Adolescent Sleep Disorders

The National Center on Sleep Disorders research says that teenagers should get at least nine hours sleep a night, but estimate the average 17-year-old was only sleeping for 6.9 hours per night, which was having a negative effect on their school performance. There are a few theories as to why adolescent are sleeping less with many of the pointing to increased school work loads, extracurricular activities as well as distractions created by modern technology’s access to communication and social media 24 hours, 7 days a week.

Problem is missing sleep repeatedly affects every part of your life. Many teens who miss sleep suffer with irritability, mood swings, and even depression. This can affect your relationships with friends, your ability to concentrate at school and your mood. Too little sleep can also make young people more likely to suffer injuries and have auto accidents. According to the National Highway Traffic Safety Administration, for example, drowsiness and fatigue cause more than 100,000 traffic accidents each year--and young drivers are at the wheel in more than half of these crashes.

Our circadian cycles -- that is, our internal "body clocks" -- determine our daily sleep-wake cycles, performance, alertness, moods, and even our gastrointestinal and metabolism. Melatonin, a hormone that makes you sleepy, is made by the pineal gland in the base of the brain. Along with sunlight, melatonin helps to set the brain's biological clock. When there is less light at night more melatonin is secreted, causing the body temperature to lower, and helping us sleep.

Sleep has four distinct stages, each with specific characteristics defined by your brain waves, eye movements, and muscle tension. There are two broad categories of sleep:

REM (rapid eye movement) sleep, when you may recall vivid dreams and NREM (non-rapid eye movement) sleep.

During sleep, the body cycles between non-REM and REM sleep. Typically, people begin the sleep cycle with a period of non-REM sleep followed by a very short period of REM sleep. Dreams generally occur in the REM stage of sleep.                                 

NREM sleep has three levels or stages.

  • Stage N1 sleep - the lightest stage, is the transition from being awake to deeper sleep.
  • Stage N2, intermediate sleep, accounts for 40% to 50% percent of your sleep time.
  • Stages N3, called slow wave or delta sleep, are the deepest levels and occur mostly in the first third of the night. It is during delta sleep when your body heals itself. It is also difficult to awaken from delta sleep, as most of us feel dazed or groggy. N3 corresponds to what was previously labeled as stages 3 and 4.

Sleep stages cycle every 90 to 120 minutes. During a normal night, there are about four to five sleep cycles.

Most often sleep patterns can be corrected by developing good sleeping habits also know as sleep hygiene. However, sometimes there are other reasons for disturbed sleep. Here are some medical conditions can cause sleep problems:

Snoring - occurs when airflow is limited and the soft tissues in the back of the throat vibrate. While snoring is annoying and causes poor sleep, it can be a symptom of a more serious sleep disorder called Sleep Apnea.

Sleep Apnea –  is a sleeping disorder where a person suffers from various breathing problems which can last from ten to twenty seconds and happens every now and then thereby depriving you of a good night's sleep. There are three types of sleep apnea:

  • Obstructive Sleep Apnea - is the condition where there is a blockage in the airway due to the collapse of the soft tissue in the throat during sleep. This is also the most common types of sleep apnea.
  • Central Sleep Apnea - In central sleep apnea the brain is not sending the right signals to the respiratory muscles to make you breathe.
  • Mixed Sleep Apnea - is the condition which is a combination of the previous two types of sleep disorders.

Restless Leg Syndrome - Restless legs syndrome is a creeping, crawling sensation in the legs that creates an irresistible urge to move. It sometimes starts between ages 11 and 20. Not only does it disturb sleep, it is also linked with involuntary jerking movements of the legs during sleep, called periodic leg movements of sleep (PLMS).

Obstructive sleep apnea syndrome – a common childhood condition, characterized by symptoms of labored breathing and snoring.

Circadian rhythm disorders – a common cause of insomnia or daytime sleepiness in school age children, in which they have trouble falling asleep and waking up at appropriate times.

Narcolepsy – a condition that usually presents during the teenage years, with symptoms that include excessive daytime sleepiness, unavoidable naps or “sleep attacks” during the day, and cataplexy, or sudden loss of muscle tone.

Parasomnias – undesirable events that occur during sleep, such as sleepwalking, sleep terrors, or rhythmic body movements (body rocking).

Gastroesophageal Reflux Disease (GERD) - which generally occurs at night when you are lying down and interrupts your sleep. Normally, a muscular valve between the esophagus and the gastric system prevents stomach acids from backing up into the esophagus. In GERD, this valve does not work properly. The stomach acids "reflux" or back up into the esophagus. This causes irritation and inflammation, and it can interfere with the sleep cycle.

If your primary Physician suspects that you may be suffering from a sleep disorder then he/she would refer you to a Pediatric Sleep Medicine Specialists to determine if there is an underlying disorder. The specialist will perform a thorough exam and may have you do a sleep study at a sleep lab or sleep clinic.

A sleep lab or sleep clinic is a facility which has been designed for the purpose of studying sleep disorders. Because the study of such disorders requires getting people to go to sleep, a sleep lab is designed to be a comfortable place to sleep in addition to being a scientific facility. Most sleep labs are often attached to major universities and hospitals.

The most common sleep studies are:

Polysomnogram (PSG) -  This test records several body functions during sleep, including brain activity, eye movement, oxygen and carbon dioxide blood levels, heart rate and rhythm, breathing rate and rhythm, the flow of air through your mouth and nose, snoring, body muscle movements, and chest and belly movement.

Multiple sleep latency test (MSLT) - This test measures how long it takes you to fall asleep. It also determines whether you enter REM sleep.

Maintenance of wakefulness test (MWT) - This test measures whether you can stay awake during a time when you are normally awake.

On the evening you are scheduled for the sleep study will be asked to bring comfortable clothes/pajamas to the sleep lab. First you will check in at the facility and then be shown to your room. Then you change into your bedclothes. Before you are ready to go to sleep, the sleep technologist will apply sensors designed to monitor your brainwaves, muscle activity, heart rhythms, respiratory activity and oxygen saturation levels throughout the night. You go home the next morning the results are then carefully analyzed by a physician. At a follow up appointment with your physician will go over the results of the sleep study and suggest a course of treatment if necessary

If you are looking for a specialized Pediatric Sleep Disorder Center and live in the tri-state area, you can contact Pediatric Sleep Disorders Center at Goryeb Children's Hospital at 1-866-906-5666. Outside this are you can find a certified center on SleepCenters.org