Sleepy, Dopey and Grumpy, (sleep disorders in puberty and adolescence).

Around the time of puberty onset the previous sleep wake cycle is known to be physiologically delayed by about 2 hours. This later sleep onset and wake time than in middle childhood is a result of the pubertal hormonal influences on the circadian sleep wake cycle and on the secretions of melatonin.
The child's sleep needs do not differ dramatically, this should still be 9-9.5 hours, but many children at this stage only have 7-7.25 hours of sleep. This results in a considerable sleep deficit. Adolescents are recognised as having a decreased daytime awareness and some studies suggest that many teens function for a good part of the day in a "twilight zone". This is not dissimilar from an individual with Narcolepsy.

External factors which impact on this sleep include;-

• Early school start time
• Homework
• After school jobs
• Extracurricular activities

High achievers and children with chronic medical issues or psychiatric problems such as depression, are at particularly high risk of developing sleep disorders. It is suggested that the prevalence of sleep disorders in this group may be as high as 20%. Chronic sleep deficit in this age group leads to significant negative neurobehavioural consequenses such as;-

• Negative impact on mood
• Vigilance
• Motivation
• Reaction time
• Memory
• Attention

It is very important that at this critical time children maintain good sleep hyigene and regular sleep wake times which will strengthen the circadian rhythm.