A growing number of teenagers in Anne Mason’s psychiatric-mental health nurse practitioner practice are asking for prescriptions to get sleep medications.
“I’ve got 15- to 17-year-olds coming in to the clinic reporting they can’t sleep at night,” said Mason, who’s also director of the Washington State University College of Nursing’s Doctor of Nursing Practice (DNP) degree program. “These young men and woman are describing sleep interruptions not typically seen until late adulthood.”
Sleep problems in teens have sometimes serious consequences. Daytime sleepiness interrupts school life and can contribute to depression, anxiety and irritability. “A lack of sleep also can have a snowballing effect,” Mason said. “There are negative consequences on physical health, such as obesity, and possible links to more serious mental health problems like suicidal thoughts.”
The issue of sleeplessness in teens has risen to an epidemic, according to the Stanford Children’s Health Sleep Center. In most cases, however, prescribing sleeping pills to teens is not a good solution, Mason said.
Prescription sleep medications can have serious side effects including addiction, daytime sleepiness, depression, memory loss and nighttime behaviors such as sleep-walking, sleep-eating and even sleep-driving.
Even over-the-counter remedies like melatonin, “PM” analgesics like “Advil PM,” or diphenhydramine (generic Benadryl), can be inappropriate for young people. Studies evaluating efficacy and safety of these medications were never intended to evaluate efficacy and safety in children.
So rather than immediately prescribe medications, Mason suggests improving “sleep hygiene.” That’s a catch-all term for things like sleeping in a cool, dark, quiet room, and avoiding caffeine in the afternoon and evening.
But evidence is piling up that electronics, and especially 24-7 access to social media, is a major culprit of sleeplessness in teens.
A Pew Research Center report this spring found that 95 percent of teens have access to a smartphone, and 45 percent described themselves as online “constantly.” In a large 2017 study of over 700 teens, social media access — especially a cellphone in a teen’s bedroom — was associated with a significant reduction in sleep time and negative effects on daily functioning, including mood.
“A lot of these teenagers have a TV, computer, phone and tablet in their room,” Mason said. “They’re playing video games before sleep that are highly activating, and they’re Snapchatting with their buddies until midnight.”
Mason, a mother of a teenager, said she knows parents often struggle to set boundaries on the use of electronics, especially when parents have the same media habits as their children. So the key to a better night’s sleep for a teenager might also include a new set of habits for the family.
“Every person in the household benefits from setting limits on electronics and creating a relaxing environment in the evening,” Mason said. “Families are extraordinarily busy, between parents’ careers and kids’ academic or sports schedules. Taking the later evening time to disconnect from electronics and talking to one another about something not stress-inducing, or just being present like working on a puzzle, can create the mindset for your teen’s and your best night’s sleep.”