Why Your Teen is Tired: Insights from a Psychotherapist

Welcome to Where Parents Talk.

My name is Leanne Castellino.

Our guest today is a psychotherapist and a registered marriage and family therapist who has a particular focus on sleep and parenting.

Heather Terjon is also an author.

Her most recent book, co authored with Julie Wright, is called Generation Sleepless.

Why Teens and Tweens Aren't Sleeping Enough and How We Can Help Them.

Heather is also a mother of two and she joins us today from Los Angeles.

Thank you so much for taking the time.

Oh, thanks.

I'm so happy to be here.

Heather, I wonder if you could set the scene for us because you're looking at this question of sleep among tweens, teens really, kids in general, from multiple different lenses.

As a mother, as somebody with a clinical practice, as a psychotherapist, and a registered marriage and family therapist.

How would you describe the current state, state of sleep as it pertains to tweens and teens?

Oh, it's not good.

It's really not good.

And Julie and I have been working with families for many years on sleep.

We wrote our first book was about babies and little kids called the Happy Sleeper.

We worked with, you know, parent, and we still do with parents of young ones for many years.

And then as our practice expanded and we started, you know, following more of the research, we, we kind of looked around and we're like, gosh, the teens are really the ones who need our help the most.

They turn out to be the most sleep deprived segment of the population.

They're the most sleep deprived of any generation in history.

In human history, there's never been a group of individuals as sleep deprived as today's teenagers.

And overlapping with that, what we're seeing in terms of the mental health issues that have been so widely discussed, those two trends are highly connected, extremely interconnected.

So when we looked at that, we thought, well, this is what we really need.

This is an urgent.

When our kids are little, we know how important sleep is and we are so impacted by when our little kids don't sleep.

So we're desperate for the information.

But then as kids get older, parents either start forgetting that it's important or they feel like, well, my teen is so busy, what am I supposed to do?

Or they go to bed before their teenager does.

Meanwhile, these poor teens are missing.

I mean, teenagers need an average of nine and a quarter hours of sleep.

They're getting around six.

So that's three and a half hours almost of missing sleep every night for the average teenager.

So I guess it really begs the question, if we break it down.

First of all, how did we get here?

And I understand that, you know, the topic has been described as a silent epidemic.

So why is it a silent epidemic and how did we get here?

We got here through, we call it a perfect storm of factors.

So we have.

If you imagine teenagers sleep as being nine and a quarter hours on the bedtime end, we have a shift in the biological clock that naturally happens for teenagers.

They have about two hours of a natural shift in their circadian rhythm, meaning completely natural for the average teen to be two hours delayed in wanting to fall asleep.

So they don't get tired until two hours later than they used to and they don't want to wake up and they don't feel alert and their brains are not as active two hours later in the morning.

So you have this shift in the period of sleep.

Then you have technology that's a huge impact.

You have the activities and just the, the general workload of a teenager.

They're busy, they're social.

And so all of those things push their bedtime later.

And then you had, on the other end, at least in this country, we have a huge problem with early start times for teenagers.

So their morning start times are way too early for their biological rhythms.

So those forces have been, you know, working for sort of decades, I would say, to whittle away at teenagers sleep.

The smartphone definitely jumped that, that decline.

So when the smartphone became really, you know, just an appendage for all of us, which was, you know, like the saturation point for smartphones, you see a diplomatic, like teenager sleep really tanks at that point.

So smartphones are definitely, you know, as any parent knows, and I'm included, that's a real deterrent.

So.

And it's silent because again, lots of teens can muscle through, although it shows in their, in their mental health, but they're tough and they can muscle through, except that their mental and physical health is deteriorate, is, you know, not optimal when they're sleep deprived.

So they seem tough and they start their day and we wonder, like, why are they grumpy?

Like, why, you know, why is my teen not talking to me?

Why do they seem, you know, like, difficult to interact with?

They're sleep deprived.

They're massively sleep deprived.

And it's accumulating over the week, you know, and sometimes they sleep in, you know, really late one day to try to make up for it.

But.

And I think that's why it's silent.

You know, it's really interesting because many parents struggle with this in their homes, regardless of the age of their children.

And you know, you, you, you talk about grumpiness as an example of how a lack of sleep can affect a teen's mental health.

Do you have any other examples that maybe can be tangible so that parents, if they see it, can sort of relate to it?

Yeah.

Well, a teenager who, you know, seems like they're sleeping okay, but then you notice that on Saturday morning they sleep until one in the afternoon.

That's a teen who's making up for a lot of lost sleep.

A teenager whose schedule is moving around a lot.

