Teen Sleep 101 Understanding The Science Behind Sleepy Teens

Teen Sleep 101: Understanding the Science Behind Sleepy Teens

by with No Comment Sleep

The Intricacies of Adolescent Sleep Patterns

As children transition into adolescence, their sleep patterns undergo profound shifts. This evolution isn’t merely a consequence of academic stress or hormonal surges associated with puberty. A more foundational physiological mechanism is at work.

The Adolescent Sleep Conundrum

On any given morning, a ubiquitous scene unfolds: adolescents, resembling somnambulists, awaiting their dawn school commute. The prevailing assumption among many adults? “It’s the cumulative hours on digital devices!” Yet, such a hypothesis might be an oversimplification, its their biology that is keeping them awake and they need/want something to do!

First a bit of background…

The Circadian Rhythm: A Symphony of Biological Timings

Central to our sleep architecture is the circadian rhythm – an innate biological metronome synchronising myriad bodily functions. Within the context of sleep, two pivotal mechanisms come to the fore:

Sleep Pressure: As diurnal hours progress and wakefulness persist, adenosine, a neurotransmitter, accrues within our neural pathways, cultivating a state of drowsiness – colloquially referred to as ‘sleep pressure’.

Sleep Windows: Throughout nocturnal hours, our circadian rhythm delineates ‘sleep windows’: periods during which sleep is physiologically optimal. While the intricacies of these windows warrant their dedicated exposition, we’ll earmark that for subsequent discussions.

Chronotypes: The Taxonomy of Sleep Profiles

In broad strokes, individual sleep-wake patterns can be stratified into ‘chronotypes’:

Morning Larks: Constituting approximately 10-15% of the populace, this cohort embodies the proverbial “early birds,” both in terms of retiring and rising.

Intermediates: Encompassing a sizable 70-80%, this demographic’s sleep-wake cadence is largely congruent with societal expectations.

Night Owls: Comprising an analogous 10-15%, these individuals exhibit peak physiological and cognitive vigour during the latter evening hours, favouring predawn for repose.

At the nexus of teenage sleep patterns is their unique circadian rhythm—a distinct internal biological metronome that’s undergoing transition just as the rest of their bodies and minds are. Unlike younger children or mature adults, the adolescent circadian rhythm exhibits certain peculiarities that influence their sleep behaviour.

Sleep Pressure in Teens: Throughout an adolescent’s day, as hours elapse and wakefulness dominates, sleep pressure levels accumulate within their neural structures at varying rates compared to other age groups. And here lies the issue: for many teenagers, this sensation intensifies later in the evening, as opposed to early evenings seen in younger children. They simply aren’t sleepy!

Teen Sleep Windows: Adolescence is also characterised by a shift in circadian-delineated ‘sleep windows’. For many teens, this means an optimal, physiological sleep period that starts and ends later than what traditional schedules may permit. While these sleep windows are a subject of extensive research and fascination, their implications are clear: societal norms, especially early school start times, often misalign with the biologically optimal sleep schedules of teenagers.

Its a biological disaster that meets a societal structure resulting in extreme sleep deprivation

Visualise an adolescent predisposed to remain alert until 2 a.m., yet physiologically necessitating 9-11 hours of recuperative sleep. Introduce into this equation a 7 a.m. academic commencement. The aftermath? A chronically sleep-deprived teenager, experiencing the equivalent of a 3 a.m. daily arousal.

A Plea for Empathy and Insight

When next confronted with an adolescent seemingly wrestling against the weight of their eyelids, exercise restraint in your judgment. Their lethargy is less about nocturnal digital engagements or a lack of self-regulation and more about a physiological metamorphosis clashing with societal timetables. Empathetic comprehension, coupled with adjusted anticipations, could be instrumental in aiding them through this labyrinthine developmental phase.

The Relationship Between The Hormone Cortisol And Sleep

The relationship between the hormone cortisol and sleep

by with No Comment SleepStress

Cortisol, often labeled the “stress hormone,” is produced by the adrenal glands through the hypothalamic-pituitary-adrenal (HPA) axis when we encounter stress. Its widespread presence, thanks to cortisol receptors in many body cells, makes it an influential chemical messenger, modulating a multitude of functions based on our environment and internal states.

