Teen Insomnia

People with insomnia have difficulty falling asleep or staying asleep, despite the opportunity to do so. It is quite common in teenagers, and the pandemic has affected sleep as well – for better and worse.

Many teens are trying to go to sleep at the “wrong time” for their body. Teenagers have a body clock or chronotype that naturally shifts to later, thus teens tend to stay up late and sleep in. In early adulthood, this shifts to an earlier chronotype, and going to sleep and waking earlier becomes the norm. In the early pandemic with remote learning and the ability to sleep in, many teenagers had an improvement in their sleep since they were not being dragged out of bed. But as schools have reopened and getting up earlier is again expected, many are struggling to fall asleep earlier and get up on time.

Additionally, the effects of pandemic-related restrictions on activity (social events, exercise, gatherings, etc.) has led to a tremendous increase in screen-time and a decrease in exercise, both of which cause problems with insomnia. Finally, the mental health challenges of coping with a global pandemic are associated with increasing difficulties falling asleep.

Readjusting the internal clock

To help a teenager with difficulty falling asleep, the most important thing to remember is that sleep can be improved! The first step is to help the teen create a bedtime ritual that leads to sleep, rather than hours of fidgeting or using their cell phone.

We usually recommend beginning with a schedule that fits your child’s present time of falling asleep and awaking for 1 or 2 days. Help them create a calm bedtime ritual and start it later than usual for now. An example of a bedtime ritual could be to take a bath, brush their teeth, say good night, then go to bed. For now, have them go to bed around the time they are currently falling asleep (even if it is quite late).

After the first few nights of going to bed with the new bedtime ritual, begin moving the waking time earlier by 15-minute increments while keeping the bedtime the same. For example, if your teen normally goes to sleep at midnight and gets up at 8 am, begin moving the waking time to 7:45, then 7:30, and so on until she is getting up at 7 am. You can then start to move the bedtime earlier, following the same pattern. Once the desired sleep phase is reached, morning wake-up time should be firmly fixed and remain consistent on schooldays, weekends, holidays, and vacations.

Other ways to help

Exposing the child to a brightly lit environment for at least 15 minutes after waking in the morning may help greatly. Screens before bedtime will also disrupt sleep. Convincing a teenager to give up their cellphone at night can be tough; it is an important link to their friends. But the screen will surely push their body clock later  ̶  some negotiation may be required!

Finally, anxiety is affecting sleep for many. For younger children, simply naming their feelings (“you’re worrying!”) may help more than trying to fix the feelings. For older children, discussions about their feelings are vital to understand what they are going through. Some will need help in the form of medication or therapy. When mental health affects sleep in ways that modest behavioral changes do not fix, seeking assessment and help is vital. For the majority of teenagers, simple changes to bedtime routines to move the body clock earlier will be enough.