What Causes Early Morning Awakenings?

By Brandon Peters, MD

There is something disappointing about waking up earlier than is necessary. It may be nice to doze in and out of sleep in the early morning hours, but it is especially upsetting if you cannot fall back asleep. What might cause someone to wake up before the alarm clock goes off? There are specific conditions, including a fair number of sleep and mood disorders, which might cause early morning awakenings.  By understanding these potential causes, you may be able to find a treatment that will keep you asleep until your desired wake time.

The Role of Insomnia

The most important cause of difficulty staying asleep near morning is insomnia. Insomnia is defined as difficulty falling or staying asleep or sleep that is simply not refreshing. These awakenings may occur throughout the night, but they tend to be more frequent in the second half of the night. This is due to a diminishing ability to sleep toward the morning hours.

The ability to sleep is linked to two processes, one called the homeostatic sleep drive and the other being the circadian rhythm (which will be discussed more later). The homeostatic sleep drive is the gradual desire for sleep that builds the longer a person stays awake. It relates to the gradual accumulation of a chemical within the brain called adenosine. This “sleepiness signal” eventually helps to initiate sleep. During sleep, it is cleared away, so that midway through the night, the desire for sleep is depleted. By morning, it should be completely gone.

If a person awakes in the night, especially if this awakening occurs toward morning, the ability to return to sleep will be compromised due to the lower levels of adenosine. Sleep may be greatly delayed, fragmented, or disrupted in insomnia, but awakenings near morning can be especially troublesome.

Anxiety and Depression May Provoke Awakenings

Any of the mood disorders, most notably anxiety and depression, can provoke awakenings. These typically occur in the several hours before the intended awakening. For example, if the alarm is set for 6 AM, someone with depression may start waking at 4 AM for no good reason. How can this be addressed?

As with insomnia, it is important to address the underlying contributing factors that lead to these awakenings. In the setting of psychiatric distress, these problems can persist. It is therefore necessary to treat any coexisting depression or anxiety. This may require the use of medications or counseling with the assistance of a psychologist or psychiatrist. Studies have shown that both, used in combination, are the most effective. Insomnia is especially well-treated with cognitive behavioral therapy for insomnia (CBTi).

It is clear that sleep can undermine mood. Conversely, mood problems can greatly affect sleep. By working on both issues together, the complexity of this relationship can be unraveled.

The Unexpected Influence of Sleep Apnea

It may seem peculiar to imagine that a breathing disorder such as obstructive sleep apnea may contribute to early morning awakenings. To better understand this relationship, it is necessary to carefully consider the structure of sleep.

It is artificial (but useful) to divide the night in half when considering the stages of sleep. In the first half of the night, slow-wave sleep more frequently occurs, especially among young people. In the second half, rapid eye movement (REM) sleep makes a more frequent appearance. Though the cycles of sleep occur regularly through the night, REM sleep becomes more prolonged towards morning. Therefore, we are more likely to awaken from it near morning and recall the vivid dreams that are associated with the state.

Sleep apnea is also more likely to occur during REM sleep. The muscles of the body are actively paralyzed during this stage, so that we are unable to act our dreams out. (If this does not occur, a condition called REM behavior disorder may result.) Muscles lining the upper airway are also paralyzed. This makes the airway more collapsible and when collapse occurs, it manifests as disrupted breathing and sleep apnea. Sleep apnea is often worsened during REM for this reason.

Therefore, morning awakenings may occur in the setting of sleep apnea that is worsened during the periods of REM that become more frequent and prolonged towards morning.

Morning Larks, Circadian Rhythms, and How Sleep Changes in Aging

The last major contributor to early morning awakenings is the class of conditions that are collectively known as circadian rhythm disorders. These include the natural tendency to wake early in the morning (so-called early birds or morning larks), advanced sleep phase syndrome, and natural changes that occur in sleep ability as we get older.

There are some who are just naturally morning people. They may prefer to fall asleep earlier (such as at 9 PM) and wake earlier (by 5 or 6 AM). This may be a lifelong preference. It isn’t necessarily abnormal, but it may lead to morning awakenings. If a sufficient amount of sleep is obtained before getting up for the day, then there is no reason to give it a second thought.

As we get older, our ability to maintain a continuous, uninterrupted period of sleep diminishes. The “machinery” of sleep (whatever we might conceive this to be) isn’t working as well as it used to. Sleep may become more fragmented. There may be more time spent awake in the transition to falling asleep and during the night. Slow-wave sleep diminishes. The total sleep time may be reduced. As part of this, early morning awakenings may occur.

In some cases, a condition called advanced sleep phase syndrome may become apparent. In this circadian rhythm disorder, the onset and offset of sleep moves forward by several hours. If it is disruptive to social life, it may be treated with the use of properly timed melatonin and light exposure at night.

If you suffer from morning awakenings, you should reflect on your situation and consider what might be contributing to the occurrence. If there is evidence for mood disorders, these should be addressed by a doctor. When a clear explanation cannot be identified, it may be useful to speak with a sleep specialist who may be able to provide additional insight. 

Are Light Therapy Glasses Right for Me?

By Brandon Peters, MD

They look a little futuristic, casting a blue light over the eyes and onto the face. In some ways, they are. Light therapy delivered via glasses also relies on science that is as old as time. The use of light therapy glasses may be helpful to manage circadian mood and sleep disorders like seasonal affective disorder (SAD), insomnia, and jet lag. They may offer a boost of energy on a winter morning. How do light glasses work and are they right for you? Learn about phototherapy, circadian rhythms, and the usefulness of artificial light delivered via glasses for several conditions.

What is Light Therapy?

Light therapy, or phototherapy, is the use of light to treat a medical condition. It may be helpful to treat problems that occur when the internal circadian rhythm is misaligned to the natural patterns of light and darkness. This may impact the ability to sleep, the release of hormones including melatonin, and even mood and energy levels.

Light therapy may be done by properly timed exposure to sunlight. Unfortunately, living at northern latitudes may make this more difficult in the winter months. In some cases, an artificial source of light may be needed.

There are certain medical conditions that respond extremely well to this treatment, but how is it delivered?

