Episode 53: How can we help our teens get better sleep? Julie Wright, MFT and Heather Turgeon, MFT

This week's Ask Dr Jessica is all about how to help our teenagers get better sleep! I am joined by Julie Wright, MFT and Heather Turgeon, MFT and we discuss their newest book "Generation Sleepless".  We all know that sleep is so important, but teenagers often get overlooked.  Their natural circadian rhythm keeps them awake later at night, but it can be so difficult for them to get enough sleep when school starts early.  What can we as parents do about this to help?  Julie and Healther offer great suggestions!  Also, for more information please check out their website:  www.thehappysleeper.com and you can follow them on instagram @thehappysleeper.

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children.  Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner. 

Do you have a future topic you'd like Dr Jessica Hochman to discuss?  Email your suggestion to: askdrjessicamd@gmail.com. 

Dr Jessica Hochman is also on social media:
Follow her on Instagram: @AskDrJessica
Subscribe to her YouTube channel! Ask Dr Jessica
Subscribe to this podcast: Ask Dr Jessica
Subscribe to her mailing list: www.askdrjessicamd.com

The information presented in Ask Dr Jessica is for general educational purposes only.  She does not diagnose medical conditions or formulate treatment plans for specific individuals.  If you have a concern about your child's health, be sure to call your child's health care provider.

Dr Jessica Hochman is a board certified pediatrician, mom to three children, and she is very passionate about the health and well being of children. Most of her educational videos are targeted towards general pediatric topics and presented in an easy to understand manner.

Do you have a future topic you'd like Dr Jessica Hochman to discuss? Email Dr Jessica Hochman askdrjessicamd@gmail.com.

Follow her on Instagram: @AskDrJessica
Subscribe to her YouTube channel! Ask Dr Jessica
Subscribe to this podcast: Ask Dr Jessica
Subscribe to her mailing list: www.askdrjessicamd.com

The information presented in Ask Dr Jessica is for general educational purposes only. She does not diagnose medical conditions or formulate treatment plans for specific individuals. If you have a concern about your child's health, be sure to call your child's health care provider.

