The Impact of Technology Use on Sleep Health for Adolescents

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Caitlin White
Remember how early you used to have to wake up to get to grade school on time? Not fun. Children and teens typically do not get enough healthy sleep because of their overloaded schedules, and now the use of electronic devices for some children and teens, sleep can be a natural challenge despite how early they try to get to bed. Lack of healthy sleep can disrupt the body's overall well-being, which is why it's important to educate children, teens, and their families about the importance of healthy sleep. Joining me to discuss this is Doctor Gary Feldman, medical director at the Stramski Children Developmental Center. So Doctor Feldman, what sleep challenges are children and teens faced with?

Doctor Gary Feldman
So, I think you can break these challenges up into sleep schedules ok, because children and teenagers are not immune to having bad sleep schedules. You know being a travel and a teenager you might want to think that you can have your own sleep schedule, but really often it has to be mandated or monitored by a parent. And you know, in our modern lifestyle you have two parents that are working or a single parent that's working and you know, is it local day child in office after school program or may have sports or something and then they get home and it's rush, rush, rush, and we've got all sorts of things to do. It's sometimes very difficult to maintain a schedule and kids may be left to their own device and that can result in some of them actually going to bed late or they just develop bad habits where they're, you know playing Fortnite, or doing video games and you know they don't want to stop and their parents are busy and answering emails etc etc. People lives are just too busy to monitor and make sure that things are done in you know things of any other regular way and schedules over here too. So I think it boils down to from a parents perspective of being diligent and meant and making sure that things are predictable. Predictability is really helpful for both children and for teenagers.

Caitlin White
It sounds like the sleep is kind of hard for everyone to attain in a family. What are some good sleep habits that adolescents and their families can build on together?

Doctor Gary Feldman
You know, again, so having good sleep hygiene, it just means good habits. So, you've got a good schedule. Having a predictable routine predictability is helpful. Like you know, so get ready for bed to go shower go you know, finish your homework, pack your stuff for school, get everything ready, turn off electronic media about an hour before bedtime. All those things what I would call front loading. So there are lot of things, you can play on the iPad sure, because I mean that is to prevent a child from being on electronic media is, you know it's worse than being in prison for life. So, it's not that you want to take it, or you know you say, well, you can't do this anymore. But this is when you can do it, and this is for how long you can be on electronic media, so it's really just front loading and saying we're fine. OK, so you know get times coming up in an hour ,you've got 30 minutes to be on your iPad and then after this time we're done, you need to put it away. So just getting everything nice and tidy in advance goes a long way to helping you know good sleep habits. The other thing that also with you know being exposed to electronic media is you know, besides the fact that it's mentally very stimulating and I don't know like if you're watching a thriller movie just before you go to bed? I don't know how easy it is for you to fall asleep, but it's hard for me. So for these kids, when they're, you know, playing something that's really exciting and there's some video game and they're online with someone else, and they're competing. You know they're in mind they're very, very amped up and then you know to go to bed straight after that, they're just looking at difficulty sleeping. The other thing is that you know being exposed to the screen, the screening with different frequencies of light, and particularly the blue frequency of light, inhibits your brain from producing melatonin, which is a very important sleep hormone. When your melatonin levels should be going up that you know, help regulate your sleep pattern and help with sleep onset that's being suppressed because you've been exposed to screen time and then it makes it more difficult for you to go to sleep.

Caitlin White
So what are some signs and symptoms that children and teens may be dealing with a sleep disorder?

