Insufficient sleep in adolescence: Individual interventions and interventions that scale

Biological changes to the circadian alignment of sleep during adolescence, coupled with myriad psychosocial and societal pressures, frequently result in insufficient sleep. This case highlights a 17-year-old male with difficulty waking in the morning that is absent on weekends related to social jet lag. Additionally, the onset of a depressive disorder and attention-deficit/hyperactivity disorder coincides with changes to his sleep schedule with insufficient sleep and a misaligned schedule relative to circadian timing. Optimizing the timing of school activities and reducing evening screen time may improve sleep opportunity to match circadian timing in many adolescents better. In individuals with more severely delayed sleep-wake phase, morning bright light exposure and the timed administration of exogenous melatonin can increase sleep opportunity by advancing the sleep phase to align circadian timing better. Given the prevalence of this and related clinical scenarios, public health interventions to delay school start times and education on sleep and circadian biology would have a broader impact.