Its both our friend and foe and plays several pivotal roles in our physiology. For instance, by promoting the release of glucose from the liver, it ensures stable blood sugar levels, supporting the increased heart rate and blood pressure typical of stress responses.

When the stress response is triggered – our body switches to the fight/flight/freeze/fawn mode, the energy demand escalates, necessitating enhanced respiration and muscle readiness to prepare our body to rapidly respond. Cortisol elevates our sensory awareness, making us more alert. At the same time, it wisely economises energy by temporarily pausing systems like digestion and reproduction, which aren’t immediately vital. Its importance in preserving our overall health and well-being cannot be overstated.

Cortisol’s diurnal rhythm is a telling reflection of our well-being. While its levels naturally ebb at midnight and surge in the early morning, assisting our wakefulness, disruptions to this rhythm can provide clues about underlying stressors or mental health issues.

Cortisol and Sleep

Ideally, our cortisol dips during sleep and spikes upon waking. However, persistent aka chronic stress, indicative of an overactive HPA axis, can play havoc with this balance, leading to sleep disturbances like insomnia or fragmented sleep. Such disruptions can trap individuals in a harmful loop: poor sleep heightens stress, which in turn agitates the HPA axis, further misaligning cortisol production.

From a psychotherapeutic perspective, sleep disturbances and cortisol imbalances can be both a symptom and a cause. For instance, chronic insomnia might be a manifestation of underlying anxiety or trauma, which then exacerbates stress, leading to erratic cortisol levels. Furthermore, disorders like obstructive sleep apnea not only interrupt restorative sleep but can cause fluctuations in cortisol, adding another layer of strain to the HPA axis, further heightening stress and anxiety.

Recognising these intertwined relationships, in therapy we don’t only address the sleep disruptions and physiological implications but also delve into underlying emotional or psychological stressors. There is often a good reason for the stress response to be on high so understanding more about this, gives us the opportunity to start to reduce in. In the work we are always aiming to create a feedback loop of healing, where resolving one issue aids the natural resolution of others.

My Legs Are Painful And Restless At Night

My legs are painful and restless at night. Why?

by with No Comment RelaxationSleep

Do you ever feel a crawling sensation in your lower limbs at night and the irresistible urge to move your legs? If so, you’re not alone. Many people routinely suffer from Restless Leg Syndrome (RLS), a neurological disorder that sometimes lasts for several hours and can disrupt your sleep.

Why does it happen?

RLS seems to occur during periods of inactivity, usually in the evening when people are resting or falling asleep. For some people, nerve damage can trigger sleep apnea or sleep deprivation, but there is no universal consensus on causality. Interestingly, although it was once thought RLS may occur due to muscle abnormalities or a disturbance in the part of the brain that controls movement, new research seems to suggest low iron levels may cause it in the brain, for which, unfortunately, there are no tests. This is very different from iron levels in the blood; subsequently, many people with RLS symptoms can have a blood test for iron- deficiency only for it to come back normal.

Who gets it?

RLS has a 60% chance of being inherited, and it can appear at any age, although women are twice as likely to get it than men. In children, is it sometimes mistaken for “growing pains”. There’s no apparent trigger for onset in most cases, and some may get it occasionally, whereas others suffer from it daily.

There’s also a recognised link between RLS and pregnancy, possibly brought on by low iron and folate levels. Around 20% of women experience RLS during pregnancy, although it often stops once the baby arrives.

How to manage it

Despite the high number of people suffering from RLS and the significant impact upon their lives, research into effective treatments is still ongoing, and the exact cause remains unknown. The pathophysiology is known partially, and it is believed that there is an association between the different variants of genetic mutations combined with dopaminergic and brain iron dysregulation, which plays an important role.

Fortunately, however, there are things you can try to help reduce your symptoms, but discovering what works for you may be a matter of trial and error as everyone will respond differently.

Medication

Only around 20% of sufferers will require medication (such as anti-seizure drugs), but it is essential to seek the advice of your GP if your symptoms are impacting your day to day life.