Transcript

Unknown: 0:00

Hi, Welcome to the Ask Dr. Jessica Podcast. I'm so excited to have you guys here. Thanks for having us. Thank you. So I'm here with Heather and Julie. They are both psychotherapist and they have authored three books together, the first book that came out in 2014, the happy sleeper. And recently you've come out with a book called Generation sleepless, which delves into the importance of sleep for teenagers. I'm so excited to talk with you guys. I'm so excited to ask you questions, I have so many questions, can we first start by just getting you guys to explain who you are, how you know each other, and what the books are about. Sure. So we met many years ago, and sort of bonded over the topic of baby sleep. And we wrote the happy sleeper because we found parents to be so torn between sleep approaches that seem to conflict with each other advice that was, you know, attachment, parenting and emotional responsiveness. And also on the other side of the equation, more harsh sleep training, shut the door and no go in kinds of approaches. And we felt like it didn't make any sense that parents felt so torn or polarised when sleep is natural. And attachment is natural. So we wrote the happy sleeper to be a middle ground, effective, but also reasonable approach that made sense and that parents felt good about. So we helped parents would in that book solve this dilemma of these polarised camps. And so that that's why we came together. And we love that work with with families and babies and little kids. But we, over the years are happy sleepers started growing up, we started working with families with you know, kids of all ages. And looking at the research on sleep deprivation. And seeing the kids around us, it became so clear that teenagers are the ones who really need our help the most. They by far suffer more sleep deprivation than any of us. So we felt compelled, you know, absolutely compelled to write this book. When you guys did your research, can you touch upon some of the mental health statistics that you came across with teens and sleep? Sleep deprivation? Yes, so we were just talking about this earlier today. The tipping point seems to be about eight hours of sleep. I mean, we defined based on working with, you know, talking to and researching all these really eminent sleep scientists around the country. And the consensus there is that the ideal amount of sleep for a teenager is about nine and a quarter hours they do these camping studies. But they also define eight hours as adequate. So below eight hours is when we start to see the mental health kind of fall apart, we see. You know, we can see as much as twice as much depression, we can see increased anxiety kids, unfortunately, you know, when kids start sleeping less than six hours a night or even just six hours a night, their suicidal thinking can go up by as much as 80%. And that might feel like well, wow, that's really a stark drop in sleep. But guess what the average sleep time is for the American high schooler six and a half hours. That is the average amount of sleep that the high schoolers are getting in the US right now. And one in five teenagers is sleeping five hours or fewer per night. So when you consider that the risk of suicidal thinking goes up by 80% when they're sleeping under six hours, and then look at one in five teens suffering that much. Or even more. That is an absolute, you know, cry for a tension. That means that really means we need to fix something. So when we see that, you know, 40% of college students and one in three high school students is reporting a persistent feeling of sadness or hopelessness. We just need to look to sleep for for a huge part of that answer. Absolutely. And do you think that I mean, I find that this is really a challenge for teenagers because they tend to be so overscheduled they tend to start school on the early side. And a lot of teens are night owls. So I think we have a lot that works against them when they have school that begins at 8am and they naturally want to stay up later. How should parents rectify this I mean we should we should we should we be looking for schools that start later in the day? What advice should you be giving to parents? What we describe in the book is is a perfect storm of factors that contribute to this really, you know, just desperate sleep loss and teenagers. So on the bedtime side as you mentioned Is this natural sleep phase delay where where their biological clock shifts two hours later, which of course means, you know, their wake up time shifts two hours later as well. And then we add on to that, you know, excessive homework and activities, which have just been snowballing over the years, his college admissions requirements have just become unreasonably high. And you add to that technology, technology is like a cop like a wrecking ball. So you have the sleep phase delay, you have just overburdened with homework and activities. And then technology comes in pushes that bedtime, even later, and the other side of their night to early school start times, just like you mentioned, squeeze their sleep from the other end. So they end up with a mathematically impossible amount of time in which to even get that adequate eight hours of sleep. You and Heather live in California, which I'm sure you know, just passed a new law, which started in July, saying that all high schools in the state of California have to start at 830 or later, so that we're thrilled about that. And we're following similar legislation in other states and working with some of these activist organisations that have been literally working on this issue for decades. So the school start time issue is very important. We have a whole chapter in our book devoted to technology to, you know, school start times to all of these different contributing factors in the school start times issue is definitely one. That's wonderful. It's so nice that you advocate for later start times, because I do think I do think it's helpful. I mean, now in my life, I am a morning person. But when I was a teenager, I remember it was brutal. setting my alarm for six o'clock 630 to make it to school on time. And it just seems so unfair that we're asking teens, we know that their clocks are later to have them start school so early and be alert and ready to learn. It just seems like we are you know, we're stacking, stacking everything against against them. I remember that that waking up in the dark, going to wait for the school bus in the dark. And even getting to school in the dark with you know, just absolutely. And that was in the 90s. I went to high school in the 90s. So homework has piled up, technology has changed. So kids are getting to bed later and later but still having to wake up this really, really biologically unfriendly hour. Absolutely. And