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In contrast to just feeling tired, how likely are you to doze off or fall asleep in the following situations? (Even if you have not done some of these things recently, try to work out how they would have affected you.) Use the following sleep test scale to choose the most appropriate number for each situation:

0 = Would never doze
1 = Slight chance of dozing
2 = Moderate chance of dozing
3 = High chance of dozing

Your Situation:

Sitting and Reading

Watching Television

Sitting inactive in a public place

As a car passenger for 1 hour, no break

Lying down to rest in the afternoon

Sitting and talking to someone

Sitting quietly after lunch without alcohol

In a car stopped in traffic


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Teen Insomnia Linked To Depression and Poor Performance

A recent study conducted by the University of Adelaide in Australia has shown that insomnia may be linked to mental health conditions amongst teenagers.  The study, published in Sleep Medicine, identified that up to 11 percent of teens, ages 13 to 16, have experienced insomnia at some point.  (1)

Insomnia or lack of sleep makes it more likely that a teen will have depression, an anxiety disorder, or a panic disorder.

Teens naturally have difficulties getting enough sleep.  As a child passes through puberty, changes in the circadian rhythm may occur.  Before puberty, the body is programmed to “go to sleep”, usually by 9 p.m.  After puberty occurs, the sleep signal shifts about 2 hours.  This is called a “sleep phase delay” and can present challenges with teens who have to get up early. (2) In addition, teens are more likely to stay up late at night because of active social lives, busier schedules, and the ever-present electronic interference of computers, smart phones, and tablets that are mentally stimulating rather than relaxing.  Consequently, it appears that insomnia may be caused in part by changing lifestyles and physiological changes.  (2)

In addition, researchers found that different people fall into categories based on periods of time in which they are most active or alert during the day.  Teens who were more active during the evening and fall into the “eveningness chronotype” were more likely to have insomnia and depression. (1)

An analysis of data collected by the National Institutes of Health concluded that depression and anxiety in teens were more difficult to treat if the teen also had insomnia and suggested that addressing insomnia was an integral part of achieving a positive outcome.  Further, insomnia that co-exists with depression can result in an increased risk of substance abuse, cognitive dysfunction, suicidal tendencies, and subsequent adult depression. (3)


Align School Start Times with Teen Behaviors

The American Academy of Pediatrics has addressed a general lack of sleep in teens by issuing a statement calling for later school start times because of teen late-night activities and a teen’s inability to go to sleep before 10 or 11 p.m. Forty percent of schools start classes before 8 a.m.  Currently only 41 percent of middle schoolers and 13 percent of high schoolers are getting the recommended 8 ½ to 9 ½ hours of needed sleep each night. (4)


  1. Science Daily: Teen insomnia linked with depression, anxiety http://www.sciencedaily.com/releases/2014/07/140730093516.htm  (7/30/2014)
  2. UCLA Sleep Disorders Center: Sleep and Teens http://sleepcenter.ucla.edu/body.cfm?id=63 (2014)
  3. Medscape Medical News: Insomnia thwarts treatment response in depressed teens http://www.medscape.com/viewarticle/749232 (9/7/2011)
  4. Time Magazine: School should start later so teens can sleep, urge doctors http://time.com/3162265/school-should-start-later-so-teens-can-sleep-urge-doctors/  (8/25/2014)

Alan S. Berger, M.D.