Why Teens Don't Sleep (and What Parents Can Do About It)

One thing that we talk to parents about when it comes to sleep in general is control what you can and know that you can't control everything. Your kid has a soccer practice that ends at 08:30 or 09:00. It's probably not realistic then that your kid is running home and jumping into bed at 09:15. Right? So I try to help parents to really understand that we get it.

So the biggest thing is being honest with yourself about what you can do and also just being kind to yourself because then it just becomes another stressor of, my god. They only got seven hours. That just snowballs down a bad path for everybody and doesn't lead to more sleep.

Welcome back to the Parenting Pair Podcast. I'm Doctor. Suzanne Allen.

And I'm Doctor. Annalise Caron.

And today we are really excited to welcome two excellent clinical psychologists who are also experts in sleep and wrote a fantastic book, The Essential Guide to Children's Sleep.

So those of you who are on YouTube watching this, here is the book. You want to look out for it. Very readable, very, you know, not too long, but filled with really good information. So we are going to have the the a brilliant conversation with the authors who were excited that they came today. But before we jump into that, as those of you who've been listening a while have heard us at the end of each podcast, ask if you have a moment to rate and review the podcast.

And maybe if there's someone that might find the information useful to send it along to them, to share it with them. Well, those of you who've been listening know that Susan and I started this out of a shoebox, not really knowing what we're doing at the May. And we are super excited because our podcast is being listened to in 42 states. And this may sound really silly, but we would love to get our podcast to be heard in all 50 states. So if you're listening to this podcast and if you happen to know anyone with a teen or a tween or maybe a teacher that would like to hear the kinds of discussions and the kind of experts that we bring on the podcast, would you share it with them so that maybe we could get it?

And we'll update you periodically on how it's going. But our last eight states, if you know someone in Alaska, Idaho, Kansas, Montana, Nebraska, New Mexico, Oklahoma, or West Virginia, please send it along to them because we would be really excited to ultimately be able to report back that people, our parents are listening in all 50 states. So thank you for that little self indulgent request. Let's jump in with Doctor. Roth and Doctor.

Schale.

Yep. So we would love to welcome them to the show. In addition to being experts in child and adolescent sleep, they are both highly skilled CBT therapists who treat anxiety and other mental health conditions in children, adolescents, and adults. Doctor. Andrea Roth is coming to us this morning from Michigan, where she's the clinical director of Thriving Minds Behavioral Health and also leads their training program in behavioral sleep medicine.

And Doctor. Allison Schale coming to us from Northern New Jersey, where she is the owner and director of Shale Psychology. Together, Doctor. Roth, Doctor. Shale, and their coauthor and other colleague of ours, Doctor.

Shelby Harris wrote The Essential Guide to Children's Sleep, a tired caregiver's workbook for every age and stage, which is an evidence based resource giving parents concrete strategies to improve their child's sleep and hopefully ding ding ding for parents our own sleep. The book offers targeted advice for different ages, allowing parents go directly to the relevant section for immediate help. So I would highly recommend this book because you can just go to the chapter you need without having to read several 100 pages before. It's an excellent, excellent read. So welcome Doctor.

Roth and Doctor. Schale.

Hi. Thanks for having us.

Thank you for your patience in our very long intro, appealing to the states.

The eight states that were holding out on us. So I would love to between Suzanne and I, we have, I think, four teens and one tween. Is that correct? Correct. And I would just love could we start with the basics?

Meaning, you know, for a tween. So let's say someone in that nine to twelve range, eight to 12 range. And then for teenagers, how much sleep in the world of shoulds, where, you know, we can't be promised, but how much sleep should we be aiming for with teens and tweens?

So I think we open you know, we discussed with this book that we were really getting into that kind of earlier childhood group before kind of teens and tweens, and then we kind of decided at the end, we gotta pop something in. There's gotta be something because Sleep for Teens would be its own book. And we open up that chapter with, did you know, effectively, teens and tweens should still be getting somewhere between eight to ten hours of sleep? And I think we even have a remark of like, I bet you're laughing at that. Because do you know any teenagers that are still sleeping between eight and ten hours?

