Relying on circadian rhythms to help teens

Parents and children are known to share terms of endearment before calling it a night, but for moms and dads with teens in the house, those bedtime declarations of affection are often accompanied by the frustrated and futile command: “Go to sleep!”

As maddening as it is, it’s normal.

“According to research, the natural circadian rhythm of teens makes them mentally unready for sleep when the rest of the family is yawning,” says Dr. Thomas E. Wright, chief medical officer and senior vice president for medical affairs with Rosecrance Health Network. “By the time a typical teen naturally drifts off, parents are halfway through their time of rest.”

According to the National Institute of General Medical Science, the circadian rhythm is present in most living things, and includes the physical, mental and behavioral changes that follow a 24-hour cycle with an emphasis on responses to light and darkness.

Wright, a board-certified child and adolescent psychiatrist, says the sleep cycle of an adolescent can change dramatically in ways that mirror changes in their physical, social, psychological and biologic makeup.

A significant change is the gradual shift in the timing of sleep, which begins around the age of 13. At that point, adolescents show signs of being more awake and aware during evening activities. They also require more sleep. In fact, their need for sleep peaks at 13 and begins to decrease about 14 minutes per year until they reach the age of 20. In other words, your 17-year-old son may not be engaging in an act of defiance when he’s up at all hours of the night. Instead, he simply may be responding to physiological makeup. Night-time stimulations like cell phones, computers, TVs and video games can only add to a teen’s late-night shift in sleeping patterns.

Still, getting adequate sleep each night clearly is important. Even limited sleep deprivation can result in cognitive challenges, psychological problems, hallucinations and delusions.

As a result of this shift in the timeliness of sleep, several studies have indicated that schools could delay their morning start times to more align with the natural sleep rhythms of their student population. This delayed start could help students who may have trouble falling asleep before the early a.m. hours, and could result in improved school performance and better behavior.

Many school systems across the nation have shifted to later start times for middle and high school students to bend to teenagers’ circadian rhythm.

Adjusting hours results in improvements

In the fall of 2010, Rosecrance officials decided to review the daily schedule and make modifications to allow teens in substance-abuse programs to get more sleep at Rosecrance Griffin Williamson campus, our 78-bed facility in Rockford. This change affected more than just patients. In fact, the work schedules of nearly every staff member and volunteer had to be revised in an effort to modify the schedule for therapy, school, recreation, meals and medication.

After the schedule changed, Rosecrance officials noticed improvements in patients’ mood, alertness, and motivation. Patients were satisfied with the new schedule and liked the changes, with several reporting that they felt better rested and less stressed. Counselors and other staff members indicated that patients seemed to be more motivated in the morning and had generally improved attitudes.

While admitting that it is difficult to officially measure if the schedule change has actually impacted patients and staff in one way or another, Jason Gorham, administrator of adolescent services at the Rosecrance Griffin Williamson Campus, says the overall feeling is that the longer sleep and later bed times have helped teens be more engaged in the various aspects of their care.

“It has re-established the importance of self-care, speaks to the needs of adolescents, and allows for meditation and journal time at night to take place in the manner in which it is designed,” he says.