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A new approach to experimentally lengthening sleep in short-sleeping teens

Short sleep is common in teens, particularly on school nights, with a majority obtaining less than the eight to ten hours recommended. Many factors contribute to insufficient sleep during adolescence including increased social and academic demands, bedtime autonomy, the use of electronics, and early school start times coupled with a biological and behavioral tendency to stay up later. Although common, short sleep can be detrimental to healthy functioning in teens and has been associated with worse school performance, negative mood, difficulty with attention, and increases in risky behaviors and accidental injuries. Although there is a good understanding of the negative consequences of short sleep, more work is needed to determine whether extending sleep in teens improves these outcomes.

To learn more about the effects of sleep patterns on teens, we spoke to Tori Van Dyk, PhD and author of “Feasibility and Emotional Impact of Experimentally Extending Sleep in Short-Sleeping Adolescents”, reflected in the interview below.

What was new in your approach to evaluating the effects of extending sleep in adolescents?

Experiments are important, because they can really show cause-effect relationships. But often they can stray far from real-world situations. In the case of teen sleep, prior experimental approaches have been limited to the summer months or have been conducted in laboratory settings. With unique schedules, social interactions, and stressors, the life of a teen may be very different outside of the lab or during the school year. We didn’t want to restrict sleep during the school year, because that could do harm (for example, poor classroom learning or poor test scores). Instead, we developed a home-based experimental protocol that could be ethically implemented on school nights, when short sleep is most common for teens, by helping teens who were already getting too little sleep get a bit more. We were able to design a protocol which significantly lengthened habitually short-sleeping teens’ sleep during school nights for a two week period. We could then compare functioning when sleep was improved to functioning when the teens experienced their typical, short sleep duration.

What strategies did you use to help adolescents extend their sleep during the school week and how much did sleep times increase?

Our protocol had two experimental sleep conditions: during the habitual sleep condition we asked the short-sleeping teens to go to bed and wake up at their normal times and during the extended sleep condition we worked to increase their time in bed by 1.5 hours per night. On average during the habitual sleep condition, teens slept about six hours per night. To strategize ways to lengthen sleep for a two week period during the sleep extension condition, we included both the parent and teen in a 25-minute problem-solving session. Most teens in our study were already sleeping in as late as possible in the morning, often because of early school start times. We could not control school start times, so we primarily used behavioral strategies to move bedtimes earlier. These strategies included securing buy-in from both the parent and teen, setting specific goals for bedtime and wake time, identifying and problem-solving barriers to moving bedtime earlier (e.g., completing homework earlier in the day), encouraging positive routines leading up to bed, promoting healthy sleep hygiene (e.g., eliminating digital screens at bedtime), and having teens self-monitor sleep via daily diaries. We also positively reinforced teens for adhering to the sleep schedule and encouraged parents to do the same. These strategies were successful; the teens who finished the study averaged over 70 extra minutes of sleep per night during the sleep extension condition.

What benefits of sleep extension were you able to document?

Despite the notion that perhaps teens who don’t sleep a lot simply do not need as much sleep, we found that by lengthening sleep on school nights, these teens experienced improvements in their emotional functioning. When they slept more, teens weren’t as sleepy, fatigued, or angry but did report feeling more energetic and better able to concentrate.

Did participating adolescents and their parents recognize the benefits of increasing sleep time on school nights?

The fact that parents and teens responded to questions more positively during the extended sleep condition is an indication that there was a perceived benefit to sleeping more. However, because we did not ask for a direct comparison of sleepiness or mood between the two condition, we can’t be sure that parents and teens were fully aware of these benefits or if perceived benefits led to any long term behavior change. What we do know is that, despite teens reporting that lengthening their sleep for a two week period was challenging, a vast majority of parents and teens were satisfied with the protocol and would recommend the study to other families.

Featured image credit: Photo by Krista McPhee. CC0 public domain via Unsplash.

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