Mental Health Can Improve With Sleep

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In a recent post, I addressed how we could improve adolescent mental health by implementing changes in access to mental healthcare services in this country. In this post, I propose how we might decrease the prevalence of mental health issues by coaching teenagers to allot more time for sleep.

Prevention of Mental Health Issues

Between 2007 and 2019, the proportion of adolescents who reported sleeping at least eight hours per night fell from 31 percent to 22 percent, according to the CDC’s Youth Risk Behavior Surveillance System surveys. Further, more than a third of adolescents reported that they routinely sleep less than seven hours per night (Twenge et al.,2017), as opposed to the recommended eight to 10 hours of sleep. The decrease in sleep time was associated with increased use of electronic devices, social media, and reading news online but was unrelated to increased time allotted for homework, working for pay, or watching television.

Further, lack of sufficient sleep in adolescents is known to be associated with increased rates of anxiety, depression, suicidality, difficulty in dealing with stressors such as bullying, and higher risk of being involved with substance abuse, risky sexual behavior, and dangerous driving (Agostini & Centofanti, 2021).

Promoting Sleep

Is it possible that the mental health crisis in adolescents could be addressed simply by helping to restructure their lives to allow them to sleep more? Would such increased sleep prevent the development of mental health diseases in many people?

Changes in the lives of adolescents that could help them sleep more include:

Later start times for middle and high school days as has already been adopted in California and are being considered in other states at this time. This is a position that the American Academy of Pediatrics has advocated since 2014.

Use of electronic devices should cease 30 minutes before bedtime and then be avoided until morning. One way to do this is to charge these devices outside the students’ bedrooms.

Alternatively, electronic devices could be set in a mode that prevents receiving texts or phone calls during sleep hours.

Teens should be counseled to avoid exposure to blue light from computer screens and phones prior to bedtime, which interferes with melatonin production, and thus makes it more difficult to fall asleep.

Primary care providers and schools should provide annual education about the importance of sufficient sleep. Such education should include a discussion of the importance of sleep not only in terms of helping mental health but also in the promotion of physical health and optimal academic and athletic achievements.

High school administrators should be charged to coordinate homework assignments between different classes to ensure that the total hours of homework assigned to students do not exceed four hours per weeknight. To achieve this goal, schools may decide to limit the number of concurrent advanced placement (AP) or honors classes in which students are permitted to enroll.

Athletic directors should be charged to ensure that student-athletes are able to complete their academic requirements early enough in the evening to allow nine hours of sleep each night. (Some students may require less sleep, but the regulations should fit the average adolescent.) For example, if a sport requires 6 am practices, the student-athlete should be encouraged to go to bed by 9 pm. Thus, some sports may require adjustment in their practice schedules.

Sleep Essential Reads

Are Afternoon Naps Good or Bad for You?

To Nap or Not to Nap?

Students who choose to hold down jobs while school is in session should be asked to provide documentation that their work hours, other extracurricular activities, and academic requirements can be completed before 11 pm on school nights.

Students who find it difficult to fall asleep quickly on school nights should be offered sleep hygiene counseling, including:

• Avoid drinking caffeinated beverages or eating large meals late in the day.
• Avoid activities that stimulate their thinking at bedtime, such as watching horror movies or participating in exciting social activities.
• Avoid exercising close to bedtime.
• Learn to use their beds only for sleeping rather than for studying or gaming in order that their bodies learn to associate bed with sleep.
• Reduce sources of light and noise in the room, e.g., by turning off lights or music in the bedroom, drawing the window shades, and closing the bedroom door.
• Keep the same sleep schedule during weekdays and weekends so that their bodies get used to a set schedule.
• Under the supervision of a health care provider, students may be taught meditation, self-hypnosis, or prescribed melatonin or other sleep aid.

Call to Action

There is no doubt that adolescents in the U.S. do not sleep sufficiently and that this has contributed to the increased burden of mental health problems in this country. What remains to be seen is whether we can make effective changes in our culture to permit and encourage our teenagers to sleep more. Then, over the subsequent decade, we could begin evaluating the effectiveness of such an intervention on the mental health of our young people.

If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist, visit the Psychology Today Therapy Directory.