But as you guys know, there's still so much neurological development going on at that age, there's still so much going on that they still need so much sleep. So in the world of shoulds, somewhere in the ballpark between eight and ten, kind of like you said, that's a wide range between and teen, but it's still a higher number I think than people believe it to be.

It really is. Yeah.

And I think this as clinicians, not to kind of throw a a tough one out right away, but I think the thing I often kind of dread sleep discussions with parents because I think a lot of parents feel tremendous pressure, you know, that their teens are supposed to be or tweens are supposed to be getting that much sleep. And yet there are many things in the environment working against that. So, you know, school, school hours, after school activities, homework, college applications, work, you know, a multitude of other things. What advice do you give to parents of teens and tweens who are facing that? And I think, you know, it it feels so hard to get that message of eight to ten hours and then to try to be in charge of that for a teenager who's also trying to individuate.

Yeah. You know, I think one thing that we talk to parents about when it comes to sleep in general is control what you can and know that you can't control everything. Right? And and, you know, be nice to yourself to some degree. Right?

If your kid has a soccer practice that ends at 08:30 or 09:00, you know, it's probably not realistic then that your kid is running home and jumping into bed at 09:15. Right? Everybody need I need wind down time too, right, to shower, maybe to eat something, to finish an assignment. So we'll talk to parents a lot about like, let's see what your actual schedule is so we can help you come up with something that actually is realistic for you. Are there nights where you could do bed a little bit earlier?

Again, we're not saying you know, we we never recommend, like, crazy swings of, you know, three hours earlier one day because that just throws off their sleep cycle. But I try to help parents to really understand that we get it and that it is hard and that by telling me, oh, yeah. Yeah. Yeah. I'll do ten hours.

Yeah. I'll have him in bed by 09:00, and then they can, that it doesn't help them. It doesn't help me give good advice. So the biggest thing is being honest with yourself about what you can do and also just being kind to yourself because you like you said, you know, there's so many things working against kids to be able to do that that, you know, I'll even sometimes say to parents, like, kind of forget that that's, you know, what the doctor ordered because then it just becomes another stressor of, my god. They only got seven hours.

And then when it becomes more stressful, right, that just snowballs down a bad path for everybody and doesn't lead to more sleep.

Mhmm. And often, I think leads to a lot of anxiety awareness too.

Oh, yeah. Because I hear a

lot of, you know, teens and tweens kind of get somewhat catastrophic about their sleep or worry about it. Then I'm gonna have terrible sleep. Then I'm gonna do very bad in school. Kind of another problem develops on top of the issue of not being able to find the time to sleep.

And to try to engender a little even greater self compassion for the parents and the kids here, could you guys speak to us a little bit about kind of the biological changes too that that also impacts the sleep during the teenage years, right, that also make it more difficult? So not only are teens, many teens, having incredibly busy schedules and a lot of requirements on them, but they're also kind of neurologically sometimes not ready to sleep as much as they were when they were younger. Is that right?

Yeah, absolutely. We think of sleep preferences and our schedules as kind of being a bell curve. So when they're really little, if we could all remember back to when our kids were infants and teeny tiny, they had that early preference. And so they went to bed early, they woke up early, they did everything a little bit earlier, and then as they aged it started to go up and they started shifting until later in the evening, peaking kind of in adolescence and early adulthood, so they are really, what we would say, kind of getting, becoming phase delayed. They're becoming night owls.

They have this, as you mentioned, kind of biological hormonal shift that makes them be a little more evening oriented. So their bodies aren't becoming tired until later at night. They're wanting to sleep in and then it is really that kind of compounding of the social demands, the social and environmental demands. So their body doesn't want them to go to bed till later, and then they stay up later because they have so much going on and it just again compounds on itself. And so they are really kind of fighting an uphill battle when it comes to trying to get to bed early, and then looping in with as you also have mentioned, the insanely early school start times that they face in high school.