I know, I'm sure everybody listening can relate that if we don't get enough sleep, you know, of course, there are the long term mental health effects that you talked about, that were correlating with lack of sleep, but even just the next day, it feels terrible to be sleep deprived. Just you start off the day with, you know, with the wrong foot forward. Yeah, we characterise teens, you know, we sort of had this idea that teens are grouchy, and, you know, barely answer us when we talked to them. And, you know, our relationship seemed to kind of go down the tubes. But if you if you really think about it, you know, if you have a severely sleep deprived teenager, that could, you know, be what, what to what you attribute their mood, you know, if they sleep, if they get enough sleep, you know, you might find that they actually answer you when you when you talk to them, and they're not so grouchy. So none of us like just like you say none of us like the way it feels. Our poor teenagers, they're going to school, when their brains are still really in sleep mode, their cortisol has not risen, their melatonin is still pumping, they've missed out not only on duration of sleep, but they've missed out that latter half of the night on, you know, a more concentrated amount of REM sleep. So they're missing out on a lot of dream sleep, which is really important for the processing of emotions and sort of putting them in their proper categories, which helps them end up with a more positive outlook. You're so right, I think that we tend to be quick to blame teenagers and their moodiness on their hormones. But maybe sleep has a big, big role in this. One of the things that happens when you sleep is that your brain flushes out all the toxins that have built up during the day. So the byproducts of an active brain like we have all day long are you can think of them like waste products that build up in the brain just just metabolism in the brain from activity. And when you start to sleep, you can see it really it's a really neat thing that happens in brain scans. They show that there's this flushing out of toxins that happens, but it only happens when we sleep. So if you're not sleeping enough, essentially it's that it's that foggy, terrible feeling. It is like toxic. It is a toxic feeling. And it means that the teen brain is not cleared out of all that those waste products so it's it makes perfect sense for me. Now when I when I wake up after not enough sleep, I'm like, oh my god, I can totally feel, feel the toxins and the waste brain. It's exactly what it feels like. Oh, absolutely. I mean, one thing, you know, as we're coming out of the pandemic, and kids are back to school for the time that they are home, you know, I was an advocate for kids being in person and learning, but I have to say one big plus, or one big benefit to kids being at home, that I noticed in my office is that a lot of teenagers pointed out that they were sleeping better, they really enjoyed, you know, while they missed their friends, they really enjoyed being home because they could sleep to the last moment before school started. And that made sense to me. Yeah, yeah, that was the what the study showed, overall was that that happened initially, and kids did get more sleep. And as the pandemic wore on, longer than we ever imagined it would. Technology started to really the fact that teens were indoors a lot, they weren't getting a lot of cues from the sun. So their circadian rhythms just shifted later and later, to the point where even though they didn't have to wake up until like, 859, to go to school, their bedtimes got so late, that their sleep started to really suffer. So that just shows you how much we need the sun, we need daily cues. We need not to not be on technology for so many hours, especially late at night. Now, you touched upon getting enough light to help with a circadian rhythm. Are there any other actionable pieces of advice for parents listening, where we can help teens get better sleep in terms of what we can do during the day? So you talked about getting enough light during the day? What about things like caffeine or exercise or napping? Are there things that we should avoid? Or do during the day to help promote better sleep? Yes, yeah, it's really important to think about sleep as being a 24 hour process, not a nighttime process. Because everything we do during the day, all of our habits contribute to our nighttime sleep. So starting in the in the morning, the earlier you can wake up and be exposed to the sun. Not you know, teens shouldn't be awake at six o'clock in the morning. But when they do wake up, let's say they have to be awake at seven o'clock for school, getting five minutes of sunlight. And that means even through the clouds, on a on a cloudy winter day, the sun is more powerful outside, you know, much more powerful than indoor light. So even just getting five minutes of Sun first thing in the morning, it's why we really don't want them going to school in the dark. And why we really are very disturbed by this permanent Daylight Savings Time idea, which could be a whole nother discussion. But so we want them to get five to 10 minutes of outdoor light. And we want them to wake up on the weekends within one hour or max two hours of their weekday schedule. Because even though sleeping in feels good in the at that time that you get, you know, 12 hours of sleep and you wake up at noon, you are going into social jetlag. So we want to keep the wakeup time and the exposure to sun within an hour or two. That's a really, I think that's one of the most actionable and powerful aspects of a routine for a family with teenagers. So reduce the weekend sleep in. And then like you said caffeine, you have to find a cut off time that works for you. But I think somewhere around two o'clock is a pretty good one. That it depends, but the half life of caffeine is very long. So Coke or caffeine or read any of those energy drinks. Nothing after two o'clock would be a general rule of thumb. And then you know, we have to talk about technology because creeping into the evening and being on screens that's that you know, having a wine downtime putting away technology is a huge part of this. Absolutely, absolutely. No and I think what's so hard is that kids now so much of their schoolwork is done online so much of their social outlets are online. So I think it's almost asking a lot of kids to put it away for a while before bedtime. You know, I'm just picturing they go to school, they come home, they do their homework, and that's their, that's their outlet. It's unfortunate that it's become this way but nevertheless, that's our reality. So we have this this sort we have some sort of like, you know, pie in the sky ideas. One of them is that schools really do you know, it