Light Boxes Versus Light Glasses

Historically, light boxes were used to artificially deliver phototherapy. Initially quite large, the technology has become more portable. In fact, there are now several brands of light glasses that are capable of performing the task:

Ayo

The smallest glasses are available for $299 from Ayo. With a well-integrated app, it is possible to personalize the program by providing information on sleep habits and lifestyle. The light intensity, timing, and duration varies based on the mode and purpose. Boost energy, optimize the sleep-wake cycle, or even beat jet lag and adjust to the new time zone faster. There is some built-in flexibility in the timing of their use. The glasses are comfortable, with a sleek visor-like design that is unobtrusive. It is easy to charge the glasses by placing them in a pill-shaped pod that connects to a computer with a USB cable.

Luminette

For a lower price point, consider the light therapy glasses offered by Luminette. For $199 to buy, or $39 for a trial, similar technology is used to deliver the light therapy directly into the eyes. Unlike a light box, which may require 10,000 lux to be effective, the blue light directed into the eye accomplishes the same treatment with a lesser intensity. There are 3 intensity levels offered: 500, 1000, and 1500. The glasses themselves are larger, broadly situated above the eyes. It is recommended that they be used for 30 minutes daily for best effect.

Re-Timer

Similarly priced, at $199, Re-Timer delivers blue-green light into the eyes for the purposes of phototherapy. Designed to frame the eyes, these glasses were developed at a university based on 25 years of research. It is recommended that the glasses be used for 60 minutes daily, the longest recommended usage of the three models.

Conditions That Respond to Light

The circadian rhythms of the body are mostly affected by exposure to blue light. This part of the light spectrum is present in full-spectrum sunlight. It can also be isolated and delivered at a lower intensity with equivalent effectiveness. What conditions respond best to light therapy delivered via light glasses?

Seasonal affective disorder

Also known as winter depression, it occurs seasonally when the lack of light availability leads to a deterioration of mood. It may be associated with increased sleeping, lack of initiative and social isolation, and changes in appetite and weight gain.

Insomnia

Difficulty falling asleep may be especially responsive to the use of phototherapy. Artificial light exposure in the evening may be a problem, but using light glasses in the morning upon awakening may help to realign the circadian rhythm.

Delayed sleep phase syndrome

Night owls experience this condition that leads to both difficulty falling asleep at a conventional time as well as difficulty waking in the morning at an earlier time. Bedtimes may be at 2 a.m. or later and waking may naturally occur mid-morning or even mid-day. Though it does not necessarily have to be associated with insomnia, it often does when social pressures require sleep-wake timing that is not consistent with this genetic tendency.

Morning sleepiness

Difficulty getting out of bed in the morning due to sleepiness may be relieved with phototherapy. Light naturally wakes us. It initiates the circadian alerting signal. Consistent use in the morning may help to align sleep’s place to the darkness of the night.

Jet lag

In the modern age, jet travel allows a rapid misalignment of the body’s circadian rhythms to the patterns of light and darkness in the environment. It may take one day to adjust to each time zone crossed, but light therapy may make this adjustment occur more quickly. 

Cautions and Side Effects

Phototherapy is generally well tolerated. If it is bothersome, it should be discontinued. Any perceived side effects should resolve once the light glasses are no longer being used. In some cases, the following side effects may occur:

Headaches

Artificial light therapy may trigger headaches or migraines in those predisposed. In this case, a lower light intensity for a more prolonged period may be useful.

Insomnia

Light at the wrong time may lead to difficult sleeping. For example, using light glasses at bedtime may cause a shift in the timing of sleep later. This will make it hard to fall asleep, and hard to wake. Avoid this by following the instructions associated with the light glasses program.

Photophobia

Sensitivity to light may occur. This may lead to pain or simply an aversion to exposure characterized by squinting. It will go away when the light stimulus is removed.

Fatigue

Rarely, fatigue may occur with phototherapy. This may have to do with the changes that occur in the sleep-wake schedule. Following the directions of the program should help to minimize this risk.

Hypomania

For those who have a history of bipolar disorder, light therapy needs to be used with caution. There is a risk that the light may lead to a state of hypomania. This may be associated with an elevated mood, increased productivity, hypersexuality, or other symptoms.

Irritability

Although mood would typically improve with light therapy, in some cases it may lead to irritability. Like the other side effects, it should resolve by stopping the use of the light therapy glasses.

Importantly, there is no ultraviolet (UV) light exposure with the use of light therapy glasses. Therefore, the risks associated with this—such as damage to the eye or cancer—would not be present.

Conclusion

If you are interested in learning more about your sleep, consider evaluation by a board-certified sleep physician. In some cases, consultation with this specialist may optimize your response to the light therapy glasses. Should you experience any problems with their use, seek further assistance by an expert.

Sources:

Peters, BR. “Irregular Bedtimes and Awakenings.” Evaluation of Sleep Complaints. Sleep Med Clinic. 9(2014)481-489.

Reid, KJ and Zee, PC. “Circadian disorders of the sleep-wake cycle,” in Principles and Practices of Sleep Medicine. Edited by Kryger MH, Roth T, Dement WC. St. Louis, Missouri, Elsevier Saunders, 2011, pp. 470-482.

How the Best Sunrise Alarm Clocks Make Waking Easier

By Brandon Peters, MD

It is pretty normal to use an alarm clock to wake up. What is not as common, however, is for the clock to mimic a sunrise and wake you with a gradually increasing amount of light. How do the best sunrise alarm clocks make waking easier? Learn how a dawn simulation light works, why it might be preferable to an audible alarm, who benefits most from its use, and what alternatives exist that may help to enforce a circadian pattern, easing insomnia and making it easier to wake and get up.

What Is a Sunrise Alarm Clock?

A sunrise alarm clock, or dawn simulation light, is an artificial light source that is integrated into a standard digital clock. It is timed to gradually wake a person at a selected time. It does this by mimicking the steadily increasing light of sunrise, often over 30 to 40 minutes, but some models may allow the timer to be adjusted from 15 to 60 minutes.

These simulators may have a full-spectrum white or yellow LED lightbulb. The color spectrum, or color temperature (think of this as the “warmth”), of this light may vary slightly from one model to the next. Most are of modest intensity, often 100 to 300 lux, with less light than a standard light box.

There are a variety of models, most costing less than $25 to $100, including:

• Philips Wake-Up Light HF3520

• Philips HF3505

• Philips Somneo HF3650

• hOmeLabs Sunrise Alarm Clock

• Mosche Sunrise Alarm Clock

• INLIFE Wake Up Light Alarm Clock

• NATPLUS Sunrise Alarm Clock

• iHome Zenergy Bedside Sleep Therapy Machine

• totobay

• Sharp Sunrise Simulator

• Lumie

The add-on features also vary widely from one product to the next. Many have the ability to adjust the light intensity, snooze features, and associated standard alarm sounds or music. There may be USB ports integrated for charging devices. Beyond encouraging a gradual awakening, some can even dim light gradually (a so-called sunset feature), making it feel more natural to fall asleep.