So like they're, they have to get up at 6:30 for school every morning and then maybe they're taking a nap in the afternoon and then some nights they're staying up really late and other nights, you know, they're, they're not.

And then they have this big sleep in on the weekend.

That would be a definite.

And I do think that the mental health aspect is something, you know, if you feel like your child's anxiety is high and it feels out of proportion, it's something to think about.

Are they sleeping enough?

Because we do need sleep to be able to regulate our feelings and keep our feelings in check and know when something is a big deal or when it's not a big deal.

Our barometer for what's a big deal kind of goes out of whack when we're not sleeping enough.

So.

And then also kids who fall asleep in the car, you know, like you're, you're going, going, going, and then you get in the car and you can just pass out at any point.

And also teens who are drinking energy drinks, which are really pretty common, they're just trying to stay awake because they're not sleeping enough.

So they're drinking coffee or they're drinking an energy drink.

So along those same lines, do you have examples that you can share with us with respect to sleep deprivation in a teen and how it affects their physical health?

Physical health is something, you know, for example, if you have, there's certain things that are short term obvious and then there's long term consequences of sleep deprivation that are harder to quantify because we don't, you know, we're just talking about cardiovascular risk, for example, for the future.

That's not something we can see right now.

But things that you can see are, for example, injuries like athletes who have chronic injuries, who have trouble getting recovering from injuries.

Sleep deprivation is very closely tied to risk of injury.

And also you need growth hormone during the night to repair your injuries.

So for athletes high School athletes who are not, you know, feeling like, like, why do I keep hurting my shoulder?

Why does my tennis, you know, I'm playing tennis, but why does my shoulder keep hurting?

Those are some of the physical, you know, signs that, that sleep deprivation is a problem.

You can also look at immune function and see that when we're not sleeping enough, we're more likely to get sick and we don't recover as quickly.

Along those same lines, I guess for some parents who don't sleep enough themselves, you know, you have to make the case to them before they're able to support their children.

Can you take us through, Heather, what is happen when we're sleeping to our bodies, to our brains, that maybe really is important for those individuals and all of us really to understand?

Yeah, so the first thing to know about sleep is that it's not rest.

So this is kind of a fundamental shift in how you think about sleep.

You don't experience sleep because you're not conscious.

So you don't kind of appreciate all the work that's going on during sleep.

But I think it's helpful to think about sleep as not being a time that your brain shuts off, but that a time that certain parts of, of your brain are really firing extra hard.

They're going extra hard in a way that they don't during the day.

Because there's really important work that happens during sleep.

So for example, your memories are being shuttled from one place to another from short term memory into long term memory.

So for students, for, for high school students, this is really important.

If you're learning a lot, which that you are, you need somewhere to put that memory.

You need to take that information and put it somewhere.

And that happens during sleep.

It goes from short term active memories into the long term memory.

And I mean, all kinds of things are happening.

Your brain is sort of getting.

There's a system in the brain that cleanses during sleep.

This is a system called the glymphatic system.

It's like the lymphatic system, but it's your brain shuttling toxins out.

So when you fall asleep, your brain has this way of washing kind of like a dishwasher while you're sleeping.

It's washing the toxins out, it's washing these byproducts of activity during the day out.

So when you wake up and you haven't slept enough and you feel like cloudy and just kind of like, like that's your brain not being clean.

It's not getting the time that it needs to flush those toxins out fully.

So that's a real visual, I think, representation that really resonates with teens too, when we tell them that they're like, oh my God, that makes so much sense.

Absolutely.

And then on top of that, we're talking about an age and stage of life where they're developing and changing, you know, physiologically and in a whole other list of ways.

Is it more.

Is sleep deprivation more pronounced in this age group than, let's say, others because of everything you've just described?

Absolutely.

It's way, way more pronounced.

So when you look at the percentage of kids who are asleep, for example, elementary school kids, about 70% of them get healthy sleep, but only about 5 to 10% of high schoolers get healthy sleep.

And the amount of sleep they're missing is way more.

So if they average need one and a, sorry, nine and a quarter hours of sleep, but they're getting six, that's the average amount that a high schooler is getting by about nine.

By 10th grade, they're getting about six hours of sleep.

So that's three and a quarter hours of sleep deprivation accumulating every night.

And like you're saying, they're in this period of massive brain growth and reorganization of the brain, so it's sort of like a second wave of reorganization, much like when they're the 0 to 3 age and their brains are changing so much and restructuring, it happens again in adolescence.

And we know that that brain growth is so important and so much of that work happens during sleep.