will have their son's school does not allow the kids to have their phones out at all if they if they see their phones out they to keep them till Friday. But a lot of you know schools, your favourite thing. All right, I have to jump in and say it's like my thing about the school. They are so afraid of the cell phone policy, if they see it or even if it rings in their backpack. And they didn't they forgot to turn it off. And it rings that's it Friday. You come and pick it up. And I think it's, I mean, I, they're also so conscious of it, it gives them that full seven hours to not be looking at a phone seven hours of making eye contact with people. I think itself, those cell phone policies are huge. So sorry, I know, no, no, it's all good. It's so important. Yeah, I think it sort of underscores that a theme that we feel, and we just want to encourage parents and schools to not be afraid of their kids and to not, you know, be afraid of holding limits around devices, parking them at a certain time. And it is complicated when they're on their computers to do homework. It's, it's something that, you know, it's also complicated by having too much homework, and you know, how long, much longer it takes to do homework, when they're on technology, it is very complicated, but we really want to encourage families to talk about all of this together and come up with, you know, family agreements and contracts around the use of technology and for parents to really, you know, model, this kind of, you know, responsible behaviour. And the other thing that that's relevant to this part of the discussion is the idea of, of putting nice things into their evening routine. So we're not just taking away their devices, we're, we're adding all the things in that, you know, a lot of us, you know, did before any of this existed, like, you know, finishing a baking project, or walking the dog or reading a book, or maybe even families could watch a TV show for 30 minutes, you know, from a distance together. So, we don't want teenagers to not have a pleasurable and calming and, you know, predictable bedtime routine, we just don't want it to include something that, that just takes their bedtime and pushes it later. And later and later, it also sounds like the message you're telling me is that as a parent, I also need to own some of the responsibility that I need to make sure you know, I get my kids up on a week day where they're not, you know, sleeping in too late to set them up for success for Monday morning, that I need to make sure to encourage them to not spend too much time on on media on screens. So I do I do think this is a good sort of wake up call for parents as well. I think it is, too. And we you know, we have I have one tween and one teen. So my, my I have an elementary schooler, and I am really noticing. And we see this in the research too. But I'm really noticing in our community that even the elementary schoolers are starting to go to bed later and later. And by fourth, fifth grade, a lot of them have phones. So one of the one of the things we really like to do is get to parents earlier at with school aged kids who are contemplating, you know, giving them more technology, who are contemplating more independence and say, Don't let go of healthy habits. And don't let go of bedtimes and bedtime routines. Because once you do, you know a lot of times when they get to middle school, it feels like you can't pull it back. You can't. And so we really, you know, in the book, we have five healthy habits, healthy sleep habits, and we really advocate parents read the book early, read it in elementary school, get it you know, get things going get things set up so that you don't have to try to wind it back when they're teenagers so that your home is just a home that prioritises sleep. That's just Yeah, we do in our house. We prioritise sleep. Parents do too. This is just a family value. You know, what I noticed from parents, a lot of times they'll they'll voice concern because when their children are little, they have control, you know, they know what time they're putting their kids to bed, they're they're going to bed before the parents are. And then a switch happens in the teen years where all of a sudden the kids are going to bed later than they are and they don't really know when their kids are going to bed. You know, the parents are going to bed at 10. And the teens are staying up till who knows how late. So I do think you know that that's tricky to for parents, I mean, maybe what maybe what we should be doing is really having honest conversations with our teenagers. It takes really empathic communication, it takes really good listening, it takes really knowing your teenager improving your relationships. So we have a whole chapter that is actually based on the this the approach in our second book, which is all about empathic communication in difficult moments. So you're right I mean, it's it's there's really a relational piece there big time because we're really setting our kids up to go out into the world. We don't We can't control them throughout high school. We have to, we have to step back and let them start to have more freedom as they show more responsibility. Absolutely. Absolutely. Now and what about nighttime Same as you were mentioning, sleep as a 24 hour process. We talked about the daytime getting enough light and watching caffeine. What about in the evening? How can we set our teens up for success to get to bed on time? Something I hear from a lot of teens is that they have trouble winding down, their brains are racing. Even if they put screens away an hour before bed, they have trouble figuring out how to calm themselves down. Do you have any advice maybe with you know, room temperature or light exposure, any anything that parents can glean from how to wind down at night? Yeah, so wind down is, like you said, really important to set the stage physiologically for sleep because it's like, you know, landing a plane, like you wouldn't just nosedive a plane and try to land it that way, you have to come down slowly. And that's what that's what a wide no time is. It's setting the stage physiologically. So about one to two hours before you actually want to go to sleep is when your body starts preparing for sleep. So during that wine downtime, the two important things are that the light is reduced, because we don't want our melatonin to be suppressed. So reducing the light, and then not in we we think of it like going into a stress free zone. So this is not a time to have a conversation about how to pay for college, it's not a time to talk about whether you're going to quit the basketball team or not. It's not a time to talk to your friends about a stressful school drama that keeps your mind in an activated state. So it's whatever you really want to help