How Do Dawn Simulation Lights Work?

Dawn simulation lights can make it easier to wake, but how do these devices work? It is important to consider the natural patterns of light and darkness and how the circadian rhythm enforces optimal sleep and wakefulness.

Humans, like most animals, have evolved to sleep overnight during darkness. Light, conversely, has a waking effect on the brain and body. It suppresses melatonin and activates the circadian alerting signal. Light at the wrong time, like from a screen prior to bedtime, may make it hard to fall asleep and contribute to insomnia. In the morning, when incorporated into a sunrise alarm clock, it may make it easier to wake.

Light exerts this impact by traveling from the eyes via the optic nerves to an area of the brain that regulates the body’s circadian rhythm. This area of the brain, called the suprachiasmatic nucleus, lies in the hypothalamus. It is the master clock of the body. Without it, the patterns of sleep and wakefulness, metabolism, hormone release, cortisol levels, body temperature, and other processes would run amok.

Fortunately, light at the proper time may help us to sleep and feel better. Even artificial light, if appropriately timed, may enforce the normal patterns of our body that would exist if we slept in a perfectly natural environment. A gradual increase of light in the morning hours, even in the natural darkness present in winter months at northern latitudes, may reinforce a normal pattern of waking.

Why Is Light Better Than Sound?

The sudden, blaring sound of an alarm clock will definitely wake someone. However, this abrupt shift from sleep to wakefulness can be disorienting. If full wakefulness is not attained, the snooze button may be pressed and sleep may quickly resume. Short awakenings, such as those lasting less than 5 minutes, may go unremembered. If the alarm clock is simply turned off—or smashed into 1,000 pieces—trouble may ensue!

Light may wake a person more gently and more gradually. The transition from sleep to wakefulness is more orderly. This may help to relieve sleep inertia, that profound sense of sleepiness that is difficult to shake when first opening your eyes. It is something that feels more natural. The sky does not go from pitch black to glaring sunshine. As the sun creeps over the horizon, the amount of light hitting our eyes (even through closed eyelids) steadily increases. It may reach a threshold where it finally wakes us. This may make it less likely a person would want to hit snooze repeatedly and fall back asleep. Even the thought of it seems more pleasant.

Who Should Consider a Sunrise Alarm?

Although there are certain groups who may benefit more from using a sunrise alarm, scientific research suggests that many of us could yield positive health impacts.

There are a surprising number of important benefits from the use of dawn simulation lights. Research suggests it may:

• Improve cardiac function and reduce the risk of heart attacks

• Provide a boost to the brain’s function (in select cognitive domains)

• Enhance performance in tasks done immediately after waking

Clearly there are certain conditions or groups of people who would likely enjoy the effects of a sunrise alarm even more. Consider these possibilities:

Night owls

Delayed sleep phase syndrome is a circadian disorder characterized by difficulty initiating sleep (insomnia) and profound morning sleepiness. It affects 10 percent of the population, usually starting in the teenage years. Most night owls feel naturally sleepy close to 2 a.m. and may not naturally wake until 10 a.m. The use of a dawn simulation light may make waking a little easier. In some cases, a light box may be more effective to reinforce an earlier circadian phase.

Winter depression

Seasonal affective disorder, or winter depression, impacts people living in northern latitudes during the winter months when the nights are long and the days are short. Darkness can make it hard to wake in the morning. This may lead to increased depressive symptoms, lethargy, prolonged sleep, weight gain, and other symptoms. An artificial light may help the morning to start a little easier.

Teenagers

As noted above, teenagers are susceptible to delayed sleep phase syndrome. As a general rule, teens are more likely to have a slight delay in sleep timing, even with a less profound shift in the pattern. This can make it hard for adolescents to fall asleep at a desirable time. It can also make it very difficult to wake them in the morning. This can lead to early morning fights with parents, tardiness, absenteeism, and other problems like car accidents, inattention, and academic failure. Consider how desirable it might be to have a gentle light do the waking, and let the drama of the morning fade away.

Shift workers

Those who work atypical shifts—second, third, graveyard, rotating, or even call coverage—are subject to many sleep problems. When the desire for sleep and wake is forcibly misaligned from the patterns of darkness and light, it can be difficult to function optimally. This may lead to increased errors, accidents, and health problems (including a higher risk for cardiovascular disease, weight gain, and breast and colorectal cancers). Artificial light, if properly timed, may help to alleviate some of this misalignment.

Jet lag 

For every one time zone crossed, it can take one day to adjust the circadian rhythm. Traveling across a continent, or an ocean, can lead to significant disruption. The use of a sunrise alarm clock may make this transition easier. The optimal timing of this light exposure will depend on the distance traveled, and whether preparation was made prior to departing on the trip.

Hearing impaired

Finally, those with a hearing impairment may benefit from using a light to wake, rather than an audible alarm. The deaf may otherwise need to rely on others to wake on time. The use of a sunrise alarm clock may provide a new degree of independence.

Alternatives to Sunrise Alarm Clocks

Many people will be attracted to the possibility of easing insomnia and waking and getting up easier. Not everyone may want to use a sunrise alarm clock, however. There may be a handful of alternatives to consider. Consider how these additional options may make it easier to wake in the morning:

Natural sunlight

Throw the window shades open in your bedroom before retiring for the evening. This will let in natural light. After sunrise, the light will be able to stream through the windows and promote wakefulness. Unfortunately, this may not be ideally timed certain times of the year.

Light box

Consider a light box with 10,000 lux of intensity. It is powerful enough to shift the circadian rhythm, benefiting seasonal affective disorder as well.

Light therapy glasses

For those with a little extra buying power, light therapy glasses are a convenient and effective option. With a lower amount of light, shone directly into the eyes, these glasses can make it easier to wake.

Caffeine

A cup of coffee or tea can make it easier to get the morning started. Caffeine blocks adenosine, a signal for sleep, within the brain. With a half-life of 4 to 6 hours, it can get you through the morning.

