well-being
CENTER FOR RESEARCH ON GIRLS
A SERIES OF RESEARCH AND INFORMATIONAL PUBLICATIONS BY LCRG
“Putting the world’s best research to work for girls.”
by Dr. Tori Cordiano and Dr. Lisa Damour
GIRLS AND WELL-BEING: SLEEP Research on sleep deprivation in children and adolescents demonstrates that “sleep deprivation is not only common, but also represents a chronic problem among youths.” 1 Studies find that more than half of adolescents in the United States sleep less than eight hours per night and 58% of 15-17 year-olds sleep seven hours or fewer, when eight to ten hours are recommended.2, 3 Not surprisingly, sleep deprivation is associated with poor cognitive performance, emotional health, and physical health.4, 5 As children, boys and girls tend to sleep equally well.6, 7 A dramatic rise in sleep problems emerges with the onset of puberty for girls; a similar trend does not occur with the onset of puberty for boys. Beginning in adolescence, research indicates that girls experience greater sleep impairment, including shorter self-reported sleep duration, more night awakenings, and more difficulty falling asleep.8, 9, 10 While hormonal causes may play a role in the increased rate of sleep problems in girls relative to boys, several other factors that interfere with sleep in childhood and adolescence have also been identified by researchers.11 These include the use of technology, adolescents’ efforts to “catch up” on sleep during weekends, and the consumption of caffeine.
LCRG: GIRLS AND WELL-BEING: SLEEP TECHNOLOGY USE Technology use interferes with sleep in several ways: • using computers and cell phones in bed interferes with the habit of falling asleep in bed • light emitted by technological devices can trick the body into thinking that it is time to wake up • technology use can delay sleep or interfere with the relaxation needed to fall asleep Psychologists have long known that the human body makes powerful associations between places and the functions that are typically performed in those places. With portable technology, children and adolescents can use their beds as “offices” where they do homework, call and text their peers, and use their computers to watch online video content.12 The use of the bed for a variety of activities besides sleep gradually weakens the body’s link between being in bed and falling asleep and leads to difficulty sleeping, regardless of actual levels of fatigue. An essential part of healthy “sleep hygiene”—the term used to describe the behaviors that promote good sleep—is to restrict the use of the bed to sleep and activities that almost exclusively precede sleep (e.g., leisure reading).13 Research also indicates that evening technology use may disrupt the secretion of melatonin, a hormone that naturally increases during darkness and helps promote sleep. Late-night light exposure is known to suppress melatonin levels, and some research suggests that the use of technological devices—which involves staring directly at a light source from a relatively close distance—may be especially disruptive to sleep.14 Studies also demonstrate that the content associated with adolescent technology use can interrupt sleep, delay sleep, or cause stimulation that disrupts sleep.15 Research has found that a majority of adolescents have taken their phones to bed with them and been awakened by text messages or phone calls after bedtime hours. Further, adolescents who multi-task with two or more forms of digital technology have been found to sleep less than their peers who tune into one form of technology at a time.16 Finally, research demonstrates that late-night television viewing or video game playing delays sleep and that the excitement associated with video gaming can also reduce the amount of time spent in deep, restorative sleep.17 STRESS AND SLEEP More than a third of teenagers report that stress interferes with their ability to fall asleep, and teenagers who sleep less than eight hours per weeknight report higher levels of stress than those who sleep at least eight hours.18 The negative consequences of stress and insufficient sleep are cyclical; compared to teens reporting lower stress levels, more of those reporting higher stress levels say that not getting enough sleep causes them to feel even more stressed.