Compression socks

These may help by applying pressure to the leg and increasing blood flow into the extremities at night.

Evening stroll

When symptoms tend to be at their worst in the evening, a gentle walk around the block can help, and some people say that using an exercise bike is useful.

Pillow support

Try sleeping with a pillow between your legs; this may prevent compression of the nerves in your legs.

Supplements

Supplements including iron, magnesium, vitamin D and folic acid can also help but check with your GP first before taking these.

Reduce caffeine intake

For many people with RLS, caffeine is a trigger, but recent research has shown that caffeine can also help, so you need to identify whether or not you are sensitive to caffeine. If you are, you probably already know, but if you drink a lot of caffeine, you may have become immune to it, so reduce your consumption (don’t just stop as you might experience withdrawal) to see how it impacts your symptoms.

5 Tips To Improve Your Sleep

5 tips to improve your sleep

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  1. Realistically, it can be hard to shut off thinking about the next day activities, such as work responsibilities. A highly effective practice can be to set aside 20 minutes to write down all the things that occupy the brain’s to-do space. This puts them somewhere so that when they come up again, you know that you have captured the thoughts and have a plan as to what to do with them the next day.
  2. Keep the ‘three good things’ diary where your last thoughts recognise three good things in your day. We do this as a family, so we always end our day remembering three good things, and it has become a positive habit. It is also lovely to read back to see what was happening in previous months.
  3. If you are sensitive to caffeine, keep an eye on your consumption, especially a few hours before you go to sleep. Hot drinks should be either herbal or oat-based.
  4. Sleep is a sensory experience, so give yourself somewhere that you want to spend the night. Ensure you have the cosiest clean, comfortable bed and pillows in a dark room, which is not too warm. Is your mattress the right one for you? Investment in a decent bed can prove to be the best sleep aid out there!
  5. Think about the timing of exercise. We know that exercise is highly beneficial to sleep. However, a late intense workout will take some time to recover from. Allow yourself time to wind down and take a cool shower to reduce your core body temperature.
When The Prospect Of Going To Sleep Becomes Frightening

When the prospect of going to sleep becomes frightening

by with No Comment Sleep

Most of us never think about getting into bed and going to sleep; it’s just what we do. But for many people, the closer it is to bedtime, the more their anxiety rises, and for some, this develops into a full-blown fear that takes over their lives. Fear of sleep, also known as somniphobia (sleep phobia), can be debilitating and life-changing.

Sleep is an essential biological process. At a basic level, your body knows how to do it, but for a mixture of reasons, something changes, the experience of poor sleep is distressing, and the fear that it will happen again stops you from falling asleep. Very quickly, it escalates into a serious issue.

Descriptions of fear of sleep range from an “internal metronome of fear that speeds up as it gets dark” or an “increase in anxiety when finishing dinner as the evening draws to a close”. At its worst, the panic rises as soon as the sufferer wakes in the morning, and the fear becomes an overriding noise crowding out everything else in life. Panic attacks are not uncommon, and sufferers describe the extreme lengths they will go to solve the problem. One of the worst aspects of fear of sleep is that it is a self-perpetuating cycle: the fear stops you from sleeping, but the lack of sleep makes you fearful. It is a horrible condition with which to be living.

What causes the fear?

Like many night-time disorders, somniphobia has many potential causes, and there may be more than one.

Stress and anxiety

Anxiety is a feeling of unease, such as worry or fear, that can be mild or severe. Everyone has feelings of anxiety at some point in their life, and it can manifest itself in various ways. It is normal to experience anxiety, worry and fear from time to time; sometimes, the underlying biological mechanism of anxiety is useful to help us manage a challenging situation. This reaction is known as ‘fight or flight’ or the stress response.

Your brain responds to a threat or danger by releasing stress hormones such as adrenaline and cortisol, which places the nervous system into a state of hyperarousal. Even if the threat is not real, these hormones still cause the physical symptoms of anxiety. Once the threatening situation has stopped, your body will usually return to normal. If you have an anxiety disorder, these feelings of fear and danger can be ongoing and interrupt your daily routine long after the threat has gone. They can make you feel as though things are worse than they are.

