Adequate Sleep - Children in United States

United States

Sleep is critical for basic bodily functions such as cognitive processing, mood regulation, regular blood sugar level and immune system response. Sleeping heals the body, repairs blood vessels and regenerates cells. In children, adequate sleep can help prevent poor mental health, attention problems, injuries, obesity and Type 2 diabetes. According to the Centers for Disease Control and Prevention (CDC), up to 70% of adolescents in the United States — some 42 million teenagers — consistently sleep less than eight hours per night. The high prevalence of short sleep duration among students suggests an urgent need to address sleep health and its barriers.

For years, it was believed that people needed less sleep as they developed from infancy to adulthood; however, recent research shows that teenagers need more sleep than they did as children or will as adults. Despite this understanding, school start times often do not align with adolescent sleep needs. An alarming 6.6% of teenagers get the recommended nine hours of sleep per night. For adolescents, not getting adequate sleep is associated with higher rates of: 

• Psychiatric disorders and poor mental health.
• Poor academic performance.
• Unsafe behaviors such as risky driving, alcohol use and self-harm.
• Car accidents.

The prevalence of adequate sleep among children ages 4 months to 17 years is higher among:

• Girls compared with males.
• Non-Hispanic white children compared with non-Hispanic Black, Hispanic and Asian children.
• Children from higher-income households compared with children from lower-income households.
• Children without adverse childhood experiences (ACEs) compared with children with one or more ACEs.

Despite maintaining healthy sleep practices, some adolescents may still struggle to get enough restful sleep. It is important to discuss any sleep concerns with your primary care provider, as many teenagers suffer from sleep disorders such as chronic insomnia, obstructive sleep apnea, or restless legs syndrome. If left untreated, these conditions can significantly affect overall well-being. 

Inadequate sleep greatly affects academic success. The American Academy of Pediatrics urges school districts to delay start times to help students achieve adequate sleep every night. Strong evidence indicates that delaying school start times increases average sleep duration, reduces fatigue and improves academic performance among students.

Healthy People 2030 has an objective to increase the proportion of children who get sufficient sleep.

Adolescent sleep working group, COMMITTEE ON ADOLESCENCE, COUNCIL ON SCHOOL HEALTH, Rhoda Au, Mary Carskadon, Richard Millman, Amy Wolfson, et al. “School Start Times for Adolescents.” Pediatrics 134, no. 3 (September 1, 2014): 642–49. https://doi.org/10.1542/peds.2014-1697.

Pizza, Fabio, Sara Contardi, Alessandro Baldi Antognini, Maroussa Zagoraiou, Matteo Borrotti, Barbara Mostacci, Susanna Mondini, and Fabio Cirignotta. “Sleep Quality and Motor Vehicle Crashes in Adolescents.” Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine 6, no. 1 (February 15, 2010): 41–45.

Quist, Jonas S., Anders Sjödin, Jean-Philippe Chaput, and Mads F. Hjorth. “Sleep and Cardiometabolic Risk in Children and Adolescents.” Sleep Medicine Reviews 29 (October 1, 2016): 76–100. https://doi.org/10.1016/j.smrv.2015.09.001.

Short, Michelle A., Sarah Blunden, Gabrielle Rigney, Lisa Matricciani, Scott Coussens, Chelsea M. Reynolds, and Barbara Galland. “Cognition and Objectively Measured Sleep Duration in Children: A Systematic Review and Meta-Analysis.” Sleep Health 4, no. 3 (June 1, 2018): 292–300. https://doi.org/10.1016/j.sleh.2018.02.004.

Weaver, Matthew D., Laura K. Barger, Susan Kohl Malone, Lori S. Anderson, and Elizabeth B. Klerman. “Dose-Dependent Associations Between Sleep Duration and Unsafe Behaviors Among US High School Students.” JAMA Pediatrics 172, no. 12 (December 1, 2018): 1187. https://doi.org/10.1001/jamapediatrics.2018.2777.

Wheaton, Anne G., Sherry Everett Jones, Adina C. Cooper, and Janet B. Croft. “Short Sleep Duration Among Middle School and High School Students — United States, 2015.” MMWR. Morbidity and Mortality Weekly Report 67, no. 3 (January 26, 2018): 85–90. https://doi.org/10.15585/mmwr.mm6703a1.