So a lot of it really works against itself. But yes, they definitely shift. And then again, the end of that bell curve, they're coming down the other end into those lovely years at the end when we're going to bed early and eating the early bird special and getting up early. So it kind of comes back down, but yeah, we're really seeing that peak. I can't I'm already there.

I'm so excited. Yes. Yeah, biologically, they also are unable to go to bed super duper early like we were kind of able to do this as we younger.

And I think that mismatch, you know, that you myself as well, I have a much greater drive to go to sleep earlier now. But it's interesting, you know, my teenagers being up later also sort of like the time that I might have an opportunity to chat with them or they might wanna open up is like late at night when I want to be asleep. So it's this interesting balance that I've noticed, you know, particularly with my daughter who's 14. She'd rather talk at, like, you know, when she's going to bed at, 10:45, eleven at night. I know that that's bad, but there's a lot going on.

And I wanna be asleep. So it's this interesting thing to sort of finding those times and others' times to connect because our our sleep is in different directions.

Mhmm.

Yep. I know you mentioned not wanting huge swings, but I think a lot of the I am curious about your recommendation. A lot of teenagers talk about when they can get to a weekend and finally sleep in. Mhmm. And I think often parents were, you know, like, should we be waking them at some point?

So, you know, is there kind of a a a swing or an allowance for some catch up time on weekends? What what would you recommend?

Yeah. You know, this gets to be a tricky one because, you know, there's one side of it where they really are in this sleep debt and, like, kinda do wanna let them sleep and catch up a little bit. But then there's the other part where if they sleep until noon on Saturday, then they wanna go to bed even later because they then they can't go to bed at 10:00 because they haven't been awake and they haven't been doing much. And then you run into that even worse on, like, a Sunday night. Right?

So, like, again, in a perfect world, I think we often tell people, like, an hour later than, you know, like, you you can have about an hour swing in the morning, ninety minutes. But, again and and for some kids, that's really easy. Right? If they're on the soccer team, they might have nine AM practice on Saturday, and it's not as hard to get them up. But for a lot of kids, they they really kind of do need the catch up.

But then, like Andrea said, that word compounded, that I feel like is something we're constantly talking about, how things just snowball a bit, that you wanna let them catch up, but then Saturday night, there's no chance of them going to bed at a normal time because they need to be awake for ten hours, you know, to actually feel tired at all. And then they sleep in again, and then Sunday night, and then all of a sudden Monday rolls around, and they need to be up at 6AM, and they're exhausted again. And that sleep they caught up on is, like, gone. So, again, like, in a perfect world, I typically I think, Andrew, you might say the same. I typically say, like, an hour ish is a night swing on the weekends or on a day off.

Give them a little bit of extra time. But if you're letting them sleep till, like, 01:00, again, it just it unfortunately just kind of backfires very quickly Monday morning.

Well, it is really person to person too. I think Alison's totally right. It's totally kid to kid. And if you've got a kid that's really struggling with kind of maintaining their schedule, we will be stricter. Whereas maybe there's a child who's able to be a little bit more flexible with how they sleep.

Sometimes we'll let them have, like, Saturday morning. Saturday morning can be a bigger morning. And then we kind of say, okay. No matter what, no matter what time, you know, you get up on Saturday, we're still gonna try to get to bed at a fairly reasonable time and then get up at a better time on Sunday and have a little bit of catch up, you know, again, up on Saturday morning. But we we have to be smart about it.

So again, it's person to person. If they're really able to to roll with it and flex a little bit, we can be a little bit more so. But those kids that really struggle to maintain, we have to be pretty strict. And I think that what's really good about this is this can be some of the bargaining chip, and I'm sure we'll get into this. But one of the biggest issues for treatment and barriers for treatment is buy in from teens.

