Doctor, I am tired of this girl now!' Namrata's mother was on the verge of tears. Namrata is in 11th standard and for the past 4-5 years, her usually patient mother seems to be facing one crisis after another. As I have been seeing Namrata as a patient since she was a baby, I am witness to her transition to a teenager and in a way, can appreciate her mother's concern! This time, the problem is Namrata's sleep pattern! Apparently, she is all the time sleepy. She takes ages to get up in the morning, then skips her breakfast because she is too late, sits up late at night chatting on phone or on the net and is invariably sleepy throughout the day!
Sleep constitutes an important part of our circadian rhythm which is an internal clock that dictates periods of activity and inactivity based on light-dark cycle. We all know the story of the scientist who thought sleep to be a waste of valuable time, conquered it and almost went mad from the lack of it! Thank god, all the rest of us mere mortals do not think so and treasure our beauty sleep! At the end of a busy day, the thought of a good slumber in a cozy bed is the most welcome.
Sleep has many important functions. Our body repairs and regenerates tissues, builds bone and muscle and strengthens immune system during sleep. Most of the growth hormone secretion and spurts of secretion of sex hormones occur during sleep.
Sleep deprivation can lead to impaired memory and thought processes, depression, headache, can affect mood negatively and can increase risky behaviour such as drunken driving, unsafe sexual activity etc. It may lead to poor school and social functioning.
Adolescents go through a major transition and their sleep pattern is changing too. As we are well aware, this period is marked by a lot of hormonal and emotional upheavals. Also, there are many social changes. Today's overtly competitive world only aggravates the problem. Talk to any youngster today and you will find him entangled in a web of activities such as college, tuitions, unending entrance examinations and extracurricular activities. As they get caught up in a vicious cycle of brutal competition, they hardly get time to stop and think. Coaching classes, colleges, practicals start early in the morning and merge into one another till late in the evening. Coupled with this hectic schedule, there are changes in the secretion of a hormone called Melatonin which leads to a delayed circadian phase. Teens tend to delay both their sleeping and waking time and as a result, collect a significant sleep debt. This then leads to excessive daytime sleepiness and increased sleep over the weekends. We also need to exclude other causes of excessive sleepiness such as anemia and hypothyroidism.
Parental influence starts shifting from setting bedtimes during childhood to assisting with rising times during adolescence.Namrata's mother received all this information with interest and we came to a consensus regarding Namrata's sleep. She decided to share the newfound knowledge with Namrata, acknowledge her changing sleep pattern and at the same time make her aware of the necessity to get adequate sleep. She also decided to let Namrata catch up with her sleep over the weekends. Namrata's tight schedule of activities was reviewed and prioritized. They decided to start the day a little later and keep a short quiet period before bedtime.
Hoping to get a positive feedback during their next visit!
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