Skip to main content

Defining, Assessing, and Treating Adolescent Insomnia and Related Sleep Problems

  • Chapter
  • 801 Accesses

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

As parents, teachers, coaches, health care providers, and teenagers themselves know, adolescence is filled with significant physical, cognitive, emotional, and social change. Sleep is a crucial and often ignored aspect of adolescents’ lives as it changes and influences factors in their overall development, as well as in their daily lives. The quality and quantity of adolescents’ sleep significantly influences their ability to think, behave, and feel in school, on the playing field, at work, as well as in a variety of other situations. Over the last two decades, laboratory data have demonstrated that adolescents have an increased need for sleep and experience a phase delay during puberty (15). Despite this need, survey and field studies indicate that as early as sixth grade, adolescents obtain less sleep, report increased morning drowsiness, and have more spontaneous daytime naps than do younger children (68). School schedules, work and extracurricular hours, and other environmental constraints are not beneficial to adolescents’ sleep schedules and requirements (2,4,7,9). In fact, teenagers develop a sleep debt by getting a minimal amount of sleep on school nights and making up for this by sleeping longer on the weekends (7). Sleep debt results in frequent absences or tardiness from school, sleepiness and emotional lability, attention difficulties, and academic struggles (7,1013). Other adolescents may develop sleep disorders such as insomnia, phase-delay disorder, sleep apnea, or other sleep problems that also impair ability to function during the day. Recently, the National Institutes of Health recognized adolescents and young adults (1225 years) as a population at high risk for problem sleepiness based on “evidence that the prevalence of problem sleepiness is high and increasing with particularly serious consequences” (14). This chapter focuses on insomnia and phase-delay disorders in adolescents.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   109.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   149.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Carskadon, M.A., C. Acebo, and O.G. Jenni, Regulation of adolescent sleep: implications for behavior. Ann NY Acad Sci, 2004;1021:276–291

    Article  PubMed  Google Scholar 

  2. Carskadon, M.A., K. Harvey, P. Duke, T.F. Anders, and W.C. Dement, Pubertal changes in daytime sleepiness. Sleep, 1980;2:453–460.

    PubMed  CAS  Google Scholar 

  3. Carskadon, M.A., C. Vieira, and C. Acebo, Association between puberty and delayed phase preference. Sleep, 1993;16(3):258–262.

    PubMed  CAS  Google Scholar 

  4. Carskadon, M., A. Wolfson, C. Acebo, O. Tzischinsky, and R. Seifer, Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep, 1998;21(8):871–881.

    PubMed  CAS  Google Scholar 

  5. Carskadon, M.A. and C. Acebo, Regulation of sleepiness in adolescents: update, insights, and speculation. Sleep, 2002;25(6):606–614.

    PubMed  Google Scholar 

  6. Sadeh, A., R. Raviv, and R. Gruber, Sleep patterns and sleep disruptions in school-age children. Dev Psychol, 2000;36(3):291–301.

    Article  PubMed  CAS  Google Scholar 

  7. Wolfson, A.R. and M.A. Carskadon, Sleep schedules and daytime functioning in adolescents. Child Dev, 1998;69:875–887.

    Article  PubMed  CAS  Google Scholar 

  8. Wolfson, A.R., C. Acebo, G. Fallone, and M.A. Carskadon, Actigraphically-estimated sleep patterns of middle school students. Sleep (Suppl), 2003;26:313.

    Google Scholar 

  9. Wolfson, A. Bridging the gap between research and practice: What will adolescents’ sleep/wake patterns look like in the 21st century? In: Adolescent Sleep Patterns: Biological, Social, and Psychological Influences (M.A. Carskadon, ed.). New York: Cambridge University Press, 2002, pp. 198–219.

    Google Scholar 

  10. Carskadon, M.A. Patterns of sleep and sleepiness in adolescents. Pediatrician, 1990;7:5–12.

    Google Scholar 

  11. Comstock, G. Televison and the American Child. San Diego, CA: Academic Press, 199

    Google Scholar 

  12. Wahlstrom, K. Changing times: findings from the first longitudinal study of later high school start times. NASSP Bull, 2002;86(633):3–21.

    Article  Google Scholar 

  13. Wolfson, A.R. and M.A. Carskadon, Understanding adolescents’ sleep patterns and school performance: a critical appraisal. Sleep Med Rev, 2003;7(6):491–506.

    Article  PubMed  Google Scholar 

  14. Working Group Report on Problem Sleepiness. Bethesda, MO: National Institutes of Health, National Center on Sleep Disorders Research and Office Prevention, Education, and Control, 1997

    Google Scholar 

  15. Carskadon, M.A. The second decade. In: Sleeping and Waking Disorders: Indications and Techniques (C. Guilleminault, ed.). Menlo Park: Addison-Wesley, 1982, pp. 99–125.