And so I think often a lot of the time we're doing a lot of motivational interviewing and what feels like a lot of bargaining. If I give you a little bit of Saturday morning, can you try to do this on the rest of the nights? You know, so it becomes a little bit of a bargaining chip for us too, which is

helpful.

One of the things, you know, that we, our clinical practice but also on the podcast, really try to help with is is increasing understanding. And so parents understanding, as we've been talking about kind of the biological need or or some of these changes that happened during the teen years. You mentioned something really interesting. I haven't seen this term before, this sleep inertia and social jet lag. And I wonder you mentioned that in the book.

I wonder if that's something you could describe a little bit because when I read it, I thought, oh my gosh. This is such a neat thing for parents to have a better understanding of that might increase some empathy for teens in the morning.

Absolutely. And I think this is actually quite a delightful piggyback because I feel like I've just said this thing about motivational interviewing and buy in and getting them all on board. And I think psychoeducation is like the biggest thing that we can do to really help with that on both sides. Not just the teen side, but also the parent or caregiver side. And right, understanding of these terms can be really helpful.

So this concept of sleep inertia is effectively this idea that when you first get up, it's not uncommon to still feel really groggy. You're still experiencing some amount of kind of sleep drive, especially if you're an adolescent and you've maybe not slept enough. A lot of the times we'll get up and we'll just say like, I didn't sleep enough, I still feel groggy or tired, I feel really exhausted still, I obviously did not sleep enough. And again, the sleep inertia is kind of this broad concept that that's not necessarily accurate. We don't want to base how well we slept or how much we slept on how we feel right when we got up.

We want to think of it a little bit more like I would say, tell me how you're feeling maybe after breakfast. Give it a little bit of time. Give it thirty, sixty minutes, you know, how, a little bit of time before you really start to judge how well rested do I feel, how alert and aware am I. So it's not abnormal, oh my gosh. And we talk about I love those, you know, that understanding of what's kind of typical in adolescence versus what's maybe more a little clinically concerning.

Put that, like add this to the list, that wonderful list that we have with, and you know, whose manual is that? Alec Miller, the DBT manual. Typical adolescent behavior concerning adolescent behavior. Feeling groggy in the morning? Typical.

Grogginess all day long and struggle to kind of focus all day long, a little bit concerning. Social jet lag is the same thing as regular jet lag just without the cool travel. Social jet lag is this concept of I'm going to bed, you know, if I think of my, oh god, desirable adolescent sleep schedule, maybe I'm going to bed at 10:00 and waking up at 6AM Monday through Friday. And then on the weekends, I'm going to bed at 2AM and waking up at noon, and then for two days a week, and then I'm shifting back. So I always say to adolescents, it's like getting on a plane and flying to California every weekend.

That wouldn't feel great for you. And we're going use this word, I guess, today all day long, compounding on that is the fact that you don't actually have the cues. So the benefit of actually getting on the plane and going to California is that you've the sun, the thing that sets our clock, to help you to kind of reset and shift to that sleep schedule. When I'm just staying here in Michigan all seven days of the week, but I'm sleeping like this, I don't have any natural cues to help my body regulate and adjust. It's just meep.

And so it just makes it even harder. So that social jet lag, again, it's that social demand of kind of being up later, sleeping in later two days, I guess, in this idea really two days out of the week. But without the benefit of the sun and the cool travel.

That's such a good way. That's so true with jet lag. You're getting that hue is that's really, really a good point. I'm curious. This is this is a little off topic, but related to what you just said, in in in light of that, you know, you read sort of, you know, in magazines here or there that it's really important to get light first thing in the morning.

Is that something because I'm imagining if we're trying to not have that full social jet lag, what we might be saying to our teens who get to maybe go out on the weekends or stay up a bit later that, yes, they can sleep in, but maybe as you suggested, maybe just an hour or a little bit more, not the full four hour swing, but that would put them in a little bit of a sleep dent. Them not getting what that means is not getting as much sleep as they typically would need, right, on that night because you're still encouraging them to get up. Is that something you encourage? Like, if if if you're a little bit under on sleep, be sure to get yourself in the light. I'm just curious.