For some people, their anxiety manifests in fears about their health; for others, anxiety about appearance, but there are those for whom anxiety is expressed via their relationship to sleep.

Other reasons might be ongoing experiences of frightening and vivid nightmares that seem as real as if you were experiencing them while awake.

Sleep disorders (such as narcolepsy or sleep apnea) that disrupt sleep reduce sleep quality and trigger a fear of sleep.

Previous trauma

Often we don’t know why the fear has emerged; this can be highly distressing but is not unusual. Fear is often formed without our conscious knowledge, and a single moment in time, even if long forgotten, can leave us with a lifelong unease. The same is true of your sleep; if you have different associations, no matter how insignificant or significant they may seem to you, this could be the root cause of your problem.

Can you learn to sleep without fear?

Yes, but seek professional help. This is where therapy, medication and cognitive behavioural therapy for insomnia come together in a powerful combination.

There are three fundamental rules to a good night’s sleep:

1. A comfortable sleep environment with the opportunity to get the sleep that you need.

2. Appropriate light levels: as a rule, bright light in the morning resets your circadian clock and low light in the evening increases your sleep pressure, making you feel sleepy.

3. A relaxed mind, relaxed body. At one level, this seems simple but for many people, knowing how to or being able to relax is a challenge.

Finally, you are not alone. If you have developed a fear of sleep, it is vital to reach out for help.

Does Sleep Hygiene Matter

Does sleep hygiene matter?

by with No Comment Sleep

For me, the concept of ‘sleep hygiene’ is a misnomer and somehow doesn’t fit with the idea of a good night’s sleep; it sounds too specific, too clinical.

Sleep is such a sensory experience, and different people prefer different environments.

There are no hard and fast rules about what makes a room conducive to sleep other than that the room should be dark, cool, comfy and quiet.

Clinically the definition of sleep hygiene is “a set of general recommendations about lifestyle (e.g. diet, exercise, substance use) and environmental factors (e.g. light noise, temperature) that may promote or interfere with sleep”. Sleep hygiene may include some education about what constitutes “normal” sleep and changes in sleep patterns that occur with ageing.

In other words, make your room into a room that you love so that it is enticing and relaxing. Think about the timing of food intake, exercise intensity and any other substance you might consume, such as caffeine, alcohol etc. A relaxed mind and a relaxed body in a room conducive to sleep = a great night’s sleep.

Can Using Essential Oils Help With Sleep

Can using essential oils help with sleep?

by with No Comment Living WellSleepStress

Smell is a prehistoric sense and an essential one for humans and animals as we all navigate our world. It lets us know whether our food is safe to eat and alerts us to the smell of fire. We encounter innumerable scents in our daily life, and our sense of smell plays a vital role in the physiological effects of mood, stress, and working capacity. It also affects our sex lives: the area of the brain through which we experience smells is the olfactory lobe, part of the limbic system, the emotional brain, the area in which sexual thoughts and desires are processed. Throughout the pandemic, there has been a rapid rise in those reporting losses of smell. An article in Nature* reported that of 8,438 people with COVID-19 surveyed, 41% had reported experiencing loss of their sense of smell, with 8% experiencing a total loss (otherwise known as anosmia).

Each of us has many visual and emotional associations to certain smells and aromas. Certain fragrances evoke the memories of significant moments in time. Supermarkets channel the scent of the bakery throughout the store to trigger hunger, while certain food aromas can transport you back to a moment on holiday. Each of us will have our personal favourites, those scents which trigger memories and conjure images in our minds.

Due to the vital importance of smell, all sorts of folkloric tales speak of the remarkable medicinal properties of everyday herbs and flowers. As sleep is a sensory process, it follows that our sense of smell can have broad-ranging effects. The efficacy of using certain essential oils to improve sleep and well-being continues to be researched, and the beneficial effects of a few specific scents have already been validated by clinical research.

