With back to school at home for fall, kids’ school sleep schedules still need to be addressed. They need to be alert and ready to learn during the day. It’s always been hard to transition from summer to school sleep schedules, and just because school is at home this year, it is no different. And having spoken with countless parents over the years, I have yet to meet one who does not want their kid or teen to get adequate sleep!

In my clinic yesterday, a 15-year-old patient and I were talking about his sleep habits. He said that currently, he is going to bed around midnight and waking up around 11 am. His mom was in the room and said she wished he would not be on his phone so late. I asked him what he would miss if he were not to have his phone so late, and he said, “I would miss all the YouTube videos.”

At the end of the appointment, I asked what he thought about the many things we talked about during our visit, and he looked at the floor and then at me, and even with his mask on, I could tell he was smiling, and he said, “I don’t want to be so tired anymore. I want to change how I am with my phone at night.”  I finished the appointment by suggesting how he and his mom could work together to make it a joint project to improve his sleep and not “mom” vs. “son.” They laughed-in a good way — and looked at each other.  

Today I  discuss some important research regarding how sleep deficiency can impact brain development. Having a calm conversation about the latest science of sleep and brain development before even broaching the ideas of new sleep rules can be a great way of getting more on the same page.

It is only relatively recently that researchers have understood the incredible impact that sleep deprivation has on the developing brains of young people (Remember the brain is literally still forming until around age 24).

For this week's episode of the Screenagers Podcast, I interview Dr.  Judy Owens, the director of sleep medicine at Boston Children's Hospital and a professor of neurology at Harvard medical school.  (Please subscribe to The Screenagers Podcast so the episode will automatically download when it is ready.)

Dr. Owens talks with me about the fascinating glymphatic system of the brain. Just like the body has the lymphatic systemic whose job it is to clear out infections and other things that the body needs to clear, the brain has a glymphatic system whose job it is to clear out toxins like harmful proteins that have accumulated. Consider that, for example, in Alzheimer’s disease, abnormal proteins called amyloid plaques infiltrate the brain, and years of deficient sleep are correlated with an increased risk of this disease.

Here is the key point — scientists have found that the glymphatic system is primarily in action only when humans are asleep, deep sleep, in fact!

Given that over half of today’s teens are chronically sleep-deprived, what does it mean for their developing brains to have more toxic proteins circulating during the day?  Researchers are still learning about the glymphatic system, and I am interested to see what they find.

Meanwhile, Dr. Adriana Galvan, a scientist of the adolescent brain, has done fascinating work looking at how sleep deprivation in teens impacts how the brain creates neuronal connections.

Building brain connections is part of the rewiring/pruning of the brain that happens during adolescence. In one study, Dr. Galvan had 14 to 18-year-olds wear special watches for two weeks that measured their sleep activity.  They used functional MRIs and special brain mapping analysis to see how the brain formed connections in regions of the brain that included the prefrontal cortex, where higher-order thought processes occur.

Here is the clencher — Dr. Galvan found that those teens who experienced more disrupted sleep than others were significantly more likely to show abnormal brain connection patterns.  This is concerning. (In the Podcast, she discusses what this translated to in terms of the teen’s behaviors.)

There are many reasons that kids and teens can get less than the recommended sleep when school starts. This year they might not have all the after school activities that can make sleep challenging, but there will be many other factors, such as the increased worry and stress and sadness hitting so many of them right now.

One of the biggest culprits of sleep disruption is having tech devices in bedrooms at night. In Screenagers NEXT CHAPTER, I share the eye-opening data that 36% of teens self-report that they wake up at least once a night and check their phone.

That is a staggering number of young people who are having their sleep disturbed. Meanwhile, studies have shown that just having the phone in the bedroom at night turned off, even if the person says they do not check it, negatively impacts sleep duration.

Three weeks ago, I spoke with a girl who is going into her senior year about sleep, and I mentioned there are lots of reasons that support why screens should be out of bedrooms at night. She said, “I have never heard that. I have only heard that they should not be on your pillow.” I was floored that she had never heard about the idea of devices out of the bedroom. This is the number one intervention around screen time that every family should at least try to make happen because it is so important for our kids’ development.

Frankly, I have been incredibly sad that my field, medicine, along with public health experts, have not yet created campaigns to educate people on the need for devices not to be accessible during sleep time.

The fact is parents need a lot more help then they are getting to make healthy sleep happen. For example, it can be very challenging to set up systems that seamlessly turn off tech at night. Tech companies have no incentive to get our kids off devices at night. Reed Hastings, the chairman of Netflix, said in 2017 that sleep is their biggest competitor. Three years later and the proliferation of more access to constant entertainment, that statement is only more real.

The shift from summer to school this year is different in almost every way, but ensuring our kids get enough sleep so they can be ready for a productive day of school work is crucial.

Here are some things to consider for back to school and sleep:

1. Having small recurring discussions about the fact that the brain is still developing through adolescence and studies, like the ones I shared today, reveal how important sleep is for the developing brain.
2. Consider ways that devices can be out of the bedroom during sleep time. Maybe it is a compromise and is not every night, but try to make some nights tech-free.  Pick a place like in your bedroom, or on a kitchen counter where phones, tablets, and laptops go each night.
3. Consider also committing to having your phone put in the place where your kid’s phone goes — again, maybe this is not every night, but maybe 2 nights a week.
4. Have a set time that tech is off during the school week.  And nights when your child says they need their device later for homework, let them know it is their responsibility to get the work done before the decided time. If you stay firm (and loving) over time, they will adjust to getting the work done before the tech-off time. And yes, of course, if now and then, they need more time, exceptions will be granted.
5. Dr. Judy Owens tells the kids she sees in her clinic how important it is not to hit the snooze button but instead to get up, right when the alarm clock goes off (not a phone but an actual alarm clock). This is because research shows that actual sleep is much more beneficial than the pseudo sleep that happens with hitting the snooze button over and over. Get up and open the shades right away because the light helps turn off melatonin and makes you feel more energized.
6. Check out these past TTTs for more concrete tips.

Ideas for conversation starters:

1. What are the reasons you want to get adequate sleep this coming school year?
2. What did you think of the research studies mentioned above?
3. If you were a parent, how would you handle sleep time in our tech revolution with your child?
4. Once you move out of the house and free to have screens every which way around you during sleep time, what do you imagine you will choose to do?

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As well as our weekly blog, we publish videos like this one every week on the Screenagers YouTube channel