So, yes, they're missing way more sleep than we are.

And their sleep is arguably way more important than ours because of all the work that they have to do in the night to restructure their brains.

So are the side effects of a lack of sleep also more pronounced than in the teenage and tween brain?

I think so.

I mean, when you consider that, you know, for example, teenagers who sleep, you know, six hours or less are somewhere around double as likely to say that they have thoughts of hurting themselves.

And the rates of depression and anxiety really skyrocket during.

In that, you know, pattern of missing that much sleep.

And when you consider how much we care about our kids mental health and how we prioritize that and we puzzle over it and we think, what can we do to support them?

You know, parents are always trying to work on how to support their kids, and this is a fundamental piece of their foundation of their mental health.

So, yeah, I think that the side effects are really drastic.

It's so interesting because there has been so much research around this area of sleep, certainly in the last several years.

So it's not to most of us, you know, if you've been paying attention.

Again, the different things that you do.

What struck you in the research?

Well, I think we started doing the research before COVID and Covid was an interesting experiment in what happens when you lose.

An interesting experiment in lots of ways.

What happens when you lose your daily routine.

A lot of kids were initially sleeping more because they didn't have to get up for school.

And then technology just really saturated our lives much more.

And then teenagers were kind of back to where they started, not sleeping enough, um, and feeling more isolated and like they had lost the rhythms of their daily life, which is so important for sleep.

You know, get up, get out in the sun, be, you know, have your ritual, be out in the world.

And all these kind of markers and signposts for how your day goes is really important to your.

Your internal clock.

So they really lost a lot of that.

But I think in.

In maybe the last year or two, I would say that the awareness, and I hope we've been able to contribute to this, the awareness of sleep has been growing for teenagers.

It's definitely been growing for adults.

Like, there's definitely a resurgence or like, a new understanding of how much sleep is important to our health.

But I do think teenagers are still not quite benefiting from that as much as adults are.

But there is more of an awareness.

I'm hearing, you know, My son, who's 16, I'm hearing from his friends that they're actually.

They understand.

Like, his friend told me the other night that he needs to go to bed by 10, because the most growth hormone is secreted between 10 and 12.

And he really needs to get that growth hormone in and he needs to go to bed at 10.

And I was like, yes, yes, it's so true.

And it's great that that that information is out there.

Along those lines with respect to, you know, trying to shift that narrative in a home, trying to get tweens and teens and kids in general to understand for their own lives how to adopt healthy sleeping habits.

A habit at the best of times is hard to.

To adopt.

What do you suggest in terms of, you know, laying this out for parents and how they can support their kids to create healthy sleep habits?

Yeah.

So if you have a tween, then I would say you want to be able to hold the structure of good sleep habits.

So you want to have family practices that involve like putting your, you know, everybody park your phone.

We're going to have wind down time.

We say good night to technology.

You want to model those habits and really hold on to it and hold on to a bedtime and a bedtime routine.

When, when you have a tween, when your kids are older, like 15 or so, you start to lose control of the thing, of the basic things.

You start to like not have the control anymore and it's really hard.

And at that point I would say the most important thing is to have conversations that inspire your teenagers self motivation because they have to feel it themselves or else you might be able to control certain things.

But then they're going to stay up later than you and then they're going to go to college and then you're not going to have any control.

So you have to have conversations that start with you listening.

So we always encourage and generation Sleepless.

We have a whole chapter dedicated to communication with teenagers because we have to listen first and figure out what is important to them and follow their lead and try to inspire them with whatever that is.

So if you have an athlete, that's an in.

If you have a kid who really wants to, you know, get good grades, then you talk more about that or somebody who's not feeling like as confident or as happy.

We can talk about that.

Follow what they're, what they're interested in and where their mind is going and then weave in how sleep can help.

That's really important.

Otherwise all these habits kind of just start to fall apart for them because they have to feel it themselves.

And then in the book we have five habits of happy sleepers and we have ways for families to do that together or just kids to do it on their own.

And a sleep challenge to modify your sleep habits and track them.

Let's break down some of the, you know, issues and contributing factors to sleep deprivation a little bit and I wonder if you could just provide a quick tip or two if you could.

Screen time.

You talked earlier about, you know, the wind down period.

That's required.

But what in general should parents know about screen time as it relates to trying to create those healthy sleep habits for tweens and teens?

I would say that screens affect our sleep in a few different ways.

And so it's important to think about those multiple ways because we hear a lot about blue light, which is sort Of a thing.

It's sort of a thing, but it's not quite as much of a thing as people think.

