#88 - Treating Teen Sleep: Lesson 1
Most of what I learned about treating teen sleep problems happened at the start - when I was working in an Adult Insomnia Clinic.
And that learning took a couple of months.
The remainder I learned over the past 15 years (and I’m always learning more).
So today I hope to convince you of something.
My goal is to change the way that you think about teen sleep problems.
Because the majority of people get it very wrong …
Adult Insomnia Clinic
I studied at Flinders University - and I took every sleep course that was available.
Whilst I was convinced about the scientific evidence for CBT for insomnia, we did not learn in class how to deliver CBT for insomnia.
These days things are very different.
I’m the one who gets to do the teaching.
So in my classes, I teach the students the step-by-step processes of delivering CBT for insomnia - as well as how to treat teen sleep problems.
And for the lucky few - they will do a placement with me in my Sleep Clinic.
They’re not lucky because they’re doing this with me (although I ensure they have plenty of fun) - they’re lucky because they use the skills they’ve learned to improve people’s sleep.
Likewise, it was my own on-the-job-training in an adult sleep clinic in the early 2000s where I really developed my skills to help teenagers sleep better.
No one taught me how to treat teen sleep problems back then.
But they did teach me how to treat the cause of teen sleep problems.
Lesson 1.1 - Teenagers Are Not Lazy
For too long, parents and teachers have diagnosed teens with ‘Lazy Shit Disorder (LSD)’.
This is because they won’t get out of bed in the morning.
On school mornings, teenagers won’t get out of bed quickly enough for many parents. And parents don’t understand the real underlying reason.
Thus the treatment for ‘LSD’ includes:
repeatedly going into their bedroom to wake them up
spraying them with a water bottle
throwing a cup of coffee at them (not the mug … just the coffee)
physically getting them up out of bed
threatening them that they will miss out on something they like (it worked when they were kids … so why not try it?)
To be fair, parents are not taught the real reason behind teenagers’ struggle to get erect (ie, stand up in the morning).
But it’s not just teenagers’ erections in the morning that parents try to treat - but also their nighttime behaviour.
Lesson 1.2 - Most Teen Sleep Problems Are Not Caused By Technology Use
I’ve been researching the effects of technology use for more than a decade.
I’ve given teenagers violent videogames to play before bedtime - and shone bright iPad screens in their face before bed. These things don’t make their sleep worse.
Most people find this hard to believe - and that’s because they see their teens using technology and associate this with not sleeping. This means they believe the technology use is causing the sleep issues.
To cut a long story short - my new belief - based on dozens of studies and data on ~100,000 teenagers, is that teenagers use technology at night for different reasons.
And one of those is to distract themselves from worrying.
So now think about your own evening technology use. If you’ve got a lot going on in your life, and you went to bed early and tried to fall asleep in the dark, would you have worrying thoughts flying through your mind?
Because that’s what happens to teens - and we have the data to prove it (Hiller et al., 2014).
Many parents who come to us for help with their teenager’s sleep have already tried to remove their evening tech use - and it doesn’t work.
Why?
Lesson 1.3 - It’s Their Biology!
My supervisor for my neuropsychology placement taught me something that I remember to this day.
He said “History! History! History!” - and - “Memory! Memory! Memory!”
These were reminders of the most important things to focus on when performing a neuropsychological evaluation.
So here’s your reminder when it comes to teen sleep…
“Biology! Biology! Biology!”
We all develop a nice biological clock between the ages of 3 to 6 months of age.
Our biological clock is one of the main reasons we fall asleep at a certain time at night - and we wake-up naturally at a certain time in the morning.
As teenagers begin puberty, there is a subtle change in the timing of their biological clock.
It begins to delay.
And over their teenage years - it continues to delay.
This change in their biological clock happens ‘slowly’ - and in the background - during high school.
It’s doing this ‘hidden job’ during the years when teens start to own and use technology more, when they get more study to do after school, and when the worries of the world start to weigh more heavily on them.
It’s very well disguised.
This is why I haven’t given you the reminder “Technology! Technology! Technology!”.
This delay in a teenager’s biological clock happened before Steve Jobs invented the iPhone touchscreen.
This delay happens in other teenagers - eg, rodents. And last I knew, rodents don’t use technology.
Lesson 1 Summary
This blog is apparently a 1-min read.
Somehow I had to cram in 20 years worth of research and clinical experience to convince you that the Number 1 reason for teenagers sleeping badly is because of their? ….
And if you’ve just stumbled across this blog and think this is just somebody’s opinion, I’ll just ask you for 30-secs more of your time.
Enter the following search terms into Google …
The 35,000 results are not all mine - point is, the ones I’ve contributed to are not opinions.
Everyone can provide an opinion. Far less people provide facts.
And here’s one more fact.
If you hear of a teenager having trouble falling asleep at night - and sleeping-in on the weekend, the diagnosis is not Lazy Shit Disorder.
The new diagnosis is ‘Delayed Sleep-Wake Phase Disorder’ (DSWPD; American Academy of Sleep Medicine, 2014).
Now that you know the diagnosis - you can learn next week what the best treatment is …
Prof MG