An update on adolescent sleep: New evidence informing the perfect storm model^☆

Abstract

The maturation of sleep regulatory systems during adolescence in combination with psychosocial and societal pressures culminate in a "Perfect Storm" of short and ill-timed sleep and the associated consequences for many youngsters. This model, first described by Carskadon in 2011, guides our current thinking of adolescent sleep behavior. Since the original description, the field has moved forward with remarkable pace, and this review aims to summarize recent progress and describe how this new work informs our understanding of sleep regulation and sleep behavior during this developmental time frame.

Intraindividual variability of sleep/wake patterns in adolescents with and without attention‐deficit/hyperactivity disorder

“…school start time) and psychosocial (e.g. autonomy, academic pressure, screen time) pressures to contribute to insufficient and ill‐timed sleep in adolescence (Crowley et al., ). Studies are needed to more directly test these interrelations in adolescents with ADHD specifically.…”

“…Studies are needed to more directly test these interrelations in adolescents with ADHD specifically. Some factors of the perfect storm model are modifiable, whereas others are not (Crowley et al., ). Intriguingly, a recent cognitive‐behavioral intervention conducted with adolescents with an evening chronotype not only improved adolescent‐ and parent‐reported sleep, but also resulted in a decrease in evening circadian preference, an earlier endogenous circadian phase (i.e.…”

“…In adolescence, nightly sleep duration of 9–9.35 hr is required for optimal cognitive functioning (Crowley, Wolfson, Tarokh, & Carskadon, ; Short, Weber, Reynolds, Coussens, & Carskadon, ). However, a confluence of psychosocial and biological factors contributes to changes in sleep regulation and circadian timing.…”

“…Homeostatic sleep pressure builds at a slower rate among more mature adolescents compared to less mature adolescents, giving biological ‘permission’ of later bedtimes (Jenni, Achermann, & Carskadon, ; Taylor, Jenni, Acebo, & Carskadon, ). The circadian timing system also changes during adolescence, with a shift in phase preference toward eveningness possibly due to a lengthening of the intrinsic period of the circadian clock (Crowley et al., ). These developmental changes in homeostatic sleep pressure and a circadian phase delay contribute to differences in sleep timing and duration between school nights and weekend nights (National Sleep Foundation, ).…”

Merging the Biological and Cognitive Processes of Sleep and Screens

“…The generic term "screen time" has been widely discussed in the adolescent sleep field, where it has also been established for a significant time that adolescents experience a circadian delay [3]. In relation to screen use, Carskadon [4] proposed that development of bioregulatory mechanisms alongside This article is part of the Topical Collection on Sleep and Technology psychosocial factors (such as seeking increased independence and bedtime autonomy, which can provide opportunity for pre-sleep activities such as social media use) resulted in a 'perfect storm' of short, ill-timed and inadequate sleep in many teens.…”