And first thing when you wake up?

Yeah. I mean, I I always think sunlight is a good thing to kind of help your body and help your rhythms and things like that. Again, I think with teens, of trying to convince them that when they get out of bed, they should go outside. You know, it just might not, you know, it might not land. And, again, you know, like, kind of what Andrew was saying in terms of this kind of buy in, I try to use the education piece to tell kids, like, teens, however old they are, even little kids, even like a six year old.

Right? It's, like, no different, six or 16, to try to help them to see that, like, this is for them, and mom and dad have to do things and change things. So, like, this is for them and to benefit them. And, like, your life will actually be better if you are less tired. And I'm really you know, like, this is a really concrete thing.

So sometimes you can get a little buy in of, when you get up and when you get going, you notice you feel a little bit less groggy. You get yourself outside. You might notice that when you're waiting for the bus and it's a sunnier day versus a not sunny day, you just feel better. Right? We can say that kind of seasonally outside of sleep what why why light and sunlight help us.

Right? So, again, it's like in a perfect world, yes, sunlight is so great for your rhythms and things like that and your body just knowing, like, time to be awake, time to go to bed, but also trying to just be realistic. Sometimes I'll throw a lot out at teens, and I'll say, like, you know, I threw a lot out at you. Think about what you wanna try so that they do feel some ownership of it also and knowing that it's not one size fit all and that their buy in is so much more important than me coming up with, like, the perfect plan. It's much more important that they're willing to do something.

I'd rather them do one thing and do it with commitment than try to throw 20 things at them and hope they do all of them.

Mhmm. I love what you said too that you may notice. I think that's such a great phrase as a clinician you can use, but as parents also could be something instead of you should do this or you have to or if you don't, this is bad thing is gonna happen to you, but just alerting them at times. You know, you might notice feeling a little bit better, or I notice that I feel better when I get outside in the morning. Just a thought and kind of leaving it there.

Absolutely. And I think that as parents, it's a really valuable thing to be able to say, when I go to bed really late and then have to wake up really early, here's how I feel. Right? Or even admitting. Like, I'll say to kids, I have a hard time not doomscrolling also when I know I should be in when I know when I'm fighting the sleep because I just want a little more me time, like, to really validate that this is not something that only teens struggle with.

As adults, with really, you know, full functioning frontal lobes, you know, we still don't always make the right kind of choice on it. So it is a hard thing. So I think when parents can say, here's what I notice about me, here's what I try, here's what I haven't tried, here's what works for me, here's what doesn't, that's really validating for kids. Whether it's about sleep or, you know, whatever other clinical issues we come to, that's always helpful.

So the question I have for you for people that are listening, because I think sleep is is wrought for teenagers and parents and comes up a lot. You guys obviously are experts in this and practicing clinicians dealing with sleep and the whole host of mental health problems. Obviously, you work with people on sleep in your practice. When is it do do you think a time or what might be some indicators to parents listening? Like, oh, maybe I should get some extra help with this.

This isn't, you know, typical teen, you know, concerns. What are what are some things that parents should keep in mind that maybe we're at a stage where we could use some outside help?

What's really great in adolescence, I feel like the real benefit we have is that more often than not, they will come to us. I feel like when we work with smaller children or younger children, it's really the parent or caregiver that has to observe these kind of like XYZ symptoms and know to come get help because it's been a certain amount of time. But with adolescents, more often than not they're kind of talking about it to their parents or their caregivers and then they're saying things like, I'm falling asleep a lot in class, or I'm really struggling to pay attention, or I just feel really, again, groggy all day long. And so then I think it's really obvious to us. They're maybe not asking for help, they're maybe just giving you a list of fun notes, but they're more apt to come to us.