Get motivated

Consider ways to motivate yourself out of bed. Morning exercise, quickly hopping in the shower, a special breakfast, or stepping outside to enjoy the early light may be helpful. In some cases, scheduling something you really enjoy for first thing in the morning may do the trick. 

Conclusion

There are many effective ways to wake and feel refreshed. A sunrise alarm clock may help to ease the transition to wakefulness. If you consistently struggle to wake, or have sleep of poor quality, consider getting evaluate by a board-certified sleep physician. Sleep disorders can be effectively resolved to the benefit of your health and well-being.

Sources:

Follum JD, Catchpole JM. “Sunrise alarm clock for the hearing impaired.” Biomed Sci Instrum. 2011;47:18-23.

Viola AU et al. “Dawn simulation light: a potential cardiac events protector.” Sleep Med. 2015 Apr;16(4):457-61. doi: 10.1016/j.sleep.2014.12.016. Epub 2015 Feb 26.

Gabel V et al. “Dawn simulation light impacts on different cognitive domains under sleep restriction.” Behav Brain Res. 2015 Mar 15;281:258-66. doi: 10.1016/j.bbr.2014.12.043. Epub 2014 Dec 27.

Thompson A et al. “Effects of dawn simulation on markers of sleep inertia and post-waking performance in humans.” Eur J Appl Physiol. 2014 May;114(5):1049-56. doi: 10.1007/s00421-014.2831-z. Epub 2014 Feb 11.

How Being in College Can Disrupt Sleep

For many students, starting college is like stepping into an entirely new world. There’s a new living environment, new social opportunities, academic challenges, and often a level of independence they’ve never experienced before. While these changes can be exciting, they can also wreak havoc on one of the most important — and underrated — foundations of well-being: sleep.

College life, for all its energy and activity, is a perfect storm of factors that make it easy to push bedtime later, cut rest short, and live in a cycle of fatigue. And while an occasional late night is part of the college experience, chronic sleep disruption can have serious consequences for health, mood, and academic success.

Why Sleep Is So Vulnerable in College

College students are technically adults, but their sleep needs remain similar to late teens: most still require 7–9 hours per night to function optimally. Unfortunately, surveys show that many college students average only about 6–6.5 hours on school nights, and they often catch up on weekends — creating an irregular schedule that throws off the body’s internal clock.

Several intertwined factors contribute to the disruption:

1. A Shift in Autonomy

In high school, many students had parents reminding them to go to bed, limiting screen time, and enforcing wake-up schedules. In college, that external structure disappears. Students set their own bedtime, often guided more by social plans or looming deadlines than by biological needs.

2. Irregular Class Schedules

Unlike high school’s consistent timetable, college schedules can vary wildly. One day might have an 8:00 a.m. lecture, while the next has the first class at 1:00 p.m. This inconsistency makes it tempting to stay up late on “light” days and sleep in, which can shift the sleep cycle later and make early mornings harder.

3. Academic Pressures and Workload

College courses often require more independent study, heavier reading loads, and larger projects. It’s easy for work to spill into late-night hours — especially when procrastination or underestimating assignments comes into play. For students balancing jobs or internships on top of classes, evenings may be the only time left to study, pushing bedtime further back.

4. Social Opportunities at All Hours

One of the joys of college life is the ability to hang out with friends whenever you want — whether that’s watching movies at midnight, attending campus events, or going out. Many social activities take place in the evening or late at night, creating a constant temptation to stay up past a healthy bedtime.

5. Living Environment

Dorms and shared apartments are rarely havens of quiet. Roommates may have different schedules, and communal living can mean noise in the hallways, shared bathrooms, and late-night conversations just outside your door. Even students who want to sleep may find it challenging in a bustling residence hall.

6. Technology and Screen Time

Laptops, smartphones, and gaming consoles are ever-present in college life. Not only can they consume hours that could be spent sleeping, but the blue light from screens delays the release of melatonin, making it harder to fall asleep. Students who scroll through TikTok or game until 2:00 a.m. may not feel sleepy even if they know they should.

7. Substance Use

Caffeine is a staple for many students — from morning coffee to late-night energy drinks — but too much, especially in the afternoon or evening, can make it hard to wind down. Alcohol, while sometimes making people feel drowsy, actually disrupts sleep quality and can lead to more nighttime awakenings.

8. Stress and Anxiety

The transition to college can be stressful: moving away from home, adjusting to new academic expectations, managing finances, and navigating social dynamics. Stress hormones like cortisol can make it harder to fall asleep, and worries often feel louder at night when everything is quiet.

The Consequences of Chronic Sleep Disruption

While the occasional late night won’t derail most students, consistently poor sleep can take a toll:

• Weaker academic performance: Sleep is critical for memory consolidation and focus. Sleep-deprived students struggle more with attention, problem-solving, and retaining new information.

• Mood issues: Chronic sleep loss increases the risk of depression, anxiety, and irritability.

• Physical health problems: Poor sleep can weaken the immune system, making students more prone to illness.

• Safety risks: Sleep deprivation slows reaction times, increasing the risk of accidents, especially for students who drive.

How Students Can Protect Their Sleep

While the college environment makes good sleep a challenge, it’s not impossible to maintain healthy habits. Small, consistent changes can make a big difference.

1. Set a consistent sleep and wake schedule. Even if classes start later some days, try to wake up within an hour of your usual time. Get 15-30 minutes of sunlight upon awakening.

2. Create a wind-down routine. Dim lights, read, or listen to calm music 30–60 minutes before bed.

3. Limit caffeine after early afternoon. Switch to water or herbal tea in the evenings.

4. Use screens wisely. Set a “screens off” time before bed or use blue light filters if you must use devices late.

5. Optimize your sleep environment. Earplugs, white noise apps, blackout curtains, and comfortable bedding can counteract noisy or bright dorm conditions.

6. Manage workload earlier in the day. Tackling assignments in the afternoon can free up evenings for relaxation.

7. Communicate with roommates. Agree on quiet hours and be respectful of each other’s rest needs.

The Role of Campus Support

Many colleges now recognize the importance of sleep for student well-being and academic success. Some offer workshops on sleep hygiene, quiet study spaces for daytime work, and counseling services for stress management. Residence hall staff may also help mediate noise issues or support students struggling with adjustment.

The Bottom Line

Being in college disrupts sleep for many reasons — from late-night socializing and irregular schedules to noisy dorms and heavy workloads. While the culture often treats staying up late as a normal part of student life, the reality is that chronic sleep disruption can sap energy, harm academic performance, and affect mental and physical health.

