More teens having sleep problems
By Kate Nolan
The Arizona Republic
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Erica Shafer has been tired since seventh grade.
A sophomore at the New School for the Arts in Tempe, the 14-year-old says her friends are all sleepy, too.
"That's what teenagers do; they stand around and talk about how tired they are," said Erica, a jazz bassist who plans a career in music.
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Erica's point may be unscientific, yet plenty of science and testimonials from sleep experts back her up.
The American Academy of Sleep Medicine says a third of the nation's teenagers don't get enough sleep, 40 percent have insomnia, up to 35 percent are sleepy all day and 50 percent have nightmares regularly. A recent survey by the National Sleep Foundation indicated only a fifth of teenagers get the nine or more hours of sleep doctors recommend.
Baby boomers remain the money generation for sleep experts, but local sleep doctors say they are seeing more teenagers. Science is catching up with sleepy teens and spawning a growth industry for sleep centers.
Arete Sleep Health, a network that operates nine Arizona sleep centers and more than 20 nationwide, has increased its number of beds in the state to 52 from 16 since 2004, a sales executive said. The company aggressively markets its teen services to doctors, with the expectation of reaching a large patient group.
A sleep center at Scottsdale Healthcare McDowell Mountain says that its number of teen sleep patients has doubled in the past five years and that its number of beds has risen by a third, though exact patient numbers are unavailable.
No one sees the reasons behind the teen sleeping problems quite the same way.
Doctors say teen sleep deficit is anchored in physiological change. Teachers gripe about sleep-depriving influences of the Internet and video games.
Parents, whose bedtimes often precede their teenage children's, are unsure what to make of the zombies in their midst.
Christopher Merrill, 17, a varsity lineman for Scottsdale's Saguaro High School football team, dozed off so often that his mother mistakenly thought he was using drugs.
Drew Rostain, a senior at Chandler's Hamilton High School, would stay up until 1:30 a.m. every night to fit in schoolwork, a job at a pizzeria and high school track and golf until he finally crashed and slept for a week straight. His baffled father sent the 17-year-old to a doctor who is still testing to see whether other health issues are involved.
TREATING SLEEPY TEENS
Doctors refer patients to sleep centers for a diagnosis and suggested treatment. A visit begins with a battery of questions about sleep habits.
"We talk about snoring, bedtimes, wake-up times, disturbances, eating, or whether they fall asleep during the day," said Dr. Steven Marks, Arete's Phoenix medical chief.
Sometimes, poor "sleep hygiene" is apparent, Marks said, and he makes behavioral suggestions such as keeping a regular bedtime, getting nine hours of sleep or turning off the television and computer. Some teens stay online all night connecting with friends, he said.
The interview also can produce theories of psychological or physiological causes that can be diagnosed by spending a night in a sleep lab. A microphone, video camera and an array of electrodes monitor brain activity, breathing and snoring, body movement and blood oxygen levels. Results indicate whether a teen has a treatable problem.
Truth is, the teen brain is wired to be sleepy.
Dr. Eric Benjamin, a psychiatrist who is chief of behavioral medicine at Phoenix Children's Hospital, said puberty triggers changes in brain chemistry that affect sleep. Newly occurring steroids and growth hormones turn sleep on and off at different times, he said.
Circadian rhythms, the daily 24-hour cycle that programs most living things, also change. Teenagers suddenly are geared to awaken later while the act of growing itself puts them in greater need of sleep.
Insufficient sleep can affect mood, performance and ability to learn.
It can be doubly damaging to teens because the growth hormones are produced during deep sleep. Lack of sleep can stunt growth.
"A certain number of teenagers become night owls," Benjamin said. "Some have trouble falling asleep, staying asleep or have trouble awakening in the morning. After a while, they aren't aware of it, but the problems can have a cumulative effect and can put them at risk."
Function becomes impaired, and kids get into trouble. More than half of the 100,000 U.S. car accidents caused annually by sleepy drivers involve teenagers.
School presents more challenges to the sleep-impaired.
"Some students come in, and immediately their heads go down," said teacher Phyllis Carr, chairwoman of the English department at Hamilton High School. "I may try to wake them up three or four times," she said. She typically taps the shoulders of four or five kids in each class but says all her students are groggy, echoing what many other teachers and high school students say.
WAKING UP TO SCIENCE
Merrill, the football player whose mom thought he was on drugs, was a chronic schoolroom snoozer.
"I'd fall asleep upright with a pencil in my hand," said Merrill, whose teachers mostly let him sleep. His grades plummeted, and his mother contacted an education consultant who thought his sleepiness was beyond typical.
It was.
Merrill was tested and diagnosed with sleep apnea, a syndrome more commonly associated with baby boomers who snore, where breathing stops because of an airway obstruction. The breather awakens hundreds of times a night but doesn't remember it in the morning. The condition is a precursor to heart attack and stroke.
Dr. Susan Madison, the doctor at the Sleep Disorders Center at Scottsdale Healthcare McDowell Mountain who treats Merrill, said more kids are getting sleep apnea, which is associated with being overweight or having large necks. Merrill's lineman's neck, bulked out from weight training, measures 18 inches around.