Review: The Sleep-Deprived Teen by Lisa L. Lewis

Reviewed by Kirsten Macdissi

While it is widely accepted that teens are often sleep-deprived, the consequences of that deficit are less well known and not always taken seriously. “So what?” is frequently the prevailing view. Teens are young and strong. Will a little lack of sleep really hurt anything? Especially in our culture that prizes busyness and productivity above all else, sleep is often seen as a luxury, not a necessity. But in her new book, The Sleep-Deprived Teen, parenting journalist Lisa L. Lewis thoroughly debunks that view and makes a compelling case for the necessity of adequate and high-quality sleep for teenagers. Far from being a benign condition, Lewis’s research shows that lack of sleep puts teens at higher risk for depression, suicide, substance abuse, and other risky behaviors, as well as depressing their immune response and leading to more physical illnesses. “As a journalist focused on parenting, and public health, I realized I’d found my new subject,” Lewis said.

Research that shows that teens need more sleep than adults, not less, is not particularly new. Lewis gives us a fascinating glimpse into the Stanford Summer Sleep Camp of the 1970s that found that far from needing less sleep as they matured (as had been assumed), adolescents actually need as much or even more than younger children, with eight hours being a minimum, and nine or ten hours optimal. Monitored but undisturbed, the teens were routinely clocking ten hours of sleep a night. What did change was the timing of sleep, with adolescents experiencing a burst of energy in the evening that pushed slumber back to a later hour. Consequently, the teens were often still sleepy at the eight o’clock wake-up time.

Although truly groundbreaking at the time, this finding is not going to be surprising to anyone who has faced a group of high school students for first-hour class. I can personally attest to the huge difference in discussion and engagement between a class that begins at eight in the morning and one that starts at any other time of day. Riveting anecdotes about the Salem witchcraft trials that would kill (so to speak) at ten o’clock will elicit only yawns at eight. Even the post-lunch slump pales in comparison.

Lewis notes that the American Academy of Pediatrics recommended in 2014 that schools start no earlier than eight thirty in the morning, a recommendation that has largely been met with crickets. However, when the Edina, Minnesota, school system decided to actually move its start time to eight thirty, the results were dramatic. Attendance went up. Counselors and nurses were getting fewer self-referrals for depression or illness. Principals noted calmer hallways with fewer discipline issues. It was, Lewis says, “a game-changer.”

To fully understand why it was such a game-changer, Lewis then switches gears to give readers a tour of the teenage brain. “First and foremost,” she says, “their brains are still under development.” The limbic system, the emotional center of the brain, is the first part of the brain to kick into higher gear with the advent of puberty. “The result is a new intensity in how teens perceive the world: everything from a heightened response to dopamine (one of the key neurotransmitters for experiencing pleasure) to a greater tendency to act impulsively,” Lewis says. While all of us experience some increased emotional intensity when we are short on sleep, teens are much more vulnerable to the effects of sleep-deprivation than are adults. Lewis cites study after study that show teens reporting increased feelings of anger after periods of decreased sleep (defined in one study as under seven hours). Other studies link increased anxiety and depression with a lack of sleep as well. Meanwhile, the CDC states that nearly half of American teens are averaging six or fewer hours per night. Clearly we are not setting our kids up for success.

Lewis hammers the point home with sobering statistics on teen suicide, the second-leading cause of death in the United States for that age group. Not only do teens’ still-developing brains have a lower threshold for making or acting on a decision, sleep deprivation makes that threshold even lower. This can be a lethal combination with a depressed teen. What is encouraging, though, is how something as simple as increased sleep could have a dramatic effect on those tragic stats. According to Lewis, a meta-analysis of several studies in 2018 highlighted a “dose-response relationship, showing that for every one-hour increase in adolescent sleep, the risk of planning a suicide decreased by eleven percent.”

While suicide might be the most serious consequence of ongoing sleep deprivation, Lewis also shows strong links between lack of sleep and risky behaviors: increased crime, increased alcohol use, increased drug use. Again, lack of sleep lowers the threshold of inhibition in a population whose threshold is fairly low anyway, due to their immature prefrontal cortex. As if that weren’t enough, lack of sleep also depresses the immune system, making teens more vulnerable to infections and slowing the healing of injuries. And according to one study, decreased sleep for two nights before receiving a vaccine is associated with lower antibody counts for months afterward, a result with serious implications in our current viral climate.

Lewis used all of her research to become a strong advocate and activist for changing the high school start time in her home state of California. She was successful in her quest to push the start time back to eight thirty, and the last couple of chapters are dedicated to describing that journey and answering some of the possible objections to that later start time. Bottom line: cultural change takes time and tact, but it can be achieved. Don’t be discouraged.

Lewis makes her case for the importance of sleep with solid research, but this is still a very readable and accessible book. Each chapter ends with a list of “sleep takeaways” relating to the topic of the chapter, making it a good reference for parents, educators, health professionals, or anyone working with teens.

Kirsten Macdissi is a former high school English teacher and adjunct, and current freelancer and book reviewer. When not writing or reading, or writing about reading, she is pulling weeds, kvetching about Nebraska weather, and swapping books with her large extended family. Find her @KMacdissi