    Google Scholar 

  16. Strauch, I. and B. Meier, Sleep need in adolescents: a longitudinal approach. Sleep, 1988;11(4):378–386.

    PubMed  CAS  Google Scholar 

  17. Thorleifsdottir, B., J.K. Bjornsson, B. Benediktsdottir, T. Gislason, and H. Kristbjarnarson, Sleep and sleep habits from childhood to young adulthood over a 10-year period. J Psychosom Res, 2002;53:529–537.

    Article  PubMed  CAS  Google Scholar 

  18. Price, V.A., T.J. Coates, C.E. Thoresen, and O.A. Grinstead, Prevalence and correlates of poor sleep among adolescents. Am J Dis Child, 1978;132:583–586.

    PubMed  CAS  Google Scholar 

  19. Carskadon, M.A., J. Orav, and W.C. Dement, Evolution of sleep and daytime sleepiness in adolescents. In: Sleep/Wake Disorders: Natural History, Epidemiology, and Long-Term Evolution (C. Guilleminault and E. Lugaresi, eds.). New York: Raven Press, 1983:201–216.

    Google Scholar 

  20. Andrade, M.M., A.A. Silva-Benedito, E.E.S. Domenice, I.J.P. Arnhold, and L.M. Menna-Barreto, Sleep characteristics of adolescents: a longitudinal study. J Adolesc Health, 1993;14:401–406.

    PubMed  CAS  Google Scholar 

  21. Ishihara, K., Y. Honma, and S. Miyake, Investigation of the children’s version of the morningness-eveningness questionnaire with primary and junior high school pupils in Japan. Percept Motor Skills, 1990;71:1353–1354.

    Google Scholar 

  22. Manber, R., R.E. Pardee, R.R. Bootzin, et al. Changing sleep patterns in adolescence. Sleep Res, 1995;24:106.

    Google Scholar 

  23. Gau, S.F. and W.T. Soong, Pediatric sleep disorders: sleep problems of junior high school students in Taipei. Sleep, 1995;18:667–673.

    PubMed  CAS  Google Scholar 

  24. Laberge, L., D. Petit, C. Simard, F. Vitaro, R.E. Tremblay, and J. Montplaisir, Development of sleep patterns in early adolescents. J Sleep Res, 2001;10:59–67.

    Article  PubMed  CAS  Google Scholar 

  25. Stores, G. Practicioner review: assessment and treatment of sleep disorders in children and adolescents. J Child Psychol Psychiatry, 1996;7(8):907–925.

    Article  Google Scholar 

  26. Mindell, J.A. Insomnia in children and adolescents. In: Insomnia Principles and Management (M.P. Szuba, J.D. Kloss, and D.F, Dinges, eds.). New York: Cambridge University Press, 2003:125–135.

    Google Scholar 

  27. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., revised. Washington, DC: American Psychiatric Association, 1994.

    Google Scholar 

  28. Sack, R.L., R.J. Hughes, M.L.N. Pires, and A.J. Lewy, The sleep-promoting effects of melatonin. In Insomnia Principles and Management, ed MP Szuba, JD Kloss, and DF Dinges. New York: Cambridge University Press, 2003:96–114.

    Google Scholar 

  29. Boivin, D.B. and F.O. James, Insomnia due to circadian rhythm disturbances. In: Insomnia Principles and Management (M.P. Szuba, J.D. Kloss, and D.F. Dinges, eds.). New York: Cambridge University Press, 2003:155–191.

    Google Scholar 

  30. Regestein, Q.R. and T.H. Monk, Delayed sleep phase syndrome: a review of its clinical aspects. Am J Psychiatry, 1995;152:602–608.

    PubMed  CAS  Google Scholar 

  31. National Sleep Foundation. Treating Insomnia in the Primary Care Setting. Washington, DC: National Sleep Foundation, 2000.

    Google Scholar 

  32. Ohayon, M.M. and R.E. Roberts, Comparability of sleep disorders diagnoses using DSM-IV and ICSD classifications with adolescents. Sleep, 2001;24(8):920–925.

    PubMed  CAS  Google Scholar 

  33. Morrison, D.N., R. McGee, and W.R. Stanton, Sleep problems in adolescence. J Am Acad Child Adolesc Psychiatry, 1992;31(1):94–99.

    Article  PubMed  CAS  Google Scholar 

  34. Roberts, R., C. Roberts, and I.G. Chen, Impact of insomnia on future functioning of adolescents. J Psychosom Res, 2002;53:561–569.

