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ELEVATED BLOOD PRESSURE IN ADOLESCENTS IS INCREASINGLY OCCURING
Dr Oluwatosin Olorunmoteni, a consultant pediatrician at the Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, in this report with SADE OGUNTOLA speaks on the importance of sleep, particularly to the health of adolescents and why sleep hygiene is vital to Nigerians.
ADOLESCENTS FREQUENTLY EXPERIENCE A RANGE OF SLEEP PROBLEMS THAT CAN SIGNIFICANTLY IMPACT THEIR PHYSICAL AND MENTAL HEALTH. WHY IS THIS SO?
Adolescence marks a period of profound developmental transformation, including significant changes in body shape, functions, and emotions tied to puberty. Research indicates that sleep regulation also undergoes important shifts during this developmental stage. Unfortunately, sleep problems have become increasingly common among adolescents worldwide, potentially leading to serious mental and physical health consequences including mood disorders, anxiety, depression, and behavioral issues.
Multiple factors contribute to adolescent sleep difficulties. Biological changes beginning at puberty create a physiological phase delay, causing teens to naturally feel sleepy later and need to wake later than during childhood. This biological shift occurs alongside social and environmental factors that further impact sleep quality.
Parental oversight of bedtimes often relaxes during adolescence, removing previous sleep structure. Electronic devices provide nighttime entertainment alternatives that compete with sleep. Academic pressures from schoolwork, extra lessons, and homework frequently push bedtimes later. When combined with early school start times, as commonly seen in Nigeria, adolescents experience shortened sleep duration. Beyond quantity issues, teens may struggle with sleep quality, timing, and consistency.
The relationship between sleep health and mental health appears bidirectional. Many mental health conditions include sleep disturbances among their symptoms, while sleep problems can serve as early indicators of mental health disorders. Poor sleep can also contribute to physical health problems, affecting growth and development, blood pressure regulation, and hormonal function.
These interconnected factors highlight why addressing sleep problems is crucial for supporting adolescent wellbeing and healthy development.
IN NIGERIA, WHAT IS THE MOST COMMON SLEEP PROBLEM, PARTICULARLY IN ADOLESCENTS?
Inadequate sleep duration stands as the predominant sleep issue facing today’s adolescents. Research indicates that many teens fall short of the recommended 8.5 to 9.25 hours of nightly sleep, primarily due to the combination of delayed bedtimes and early morning school schedules. This sleep insufficiency is particularly pronounced during weekdays when academic demands and technology use further compress available sleep time.
The challenge takes different forms across communities. In rural areas, limited electricity access can disrupt healthy sleep patterns, while early morning agricultural responsibilities and household chores often necessitate pre-dawn wake-up times. These factors, combined with delayed bedtimes, create a significant sleep deficit that impacts adolescent health and functioning.
WHAT IS THE BURDEN OF SLEEP PROBLEMS IN NIGERIA, PARTICULARLY IN ADOLESCENTS?
Sleep disorders among Nigerian adolescents represent a significant but often overlooked health challenge. Research shows alarmingly high rates of sleep problems, with studies indicating that 44.4 percent of in-school adolescents experience inadequate sleep duration on weekdays due to academic demands, poor sleep quality, daytime sleepiness, and potential sleep apnea risks. These issues stem from multiple factors including excessive homework, early school start times, and nighttime electronic device use.
Available questionnaire-based research reveals sleep insufficiency and related problems affect between 16.4 and 60.8 percent of Nigerian adolescents. A recent study using actigraphy (an objective sleep measurement method) found distinctive patterns between rural and urban students: urban adolescents showed higher rates of sleep deprivation and daytime sleepiness, while rural teens experienced poorer sleep quality with frequent nighttime awakenings. These findings highlight the need for additional research employing objective measurement tools like actigraphy and polysomnography to better understand sleep patterns among Nigerian adolescents.
IT IS SAID THAT MANY ADOLESCENTS EXPERIENCE A NATURAL SHIFT IN THEIR CIRCADIAN RYTHMS, RESULTING IN LATER BEDTIMES AND WAKE TIMES. CAN YOU EXPLAIN?
The shift in adolescent circadian rhythms stems from both internal and external factors. Internal influences include puberty-related physiological changes and delayed melatonin production, which naturally push bedtimes later. External elements such as social pressures, academic demands, and environmental conditions significantly impact sleep habits as well.
Research suggests this natural circadian shift typically intensifies as adolescents age, leading to progressively later bedtimes. When combined with fixed early morning school schedules, this creates a worsening pattern of sleep deprivation as teens advance through adolescence.
WHAT ARE THE CONTRIBUTING FACTORS TO SLEEPING PROBLEMS IN ADOLESCENTS?
Several interconnected factors contribute to sleep difficulties among adolescents:
Biological Factors The natural circadian rhythm shift during puberty causes adolescents to feel sleepy later and need to wake later than in childhood.
Individual Factors Poor sleep hygiene practices significantly impact sleep quality, including caffeine consumption near bedtime, substance use, irregular sleep schedules, and mental health challenges. Academic pressures, extracurricular commitments, and part-time employment further compress available sleep time.
Technology Use The growing prevalence of electronic devices represents a particularly concerning factor, with screen time before bed disrupting natural sleep cycles and delaying sleep onset.
Family Factors Limited parental oversight of bedtime routines, inconsistent family sleep patterns, strained parent-teen relationships, domestic conflicts, and bed-sharing arrangements all influence adolescent sleep.
Environmental Factors Sleep quality is affected by exposure to artificial light, inconsistent electricity access in urban areas (particularly generator noise), and suboptimal sleeping conditions in rural communities, creating distinct urban-rural sleep challenge patterns.
School-Related Factors Demanding academic schedules with early start times, late dismissals, and extended after-school classes significantly reduce opportunities for adequate sleep.
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