Adolescent Sleep Disorders
During adolescence, the biological clock shifts to a later time leading to a natural tendency for them to stay awake later. When you add electronic use, the growing desire for independence, and earlier school start times to this natural tendency, we often see significant daytime struggles.
Adolescents can frequently get their days and nights “flipped” which requires considerable intervention to reverse. Mental health struggles such as depression and anxiety which can accompany some adolescents, can be complicating factors impacting sleep health and must be addressed simultaneously to see improvement in both. Lastly, one of the peak incidental times for Narcolepsy to present is during adolescence. It may present slowly over time or suddenly with sleep fragmentation, sleep paralysis, hallucinations at night and severe excessive daytime sleepiness. Cataplexy can be part of the presentation as well where an individual laughs and develops muscle weakness—sometimes as simple as ones’ mouth hanging open or having droopy eyes.
A thorough and detailed history can often clearly identify what the underlying problem is. Sometimes light therapy may be needed to shift the biological clock and strict sleep hygiene is always needed. Evaluation for Narcolepsy requires a formal overnight sleep study followed by a daytime nap test called a Multiple Sleep Latency Test. Once the diagnosis is made, symptoms almost immediately improve with medications. It may take several weeks to a few months to optimize treatment and then careful long-term follow-up is required often 2-3 times a year. We help with letters of accommodation for school supporting documentation for 504 plans or help with requesting extra time for college entrance exams. Advice is given as students transition to college life as well.
Sleep disorders in adolescence can be challenging and successful treatment requires a patient’s desire to work with us on solutions. A willingness to implement sleep hygiene recommendations consistently can markedly improve daytime symptoms. Patients with Narcolepsy, once treatment is started can have their life transformed almost overnight. It is always a significant relief for these patients to finally have a diagnosis as it has taken many years to get answers. I have seen all of my patients with Narcolepsy thrive and go on to lead productive lives.
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