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Coping with teen sleep issues

Is your adolescent yawning during the day and struggling to fall asleep at night? Is your child persistently late for school or falling asleep in class? The problem could easily be not enough sleep.

Editor's note: Diane Girardot is sending dispatches from the American Psychological Association conference in Orlando, Fla. from August 2-5.

By Diane Russell Girardot, L.P.C.

Is your adolescent yawning during the day and struggling to fall asleep at night? Is your child persistently late for school or falling asleep in class? The problem could easily be not enough sleep. Is your adolescent impulsive, hyperactive, irritable, unfocused and performing poorly in school?  Again, not enough sleep?

At least nine hours of  "quality" sleep or more is optimal for children ages 13-18, according to Sarah Morsbach Honaker, Ph.D., a pediatric behavior sleep medicine specialist at the University of Louisville School of Medicine who spoke Thursday at the American Psychological Association Convention in Orlando. That number goes up the younger the child.

Sleep deprivation is a common adolescent diagnosis because teens stay up late then oversleep, which exacerbates the problem because they literally have less time in the light. "They delay the Circadian Sleep Rhythm because they don't get light exposure until they wake up," Dr. Honaker explained.

Pediatric sleep apnea is also problematic where poor quality of sleep interrupts the REM phase and disrupts how the child functions when awake, often mimicking ADHD characteristics, she adds.

Interventions like going to bed early enough on weeknights to get nine hours of sleep are challenging, when biologically teens aren't tired until 10 or 11 p.m. and high school schedules have them up and out sometimes before the sun comes up. Or, convincing your child to shut down electronics an hour before bedtime and creating a calming environment with music, reading, or puzzles. Even a little before bed conversation with family members has been shown to help. Imagine that.  "The blue light from electronic screens sends strong signals to the brain suppressing melatonin and inhibiting sleep," she says.  "Instead of TV, games or Internet surfing, experiment with other before bed activities to promote readiness for a good night's sleep."

If you notice your child operates well with a summer schedule and falls apart during the school year then seeing a sleep professional in advance could be helpful to realign the Circadian rhythm.  "The first line of treatment is behavioral intervention," Dr. Honaker says.  "Light therapy, sleep scheduling, and melatonin pills are others. Sleep medications are not approved by the FDA for use by children and adolescents."

For further information contact the National Sleep Foundation, nsf.org, or find a certified behavioral sleep specialist through the Society of Behavior Sleep Medicine at behavioralsleep.org.  Locally, Children's Hospital of Philadelphia (CHOP) has a pediatric sleep psychology center.

Diane Russell Girardot is a Chester County-based licensed mental health professional, who is a former Philadelphia Inquirer reporter now merging both careers with her coverage of the APA convention.

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