I think the biggest thing that we see the majority of the time in this population is just that excessive daytime sleepiness. They are struggling to stay awake in class, they are struggling to stay awake after school, or that bedtime anxiety that you guys were referring to earlier is really oh my gosh, unbelievably common. I'm always so surprised by that because I think back to my own adolescence, which feels like eons ago, I don't ever remember feeling worried or anxious that I wasn't and I had anxiety as I get it, still have anxiety now. I don't remember ever feeling anxious that I wasn't falling asleep. So the sheer volume of adolescents that are coming to us that have such anxiety about sleep and falling asleep and staying asleep is really interesting.

But so I think if we listen to them, they tend to tell us. But if we just observe that they're kind of falling asleep all day long or that crash out on the weekends when they don't have to

wake up

is really significant, I think that's when we do need to to talk to someone.

Yeah. And I think also, you know, sometimes I'll have people call and they'll say, you know, we're just not sure. And I'll say to people, you can just I can send you my sleep log. You can track it, and you can pay attention to it, and you might notice, like, oh, this is they're getting far less sleep than I thought, or they're much more tired than I realized, or I'll sometimes have teens track, like, how many times does your kid say that, like, they wish they could take a You know, things like that. And there's never harm in getting help.

Right? So if you're starting to think it might be an issue, call someone. You could do an intake with somebody and have a conversation, and that doesn't mean you're committing. I would say you're only committing to the appointment you're in. So, like, you don't need to commit to a lifetime of sleep treatment.

Sometimes people need an intake, an appointment or two, and they feel like they have things. And parents feel supported. They feel like they've got education behind them now. They've got someone on their team. Their kid, they had someone lay eyes on their kid to say, yeah.

Maybe this could change or that, but but I think we're okay. So sometimes just that reassurance from a clinician can be so powerful. So, you know, a lot of times when people call, I'll say to them, like, if you're calling, it tells me that you're thinking something's up. So, like, let's have a deep one deeper conversation and see what we think.

And I I also think the gift of going to experts like yourselves or reading a book like this, you know, is sometimes there's things that we just don't know. We might assume that it's they're not getting enough sleep. That's their daytime sleepiness. But sometimes that can mean other sleep disorders or other types of concerns that could be picked up, you know, by yourselves or or by other people. So it's important, you know, not to minimize that, that that there may there may be more nuance to it.

You know? In addition, I think there's also something betweens and teens that sometimes it's just better, even if it's the straightforward, we're not getting enough sleep and we need to problem solve that, it can be better coming from a different adult than the parent. You know? There are things that I am able to connect with and work on in session that probably any parent could do. But because I'm not the parent of that child's gene, they're more willing.

Oh, absolutely. And I'll say that to parents. Like, you may hear something I say and go, I've said that forty sixth time, and it's suddenly like they were speaking French and I'm speaking English. Mhmm. It's you know, I try to lay that out to people that it's the total truth.

Sometimes it's just a different voice. I'm not their mom, so suddenly it's different. I'm the doctor, so it lands a little different. But absolutely, it's just to have someone else, like, in your corner. Mhmm.

That that can be really helpful.

Mhmm. And providing that psychoeducation. Yeah. Right? Because I think sometimes coming from a parent, for whatever reason, it can feel like there's judgment or criticism, right, that can be tougher for kids to hear versus coming to see a doctor or an expert, right, or or someone in an office, then it's just information.

Well, we're getting close to wrapping up. But I did have one last question because I hear about this a lot, you know, with my own clients. You make very clear in your book that as a first line sort of approach to managing sleep concerns for children and teens, you don't recommend immediately. And of course, is individual based on the person using melatonin. I wonder if you could speak to that because I certainly hear a wide range of dosing that teenagers are using, different types of it.

If you could just speak to why that is your thought and if you do ever suggest using melatonin and any parameters on that because I think it would help to ground some parents on what kind of the research says or what you think.