Lavender has a long history of medicinal use and has been proven to provide a sedative and calming effect. In a small hospital study in which lavender was used as aromatherapy, patients were shown to experience reduced daytime drowsiness and enjoyed more consistent sleep at night. It’s not just lavender; in another study, a mixture of essential oils including lavender, basil, juniper and sweet marjoram was shown to reduce sleep disturbance and improve a sense of overall well-being in older patients.

If you are not a fan of lavender but want to enjoy the same effects, try using bergamot or ylang-ylang. All three scents were shown to improve the quality of sleep for patients recovering from heart problems.

While research is needed into a wide range of other fragrances to determine their effectiveness in treating clinical conditions, aromatics have been used for mental, spiritual and physical healing since the beginning of recorded history. If a good night’s sleep is all about relaxation, soothing the senses with an aroma that evokes happiness and relaxation can only be good. Which particular scent you use is a personal choice.

References

Koulivand, P. H., Khaleghi Ghadiri, M., & Gorji, A., 2013. Lavender and the nervous system, Evidence-based complementary and alternative medicine, 2013, pp.1-10.

Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3612440/#:~:text=A%20mixture%20of%20essential%20oils,in%20older%20patients%20%5B78%5D [Accessed 11 March 2021]

McDonnell, B. and Newcomb, P., 2019. Trial of Essential Oils to Improve Sleep for Patients in Cardiac Rehabilitation. The Journal of Alternative and Complementary Medicine, 25(12), pp.1193-1199. Available at: https://pubmed.ncbi.nlm.nih.gov/31556690/ [Accessed 11 March 2021]

Chang, S. and Chen, C., 2015. Effects of an intervention with drinking chamomile tea on sleep quality and depression in sleep disturbed postnatal women: a randomised controlled trial. Journal of Advanced Nursing, 72(2), pp.306-315. Available at: https://pubmed.ncbi.nlm.nih.gov/26483209/ [Accessed 11 March 2021].

Marshall, M., 2021. COVID’s toll on smell and taste: what scientists do and don’t know. Nature, [online] Available at: https://www.nature.com/articles/d41586-021-00055-6#:~:text=How%20many%20people%20with%20COVID,had%20reported%20experiencing%20smell%20loss [Accessed 11 March 2021].

Using Neuroplasticity To Change Your Brain

Using neuroplasticity to change your brain

by with No Comment RelaxationSleepStress

For those of us old enough to remember playing our favourite record over and over again until the track became a deep groove where the needle repeatedly stuck, the imagery is clear.

Returning to that record, it’s a catchy tune that seems to hang around. Thoughts are like that – both positive and negative. We can get caught in a cycle of rumination, repeatedly playing the thought over and over and over again. Who notices that they do that and what sort of memories come up? It is proven that the negative will outweigh the positive.

Neuropsychologist Rick Hanson (www.rickhanson.net) refers to this as “the brain’s negativity bias.” The human nervous system, he writes, “scans for, reacts to, stores, and recalls negative information about oneself and one’s world. The brain is like velcro for negative experiences and teflon for positive ones. The natural result is a growing – and unfair – the residue of emotional pain, pessimism, and numbing inhibition in implicit memory.”

Our primitive brain, see here: http://www.brainwaves.com/brain_basics.html, thinks this is a good idea. The term “reptilian” refers to our primitive, instinctive brain function shared by all reptiles and mammals, including humans. It is the most powerful and oldest of our coping brain functions since we would not be alive without it. It makes sure that we remember danger, so we don’t do it again was helpful when we were pre-modern humans, not quite so beneficial now that tigers are not lurking behind parked cars.

So returning to the record. We can repeatedly replay a memory or a thought until it becomes an indented groove in our brain’s neural pathways. Knowing this, it is logical that getting the needle out of the groove requires physical action. Keep playing the record, or stop playing the record? Change the groove.

This is where it gets exciting. We used to believe that the brain was a fixed entity but the discovery that active repetition changes the brain means that our thought patterns can and do change. Neuroplasticity, also known as neural plasticity, or brain plasticity, is the ability of neural networks in the brain to change through growth and reorganisation. These changes range from individual neuron pathways making new connections, to systematic adjustments like cortical remapping.

