Teens and Sleep Disorders

Many teenagers suffer from anxieties that keep them awake at night. Therapist Claudia Arthrell gives some suggestions for getting a better night’s slumber.

Q: I dread the start of school because my 16-year-old daughter has difficulty sleeping. It’s not so bad in the summer because her schedule is more relaxed, but I can see that she becomes extremely anxious over it during the year. Her pediatrician doesn’t seem to take it seriously, but I can see that it bothers my daughter, and that she worries about getting enough sleep, but how can I help her?”

A: This is a great question, since there are so many possibilities regarding what may be creating the anxiety, and there are so many excellent ways to deal with the issue once it is clarified.

It is also excellent that she has let you know two things: First, she knows that sleep is important to her doing well and, secondly, that she realizes that she has sleep difficulties.

Talking about this in the summer will make it easier for her to begin to try new things and create new skills and habits before the added stress of school begins.

Two Key Areas of Focus

The two of you can break down two areas of focus from the very beginning. First, what pre-bedtime habits does she follow? Make sure she details these bedtime routines first since they may be the source of the problem. Take into account that any eating or use of electronic devices should take place at least three hours prior to going to bed. Relaxing her mind and body are important in getting a good night’s sleep.

The second area to evaluate includes her thought processes. What is the sleep pattern she has right now? Does she struggle with falling asleep or does she wake and find it hard to go back to sleep? Does she stay in bed getting anxious about not falling asleep, or does she do something else to refocus herself. If she does something else, does it help?

Always make sure you find out if some nights are easier than others. What is the difference between problem-free and problem-full nights? By guiding her through this discussion, you are letting her know that this is a common problem many people struggle with. In fact 90 percent of youth age 2 to 14 have at least one fear according to the Child Anxiety Network. This leads to another aspect of the sleep problem: Do your daughter’s nighttime thoughts have anything to do with any specific fears?

These fears could have to do with unfinished issues from the day, worries about friends, school, natural disasters, illnesses, getting enough sleep, to fears about waking up in general. If being fearful or have reoccurring thoughts that she can’t stop are part of her problem, this can be addressed. You can try to help, and if the problem doesn’t get better within a few weeks, a therapist could work with her.

Cognitive Behavioral Therapy Strategies

Cognitive Behavioral Therapy makes a big difference in how people take charge of problems in their lives. It has some basic elements that most of us use in coping with our everyday living. Here are some elements:

• Help your daughter identify clearly what issues keep her awake—this is defining a specific problem.
• As you both talk over this fear, ask, “Is it realistic?” You want her to learn how to confront and disagree with her own negative thoughts.
• Help your daughter learn the skill of refocusing her thoughts on issues that work for her that are relaxing and calming — thoughts that are not based on fears or worries.
• You can share with your daughter the ways you relax yourself when you are tense about something happening. Give her examples of how you have handled similar problems.
• It helps if your daughter has friends and a good social network. If she has one, ask her to talk to herself with as much understanding as she would a friend with the same problem. What would she recommend?
• We all know that caffeine and lack of exercise can increase our tension and reduce our ability to handle distress. If you can, make sure your family is active and has healthful habits.
• Teach your daughter the stress management tools we all need to manage life. Use Dr. Dan Siegel’s Healthy Mind Platter as a tool to talk about stress management. This new framework discusses our need for focus time, play time, down time, sleep time, physical time, connecting time, in addition to time that allows our minds an internal focus and connection with our senses.

Track Physical Responses

There is a good chance that a new bedtime routine will make a big difference to her. If not, have her track carefully the physical responses she has at night which distress her. They may include:

• Increased heart rate.
• Shallow or rapid breathing.
• Sweating while being either chilled or hot.
• Reoccurring thoughts which might invite a sense of panic and being out of control.