your team and we have a section in the book that's like a cheat sheet for teams that speaks directly to them. So that they can come up with their own wind down routine. But it's it's anything that you that doesn't keep your brain pulled to the exterior thinking and puzzling and the teen brain is very social. So we do want to turn off FaceTime, we do want to stop texting because it keeps your mind activated and wondering what's my friend doing and she's still struggling with that thing. lets you know that that stress free zone is super important for teens, even more than for grownups because like you said, grown ups are kind of programmed to go to bed early, some of them most of them. But teens need extra wind downtime, it's really a matter of creating a routine that they enjoy that they look forward to. And that has some fairly predictable steps because the body is very curable, we really queue our bodies and we we prepare for sleep. When you combine that wine down and bedtime routine with holding a regular bedtime. We haven't talked too much about how important regularity is. Some of the science points to the fact that regularity around sleep is as important as duration. So what and one of the reasons is because we train our internal clocks for that time, so let's say I go to bed, every night, I do go to bed every night at 1030. My my internal clock is really trained for that time, which makes it much easier for me to fall asleep than if I you know, move my bedtime around. So we really want to stack the deck in favour of making this successful. You know, teenagers, we don't want them to try this and then lie they're wide awake at night, we want it to really work for them. So if their bedtime in the case of the the teenager that we're talking about, let's say this teenager has been going to bed at 1115 or 1131. One idea would be for that teenager to move their bedtime as little as five minutes a night earlier until they get to 1015 so that they're not just lying there for an hour because their internal clock is trained for that 1115 bedtime. Yes. Yeah. So when you say park your cell phones, does that mean take the cell phones out of your room? What does that look like? Yeah, yeah, that's that's the tricky one. And it honestly, it's the thing that we find parents are really kind of giving up on and we they're giving up on it. And they're giving up on it earlier and earlier. Like I was mentioning with the the elementary schoolers, you would think I think if you're the parent of a third grader, you're like, oh my god, are you kidding me? I would never, you know, my kids not gonna have a cell phone. And of course, I wouldn't put it in the bedroom. Somehow, two or three years later, it just feels like it's this irresistible, intractable, you know, habit. And so we really want to advocate for parents and teens, sticking with that habit of parking their devices outside the room, and having a place where you do that too as the parent because it helps your sleep as well. And use an alarm clock that is just a regular clock. And, you know, it's it's very possible and it really helps Think of it like, like we call it in the book a sleep bubble. We want to create a little bubble around our sleep, because the mind needs to disconnect and that by fill that space around sleep is so important in protecting sleep. Absolutely. I think that's really well said that we really have to make an effort a conscious effort to make that bubble. Another question, a lot of people asked me what room temperature is best to promote sleep? Do you guys have a number in mind? Yeah, I was just realising we didn't answer that part of your question. So dark and cool, definitely helps enormously with sleep. And I'm sure you've read some of the more recent research coming in about darkness. And how important it is. It's fascinating. And I remember reading some of these early studies many, many years ago, pointing to the fact that not only does sleeping in a completely dark room help us sleep better, but it actually contributes to our overall health, I Temperature wise, the optimal temperature. And this includes babies and little children, maybe not a newborn for the first two weeks or something. But the optimal temperature is 65 to 68 degrees. And I believe that that is going to even go lower. So we don't want to feel cold, you want to have the proper amount of covers on the you want the air that you're breathing to be nice and cool. I really appreciate you saying this, because honestly, this for my husband, because poor, My poor husband, I do set the temperature at night to be 65 degrees. And I also get teased because I wear one of those dark imass at night. Because I really want to ensure darkness. So I do get I do get a fair bit of teasing, because of what I look like at night and how cold the house is. But I appreciate you guys backing me up. And I'm just curious, in your own personal experience, do you find that as you've been researching sleep and implementing this, I'm sure into your own lives? Do you feel like it's made a difference? I definitely. I mean, because Julie and I have been working on sleep since my children were babies. You know, when we wrote the happy sleeper, my daughter was a newborn. And now we're writing about teenagers and I have a teenager, my kids are completely indoctrinated into our entire, like I said, our whole family value, our value system around sleep has always put what we describe in the book as a sleep forward approach. So as opposed to what what sleep usually is, which is a sleep leftover, it's just what's leftover at the end of the day. It's just you know, it's a left sleep leftover approach is what a lot of families are faced with. We want to help people shift to a sleep forward approach. So it sleep is set as a priority. And then other life. Things happen around it. So my absolutely my I mean, my teenager sleeps at least nine hours a night, and my fifth grader at least 10. And that it's just always been that way. So it's great. It's great. You're you're making it a priority. So where where can people find you if they want to read your book? Can you can you talk about the services that you provide and, and courses so people know where to learn more? Sure, yeah, our website is the happy sleeper.com And the happy sleepers the title of our first book. And on that website, we also offer online classes for little babies, babies, four to 24 months. And then little kids we have three online classes. And the new book is called Generation sleepless and it's available wherever books are sold, and you can see information about it on on our happy sleeper website as well. Thank you so much. That's our instinct. Our Instagram is the happy sleeper at the happy sleeper. Yeah. All right. Give them a follow. All right, thank thank you guys so much.