College students who learn to prioritize and protect their sleep gain a significant advantage: more focus, better grades, steadier moods, and greater resilience. In an environment where so much feels new and out of control, sleep is one area where smart habits can make all the difference.

This article was created using OpenAI’s ChatGPT on August 15, 2025 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

When School Starts Late, Teens Sleep Great

It’s no secret that most teenagers don’t bounce out of bed at 6:30 in the morning with a smile on their face. In fact, for many high school students, early mornings can feel like a battle against biology. When schools start later in the day, something remarkable happens: teenagers actually get more sleep — and not just more, but better sleep. That extra rest can transform their health, mood, and performance.

The Biology of a Teenage Sleep Clock

To understand why later start times work so well, you need to know about adolescent circadian rhythms. During puberty, the body’s internal clock shifts. The natural release of melatonin — the hormone that signals “time to sleep” — is delayed by about two hours compared to childhood. That means a teen who used to get sleepy at 9:30 p.m. may now feel wide awake until 11:30 p.m. or later.

This isn’t laziness or bad time management; it’s a physiological change rooted in brain chemistry. Combine that shift with early school bells, and you have a recipe for chronic sleep deprivation. Even a conscientious teen who goes to bed “on time” may still be fighting their biology.

The Problem With Early Starts

The American Academy of Pediatrics (AAP) recommends that middle and high schools start no earlier than 8:30 a.m. so that students can get the 8–10 hours of sleep they need each night. Yet, as of recent data, many U.S. high schools still ring their first bell before 8:00 a.m. In some districts, classes start as early as 7:15 a.m.

For a teenager who can’t fall asleep until 11:30 p.m., a 7:15 start time may require a wake-up alarm at 5:30 a.m. — meaning they’re functioning on just 6 hours of rest, night after night. Chronic sleep loss in teens is linked to a wide array of issues, including:

• Lower academic performance

• Increased risk of depression and anxiety

• Weakened immune function

• Slower reaction times and higher accident risk (especially for teen drivers)

• Irritability and mood swings

It’s not that teens can’t adapt at all — they often do, because they have no choice — but the adaptation comes at a cost to their mental and physical health.

The Late Start Experiment

In recent years, some school districts have experimented with later start times, and the results have been eye-opening. For example:

• Seattle, Washington moved high school start times from 7:50 to 8:45 a.m. in 2016. Researchers found that students got an average of 34 minutes more sleep per night, their grades improved, and attendance increased.

• Edina, Minnesota was one of the first districts to delay high school start times back in the 1990s. Studies showed improved mood, fewer visits to the school nurse, and higher standardized test scores.

• California passed a state law requiring most high schools to start no earlier than 8:30 a.m. as of 2022, citing public health benefits.

The common pattern is that when the start time moves later, teenagers don’t just stay up even later — they actually gain net sleep time. That’s because their schedules finally align with their biological clocks.

Why the Sleep Is Better

It’s not just the total hours of sleep that matter — it’s also the quality of that sleep. Later start times help teens get more time in the crucial stages of deep and REM sleep, which are essential for:

• Consolidating memories (important for learning)

• Regulating emotions

• Physical recovery and growth

• Strengthening the immune system

When teens are forced to wake up in the middle of these deep cycles, the sleep they’ve had is less restorative. Pushing back the start time reduces that disruption, letting them complete more full sleep cycles.

The Ripple Effects

The benefits of well-rested teens ripple outward:

• Academic Gains: Sleep improves attention, working memory, and problem-solving — all critical for learning. Students are more likely to engage in class when they aren’t fighting fatigue.

• Mental Health Boost: Adequate sleep is strongly linked to lower rates of depression and anxiety in adolescents. Given rising concerns about teen mental health, this is a major public health argument for later starts.

• Safer Roads: Studies have shown a significant drop in car crashes involving teen drivers after districts delay start times. Sleep deprivation slows reaction time, and the morning commute is one of the most dangerous windows for young drivers.

• Better Behavior: Teachers often report fewer discipline problems and less classroom disruption when students are better rested.

The Pushback and the Practicalities

Of course, shifting school schedules isn’t without challenges. Common concerns include:

• Impact on after-school activities: Later dismissal times can affect sports practices, part-time jobs, and family schedules.

• Transportation logistics: Many districts stagger start times across grade levels to optimize bus routes, so changing one group’s schedule can create a domino effect.

• Parental work schedules: Some families rely on earlier school starts for childcare coverage in the mornings.

However, districts that have made the change often find creative solutions — such as adjusting practice times, using community facilities for late sports, or reorganizing bus routes. Over time, many communities report that the benefits outweigh the logistical hurdles.

What Families Can Do in the Meantime

Even if your teen’s school starts early, there are steps you can take to help them get better rest:

1. Limit late-night screen time. The blue light from phones and laptops delays melatonin release even further.

2. Create a wind-down routine. Dim lights, read a physical book, or do a relaxing activity before bed.

3. Encourage consistency. Sleeping in until noon on weekends can make Monday mornings even harder; a moderate weekend sleep-in is better.

4. Advocate locally. Join with other parents to petition your school board for a later start time.

The Takeaway

Teenagers aren’t just being dramatic when they say mornings are hard — they’re speaking from the experience of living in a body that’s wired for a later schedule. When schools start later, students sleep longer and better, with measurable benefits for learning, health, and safety. The science is clear: aligning school schedules with adolescent biology isn’t a luxury; it’s an investment in the well-being and potential of our youth.

This article was created using OpenAI’s ChatGPT on August 15, 2025 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

What Are the Symptoms of Sleep Deprivation?

Sleep is a vital biological function that supports every system in the human body. From restoring physical health to maintaining mental balance, adequate sleep is crucial for overall well-being. Yet, in today's fast-paced society, many people sacrifice sleep in favor of work, social commitments, or digital distractions. When the body and brain do not get the sleep they need, a condition known as sleep deprivation can occur. The symptoms of sleep deprivation vary in intensity depending on the duration and severity of the sleep loss, but even short-term deprivation can have noticeable effects. This article explores the physical, mental, emotional, and behavioral symptoms of sleep deprivation, and why recognizing them early is key to preventing more serious health consequences.

What Is Sleep Deprivation?

