Hi Dr. Meeker–
My 15- year -old daughter sometimes has trouble falling asleep and staying asleep. When this happens, she becomes anxious which then makes the whole sleep situation worse. We have tried many typical things: electronics are put away, the room is dark, use of a mediation tape and sound machine, getting ready for bed and going to bed around the same time, turning the alarm clock so that she can’t see the time, and sometimes a warm shower. She says she isn’t concerned or worried about anything. Any other suggestions? What are your thoughts about the use of melatonin supplements? Thank you for your time.
-Mom of Sleepy Teen
If I had a nickel for every teen that has difficulty sleeping I’d be a millionaire. Here’s what can happen to teens. Many have trouble sleeping and the reasons are varied: sleep apnea, sleep disorders, fatigue, overstimulation and busyness. I don’t know much about your daughter, but if she is a typical American teen, I can tell you that she is probably more tired than you think and fatigue plays a critical role in poor sleep. Just like infants, when teens are over tired, they can’t fall asleep or stay asleep. Insomnia can become a real problem because the harder they try to sleep, the more frustrated they become and this leads to poorer sleep.
Before you do anything, pay attention to her sleep cycles. Does she snore? If so, she could have sleep apnea and this can cause chronic fatigue that can worsen sleep. Does she fall asleep and then awaken after one or two hours? If so, she may have a sleep disorder. If she has either of these, take her to her doctor. If these are not true, then she may suffer from issues common to most teens.
Most children ages 14-18 lack a healthy rhythm of activity alternating with quiet in their lives. They live in constant over-drive. Too much auditory, visual or physical stimulation supercharges them, and they experience constant adrenaline surges with few or no quiet moments during the day. Your daughter needs a routine where she isn’t plugged in all the time. The best thing that you can do for her is to establish a couple of hours during the day when she can be with a screen (computer, television, phone, Ipad) and then make her put them away. Even if she is stimulated all day but stops at 6 pm, this could be too much for her because her brain can’s turn off the stimulations from earlier in the day. She must have scheduled quiet in her days so her brain can have a break.
Finally, take a hard look at her schedule. Is she over booked? She should have several days during the week when she comes home before or near dinnertime and has a few hours to relax. Everyone needs downtime and in my experience, most teens either don’t have it or if they do, they are afraid of boredom so they turn on a screen. The best thing that your daughter can do for her sleep is to take more walks during the day with you by her side or at least without her phone on.
Try hard to rein her in and infuse quiet and some rhythm into her days. You are doing all the right things with her sleep hygiene so keep doing them. I’m not an advocate of using supplements to help kids sleep, but sometimes 2-3 mg of melatonin can help in a pinch. Sleepytime tea, warm milk with a little honey can also help. Make sure to let her sleep in on the weekends and if she still can’t sleep after a month of these changes, talk to your doctor.