sleeping lately. What can I do to help?

A: Many teens have a hard time winding down at bedtime. This can prevent them from getting the recommended eight to 10 hours of sleep they need every night. Not surprisingly, many teens I talk with report difficulty concentrating at school, daytime sleepiness and fatigue.

Teens often have more trouble falling asleep than when they were younger. Rapid body changes, especially in adolescence, can disrupt sleep. This happens because the growth phase they're in causes their circadian rhythm—the body's internal clock—to reset, delaying their .

Stress, anxiety and worry are other common reasons for sleep problems. Teens are dealing with more stress lately, interrupting their rest and recovery at night. Late-night smartphone and social media use, and sports or other close to bedtime, can also make it more difficult to fall asleep.

Other causes of sleep trouble include health conditions like iron deficiency. Teens who don't have enough of this mineral may have symptoms such as cramps and involuntary movements in their legs that can wake them up from sleep. If your doctor thinks your child may have this issue, they will typically order a hemoglobin, ferritin and/or iron test panel to check.

Sleep is vital for everyone, especially growing, developing children and teens. Kids who get enough sleep tend to have healthier immune systems, and better memory, school performance and mental health.

Not getting enough sleep can lead to many problems, including difficulty concentrating, low energy, mood changes, headaches, weight problems and behavior issues.

Lack of sleep can even affect a part of a teen's developing brain that helps control impulses. This may be why is linked with higher rates of risky behavior such as texting while driving, fighting, substance use and unsafe sexual behavior in teens.

Try these tips to help your teen sleep better:

— Encourage daily exercise and time outside: Exercise can help your teen sleep better. Kids of all ages need to move throughout the day and get plenty of physical activity. That said, try to avoid sports practices and other types of exercise late in the evening so there's time to unwind. Spending some time outdoors each day can also support a healthy sleep-wake cycle.

— Avoid overscheduling: Having too much on their plate can make it difficult for your teen to get enough sleep. If they are running from one after-school activity to another, they won't be able to finish their homework until later at night. We all need time to relax at the end of the day to help us sleep well.

— Scale back screens before bedtime: Blue light from phones, computers, tablets, TV and even night lights, can trick the brain into thinking that it's daytime. Over time, that can disrupt your teen's natural levels of melatonin, a chemical that tells us we're sleepy. Encourage your teen to put all screens away at least an hour before bedtime, and charge devices outside their bedroom overnight. Having screens near them is tempting.

— Limit late meals and caffeine: Aim to eat dinner a few hours before bedtime and offer whole foods that are easier to digest. Food sensitivities or substances that cause indigestion may disrupt your child's sleep because of the close relationship between the gut and the brain. It is important to remember that caffeine can stay in the body for more than eight hours, depending on a person's metabolism. Your teen should avoid caffeine after lunchtime.

— Make time to relax: Encourage your teen to engage in relaxing activities in the evening, such as a warm bath with Epsom salts, reading a book that's not on a screen, meditating, stretching, journaling or restorative yoga.

— Optimize your teen's sleep environment: Make sure the temperature in the bedroom is cool, but comfortable. A cooler room promotes sleep and reduces sweating and itching. If light bothers your teen, put up heavy or blackout curtains. If noise outside your teen's bedroom is a problem, turn on a fan, soft music or nature sounds. Try earplugs to see if they help.

— Look into melatonin supplements. Melatonin may help reset your teen's circadian rhythm back so they can fall asleep at a normal time. Typically, melatonin can be given for a short amount of time and in very small doses (0.3 to 0.5 mg) about 3 hours before bedtime.

— Consider therapy. Cognitive behavioral therapy can help your manage stress and anxiety, nurture their gifts, and achieve a normal sleep-wake cycle. There's even a specialized form of CBT for people with insomnia called CBT-I. Digital CBT-I apps, such as CBT-i Coach, have been shown to be effective for treating insomnia in teens.


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