Yeah, absolutely. I think, and you know, if people are watching it on YouTube, this is the moment where the scroll at the bottom is like, we are not medical professionals and we are not dispensing medical advice. Please consult with a 100 I think where we are all Cover your behind kind of gals. So I think even five years ago, know, five, six years ago, we were really reluctant, I think, as the type of doctors we are, because we're not medical doctors, to speak on melatonin. I think even in my own practice, I would kind of really cautiously defer to, oh, take that up, you should probably speak to, you know, his pediatrician about that.

Because again, I've always been really averse to that kind of liability. But in the past, you know, again, years, I attended a panel at the pediatric sleep meeting a few, gosh, at this point two years ago about how we need to speak up more about melatonin, we need to provide more psychoeducation about what the research is showing us. You know, the International Pediatric Sleep Association had a task force on it that's kind of going through all the research, doing their own research and talking a little bit more about it. And so what we kind of come to stand on now are a few tenets. A, we really need to treat melatonin supplements as what they are.

It's not a supplement, it's not like a Flinstone vitamin, it is a medication. It is more serious than we think it is. Just because it lives next to the Flinstones doesn't mean it's that. B, you need to be thoughtful about the type of melatonin you're using because as with other supplements in this country, they're not regulated by any sort of governing body with the exception of ones that have there's an NSF seal, there's also a USP seal, so those are ones that have good kind of oversight. So what it says is in the bottle is actually in the bottle.

Because what some of that research has kind of come to show in the past few years is that there is an extreme amount of variety, not just like bottle to bottle, but within the same bottle of what's in it, of how much is in it, and then other stuff was found in some of the gummies, CBD was found in some of the gummies, etcetera. Like you really have to be thoughtful about the brand you're choosing. And then on top of that the other is there is no significant long term research to support the use of melatonin use, the use of melatonin pardon, in the general population in pediatrics. There is good sound research to support its use in neurodiverse populations, children on the autism spectrum, children with ADHD, there is fantastic sound research to support that. But again, in this general population, it does not exist yet.

And then on top of that dosing. Dosing and usage, I think a lot of the time some pediatricians will recommend it and will hear kind of what the thought is or what the recommendation is, or if there was one. And often it's not necessarily following the guidelines that it's meant to. And so we really recommend a very, very small dose. So in that adolescent time period, in that age we would say five milligrams or under.

Smaller peanuts, three and under. It is such a small dose. It is such a, such a small dose. And it's meant to be not used as a sleep aid, kind of like an Ambien right before bed, which is I think often when we're seeing it be used. Either like right when they get into bed or kid's been asleep for an hour, then we're giving it to them.

Is meant to be used well before bed, forty five to sixty minutes before bed. So again, it's just kind of those basic tenets of speak to your physician, use a good brand, use it in a population that it's supported in, if you're going to use it in a long term way. And then it, like so many things, it should be used as part of a larger plan. Let's try the behavioral stuff first. There should be the behavioral strategies put into place and then if we're not seeing the gains there, that's the first step.

Melatonin and other items like that can be used as a second step because the behavioral piece maybe wasn't working enough.

I think I think because we were we were aiming to talk about teenagers where the behavioral piece, quote unquote, is kind of different than it is when we're talking about a six, seven, eight year old, you know, or or or younger child. And I could I could gander from this conversation, you know, sort of a summary. But if there were the top three behavioral tenants or the things that you would recommend for teenagers, because I I do think we gave that short shift because I was so interested in your expertise on, you know, kind of the psychoeducation around this and parents feeling compassion, you know, what would you say? Because it's not the same thing as, you know, leaving the room or, you know, sleeping or exiting the room or managing anxiety with an elementary school student. You know, it's a different approach.

So when you're dealing with tweens and teens, how would you describe that so that parents know what you mean by when the behavioral things don't work?

I think it can be things like a cell phone in the bed. You know? It can be stuff like that where it's not behavioral in the sense of, like, they're being defiant, but maybe some of their habits around sleep. Right? Maybe, like, sleep hygiene sorts of things.