Stress and anxiety may contribute to differences in girls’ and boys’ sleep. Beginning in adolescence and continuing into adulthood, girls and women report increased levels of stress and experience higher rates of anxiety disorders.19 Learning to manage stress may be an important component of improving adolescent sleep. Evidence-based treatment approaches for anxiety, such as cognitive behavioral therapy (CBT), may also positively impact sleep problems in children and teens.20 Recently, researchers have begun to explore the potential benefits of mind-body integrative health practices on improving sleep. While this has been studied more extensively in adults, there is some evidence that interventions such as mindfulness, qigong, aromatherapy, or yoga may benefit children’s sleep and their overall well-being.21 CAFFEINE USE Research finds that roughly 80% of adolescents consume caffeine on a daily basis, many with the express purpose of staying awake late at night.22 The regular consumption of caffeine has been demonstrated to lead to a cycle of delayed sleep, fatigue, and ongoing caffeine use.23 Adolescents who consume high levels of caffeine experience more interruptions to their sleep than peers who consume less caffeine, and those who fall asleep in class have been found to consume nearly twice as much caffeine as their peers who stay awake throughout the school day.24 While adolescents typically consume caffeine in the form of soft drinks, the last decade has been marked by the widespread availability and marketing of “boutique” coffee and energy drinks that contain high levels of caffeine. FACTORS THAT IMPROVE SLEEP To improve sleep duration and quality, children and adolescents should: • Treat the bed and bedroom as a “sleep sanctuary” used exclusively for sleep or leisure activities—such as light reading—that usually precede sleep. • Turn off all forms of technology at least an hour before bed to help the mind relax and to reduce light exposure. • Aim to fall asleep and wake on weekends at roughly the same times as the weekdays. • Limit caffeine use, especially late in the day. • Seek at least 20 minutes of sunlight exposure daily to support the body’s natural production and release of melatonin25 • Engage in physical activity: a large body of research finds that adolescents with higher subjective and objective levels of physical activity consistently enjoy better sleep26
Beginning in adolescence and continuing into adulthood, girls and women report increased levels of stress and experience higher rates of anxiety disorders. Learning to manage stress may be an important component of improving adolescent sleep. • Girls in this study averaged two hours less than the
LCRG RESEARCH ON SLEEP A large-scale LCRG-sponsored research study in collaboration with researchers from Boston College and Boston University explored the factors that contribute to and alleviate stress in high-achieving girls.27 Part of this study specifically examined the relationship between girls’ perceived stress and their sleep over time.28 Several important findings emerged from this study:
recommended nine hours of sleep per night, and their sleep decreased over the course of the academic year. • Higher levels of stress preceded fewer hours of sleep for girls in both the fall and the spring. • By contrast, sleep was a negative predictor of stress— greater time spent sleeping preceded lower levels of stress. • Stress appears to have long-term implications for sleep: higher levels of stress in the fall predicted decreased levels of sleep in the spring.
LCRG: GIRLS AND WELL-BEING: SLEEP
[endnotes]
Roberts, R., Roberts, C., & Duong, H. (2009). Sleepless in adolescence: prospective data on sleep deprivation, health and functioning. Journal Of Adolescence, 32(5), 1045-1057. Reynolds, A.M. et al. (2023). Pediatric sleep: current knowledge, gaps, and opportunities for the future. Sleep, 46(7). 3 National Sleep Foundation. (2014). Sleep in America poll: Sleep in the modern family. Washington (DC): The Foundation. 4 Tomaso, CC, et al. (2021). The effect of sleep deprivation and restriction on mood, emotion, and emotion regulation: three meta-analyses in one. Sleep, 44(6) 5 Dahl, R. E., & Lewin, D. S. (2002). Pathways to adolescent health sleep regulation and behavior. Journal of adolescent health, 31(6), 175-184. 6 Philbrook, L. E., et al. (2017). Sleep and cognitive functioning in childhood: Ethnicity, socioeconomic status, and sex as moderators. Developmental psychology, 53(7), 1276. 