Doctor Gary Feldman
Well, I mean the more obvious would be hey, they're having difficulty falling asleep so they would be complaining, I can't sleep. Particularly for teenagers, I mean it gets pretty complicated because teenagers, the incidence of anxiety is much higher in teenagers, generally speaking. So, if they, especially their performers at school they you know they competitive academically competitive or there's some drive for them to want to get to school and want to be at school early, and particularly for you know in high school if you have zero period. You know, I've got to get to sleep. I've got to get to sleep. I got to be up you know got to get up at 5:30 tomorrow morning. If they are anxious about that, and they've been on the screens and being on social media, and they've had, you know, had to just deal with cyber bullying or somebody said something mean to them on Instagram or Snapchat you know, then they're dealing with that as they're going to sleep, and then they might start to get anxious. Then the anxiety sort of further prohibits them from being able to fall asleep. In addition to that, for teenagers in particular, their natural Physiology such that. Where I say a middle schooler would be tired and really tired by 10:00 o'clock or 10:30. A teenager may not physiologically be tired until later because their whole body clock goes through a sort of a migration tool to the latest stage, and they only naturally, they sleep buildup or what do we call sleep pressure? As we go through our day and as the night approaches, we get more and more sleepy and to the point where we get you know, it's very difficult to resist sleep because our sleep pressure is so high. Now the rate of climb of sleep pressure in teenagers is actually slower, so they sleep Pressure only peaks at a much later time, so you've got you've got a teenager or even a parent that says you need to go to bed at 10:00 o'clock because you know you've got zero period. You got to get up at 5:30. You must go to sleep so the teenager decides all of the stuff that they've been doing to stimulate their mind and with the social media etc. Now they get into bed so their minds buzzing like crazy, but then also physiologically, their bodies are not ready to go to sleep until 11 thirty 12:00 o'clock. So now they can't sleep, I can't sleep, and now they start to get anxious when they get into this thing will I called sleep hunting? Where you start hunting for sleep and somebody once it's needed like a dove. If you gently reach out your hand, it will alight, but if you reach out to grab it, it'll fly away. So, the very act of trying to fall asleep, it makes sleep more difficult to attain because you're activating your mind in trying to hunt for sleep. So, hunting for sleep is a fruitless exercise. Sleep has to come to you, and I usually tell my patients that think about sleep as being a character is very shy and if you give it attention, it shys away. So, if you don't give it attention, it will come to you when it's ready, so the idea is to take your mind off sleep so it's important to you know to have a kind of a good sleep schedule. Prevent your teenagers from being exposed to all these things that stimulate them, but also at least for teenagers having some allowance to understand allowance for them to actually go to sleep a little later, which is a little counter intuitive, but also, it's beneficial because if they go to bed now I'm talking about within reason of course, because if they go to bed too early and they their body is not ready to sleep, you can induce a secondary problem which we you know could be anxiety or even something which we call psychophysiological insomnia and then that just perpetuates itself. The challenge though, with teenagers you know, because OK finds their teenager, maybe only ready to go to sleep at 11:30, maybe sometimes as late as midnight. OK, but they need about like 9 hours of sleep. Teenagers actually need little bit more sleep than a middle schooler, so if you admit that any school really needs to start at 9:00 o'clock, right? Because if you got to get up at. 5:00 o'clock for zero period, you're going to be chronically sleep deprived, right and the every senior is getting about 6 and 1/2 hours of sleep. That's why it is such a Porsche like in state of Minnesota you know with the school high school start times over I think 9:00 o'clock or 9:30, and that's how it should because that fits in for the teenagers Physiology is where they go to sleep late, not because they're necessarily being oppositional or willful, but just because that's what their Physiology is and they need to sleep in to get their nine hours of sleep.

Caitlin White
Gosh, I remember waking up for school like that and it always seemed impossible.

Doctor Gary Feldman
Yeah, The thing is it's really very difficult because I mean our lives are just not our lives are just not compatible. Our society, the way I try to operate is just not compatible for the life of a teenager who goes to school? It's not to make excuses for them, because teenagers of course, can be irresponsible, you know, and they can be playing fortnite until 3 or 4 AM, that's irresponsible, and that's where parents have to say that cut it out.

Caitlin White
Well, that leads me into my next question is why is it important for parents to be aware of their child sleep habits? I guess for you know, to make sure they're not staying up all night, but maybe to kind of be more understanding also of that wiggle room.