    Article  PubMed  Google Scholar 

  35. Roberts, R.E., E.S. Lee, M. Hernandez, and A.C. Solari, Symptoms of insomnia among adolescents in the Lower Rio Grand Valley of Texas. Sleep, 2004;27(4):751–759.

    PubMed  Google Scholar 

  36. Roberts, R.E., C.E. Roberts, and I.G. Chen, Ethnocultural differences in sleep complaints among adolescents. J Nerv Ment Dis, 2002;188(4):222–229.

    Article  Google Scholar 

  37. Wolfson, A.R. The Women’s Book of Sleep: A Complete Resource Guide. Oakland, CA: New Harbinger Publications, Inc., 2001.

    Google Scholar 

  38. Bailly, D., I. Bailly-Lambin, D. Querleu, R. Beuscart, and C. Collinet, Sleep in adolescents and its disorders. A survey in schools. Encephale, 2004;30(4):352–359.

    PubMed  CAS  Google Scholar 

  39. Johnson, E.O., T. Roth, and N. Breslau, Epidemiology of DSM-IV insomnia among a community based cohort of adolescents. Sleep (Suppl), 2004;27:A112.

    Google Scholar 

  40. Yang, L., C. Zuo, and L.F. Eaton, Research note: sleep problems of normal Chinese adolescents. J Child Psychol Psychiatry, 1987;28:162–172.

    Article  Google Scholar 

  41. Camhi, S.L., W.J. Morgan, N. Pernisco, and S.F. Quan, Factors affecting sleep disturbances in children and adolescents. Sleep Med, 2000;1:117–123.

    Article  PubMed  Google Scholar 

  42. Driver, H.S. and F.C. Baker, Menstrual factors in sleep. Sleep Med Rev, 1998;2(4):213–229.

    Article  PubMed  CAS  Google Scholar 

  43. Baker, F.C. and H.S. Driver, Self reported sleep across the menstrual cycle in young, healthy women. J Psychosom Res, 2004;56:239–243.

    Article  PubMed  Google Scholar 

  44. Dickerson, L.M., P.J. Mazyck, and M.H. Hunter, Premenstrual syndrome. Am Fam Physician, 2003;67(8):1–15.

    Google Scholar 

  45. Derman, O., N.O. Kanbur, N.E. Tokur, and T. Kutluk, Premenstrual syndrome and associated symptoms in adolescent girls. Eur J Obstet Gynecol Reprod Biol, 2004;116(2):201–206.

    Article  PubMed  Google Scholar 

  46. Krystal, A.D. Insomnia in women. Chron Insomnia, 2003;5(3):41–50.

    Google Scholar 

  47. Spielman, A.J. and P.B. Glovinsky, The diagnostic interview and differential diagnosis for complaints of insomnia. In: Understanding Sleep: The Evaluation and Treatment of Sleep Disorders (M.R. Pressman and W.C. Orr, eds.). Washington, DC: American Psychological Association, 1997, pp. 125–160.

    Chapter  Google Scholar 

  48. Dahl, R.E., N.D. Ryan, M.K. Matty, B. et al. Sleep onset abnormalities in depressed adolescents. Biol Psychiatry, 1996;39(6):400–410.

    Article  PubMed  CAS  Google Scholar 

  49. Choquet, M., V. Kovess, and N. Poutignat, Suicidal thoughts among adolescents: an intercultural approach. Adolescence, 1993;28:649–659.

    PubMed  CAS  Google Scholar 

  50. Patten, C.A., W.S. Choi, J.C. Gillin, and J.P. Pierce, Depressive symptoms and cigarette smoking predict development and persistence of sleep problems in U.S. adolescents. Pediatrics, 2000;106(2):1–17.

    Article  Google Scholar 

  51. Van den Bulck, J. Text messaging as a cause of sleep interruption in adolescents, evidence from a cross sectional study. J Sleep Res, 2003;12(3):263.

    Article  PubMed  Google Scholar 

  52. Van den Bulck, J. Television viewing, computer game playing, and internet use and self-reported time out of bed in secondary school children. Sleep, 2004;27(1):101–104.

    PubMed  Google Scholar 

  53. Johnson, J.G., P. Cohen, S. Kasen, M.B. First, and J.S. Brook, Association between television viewing and sleep problems during adolescence and early adulthood. Arch Pediatr Adolesc Med, 2004;158(6):652–568.

    Article  Google Scholar 

  54. Carskadon, M.A. and C. Acebo, A self-administered rating scale for pubertal development. J Adolesc Health, 1993;14:190–195.