The key to overriding that negativity bias is to notice when a familiar thought arises and think about the following: Does it feel good? What is happening now? Does this thought matter? I am sure we all recognise these thoughts. They are often the ones that wake us up at 3 am and feel huge in the darkness. It might be the thought that replays as you walk into a room full of strangers – most of us will experience several thoughts at that moment; are they good or bad? When you look back on a typical day or survey your life, what experiences capture your attention – your successes and pleasant times, or the failures, hurts and disappointments?

Noticing that these thoughts are happening is so important. Think about it. If you think something is it real? (See the Matrix film series for what is real or not :-)) When you last had this thought or feeling, did the ceiling cave in? See if you can look at it differently. A new tune is a perfect distraction; find a tune to oppose the thought – upbeat songs work all-round. Do a little dance? An actual dance if you feel relaxed with that – on the tube, I wish you luck but do a dance in your head, visualise a character dancing and make it your internal friendly dancer. (If you remember records, you are likely to remember the dancing baby in Ally McBeal https://www.youtube.com/watch?v=Rx88NMh-YRs )

Overall have some compassion for yourself. Our thoughts come and go. Holding onto any of them, good or bad, are transient moments. Ruminating on them deepens their effect. When our son was little we had a before bed practice called ‘three good things in our house.’ Together we find three good things to talk about from each of our days regardless of how bad we think our day has been. There will ALWAYS be something somewhere.

Finally, rumination is a large part of depression. If you are experiencing ongoing negative thoughts that you cannot seem to shift, if you can, seek support through friends, family or a therapist when times become challenging.

Footnote

For an experts approach, I mentioned Rick Hanson. A favourite resource of mine is excellent TED talks, a great website, and great books. He offers excellent advice on how we might hardwire happiness. http://www.rickhanson.net/hardwiring-happiness/faq/

References

Law, B., 2021. Probing the depression-rumination cycle. [online] https://www.apa.org. Available at: https://www.apa.org/monitor/nov05/cycle [Accessed 11 March 2021].

http://www.tommoon.net/articles/are_we_hardwired-1.html

Life Is Busy

Life is busy

by with No Comment Sleep

Many of us know what it’s like to have the odd sleepless night. When it goes on, and on night after night, the wear and tear on our overall health is debilitating.

For some of us – new parents being the obvious example, there is a tangible reason for lack of sleep or those with chronic pain and illness for whom lack of sleep becomes a serious issue but for many people there doesn’t seem to be an obvious reason.

Wake up. And we’re off…

Life is very different for each of us and it’s important not to compare ourselves to others. We might think that everyone else has their lives sorted but it is often not the case.

Time to deal with your household universe, children our house share. Maybe you are a carer for someone else, or perhaps you are on your own. Off to work… everyone is trying to get to work/school/somewhere. Packed trains, too hot, too cold, leaves on the line. Breathe. At work, it’s all going on. Things to do, so little time, oppressive environment. Coffee. Fluorescent lights, screens, screens everywhere. Sometime. Repeat in reverse. Pub, gym, deadline to pick up kids. Go home, fix the universe. Go to sleep… wake up… feel the stress levels rise.

This sounds like an incredibly negative take on life, but I want to illustrate the cycle of time that many face. I feel it is essential to acknowledge that for some life is hectic.

3.5 million adults in the UK get less than 5 hours of sleep a night.

Lack of sleep can almost double the risk of a heart attack. We need 7-9 hours of sleep a night to complete a full sleep cycle. Regularly interrupting your sleep cycle is bad for your health. Shift workers are known to experience longterm issues due to the interrupted patterns in their sleep. These are some ok the reasons that sleep has become a science. The cost to the economy is increasing as a result, and many longterm health issues have a direct impact on sleep. Once any physical issues are ruled out, the biggest reason for sleep issues is stress.

The truth is that life is busy, which creates stress.

Work with what you can change and let go of what you can’t.

The reality is that there may be many reasons for poor sleep. I wish I had a magic wand to make your sleep better. I can offer that starting to Identify what you can change is the first step. Accept that you cannot change everything overnight and you may not be able to remove many of the things that cause you stress, so consider what is in your power to change.