How pediatricians can help teens get better sleep

Having a teenager in the home can be, for many families, a reminder that there are simply not enough hours in the day. Between school, athletics, after-school commitments, social events and family commitments, many adolescents today feel like they are running on fumes.

While some families accept low sleep as a fact of life for teens, health agencies such as the American Academy of Pediatrics (AAP) are urging adolescents to prioritize sleep for several reasons.

Why are teenagers so low on sleep, and why is sleep so important to them?

Sleep is a topic CHOC Children’s pediatrician Dr. Kate Williamson encounters daily. She estimates that most of her teenage patients are chronically low on sleep.

Dr. Katherine Williamson, CHOC Children’s pediatrician

She points to two key considerations about adolescent sleep:

  1. Adolescents have a different sleep cycle than all other age groups. Their biological clocks signal them to sleep later at night, which mean they need to wake up later the next morning. An alarm set for 5:45 a.m. can feel like the middle of the night to an adolescent body.
  2. Adolescent sleep deprivation contributes to obesity, depression, increasing rates of suicide and declining academic performance, among many other consequences. At a time when academic pressures could not be higher, it’s a dangerous combo.

Williamson is not alone in viewing poor sleep hygiene as a public health crisis. The AAP points to low sleep as a contributor to physical and mental health problems in teens, calls for later school start times and suggests teens sleep eight to 10 hours per day.

The recently signed Senate Bill 328 will require most middle schools to start at 8 a.m. or later, and high schools at 8:30 a.m. or later, beginning July 2022. But legislation is the first step, Williamson says, in a conversation that needs to include parents, educators, health officials and many others.

How can pediatricians help?

For many families, more sleep can be low on a growing priority list—especially when barriers like parent work schedules or differences in socioeconomic status can make changing the routine feel impossible.

This is where pediatricians can step in to help families understand that sleep needs to be the priority for their teens.

Here are some steps pediatricians can take to help teens adopt better sleeping habits:

  1. Start the conversation. Make a point to ask adolescent patients about their sleeping habits and discuss how they could improve.
  2. Talk to patients and parents about the research, including possible consequences of chronic sleep deprivation.
  3. Point out any symptoms you can spot already, such as stress, moodiness or depression.
  4. Urge families to adopt a new sleep routine, and point out that the benefits will outweigh the logistical challenges.
  5. Encourage parents to talk about sleep hygiene with school officials and their workplace/s. Healthier adolescent sleep requires collaboration both within the family and among the wider community.

“Sleep should be addressed by all pediatricians to all teenagers,” Williamson says. “We need to assure families that there is more that goes into this conversation than a new law. It’s about widespread mental health among California’s youth.”

Read more about kids and sleep on choc.org.

CHOC pediatrician talks adolescent sleep hygiene on SiriusXM’s “Doctor Radio” show

CHOC Children’s pediatrician Eric Ball, M.D., was a guest on SiriusXM’s Doctor Radio show to discuss sleep hygiene among adolescents—an often misunderstood topic.

Dr. Eric Ball, Pediatrics

“As a pediatrician, I have this conversation several times per day,” says Ball. “Many people don’t realize teens need more sleep than the average adult.”

Dr. Ball explained that adolescence is a tricky time in terms of sleep habit changes. Puberty transforms the average teen from a morning person to a night owl, and their sleep schedules need to reflect that.

Part of the issue, he says, is that schools have not yet adjusted to reflect this need; 43% of American high schools start before 8 a.m., he notes, but that ideally should be 8:30 a.m. or later. Dr. Ball has advocated for California state legislation that would mandate such a start time among high schools.

On the show, Dr. Ball also shared a few tips to help teens improve their sleep hygiene.

7 ways pediatricians can help parents manage their teen’s sleeping habits:

  1. Encourage parents to limit screen time after dark
    “I’m happy my kids are involved in their culture and keeping in touch with friends,” says Dr. Ball. “But bright light tells your brain it’s noon and not 10 p.m., so there’s no melatonin surge telling your brain it’s time for bed.” Blue light glasses may help, but it’s much safer and healthier to simply shut off the screens and focus on relaxation once the sun goes down.

  2. Suggest parents develop a “digital curfew”
    It is much easier to limit screen time if parents replace that time with something fun. Suggest family meditation or a starting a membership to a meditation app that teens can use on their own, if they prefer. If parents have a young child prone to waking up during the night, encourage them to try guided imagery to teach their child to put themselves back to sleep.




  3. Help parents start a sleep diary
    Sleepfoundation.org has a sleep diary function parents can easily introduce to their kids. It is a quick and simple way to keep track of sleeping habits, see where problems arise and work alongside their child to improve those habits.

  4. Have parents to work backwards to find the best bedtime
    Parents can start by figuring out what time their teen needs to wake up to get to school on time. Work backwards from there to find an appropriate bedtime. Then, keep working backwards to see how to fit in after-school necessities like homework, sports, social time and family time. The key is making bedtime the priority.

  5. Make sure parents focus on weekend sleep hygiene, too
    Sleeping in a little on weekends is fine, says Dr. Ball, but teens should avoid sleeping hours into the day. Helping adolescents develop more consistent sleep hygiene throughout the week and weekend is critical.

  6. Tell parents to avoid melatonin unless necessary
    Sometimes kids with autism spectrum disorder or who have attention deficit hyperactivity disorder require the aid of melatonin, but in other cases, says Dr. Ball, it’s best for doctors to use it as a last resort. “If teens have poor sleep hygiene, there’s not enough melatonin in the world to fix that,” he says. “It becomes a crutch, and then you’re treating the symptoms—not the cause.”

  7. Urge parents to prioritize sleep
    Adolescents in competitive schools or programs tend to prioritize just about everything other than sleep, but no amount of studying will prepare a kid to perform their best the way good sleep will. Remind busy and high-achieving kids that sleep is not a luxury but a necessity, and that an extra half hour of studying likely won’t make the difference that eight hours of sleep will.