    Article  PubMed  CAS  Google Scholar 

  55. Morin, C.M. Cognitive-behavioral approaches to the treatment of insomnia. J Clin Psychiatry, 2004;65(16):33–40.

    PubMed  Google Scholar 

  56. Jacobs, G.D., E.F. Pace-Schott, R. Stickgold, and M.W. Otto, Cognitive behavior therapy and pharmacotherapy for insomnia: a randomized controlled trial and direct comparison. Arch Intern Med, 2004;164(17):1888–1896.

    Article  PubMed  Google Scholar 

  57. Bastien, C.H., A. Vallieeres, and C.M. Morin, Precipitating factors of insomnia. Behav Sleep Med, 2004;2(1):50–62.

    Article  PubMed  Google Scholar 

  58. Weil, G. and M.R. Goldfried, Treatment of insomnia in an eleven-year-old child through self-relaxation. Behav Ther, 1973;4:282–294.

    Article  Google Scholar 

  59. Anderson, D.R. Treatment of insomnia in a 13-year-old boy by relaxation training and reduction of parental attention. J Behav Ther Exp Psychiatry, 1979;10:263–265.

    Article  Google Scholar 

  60. Barowsky, E.I., J. Moskowitz, and J.B. Zweig, Biofeedback for disorders of initiating and main-taining sleep. Ann NY Acad Sci, 1990;602:97–103.

    Article  PubMed  CAS  Google Scholar 

  61. LeBourgeois, M.K., F. Giannotti, F. Cortesi, A.R. Wolfson, and J. Harsh, The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics, 2005;115:257–265.

    Article  PubMed  Google Scholar 

  62. Spielman, A.J., P. Saskin, and M.J. Thorpy, Treatment of chronic insomnia by restriction of time in bed. Sleep, 1987;10(1):45–56.

    PubMed  CAS  Google Scholar 

  63. Kallepalli, B.R., V.S. Bhatara, B.S. Fogas, R.C. Tervo, and L.K. Misra, Trazadone is only slightly faster than fluoxetine in relieving insomnia in adolescents with depressive disorders. J Child Adolesc Psychopharmacol, 1997;7:97–107.

    Article  PubMed  CAS  Google Scholar 

  64. Labyak, S. Sleep and circadian schedule disorders. Nurs Clin North Am, 2002;37:599–610.

    Article  PubMed  Google Scholar 

  65. Garcia, J., G. Rosen, and M. Mahowald, Circadian rhythms and circadian rhythm disorders in children and adolescents. Semin Pediatr Neurol, 2001;8:229–240.

    Article  PubMed  CAS  Google Scholar 

  66. Wyatt, J.K. Delayed sleep phase syndrome: pathophysiology and treatment options. Sleep, 2004;27(6):1195–1203.

    PubMed  Google Scholar 

  67. Okawa, M., U. Michiyama, S. Ozaki, K. Shibui, and H. Ichikawa, Circadian rhythm disorders in adolescents: Clinical trials of combined treatments based on chronobiology. Psychiatry Clin Neurosci, 1998;52:483–490.

    Article  PubMed  CAS  Google Scholar 

  68. The International Classification of Sleep Disorders-Revised: Diagnostic and Coding Manual. Rochester, MN: American Sleep Disorders Association, 1997.

    Google Scholar 

  69. Wolfson, A.R., M.A. Carskadon, C. Acebo, R. Seifer, G. Fallone, S.E. Labyak, and J.L. Martin, Evidence for the validity of a sleep habits survey for adolescents. Sleep, 2003;26(2):213–216.

    PubMed  Google Scholar 

  70. Sadeh, A., P.J. Hauri, D.F. Kripke, and P. Lavie, The role of actigraphy in the evaluation of sleep disorders. Sleep, 1995;18:288–302.

    PubMed  CAS  Google Scholar 

  71. Acebo, C., A. Sadeh, R. Seifer, et al., Estimating sleep patterns with activity monitoring in children and adolescents: How many nights are necessary for reliable measures? Sleep, 1999;22(1):95–103.

    PubMed  CAS  Google Scholar 

  72. Halbower, A.C. and C.L. Marcus, Sleep disorders in children. Curr Opin Pulm Med, 2003;9(6):471–476.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humna Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Wolfson, A.R., Quinn, A., Vannucci, A. (2006). Defining, Assessing, and Treating Adolescent Insomnia and Related Sleep Problems. In: Attarian, H.P. (eds) Sleep Disorders in Women. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59745-115-4_7

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-115-4_7

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-592-7

  • Online ISBN: 978-1-59745-115-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics