School was going pretty well, and with a number of B's and a smattering of A's to show for his effort, the high school freshman should have been pleased with his academic progress. Instead, both he and his mother were concerned, as he struggled each night to stay focused on evening homework and prepare for the next day's presentations and tests.
I asked the boy how he had been sleeping, since a poor night's sleep can lead to difficulty with daytime concentration. The 14-year-old explained that he regularly had trouble initiating and maintaining sleep, often tossing and turning for hours before drifting off. He was not overweight, was not a loud snorer, and had never been observed struggling to breathe or taking excessively long pauses between breaths while sleeping, making obstructive sleep apnea an unlikely cause for the boy's lack of focus.
Knowing that the teen had participated in sports earlier in the school year, I wondered if he'd noticed the same sleep problems during the fall soccer season. After giving it some thought, the high-schooler recalled that he'd had less trouble falling asleep and staying asleep after a busy day of school and soccer practice than while leading a more sedentary lifestyle. I suggested a return to a routine of daily exercise, and asked the family to contact me if sleep issues did not show signs of improving.
The American Academy of Pediatrics stresses that teens still need 9 to 10 hours of sleep each night. In reality, adolescents' sleep patterns and lifestyle choices, as well as their demanding school and work schedules, often result in a much shorter, and less than ideal, duration of sleep.
In a technical report titled, "Excessive Sleepiness In Adolescents and Young Adults," academy experts point out that inadequate night sleep can lead to a multitude of daytime negatives including excessive daytime sleepiness, school performance problems, difficulties with attention and concentration, mood and motivational disturbances, and drowsy driving, a frequent cause of auto accidents and bodily injury.
Daytime sleepiness is usually the result of inadequate time in bed due to altered sleep schedules, but excessive teen drowsiness can also be caused by recognized medical disorders. Conditions known to negatively affect sleep quality include obstructive sleep apnea caused by enlarged tonsils and adenoids or obesity; insomnia, narcolepsy and other sleep problems; restless legs syndrome; and clinical depression.
Parents should keep in mind that the use of certain prescription medications and over-the-counter products, including stimulants, nicotine and caffeine-containing foods and beverages, can also interfere with their teen's healthy night of sleep.
Avoiding nighttime stimulants and practicing proper sleep hygiene can help adolescents get the nighttime rest they need. While younger children tend to sleep the same number of hours on weekdays and weekends, teens and young adults often use weekends to try to catch up on sleep, often extending sleep time until late morning or even early afternoon.
Though the suggestion is usually not met with great enthusiasm, I do advise adolescents not to change their sleep schedules quite so drastically from weekday to weekend. Weekend sleep and wake times should ideally be kept within a couple of hours of normal school week schedules. Following a relatively stable sleep pattern seven days a week prevents the excessive Monday drowsiness that occurs when a teen attempts a rapid shift from the midnight to noon stretch of weekend sleep back to the structured 9 p.m. to 6 a.m. school day sleep schedule.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.