The Importance of Not Falling Asleep

Any review of adolescent lifestyles in our society will reveal more than a dozen forces converging to push the sleep/arousal balance away from sleep and toward ever-higher arousal. What harm could there be in trying to push back a little toward valuing sleep? In this article I provide an overview of current scientific and clinical information regarding the consequences of insufficient sleep in adolescents. I pay particular attention to links between sleep and emotional regulation. The following is a brief outline of the main points to be presented: 1. Sleepiness. This is the most direct consequence of adolescent sleep loss, and it manifests itself most significantly in difficulty getting up on time for school and in falling asleep in school. These problems can further contribute to conflicts with parents and teachers and to poor self-esteem. Sleepiness is also associated with a strong tendency toward brief mental lapses (or microsleeps) that greatly increase the risk of motor vehicle and other kinds of accidents. 2. Tiredness. This is a symptom of sleep loss and includes changes in motivation - particularly difficulty initiating behaviors related to long-term or abstract goals and decreased persistence in working toward goals.

3. Mood, attention, and behavior. Sleep loss can have negative effects on the control of mood, attention, and behavior. Irritability, moodiness, and low tolerance for frustration are the most frequently described symptoms in sleep-deprived adolescents. However, in some situations, sleepy teenagers are more likely to appear silly, impulsive, or sad. 4. Impact of emotional and behavioral problems. ?motional arousal and distress can cause both difficulty falling asleep and sleep disruptions. Behavioral problems and family chaos can contribute to even later bedtimes and to sleep schedules that are ever more incompatible with school schedules.

5. Bi-directional effects. There are bi-directional effects between sleep and behavioral/emotional problems. It can be difficult at times to identify the causal links. For example, a depressed adolescent with severe sleep problems may be showing sleep disturbances that stem from depression or mood problems that stem from sleep disruption. Sleep loss can also contribute to a negative spiral or vicious cycle of deterioration. That is, sleep loss can have a negative effect on mood and behavior, which leads to subsequent emotional/behavioral difficulties that further interfere with sleep. This produces a sequence of negative effects in both domains. In some clinical cases, such negative spirals appear to be a pathway to withdrawal from school or serious psychiatric problems. (Dahl, pp.43) Before discussing the specific consequences of insufficient sleep in adolescents, it is necessary to begin with a general overview on what sleep is and why it is necessary at all. Sleep is not simply rest. Mere rest does not create the restorative state of having slept. (Anyone who doubts this should try the following experiment tonight: spend eight hours resting in bed, with eyes closed, body relaxed, mind floating, in a deeply tranquil state, but without ever going to sleep; then keep track of your mood and performance tomorrow.) The fundamental difference between sleep and a deeply relaxed wakefulness is that sleep involves dropping into a state with a relative loss of awareness of and responsiveness to the external world. This state of unresponsiveness appears to be necessary for the restorative processes that occur during sleep to take place. ...



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