Sleep deprivation refers to a condition that occurs when an individual consistently gets less sleep than their body requires. Most adults need around 7 to 9 hours of sleep per night, though the ideal amount can vary slightly between individuals. Sleep deprivation may be acute (short-term, often lasting a few days) or chronic (long-term and persistent over weeks or months). In both cases, it disrupts the normal functioning of the brain and body.

Cognitive Symptoms

One of the first areas to show the effects of sleep deprivation is cognitive function. Sleep is critical for memory formation, attention, problem-solving, and learning. When someone is deprived of sleep, they may experience:

1. Reduced Attention and Concentration: Sleep-deprived individuals often find it difficult to stay focused on tasks. Their attention span shortens, and they may become easily distracted or forgetful.

2. Slower Reaction Times: A lack of sleep impairs the brain's ability to process and respond to information quickly. This can be particularly dangerous in situations requiring quick thinking, such as driving or operating machinery.

3. Impaired Judgment and Decision-Making: Sleep-deprived people are more likely to make poor decisions or take risks they normally wouldn't, due to a reduction in prefrontal cortex activity — the brain region responsible for rational thinking.

4. Memory Problems: Both short-term and long-term memory can suffer. Sleep helps consolidate memories, and without it, new information may not be effectively retained.

5. Difficulty Learning: Sleep deprivation can interfere with the brain’s ability to absorb and retain information, making learning new skills or knowledge more difficult.

Emotional and Psychological Symptoms

Sleep plays a vital role in emotional regulation and mental stability. When a person is sleep-deprived, their ability to manage stress and respond to emotional challenges is weakened. Common emotional symptoms include:

1. Irritability and Mood Swings: Small annoyances may feel more frustrating or upsetting when someone is sleep-deprived. Mood instability becomes more common.

2. Increased Anxiety and Stress: Lack of sleep can heighten anxiety levels and make everyday stressors feel overwhelming.

3. Depressive Symptoms: Chronic sleep deprivation is closely linked to depression. People may feel hopeless, lack motivation, or have a persistently low mood.

4. Emotional Reactivity: Individuals may overreact to situations or exhibit disproportionate emotional responses due to impaired regulation of the amygdala, the brain’s emotion center.

Physical Symptoms

Sleep is also crucial for maintaining bodily functions and promoting physical health. Physical symptoms of sleep deprivation include:

1. Fatigue and Lethargy: The most obvious symptom, fatigue makes it difficult to stay awake or be productive during the day. People often feel sluggish, drowsy, or physically weak.

2. Weakened Immune Function: Lack of sleep impairs the body’s ability to fight off infections. Sleep-deprived individuals are more prone to catching colds or other illnesses.

3. Headaches and Muscle Aches: Sleep loss can contribute to tension headaches and general discomfort in the muscles and joints.

4. Appetite Changes and Weight Gain: Sleep affects hormones like ghrelin and leptin that regulate hunger. Sleep deprivation increases appetite, particularly for high-calorie, sugary foods, contributing to weight gain.

5. Hormonal Imbalances: Sleep deprivation disrupts the release of growth hormone, insulin, cortisol, and other important regulators, impacting metabolism and stress responses.

Behavioral Symptoms

Sleep deprivation can also change how people behave and interact with others. These behavioral symptoms may include:

1. Clumsiness and Poor Coordination: Without adequate rest, motor skills become impaired, increasing the likelihood of accidents and injuries.

2. Reduced Motivation: Sleep-deprived individuals often lack the drive to complete tasks or engage in activities they normally enjoy.

3. Social Withdrawal: Fatigue and irritability may cause people to avoid social situations or become isolated from friends and family.

4. Increased Risk-Taking Behavior: Due to impaired judgment and decision-making, sleep-deprived individuals may engage in impulsive or risky behaviors.

Long-Term Consequences of Chronic Sleep Deprivation

If left unaddressed, chronic sleep deprivation can contribute to a number of serious health problems over time, including:

• Heart Disease: Persistent sleep loss is linked to high blood pressure, heart attacks, and stroke.

• Diabetes: Poor sleep can affect insulin sensitivity, increasing the risk of type 2 diabetes.

• Obesity: Hormonal changes triggered by sleep loss can lead to overeating and weight gain.

• Immune Dysfunction: This may increase the risk of infection or difficulty returning the body to normal health.

• Cognitive Decline: Chronic deprivation increases the risk of dementia and Alzheimer’s disease.

• Mental Health Disorders: Long-term sleep deprivation can exacerbate or even trigger anxiety disorders, depression, and bipolar disorder.

Recognizing the Warning Signs

Because the symptoms of sleep deprivation can mimic or overlap with those of other conditions, it’s important to monitor sleep habits closely and recognize the early warning signs:

• Falling asleep during daytime activities (such as while reading or watching TV)

• Needing multiple cups of coffee or other caffeine to stay alert

• Struggling to stay awake during meetings, lectures, or driving

• Waking up feeling unrefreshed despite a full night in bed

Conclusion

Sleep deprivation is more than just feeling tired — it’s a serious condition that affects virtually every aspect of life, from physical health to mental clarity and emotional resilience. Recognizing the symptoms early can help individuals take the necessary steps to improve sleep quality and prevent long-term damage. Most adults need 7 to 9 hours of quality sleep to avoid the effects of sleep deprivation, and treatment of underlying sleep disorders like sleep apnea may be important. Whether it’s adjusting lifestyle habits, improving sleep hygiene, or seeking medical support, prioritizing sleep is an investment in health, safety, and well-being.

This article was created using OpenAI’s ChatGPT on May 16, 2025 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

What Substances Can Be Causes of Nightmares?

Nightmares are vivid and often distressing dreams that can lead to feelings of fear, anxiety, and confusion upon waking. While various psychological factors contribute to nightmares, certain substances can also play a significant role in triggering these unsettling experiences. Understanding how these substances influence sleep can help individuals make informed choices about their consumption and potentially mitigate the occurrence of nightmares.

1. Alcohol

Alcohol is one of the most commonly consumed substances that can disrupt sleep patterns and contribute to nightmares. Initially, alcohol may induce feelings of relaxation and drowsiness, making it easier to fall asleep. However, as the body metabolizes alcohol, its effects can lead to fragmented sleep.

Research shows that alcohol can suppress rapid eye movement (REM) sleep, the stage of sleep most closely associated with dreaming. As the body processes alcohol, REM sleep can rebound, often leading to increased intensity and frequency of dreams. When individuals wake from these heightened REM episodes, they may recall vivid nightmares that are often emotionally charged. Furthermore, alcohol can exacerbate sleep disorders like sleep apnea, further contributing to poor sleep quality and nightmare occurrences.

