How We Can Help Teens Get Better Sleep

The adolescent years (10–19 years old) represent a unique age period for studying changes in sleep-wake patterns because of the interaction between biological (e.g., delayed circadian timing) and psychosocial factors (e.g., early class start times) that give rise to accumulated sleep debt. Given the critical role that adequate sleep plays for both physical and mental health, adolescents who continuously fail to get adequate sleep are at risk for poor health outcomes, including cardiovascular disease, poor immune functioning, obesity, suicidal behaviors, depression and anxiety. Notably, a number of past studies have found that individuals of racial-ethnic minority status in the U.S (e.g., Blacks, Hispanics) typically report shorter and poorer quality sleep, relative to non-Hispanic whites.

Although researchers have implemented a number of sleep education programs among high school students, the majority of these programs have failed to actually change adolescents’ sleep behaviors and virtually none have accounted for the fact that adolescents from different racial-ethnic groups might differ in how they experience these sleep programs due to differences in culture, family values and/or sleep environments.

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In one recent study, developmental sleep researchers Royette Tavernier (Assistant Professor of Psychology at Wesleyan University) and Emma Adam (Professor of Human Development and Social Policy at Northwestern University) devised a novel approach to tackle adolescent sleep debt, while simultaneously accounting for racial-ethnic differences. According to Tavernier, lead author of the study, “we wanted to implement an intervention program that could easily be integrated into the already busy lives of high school students.” Additionally, “we wanted to design a program that was individually tailored to each student, because we know that different people have different sleep needs. It was also important for us to recruit a racially/ethnically diverse sample of adolescents to determine whether our intervention would be equally effective for different groups of adolescents.

A total of 46 high school students participated in the 3-week study (44% non-Hispanic whites). All students were given a watch-like device with a built-in accelerometer, which objectively records bedtimes and total sleep hours. Students also attended a sleep education lecture, where they learned about the important role that sleep plays for academic performance, physical health, emotional functioning, as well as strategies for good sleep hygiene. Following the lecture, students were randomly assigned to either the ‘text message intervention group’ or the ‘control group’. Tavernier explained, “only students in the text message intervention group received two text messages per day that specified a target bedtime each night for two weeks.” Tavernier noted, “one of the unique aspects of our study was the fact that these target bedtimes, which encouraged students to go to bed slightly earlier each night, were specialized for each student, based on his/her own previous sleep-wake patterns.”

After the two-week text message-based intervention program, our results showed that, in the full sample, the text message intervention did not result in longer sleep for students who had received the specialized text messages with the target bedtimes as we had expected.

However, given the racial disparities in sleep, we further analyzed the data separately for non-Hispanic whites and racial-ethnic minority adolescents (i.e., African America, Asian-American, Mixed race). Our results revealed that the text message intervention was, indeed successful at improving sleep hours but only among non-Hispanic whites and not among adolescents of racial-ethnic minority status. In fact, the intervention improved sleep by an hour among non-Hispanic whites.

We then examined a number of different factors that might differentiate the two racial groups to determine which of these factors could potentially explain our findings. We found that adolescents of racial-ethnic minority status came from homes with parents who had lower education and incomes; tended to live in homes with more people but less bedrooms; had lower prevalence of mild exercise, and tended to think they needed less sleep, relative to non-Hispanic whites. Tavernier explained, “the race difference was still present even after controlling for these factors, which suggests that none of these factors could directly explain why adolescents of racial-ethnic minority status did not benefit from the intervention program.”

These results highlight the importance of devising sleep intervention programs that are uniquely tailored to each student and calls attention to policy-makers and school administrators to account for the fact that adolescents of different racial-ethnic groups may have unique needs that are not addressed by using a “one size fits all” approach to the problem of adolescent sleep debt.

Importantly, more research is needed to determine the motivational, psychological, and societal factors that hinder the ability of certain racial-ethnic groups of adolescents to get adequate sleep, because at the end of the day everyone deserves a good night’s sleep.

Findings from the study will be published in a forthcoming issue of Sleep Health (DOI: 10.1016/j.sleh.2016.11.002).

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