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Teens & Tiredness


Hi Mark,

K's current problems are - bad sleep patterns, and not spending enough time on his study (in fact, almost no time).

Given the success of using the program for his other behaviours (still ups and downs, but he has actually modified his behaviour because of this program), I would like to state these rules & consequences:

1. No sleeping after school (or during the day on weekends). Consequence - phone disabled for 24 hours.

2. At least 1.5 hrs of study per night - in a way that is transparent. that is, when I look in on him, he should be entirely open about what homework he is doing. If he doesn't do enough time, or refuses to tell me what he is doing - Consequence - phone disabled for 24 hrs.

He had a blood test to rule out a medical cause for his tiredness (we get the results in a couple of days) - obviously if there is medical issue and the doctor says he needs more rest, I wouldn't have this rule, but I am confident that won't be the case, and I would like to have clear plan and clear expectations starting from next week.

As always, I appreciate your advice.

Thanks,

V.

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Hi V.,

I like it. Good plan.

I wouldn’t worry too much about any physical problems related to his being tired. I doubt that the tests will reveal anything. Most teens are at the developmental stage in which there is so much “growth-spurting” going on that tiredness is the rule rather than the exception. During the adolescent growth spurt, more sleep is required than previously because of increased growth (growth essentially goes on only during the hours of sleep). The social pressures of the teen years - staying up late to watch TV, chat on the phone endlessly with friends, or do the homework that should have been done earlier in the evening - when combined with the need to arise early in the morning for school, can easily create a situation in which the adolescent is chronically sleep deprived.

Inadequate sleep usually results in some variation of daytime sleepiness or tiredness, but may also curiously result in hyperactivity, school problems, emotional problems, and other daytime behavioral difficulties.

Before considering what might be causing “abnormal daytime sleepiness,” it is wise to begin by determining whether your son is even getting enough sleep to begin with. When a child goes to sleep at night and when he arouses in the morning may well be the explanation for sleepiness and lead to easy resolution of it.

For example, a 15-year-old should be getting about 8-3/4 hours of sleep per night. An 18-year-old needs about 8-1/4 hours.

Questions to consider:

Does your son consume any medications or drugs that can influence sleep patterns or lead to daytime sleepiness?

· antihistamines
· anti-seizure medications for epileptic children may cause drowsiness, especially phenobarbital
· caffeine (colas, Mountain Dew, Dr. Pepper, tea)
· chocolate (active ingredient is theobromine, closely related to caffeine with similar effects)
· in adolescents, consider drugs of abuse, notably cocaine, marijuana, and alcohol

Are there any abnormal sleep behaviors?

· abnormal sleep positions (for example,the child cannot sleep unless neck is positioned awkwardly)
· bedwetting
· night terrors or confusional arousals (screaming or crying while not totally awake)
· sleepwalking
· Snoring or sleep apnea (prolonged cessation of loud breathing noises in sleep)

Are there daytime problems with school performance or behavior?

· emotional problems, teariness
· hyperactivity, aggressiveness or disruptive behavior
· inattention, mind wandering
· interference with peer relations
· poor grades - is the child functioning well at grade level?
· sleepiness in class

Hope this helps,

Mark

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