2. Caffeine

Caffeine, a widely consumed stimulant found in coffee, tea, energy drinks, and certain medications, is known for its ability to enhance alertness and reduce fatigue. However, its effects on sleep can be detrimental. Caffeine can interfere with the ability to fall asleep and reduce overall sleep quality. When consumed later in the day, it can lead to insomnia, which is closely linked to increased anxiety and nightmares.

Research has shown that individuals who consume caffeine, particularly in high doses, may experience more vivid dreams and nightmares. This could be due to caffeine's stimulatory effects on the brain, which may increase brain activity during sleep. Additionally, caffeine can lead to restlessness and a fragmented sleep cycle, both of which are associated with a higher likelihood of experiencing nightmares.

3. Nicotine

Nicotine, a primary component of tobacco, is another substance linked to sleep disturbances and nightmares. As a stimulant, nicotine can lead to increased heart rate and blood pressure, making it harder to relax and fall asleep. Smokers often report difficulty sleeping, leading to reduced sleep duration and quality.

Nicotine withdrawal during the night can also lead to disrupted sleep patterns. When individuals try to quit smoking, the withdrawal symptoms can manifest during sleep, resulting in increased anxiety and nightmares. Research indicates that smokers experience more nightmares compared to non-smokers, particularly when they have reduced or stopped nicotine consumption.

4. Medications

Certain medications can contribute to the onset of nightmares, either as a direct side effect or due to their impact on sleep architecture. Some of the common categories of medications associated with nightmares include:

• Antidepressants: Selective serotonin reuptake inhibitors (SSRIs) and other antidepressants can affect sleep patterns and have been linked to increased vivid dreams and nightmares. While they can help alleviate symptoms of depression and anxiety, some individuals may experience heightened dream activity, leading to distressing dreams.

• Beta Blockers: These medications, often prescribed for hypertension and anxiety, can affect the REM sleep cycle and have been associated with an increase in nightmares. They can also affect the normal production and release of melatonin. Patients taking beta blockers have reported more frequent nightmares, particularly when starting or adjusting their dosage.

• Stimulants: Medications for attention-deficit hyperactivity disorder (ADHD), such as amphetamines, can impact sleep quality and lead to increased occurrences of nightmares. The stimulatory effects of these medications can interfere with the natural sleep cycle, contributing to vivid and unsettling dreams.

• Corticosteroids: These anti-inflammatory medications can lead to mood changes and sleep disturbances. Individuals taking corticosteroids have reported experiencing more vivid and distressing dreams, including nightmares.

5. Recreational Drugs

Various recreational drugs can also play a role in the development of nightmares. Substances such as marijuana, hallucinogens, and psychedelics can significantly alter sleep patterns and dream experiences.

• Marijuana: While some people use marijuana to help with sleep, it can have paradoxical effects on dream recall and intensity. Individuals who regularly use marijuana often report fewer dreams overall, but when they stop, they may experience a rebound effect, leading to an increase in vivid dreams and nightmares during withdrawal.

• Hallucinogens: Drugs like LSD and psilocybin can dramatically alter perception and consciousness. These substances can lead to intense and sometimes terrifying dream experiences, as they impact the brain's neurotransmitter systems associated with mood and perception.

• MDMA: Commonly known as ecstasy, MDMA can affect sleep quality and has been reported to cause vivid nightmares after its effects wear off. Users often experience emotional highs followed by lows, which can influence dream content and emotional tone.

6. Supplements

Some supplements may also influence sleep and dream quality. Melatonin may cause nightmares as a side effect. In addition, valerian root and kava are often used for their calming effects, but they may also have side effects. While they may promote relaxation, excessive use can lead to disrupted sleep patterns and, in some cases, nightmares.

Conversely, other herbs like St. John's Wort, commonly used for depression, can alter sleep architecture and contribute to the experience of vivid dreams and nightmares, particularly when taken in combination with other medications.

Conclusion

Understanding the substances that can trigger nightmares is crucial for anyone seeking to improve their sleep quality. Alcohol, caffeine, nicotine, certain medications, recreational drugs, and even some supplements can all contribute to the occurrence of nightmares. By identifying and moderating the use of these substances, individuals can potentially reduce the frequency and intensity of their nightmares, leading to a more restful night’s sleep.

If nightmares persist, it may be beneficial to consult a healthcare professional for guidance. They can help assess the situation, consider any underlying psychological or medical issues, and develop a tailored approach to improve sleep quality and overall well-being.

This article was created using OpenAI’s ChatGPT on October 3, 2024 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

How Caffeine May Help Night Shift Workers

Night shift work presents unique challenges, particularly in terms of maintaining alertness and cognitive performance. Many workers find themselves battling fatigue and a disrupted circadian rhythm, leading to decreased productivity and increased safety risks. Caffeine, a common stimulant, is often used by night shift workers to counteract these challenges. This article explores how caffeine can be beneficial for night shift workers, its effects on alertness, productivity, and overall well-being, as well as some considerations for its use.

Understanding the Challenges of Night Shift Work

Night shift work can significantly disrupt the body's natural circadian rhythms, which are regulated by the internal biological clock. This disruption can lead to a host of problems, including:

1. Fatigue and Sleep Disorders: Night workers often struggle with getting adequate restorative sleep during the day, leading to chronic fatigue and sleep disorders such as insomnia.

2. Cognitive Impairment: Lack of sleep can affect cognitive functions, including attention, decision-making, and reaction times. This impairment can be particularly dangerous in fields requiring high levels of focus, such as healthcare, transportation, and manufacturing.

3. Mood Disturbances: Chronic night shift work has been linked to mood disturbances, including anxiety and depression, which can affect both personal and professional life.

4. Health Risks: Long-term night shift work has been associated with various health issues, including cardiovascular disease, obesity, and metabolic disorders.

In light of these challenges, caffeine has emerged as a popular tool for night shift workers seeking to enhance alertness and mitigate the adverse effects of sleep deprivation.

The Role of Caffeine

Caffeine is a central nervous system stimulant found in coffee, tea, energy drinks, and various soft drinks. It works primarily by blocking adenosine receptors in the brain, which helps to increase dopamine production and enhance alertness. Here are some key ways caffeine may help night shift workers:

1. Increased Alertness: Caffeine can significantly improve alertness and cognitive performance, particularly in situations where fatigue threatens to take over. Studies have shown that caffeine consumption can lead to improved reaction times, better attention, and enhanced overall cognitive function, which are crucial during night shifts.

