Plight of the Teenage Insomniacs

Rachel Estrella, A high-school senior in Barrington, R.I., gets into bed every night before 10, hoping to beat her insomnia. One frustrating hour later, she gets up. She reads. She writes. She waits. Finally, at 1 or 2 a.m., Estrella's mind and body give in. On average, she gets four to five hours of sleep a night—nowhere near the nine recommended for teens. "I'm exhausted," she says. "There are times when I feel like I want to be knocked out because there would be some relief."

Plenty of kids have trouble getting up for early-morning school bells. Teen insomniacs have it much worse. Night after night, they struggle to sleep; day after day, they suffer. In a new study published in March in the Journal of Adolescent Health, researchers report that insomnia in adolescents is as prevalent as substance abuse and other disorders, like depression and ADHD. "That was a surprise," says lead author Robert Roberts of the University of Texas School of Public Health. One quarter of the 3,134 participants said they had one or more symptoms of insomnia, such as trouble falling asleep or staying asleep, every night. And 5 percent fit the classic definition, meaning their nighttime sleep problems interfered with their ability to function during the day.

The study is unique because it evaluated the effect of sleeplessness in adolescents over time. Researchers interviewed participants, ages 11 to 17, at the beginning and end of a 12-month period. Over the course of the year, insomnia symptoms and hard-core insomnia persisted for many, and the impact was significant. Those with chronic insomnia were five times more likely to think their mental health was poor, three times as likely to have health problems and trouble at school, and twice as likely to use alcohol and drugs like marijuana and cocaine. A previous study found that the use of prescription sleep medications spiked by 45 percent in children under 19 between 2001 and 2006. It is also possible, says Roberts, that adolescents are turning to drink and drugs in an effort to self-medicate.

The biology of the tired teenage brain is still emerging. Mary Carskadon of Brown University kicked things off when she identified a shift in the internal clock of teens that made them feel sleepy later at night. Now she's launching a study to pinpoint exactly how that happens. In the meantime, teens like Estrella, whose insomnia is compounded by sleep apnea and restless-leg syndrome, can be treated. Good "sleep hygiene" starts with a routine bedtime and awakening time and a ban on cell phones and other tech at night. And cognitive-behavioral therapy helps by restructuring negative thought patterns ("I can't sleep"), says Estrella's doctor and Brown researcher Judith Owens. The goal: I can sleep, and I will.