Doctor Gary Feldman
Well, parents need to be aware of child sleep habits A to make sure that they they're not playing hooky, so to speak, and they're not shirking their responsibility. I mean, I have had patients middle schoolers who come in because they're excessively sleepy and long story short, it sounds like they you know they're getting enough hours of sleep and they're still sleepy, and then eventually when you give them a wearable like a Fitbit or some other kind of monitor to monitor their sleep hours, you discover that these kids are waiting their parents out. I'm waiting for the parents to fall asleep. I turn off their lights, they wait for the parents to fall asleep, and then they pull out there you know electronic media or they read or something, or they're playing video games until you know late. So, parents, their parents, they have to really be vigilant about kids and it's you know and make sure that if their child it cannot be response. Then they have to take drastic steps to make sure that at bedtime. There's no access to any kind of entertainment whatsoever, whether television, whether it's tablets, video, gaming, whatever the case is, but I think also, you know, it's important for parents to understand that for teenagers there is this natural shift for their bodies only to want to go to sleep later. So to kind of within reason make some kinds of allowances. Now that's very difficult, because if school times remain early, you know. What are you supposed to do but at the same time, if you make your teenager go to sleep you know at 9:30 because they have zero period at 5:30, their teenager is unlikely to fall asleep until 11, so then they're going to be lying awake, and that's going to cause secondary problems.

Caitlin White
Why is healthy sleep so important for these specific age groups?

Doctor Gary Feldman
I think healthy sleep is specifically important for every age group, for all of us.  You know, sleep is vital for our functioning in the day, and you know, sleep is important because it helps us package our memories. You know, like when you imagine you're getting on a on a on a trip and you're. Packing a suitcase, there's two ways to pack a suitcase. You can just take your clothes and just throw them in a suitcase and just squish it down, or you can, like, you know, fold the items and put all your shirts on one side and this on that side. When you get to the other side and you're looking for a particular item of clothing in the suitcase that you just threw everything in, you don't have to throw everything out in order to find what you're looking for and then it will take you some time. But if you packed your suitcase nicely, you will know that in the top corner, obvious as all your shirts and the third shirt from the top was the yellow one that you're looking for you'd be able to go to it straight away and then that that's the analogy. For sleep, sleep helps package moves to make it easily retrievable. Sleep is also really important for helping you in terms of your executive functioning. You know how you, How do you function in the day? How you organize, how do you prioritize? How do you plan? How do you regulate your emotions? How well we concentrate? Sleep is vital for helping us, sort of function optimally. You know day-to-day life, so when you think about kids, I need to go to school, They have to focus, there's a lot of stuff to learn. They have to remember you have to retrieve information. We have to socialize appropriately and all those things can be compromised with lack of sleep.

Caitlin White
I know I've been having some trouble just the last couple days. You know, of course, with daylight savings time. What are some ways that parents can help their children adjust to things like that?

Doctor Gary Feldman
Yeah, so like for daylight saving time. You know we lose an hour. So essentially the simplest way to do it is just about a week before is get your child worker child up an hour earlier so that they're slightly sleep deprived. Now yeah, it's easy to say we know they've got a you know, when it's when it's weekend there's at school, so maybe we can just reduce it to just a few days before school starts or maybe the Saturday, or maybe the Friday. But essentially, if you can just get them to wake up earlier, you will get there. They'll be a little bit sleep deprived so that the next night they should go to sleep a little earlier and then that should help them anticipate you know they have their bodies kind of adjust. Ideally, we would want a whole week to be able to do this, but it's not always possible. It would be nice, you know when we have daylight saving for us to have would. Be a good time to have like a long weekend would be great, starting maybe like on a Wednesday be awesome that would really help.

Caitlin White
I like the way you think and where can people go to learn more about sleep health for adolescents at Miller children and women?

Doctor Gary Feldman
Anyone interested in more information for their child? They can do it millerchildren.org/sleep or they can call 562-728-5245.

Caitlin White
Well, thank you so much, Doctor Feldman. It's always great to talk about some ways we can get some more sleep in. Like Doctor Feldman said, you can find out more information on millerchildren.org/sleep or call 5627285245. I'm Caitlin White, thanks for tuning in.