2. Enhanced Performance: Research indicates that caffeine can boost performance on tasks requiring sustained attention and vigilance. This is particularly important for night shift workers who may be performing monotonous tasks or facing periods of low activity that could lead to drowsiness.

3. Mood Elevation: Caffeine has been associated with mood enhancement, which can help combat feelings of irritability and fatigue. For night shift workers, maintaining a positive mood is essential for job satisfaction and productivity.

4. Temporary Fatigue Relief: When used strategically, caffeine can provide temporary relief from the feelings of fatigue that often accompany night shifts. This is especially important during the early hours of a shift when energy levels may be at their lowest.

Strategic Use of Caffeine

While caffeine can offer significant benefits, its effectiveness depends on how and when it is consumed. Here are some strategies for maximizing the positive effects of caffeine for night shift workers:

1. Timing Matters: Consuming caffeine at the right times can make a big difference. For night shift workers, it is generally advisable to consume caffeine shortly before the start of a shift or during the first half of the shift when alertness is most needed. Avoiding caffeine too close to the end of a shift can help ensure better sleep quality when the shift is over.

2. Moderation is Key: Excessive caffeine intake can lead to negative side effects such as jitteriness, increased heart rate, and anxiety. It’s essential for night shift workers to find a balance that maximizes alertness without leading to overstimulation.

3. Combining Caffeine with Other Strategies: Caffeine should not be relied upon as the sole strategy for managing fatigue. It can be most effective when combined with other strategies, such as taking short breaks to move around, staying hydrated, and getting adequate rest during off-hours.

4. Understanding Personal Tolerance: Each individual has a different tolerance for caffeine, which can depend on factors like genetics, regular consumption habits, and overall health. Night shift workers should pay attention to their own bodies and adjust caffeine intake accordingly.

Potential Drawbacks of Caffeine Use

While caffeine can be beneficial, it’s important to consider its potential drawbacks, especially for night shift workers:

1. Sleep Disruption: Consuming caffeine too late in a shift can interfere with the ability to fall asleep once the shift is over. Night workers should aim to consume caffeine in a way that doesn’t hinder their sleep quality.

2. Dependence and Tolerance: Regular caffeine consumption can lead to dependence and tolerance, meaning that over time, the same amount may produce diminished effects. Night shift workers should be mindful of their consumption patterns to avoid relying too heavily on caffeine.

3. Health Considerations: For individuals with certain health conditions, such as anxiety disorders or cardiovascular issues, high caffeine intake may not be advisable. Consulting with a healthcare provider can help determine safe caffeine consumption levels.

Conclusion

Caffeine can be a powerful ally for night shift workers, providing the alertness and cognitive support needed to navigate the challenges of working during unconventional hours. By using caffeine strategically, night workers can enhance their performance, improve their mood, and mitigate some of the negative effects of sleep deprivation. However, it is crucial to approach caffeine consumption mindfully, balancing its benefits with potential drawbacks. When used effectively and in moderation, caffeine can contribute to a more productive and healthier experience for night shift workers, enabling them to thrive despite the unique demands of their schedules. Ultimately, combining caffeine with good sleep hygiene and other wellness practices can create a more sustainable approach to managing the rigors of night shift work.

This article was created using OpenAI’s ChatGPT on October 3, 2024 and it was personally reviewed and edited by Brandon Peters, M.D. to ensure its accuracy. This use of augmented intelligence in this way allows the creation of health information that can be trusted.

What Causes Insomnia in Children?

By Brandon Peters, MD

Children are often the perfect sleepers, but when they are not, what causes insomnia in children? Insomnia is the inability to fall or stay asleep or sleep that is not restorative. The causes of insomnia in children may overlap with adults, but there are also some unique conditions that may predispose your child to difficulty sleeping.

How Behavioral Problems Result in Insomnia

Perhaps the most common and frustrating of the causes of insomnia are difficulties related to your child’s behavior. Babies and toddlers may enjoy being comforted as they transition to sleep, but if they awaken and you are not there, this can be a source of great distress. This may result in frequent tearful tantrums in the middle of the night. This sleep-onset behavioral insomnia is remedied by letting your child fall asleep alone.

Another potential problem is toddlers and young children who refuse to go to bed. They will insist on a litany of needs prior to going to sleep: a drink of water, a trip to the bathroom, another bedtime story, a few more minutes with the light on, and the list goes on. This limit-setting insomnia is overcome by setting appropriate boundaries and asserting parental authority.

Moreover, children need to have a set of healthy sleep habits and a bedtime routine that will ensure a smooth transition to sleep. This includes appropriate sleep hygiene, which eliminates disruptions to sleep and makes the period of time just prior to falling asleep a time of relaxation. In addition, many distractions should be eliminated from the bedroom to ensure an appropriate sleep environment.

The Role of Medical Problems

There are a number of medical problems -- including neurologic and psychiatric conditions -- that may lead to insomnia in children. In general, these are rare disorders and other signs would exist beyond insomnia. Some of the possibilities include:

• Depression

• Post-traumatic stress disorder (PTSD)

• Attention deficit hyperactivity disorder (ADHD)

• Autism

• Asperger syndrome

In addition, some children (especially teenagers) may have circadian rhythm disorders such as delayed sleep phase syndrome that result in insomnia. These conditions lead to difficulties falling asleep at night and a desire to oversleep in the morning. This occurs because the desired sleep phase is shifted later than is standard. This may interfere with school performance and some school districts are actually shifting the start times to allow teens to sleep in. The use of phototherapy and melatonin may also help to shift these troublesome sleep patterns.

Other Causes of Insomnia in Children

Aside from the causes described above, there are a few other possible situations that may result in insomnia in children. Some children may experience insomnia as the result of medication use, especially the use of stimulants in ADHD. Finally, precocious children (those who are intellectually gifted) often have insomnia.

If your child is having difficulty falling asleep, and simple changes to address behavioral causes are ineffective, you may want to speak to your pediatrician about exploring other possibilities to improve your child’s sleep.

Brandon Peters, MD, is the author of Sleep Through Insomnia, a neurology-trained sleep medicine specialist at Virginia Mason Medical Center in Seattle, and former adjunct lecturer at the Stanford Center for Sleep Sciences and Medicine.