You don't want to have a ton of light in your home during wind down time, so you do want to lower the overhead lights and just have a couple of lamps on.

Wind down time as we describe it in the book is 1, 1 hour before bedtime.

So if your bedtime is 10, your wind down time starts at 9.

You do want to lower the lights and not have bright overhead lights on and you want to just opt for watching TV maybe at a distance.

So not having a close up screen and that blue light is, is somewhat of a thing, but it's not the only thing.

The more important thing for teenagers is that and for actually all of us, technology is so engaging that it's hard to put down.

It just is.

Everybody can identify with that.

There's just one more thing to watch, there's one more scroll, there's one more thing that or for teenagers because they're so social, it's one more text, it's one, it's.

I can't say goodnight to my friend.

I, I can't stop FaceTiming them.

I need to know, I need to respond, I need to, I'm wondering what they're doing.

So that shutting down so that the wind down time and the saying goodnight to technology is not just about blue light activation and all that stuff and melatonin.

It's really about giving your brain permission to relax because teens don't feel like they can relax.

They have so much going on.

So that's a really important thing to think about is, is saying good night to the, to the rest of the world basically.

And we all need that.

We, we can all kind of benefit from that at any age.

But I think teenagers need it, you know, even more than we do.

How does a parent who perhaps is really all over this topic in their house and has established a wind down time combat other kids who don't have this going on in their homes and now are impacting their kids, be it screen time, smartphone time or social media.

That's a great question.

I would say, you know, I've said to my kids like, you know, you, you, I understand you want to always start with the understanding piece with the, we call it the attune step.

So don't just dismiss them right away like you'll, you'll see them in the morning.

Like I think that's usually our, our go to is like, you know, just to go to what you Think and not to listen first.

So practice the tuning and, like, ask a couple of questions about that.

What is it that you're wanting to know from your friend?

Like, is there something going on?

I want to hear.

I want.

I want to understand what you're saying and then reflect it back to them.

So you're saying that what I'm.

That when you turn off your phone, it feels like you're going to miss out or you're going to.

Your.

Your friend might need you and you're not there.

Like, really try to lean into that first and then say something like, you know, I know it feels like that and I totally understand, but your brain really needs permission to sleep.

And you will be such a better friend if you can feel positive and optimistic tomorrow and like, you've really got.

You've taken care of yourself and, you know, or whatever it is that you want to say about, you know, maybe you.

If you want to stop studying at a certain point because you're going to do better on your test, if you get a good night's sleep, you give them the information.

But listening first, I would say, is the key.

Is there something that you uncovered, Heather, in either the research, through the research for the book, in your own clinical practice, or your own lived experience that really is a compelling argument or a compelling point to make to a tween or teen that kind of really gets them to understand in a granular way the impact of sleep debt on their lives.

I would say there are two things that are sort of specific, and I really think this depends on the teen.

So you have to figure out what your teen is interested in and frame it in their ways.

But I would say that the.

The athletic piece has been extremely compelling for dancers, for kids who play any sport, for gymnasts, for all the kids who are active or just want, you know, to do well in their sport.

You know, you can look at how people like LeBron James talk about sleep.

It is absolutely integral to athletic training.

And you can, you know, tell the.

Or if kids want to grow tall.

Lots of kids want to grow tall.

Tell them that the first two hours of the night from 10 to 12 are when you get your MO.

The most growth hormone.

If you're awake during that time, you're not getting that growth hormone.

So if you want to grow, go to bed before 10.

And then I think that that sort of washing the brain out.

If you look at the glymphatic system and you look at it online together and you see these videos of when we do Talks at high schools or actually any talks that we give, we always show a video of what happens in the brain.

That machine washing and it really kind of, it really kind of brings it home for a lot of teenagers.

You also mentioned early school start times, which certainly has gotten a lot of headlines over the last several years.

More in the United States, I would say, than in Canada.

What would you like to say about that in terms of.

We've talked about the household piece and what we can do in our own homes, but in terms of policymakers, sleep as it relates to this age group that we're talking about, what would you like to see done there?

Yeah, well, what we did in California, which is the, the, the state of California now has a law that you cannot start school, high school before 8:30 in the morning.

So for a lot of schools that was really a big change.

And all the research backs up that kids, you know, get sick less often.

They, overall, the mental, I mean, for me the most compelling thing is that the mental health of teenagers goes up.

There are fewer kids saying that they feel hopeless.

There are fewer kids saying they feel sad and like they have thoughts, you know, darker thoughts when start times are moved.

To me that's a no brainer.

And so I think having, you know, hopefully more states are going to move towards that 8:30 or later as a start time.

