Editor’s Note: Elizabeth Zeichner is a former high school teacher and fourth-year medical student at Emory University School of Medicine. -Rachel Y. Moon, MD, Associate Editor, Digital Media, Pediatrics
Recently, there is more conversation about the fact that most adolescents have a delayed circadian phase – there is a natural shift in circadian rhythms, so that they do not feel the need to sleep until later. Additionally, many teens have a lot of competing interests – schoolwork, extracurricular activities, spending time with friends and family – which contribute to later sleep times. However, because they typically have to wake early for school, they end up sleeping less. The resulting sleep deprivation can negatively impact academic performance. Sleep deprivation in adolescents has also been associated with increased risk of being overweight, experiencing symptoms of depression, and/or struggling with substance use.
There are many experts, including the AAP, who have advocated for later school start times for adolescents.
However, what if sleep deprivation in adolescents could be addressed with something seemingly simple – going to bed earlier?
This week, Pediatrics is early releasing an article entitled “Earlier Bedtime and Its Effect on Adolescent Sleep Duration,” by Ian G. Campbell, PhD and team at the University of California, Davis (10.1542/peds.2022-060607). The article, along with an accompanying video abstract, presents interesting findings after evaluating strategies to increase sleep duration for adolescents and young adults.
There were 2 cohorts of participants:
- A younger cohort ranging from ages 9-16, who was studied annually for 3 years
- An older cohort ranging from ages 15-20, who were studied once
For 3 weeks per year, participants were asked to follow 3 different time in bed (TIB) schedules for 4 consecutive nights: 7, 8.5, and 10 hours in bed. Wake-up time remained the same, so the TIB was increased by an earlier bedtime. Sleep was recorded with at-home polysomnography.
Even though some adolescents had some trouble going to sleep at the earlier bedtimes, the study showed that there was a fairly linear increase in sleep duration when adolescents had an earlier bedtime.
The authors suggest that the typical adolescent delay in circadian phase can be overcome with going to bed earlier.
Logistically, it might be a hard sell to encourage teens to “just” go to bed earlier. The authors acknowledge that the conditions of this study are likely challenging to apply in a consistent real-world setting, as teens have many conflicting curricular and extracurricular demands. However, especially for teens struggling with sleep deprivation and its many negative downstream effects, an earlier bedtime might be a solution.