7 Kocevska, D., et al. (2021). Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and metaanalysis. Nature human behaviour, 5(1), 113-122. 8 Elkhatib Smidt, S. D., et al. (2021). Sex differences in childhood sleep and health implications. Annals of human biology, 48(6), 474-484. 9 Vollmer, C., et al. (2017). Morningness–eveningness correlates with sleep time, quality, and hygiene in secondary school students: a multilevel analysis. Sleep Medicine, 30, 151-159. 10 Kocevska, D., et al. (2021). Sleep characteristics across the lifespan in 1.1 million people from the Netherlands, United Kingdom and United States: a systematic review and metaanalysis. Nature human behaviour, 5(1), 113-122. 11 Johnson, E., Roth, T., Schultz, L., & Breslau, N. (2006). Epidemiology of DSM-IV insomnia in adolescence: lifetime prevalence, chronicity, and an emergent gender difference. Pediatrics, 117(2), 247-256. 12 Van den Bulck, J. (2007). Adolescent use of mobile phones for calling and for sending text messages after lights out: results from a prospective cohort study with a one-year follow-up. Sleep, 30(9), 1220-1223. 13 Mindell, J., et al. (2009). Developmental aspects of sleep hygiene: findings from the 2004 National Sleep Foundation Sleep in America Poll. Sleep Medicine, 10(7), 771-779. 14 Hale, L., et al. (2018). Youth screen media habits and sleep: sleep-friendly screen behavior recommendations for clinicians, educators, and parents. Child and adolescent psychiatric clinics of North America, 27(2), 229-245. 15 Hartstein, L. E., et al. (2024). The impact of screen use on sleep health across the lifespan: a national sleep foundation consensus statement. Sleep Health, 10(4), 373-384. 16 Calamaro, C., Mason, T., & Ratcliffe, S. (2009). Adolescents living the 24/7 lifestyle: effects of caffeine and technology on sleep duration and daytime functioning. Pediatrics, 123(6), 1005-1010. 17 Altintas, E., et al. (2019). Sleep quality and video game playing: Effect of intensity of video game playing and mental health. Psychiatry research, 273, 487-492. 18 American Psychological Association. (2014). Stress in America: Are teens adopting adults’ stress habits? Available at: https://www.apa.org/news/press/releases/stress/2013/stress-report.pdf. Accessed August 18, 2015. 19 Kessler, R. C., et al. (2012). Prevalence, persistence, and sociodemographic correlates of DSM-IV disorders in the National Comorbidity Survey Replication Adolescent Supplement. Archives of general psychiatry, 69(4), 372-380. 20 Caporino, N. E., et al. (2017). Sleep-related problems and the effects of anxiety treatment in children and adolescents. Journal of Clinical Child & Adolescent Psychology, 46(5), 675-685. 21 Garbers, S., et al. (2022). Mind–body integrative health (MBIH) interventions for sleep among adolescents: a scoping review of implementation, participation and outcomes. Adolescent research review, 7(4), 565-589. 22 Reichert, C. F., et al. (2021). Wide awake at bedtime? Effects of caffeine on sleep and circadian timing in male adolescents–a randomized crossover trial. Biochemical pharmacology, 191, 114283. 23 Lunsford-Avery, J. R., et al. (2022). Impact of daily caffeine intake and timing on electroencephalogram-measured sleep in adolescents. Journal of Clinical Sleep Medicine, 18(3), 877884. 24 S., Gerber, M., et al. (2010). High exercise levels are related to favorable sleep patterns and psychological functioning in adolescents: A comparison of athletes and controls. Journal of Adolescent Health, 46(2), 133-141. 25 da Costa Lopes, L., et al. (2025). Associations between real-life light exposure patterns and sleep behaviour in adolescents. Journal of Sleep Research, 34(2), e14315. 26 Lang, C., et al. (2016). The relationship between physical activity and sleep from mid adolescence to early adulthood. A systematic review of methodological approaches and metaanalysis. Sleep medicine reviews, 28, 32-45. 27 Spencer, R., et al. (2018). Having it all? A qualitative examination of affluent adolescent girls’ perceptions of stress and their quests for success. Journal of Adolescent Research, 33(1), 3-33. 28 Desilva Mousseau, A.M., et al. (2015). Stressed and losing sleep: The sleep-stress cycle for affluent adolescent females. Manuscript in preparation. 1
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LCRG: GIRLS AND WELL-BEING: SLEEP
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