But it really is, it's like it's been a struggle because change is hard.

People just fundamentally don't like change and there's been resistance to it.

But you know, in my own kids, high schools, when I talk to parents, they're like, this is wonderful.

It feels humane, it feels better.

My kids are not as, you know, it's not as hard to peel them out of bed in the morning.

And it just makes sense.

Heather, do you believe that educators, teachers themselves have a role to play when we talk about generation sleepless teens and tweens?

I think that it's fun for educators and helpful to integrate sleep information into different classes like you imagine it being in health class.

But I, you know, I would like to see it in biology class.

I'd like to see it in, you know, other classes that just make it as part of a basic, you know, way that we take care of our brains and bodies.

So, you know, I think that that's, that can be part of the curriculum and also getting everybody on board.

So when we work with schools we try to make, we don't just put it all on the parents.

We don't want to be like, you know, this is all your, your job now.

You have to fix this.

It's another thing that's on your plate.

We talk to the kids, we want to get the common language between the kids and the parents and the school so that they can work as a system.

And that's really the most effective way to move kids into getting more sleep is for everybody to be involved in.

Your clinical practice, in the talks that you give and the, you know, with the people that you meet.

Are there certain trends or common obstacles that you're hearing from parents around this topic and how to create self motivated kids as it relates to their own sleep?

And what are some of those common obstacles?

The obstacles I suppose are technology.

That's a big obstacle because it's like, you know, it's just so woven into teenagers daily lives.

So I think that parents being not being night owls, so most parents, you know, because like I said adolescents, we shift in our internal clock two hours later but then we shift back when we're adults.

So somewhere around age 25 we, we shift back into being more morning people overall.

So it's a huge obstacle when you feel tired at 9:30 and your teenager is like just ramping up.

They're like I'm just going to start doing this whole, I have this whole other chapter of my life now where I'm going to talk to my friends and do my homework and be in my room.

And this is this whole other, you know, so that's, that's really a challenge.

And I think that another challenge is that technology is so captivating that it makes kids procrastinate.

It's harder to get your work done and sort of pack away everything in your life early in the evening so that you can wind down in time to fall asleep on time.

So technology tends to delay everything because you know, it's just harder to be productive.

I see kids with you know, homework open and their, and their phone going and they're trying to multitask and it just makes everything take longer.

So then everything just gets pushed out into the evening.

That's a really interesting point.

I don't think parents who see that happening if it looks like it seems to be working ever contest like how much actual work is really going on in terms of delaying that work getting done.

Heather, what would you want parents to take away from generation Sleepless?

I would say that, you know, remember how important you felt sleep was when you had a toddler.

When you're like oh my gosh, my toddler needs a nap.

I know they need A nap, because their brains are growing, because I can see how it affects their behavior and I know how important it is to their development.

Act like you have a toddler again.

Remember that your teenager's brain is growing in this way.

But also the empathy, because I am a parent too, of a teenager, I understand that you can't, you used to have control over all these things.

You used to, you know, be able to just change your toddler's bedtime routine and then put them in their crib.

And that's fine.

You don't have any of that same control.

So the approach is different, but the importance is still there.

It's just something we have to think about in a more holistic way.

We have to engage our kids.

We have to educate ourselves and talk about ways that we can have a mutual understanding of why this is so important and then set up family habits.

So.

And I also think that it's important to know that even if you can't just fix all of it, if you just support your teenager to sleep 30 minutes more every night, then by the end of the week, that's two and a half hours of sleep that they've put back in their, in their bank.

And that is significant.

So maybe you can't get them to sleep nine to ten hours a night.

Most people can't.

But if they can add in 30 minutes, it is, it is going to be, it's, it's helpful.

That is really something.

At what point should a family or a parent consider getting professional help if they've tried all of the things that we've talked about here and it's still not making a difference?

Yeah, that's a good question.

So we have in the, the second half of Generation Sleepless is all practical tools and we have the, the five habits that we have people follow and we say to follow them consistently for two weeks.

And if you are really being consistent and modifying all of your habits and you still feel at the end of two weeks and maybe I would say three, if you're kind of spotty about, you know, got not getting it all completely dialed in at that point, it's a good idea to talk to your doctor because then you might want to explore something else.

We do find though, that when people follow the five habits and they really do get on board for a few weeks, that their sleep can really turn around quickly.

Lots of excellent food for thought on a very important subject.

Heather Terjon, psychotherapist and author of Generation Sleepless, along with Julie Wright, co author, thank you so much for your time and your perspective today.

Thank you.

This was so fun.

Thanks a lot.