Help tired teens recharge their batteries

By BRUCE A. EPSTEIN

© St. Petersburg Times, published October 5, 2000

One would think that teenagers have enough to deal with without having sleep problems, too. Yet many teens suffer from a variety of sleep disorders, many of which are exacerbated by early morning school schedules and late-night social lives.

Not being able to fall asleep after going to bed at night, or even waking up after falling asleep or waking up too early in the morning, is usually referred to as insomnia. The causes of insomnia are many and can either be minor or be a symptom of something more serious.

In teenagers, insomnia is so frequent that it is almost "normal." For some reason, teens fall asleep later than they did as children. For example, if a child was used to going to bed at 8 p.m., a teen probably is not ready for sleep until 10 or 11 p.m. (No wonder so many teenagers complain of not being able to fall asleep and then feeling tired at school the next morning.)

The most common cause of insomnia is stress. Many teenagers have anxiety about a lot of things going on in their lives. For example, family problems, worrying about being popular with friends, fear of flunking a subject and a bad social experience can all cause trouble with sleep. A schedule that's just too hectic and busy can cause difficulty in falling asleep.

Insomnia with early morning wakening is one of the most common features of depression in teenagers. Therefore, a teen with insomnia should be evaluated by his physician to make sure everything is okay.

Stimulants such as caffeine -- from coffee, tea, chocolate or colas -- can interfere with sleep for many hours after consumption, either by making it difficult to fall asleep or causing wakening later in the night. Nicotine, also a stimulant, can disturb sleep. Some medicines, including tablets used to treat asthma and weight loss, have stimulant effects.

Should your teen find herself in bed turning and tossing, it is best to sit up, go into another room and read something that might make her sleepy (like a textbook), and then try to go to sleep when she gets drowsy.

Here are some helpful hints for those night owl teens who suffer from insomnia.

Go to bed at the same time each day, seven days a week.

A light bedtime snack can promote sleep; hunger is a sleep disrupter.

Set the alarm and get up at the same time every morning, regardless of how long you've been sleeping.

Spend 20 minutes in a hot tub or shower a few hours before going to bed.

Avoid napping during the daytime.

Get regular exercise each day in the late afternoon or early evening but not within three hours of going to sleep.

Keep the temperature in the bedroom comfortable.

Keep the bedroom quiet when sleeping.

Keep the bedroom dark. Avoid illuminated bedroom clocks.

Use the bed only for sleeping. Don't read, watch television or eat in bed.

Take medicines only as directed by a physician.

Avoid engaging in stimulating activity just before bed. Examples include playing a competitive game of cards or watching an exciting program on television.

Avoid caffeine. Remember that caffeine is present in chocolate, as well as regular coffee or tea and caffeinated sodas.

Don't lie in bed awake for more than half an hour. Instead, get up, move to another room, do some quiet activity, then return to bed when sleepy. Do this as many times in a night as necessary. The goal is to associate bed with falling asleep easily.

For best results, these tips should be tried over a period of time. Usually, two to four weeks are needed to see the best results.

Bruce A. Epstein practiced pediatrics in St. Petersburg for 26 years. He edits the Web site http://www.kidsgrowth.com.

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