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Am Fam Physician. 2005;72(2):339

The American Academy of Pediatrics (AAP) has released a technical report on the causes and consequences of adolescent sleepiness. The report, which is based on a meta-analysis, appears in the June 2005 issue of Pediatrics.

Inadequate sleep has become a widespread problem for adolescents. Physicians have an important role in identifying adolescent patients at risk for inadequate sleep and in providing counseling and support to help manage sleep-related symptoms.

Common causes of sleepiness in adolescents include normal changes that occur during the transition into adolescence (e.g., varying sleep/wake times, relaxed parental control of bedtimes, changing school start times). Many adolescents also have part-time jobs that cut into their sleep time. Studies have shown that the biological system that regulates circadian rhythms may change during adolescence, creating a later timing of sleep. Because of these changes, adolescents get less sleep than they did as children. Insomnia, narcolepsy, idiopathic hypersomnia, restless legs syndrome, and numerous medications are also common causes of inadequate sleep in adolescents.

Lack of sleep can affect adolescents’ cognitive function, concentration and attention, alertness, and ability to perform in school. Studies have shown that many adolescents who have sleep disorders also have symptoms of attention-deficit/hyperactivity disorder. Adolescents with clinical mood disorders, especially severe depression, report higher incidences of sleep disturbance. Sleepiness is also the leading cause of motor vehicle crashes among drivers 16 to 29 years of age.

The AAP concludes that physicians should recognize the significant problem of sleepiness among their adolescent patients. Physicians need to ask questions about sleep patterns, how much sleep their adolescent patients are getting, and if they are having any sleep-related symptoms. A sleep history should focus on the following points:

  • Bedtime problems

  • Excessive daytime sleepiness

  • Awakenings during the night

  • Regularity and duration of sleep

  • Sleep-disordered breathing (e.g., loud snoring)

At the least, the AAP recommends educating adolescent patients about their sleep needs and the detrimental effects of sleep loss on performance and health.

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