The Tired Teenager

by on November 16, 2013

in Monthly

Tired teenager? Shut off the gadgets to make room for sleep.

By Dr. Peter Nieman, For the Calgary Herald November 13,

A health study showed that only eight per cent of teens get the ideal amount of sleep most nights of the week.

A teenager who frequently seems to be tired, fatigued and lethargic can cause a lot of worrying and fretting in the minds of parents. The words, “Doctor, my teenager always seem to lack energy” echo in clinician’s exam rooms many times each week.

Although many parents Google “fatigue in teens” and end up worrying about some type of an infection, weak adrenals, tumours, hypothyroidism, anemia or inflammation of the bowels, the most common causes in the end centres around one single topic: lifestyle choices.

In a recent lecture at the annual meeting of the American Academy of Pediatrics (AAP) in Orlando, this topic drew a large crowd of delegates. The take home message was that the top three reasons for fatigue are: lack of sleep, TMTD (too much to do) and a media diet marked by excessive screen time.

The Journal of Adolescent Health (2010:46: 399-401) published data showing that only eight per cent of teens get the ideal amount of sleep most nights of the week. Needs may vary, but generally 9 to 9.25 hours of sleep should be the gold standard.

According to the same study, 68 per cent of teens do not sleep enough during school nights. Even though teens have a natural tendency to be nocturnal creatures, they overestimate their stamina and go to bed too late. The next day reality kicks in and it does so too early, when the alarm goes off, reminding them that school is calling.

Research which looked at melatonin in saliva confirmed that the biological rhythms of teens indeed put them in the night owl category.

On the website of the National Sleep Foundation parents are reminded to supervise teens more closely, but in reality this type of advice ends up in the “mental delete” bin of the average parent. After a while, parents become jaded by teens who simply choose to learn the hard way. (For more on why teens think the way they do, visit and see a blog on “The teenager’s brain”.)

On Oct. 28, the AAP released a policy statement on children, adolescents and the media (see Dr. Victor Srasburger, co-author of this statement, commented that “We are worried that a lot of parents are clueless about their child’s media use and how to manage it appropriately”. Dr. Srasburger went on to state that “Kids are spending more time with media than they are in school and that media have taken over the primary role of teaching kids from schools and parents in many cases” (USA Today, Oct. 29, 2013).

The problem is that too many teens spend the majority of time with media, while in bed and after midnight. In the old days, some doctors remembered to tell families that a child should not have a TV in the bedroom.

Although this advice is still true, it is also becoming stale. The best choice a parent can make is to have a rule where no electronics are allowed in bedrooms — especially smartphones. This rule should apply to all family members, parents included.

For more ideas on how to monitor your teen’s media use — especially at night — visit the Harvard Center of Media and Health ( On the topic of Family Online safety, see

School start times remain a controversial topic. Advocacy groups have tried their best to get high schools to start later in order to get in sync with a teenager’s biological clock.

In a study conducted by Dr. Kyla Wahlstrom at the University of Minnesota, where the Minneapolis Public School District changed the starting times of seven high schools from an early to a later start, it was found that teenagers obtained five or more extra hours of sleep per week.

Students were less moody and depressed, less likely to be tardy, there was reduced absenteeism, they obtained better grades, less teens fell asleep while driving and there were less negative metabolic changes predisposing teens to obesity.

However, this data has failed to convince some sleep experts and school administrators to allow schools to start later in most other North American jurisdictions.

When I saw the PowerPoint slide at the Orlando conference, unpacking TMTD, I got tired myself. TMTD is an all-too-common issue in many modern day families where the list of things to do include: school, sports, music, chores, clubs, volunteering, after hour jobs and a social life. No wonder teens are tired and no wonder they escape with their smartphones late at night to “unwind”.

The AAP offers a practical solution: Create a family media pledge. This consists of a list of ideal behaviours for both children and their parents. For more information search on by entering the words “media pledge”.

Dr. Peter Nieman has practised as a community pediatrician since 1987. He hosts and can be followed on Twitter @DRPETERNIEMAN

© Copyright (c) The Calgary Herald

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