What's their nighttime routine? When are they getting into bed? Are they then watching five hours of YouTube when they get into their you know, they think they're going to bed at ten, and then they're actually on their phone for another three hours. Right? So for me, a lot of that kind of behavioral stuff tends to be tied to cell phone screens, things like that in their beds and what's actually happening once they go in their room.

Almost you know, with little kids, it's much more about what are we doing before we get them into the bed, what's the lead up, what's our bedtime routine. I think for adolescents, it's a lot more about what are they doing once they're in their bed or not doing. That that to me is what falls in that behavioral sort of category.

Yeah. I think yeah. I think you kind of said what are some top tips we would give. I think the first one is just like get out of bed. Get out your bed.

It's not, it's not, get out of your bed. The worst thing that I say to adolescents when I talk to them about sleep, they just turn red and they get so mad at me, is providing that psychoeducation that your bed is for sleep and sex, and that's And if we really can't, we'll say just sleep. But with adolescents, I say your bed is for sleep and sex, period. That's what it's meant for. You are not supposed to do anything else in it.

Oh my God, do they really just want to shake me when I say that or just kind of melt. They are spending so much time in their bed. They're just, they're doing their homework in their bed, they're scrolling in their bed, they're chatting, so get out of bed. Bed is for sleep. Just sleep in it.

But then if we really, I mean, would take another hour today, if we really get into the behavioral framework for treating difficult sleep in adolescents, we're dealing with insomnia, phase delays, we are using a lot of kind of maybe sleep restriction, we're using maybe a little stimulus control. All things effectively meant to keep them out of their bed if they're not sleeping or to compress their sleep a little bit so that they're getting some solid sleep straight through. So if we're talking about using the behavioral stuff, as I so elegantly put it about five minutes ago, we're really saying go through a kind of real behavioral protocol first where we are using some of those strategies. Some of those strategies we would actually pull from a more adult CBTI we're able to use in adolescence. And so if that's not working, that's I think when we can lean into other things.

But yeah, think we're doing a lot of psychoeducation, a lot of just, you know, get out of your bed and cleaning up their schedule as best as possible. Wonderful.

And for anyone listening who's thinking like, but I want to hear more about insomnia Great and news. Doctor. Shale and Doctor. Roth are doing a two parter for us, so they are coming back and going to speak more specifically about some of these more clinical issues and struggles of sleep for teens and tweens.

Yeah. Both when when we have, you know, sort of insomnia, as as we were just discussing, also in clinical populations, how sleep approaches may be a little bit different. So look forward to that. I think we'll round for for now, for today's episode here. And just say as always, thank you so much, doctor Roth and doctor Schale, for coming on today.

We really appreciated your expertise and the clarity with which you spoke to our parents. I think this is a hot button issue that is a point of contention for a lot of teens and tweens for their parents. So we appreciate your book. Once again, it's The Essential Guide to Children's Sleep by Doctor. Roth, Doctor.

Schale, and Doctor. Harris. It is available now anywhere you can get your books.

Is there anywhere else that people can find you if they're looking for tips or information online, social media?

Yes. We have a a newly started Instagram page at Essential Kids Sleep where we are giving lots of tips. We're doing some giveaways of the book recently. So you can definitely follow us there. And we think it's got some great some really great stuff coming week by week.

So check us out there.

Wonderful. Thank you. All right.

Well, as always, if you have any feedback on this episode or any ideas for future episodes, please don't hesitate to reach out to us. DM us on Instagram at the parenting pair, and we'll see you soon. Have a great week. And now a quick word from our lawyers. The Parenting Pair Podcast is designed for informational and educational purposes only.

Do not rely on the information presented in this podcast as a substitute or replacement for professional psychological or medical advice, diagnosis, or treatment. If you have concerns about you or a family member's well-being, please contact a licensed mental health professional or physician.