What If Anxiety Won’t Let My Teen Sleep?

The Ask Lisa Podcast does not constitute medical advice and is not a substitute for professional mental health advice, diagnosis or treatment. If you have concerns about your child’s well-being, consult a physician or mental health professional.

The following transcript has been automatically generated by an AI system and should be used for informational purposes only. We cannot guarantee the accuracy, completeness, or timeliness of the information provided.

Reena Ninan:
My 12-year-old aughter has been struggling with getting to sleep.

Dr. Lisa Damour:
Lying in bed at night with these spinning worries. They can’t sleep. So then they go grab their phone and they’re looking at their phone and now they’re definitely not sleeping.

Reena Ninan:
How do you tell if a kid has an anxiety disorder? When is it time for a parent to worry? Shouldn’t we naturally be going to bed without the help of the audio book or meditation?

Dr. Lisa Damour:
The kid’s anxious, they’re not sleeping, so then they become more anxious and so they’re not sleeping. Then kids worry that there’s something really wrong with them.

Reena Ninan:
I love that we’re doing an episode on sleep because I said this earlier, you transform my sleep because I now put my phone in a different part of the house, in our bathroom.

Dr. Lisa Damour:
Proud of you, Reena. That’s awesome. Thank you.

Reena Ninan:
That was a big one. Awesome.

Dr. Lisa Damour:
You’re welcome.

Reena Ninan:
That was a big one.

Dr. Lisa Damour:
I’m so glad you did it.

Reena Ninan:
But at this stage of life, for some women like myself, sleep is very tough.

Dr. Lisa Damour:
I’m with you. I mean, Reena, I used to be such a good sleeper and for me, it’s so fragile now and I say to my husband, I’m like, every night’s an adventure. Every night’s an adventure. I don’t know.

Reena Ninan:
That’s a great way.

Dr. Lisa Damour:
When I’m going to fall asleep, how long I’m going to stay asleep. We’ll come to that conversation, but it is a big deal. It is a big deal.

Reena Ninan:
I know I’m in the process of doing a sleep study because I think I might have sleep apnea, so we’re trying to figure it all out. But yeah, a whole other topic for another day, but I love this letter that we got because it deals with sleep and anxiety and there’s so much that I learned when we had Lisa L. Lewis on our show last season talking about why teens, their bodies just shift their sleep cycle later. It’s not that they’re trying to be belligerent, but the hormones make them want to sleep later and sleep in later. So I want to read you this letter.
Dear Dr. Lisa, my 12-year-old daughter has been struggling with getting to sleep Most evenings. She gets out of bed after an hour or more saying she can’t sleep. She has anxious thoughts that are keeping her up. We’ve tried to send relaxing messages saying that this is normal, she can handle it. She will be okay and to try to brainstorm things that can help: take a shower, listen to guided meditation, breathing exercises in bed. We just got some melatonin since she heard from a friend that it helped, but it doesn’t seem to be improving. Of course, the stress of not falling asleep, getting more and more tired is a vicious cycle. Any advice or resources that you have to offer would really be great.
What do you think is going on here?

Dr. Lisa Damour:
There’s a thing you mentioned which we should not take lightly, which is this thing called sleep phase delay, which is when kids go into puberty and 12 would be spot on for a kid being likely to be in this phase, there is a shift in the sleep cycle and the body wants to stay up later and wants to sleep in later. Now, there’s a fine point in this data that’s actually worth articulating, which is it’s not that kids can’t fall asleep at their usual times. It’s that it’s easier for them to stay up as they hit puberty. Remember when our kids were little and they’d pass out at eight o’clock in front of the TV and you carry their bodies up to their beds. Kids can fight falling asleep better as they get older, so it’s not that they’re like, I can’t sleep at all.
It’s that I can not pass out like I did when I was a little kid. So that’s where sleep hygiene ends up being such an incredibly important thing is it is easier to stay up and so then kids have to sort of amp up and probably we in our pre-menopausal, post-menopausal phase have to amp up our devotion to the word hygiene is so weird I think in this context, but sleep hygiene where we’re really letting the body wind down and really staying away from blue light because those things just add on to the ability to stay awake. So that could be a piece of it. I think there’s more to it, but that could be a piece.

Reena Ninan:
How do you tell First off, if a kid has an anxiety disorder?

Dr. Lisa Damour:
It’s a really interesting question, this kid’s anxiety is actually keeping her up at night and that’s concerning.
We want to always first and foremost start with the understanding that anxiety on its own is not pathological, that we have anxiety as part of our lives. It helps us be aware of threats and aware of what’s coming our way. We worry about it when there’s anxiety about a threat that’s not real when a kid’s like, I’m going to fail that test and the kid has never failed a test in their life and it’s getting in the way. She might be moving towards that. I would not jump to that. I would not jump to clinical interventions. I think there’s a lot of room between where she is and that, but is it pure healthy anxiety? No. Right? It’s keeping her up at night and it sounds like she’s worrying about things that she doesn’t need to be that worried about.

Reena Ninan:
When a teen or a child can’t sleep is the right move to get out of bed?

Dr. Lisa Damour:
There’s a whole sleep science around this that I think is true across all ages, certainly starting puberty and up where there’s a general sense that if you’re lying in bed and Reena, I do this probably twice a week and you’re looking at the clock and you’re getting more and more tense and anxious about not falling asleep, then there’s the hazard that being in bed becomes paired with tension and anxiety. If that’s a repeated process.
We’re doing this, we’re both struggling with sleep. What’s your relationship with the clock? Do you look at it? For me, the clock is a big problem.

Reena Ninan:
This is a new thing that I’ve started to do when I cannot fall asleep and I’m truly, truly wide awake and it’s more than 10 minutes, and again, I don’t know if this is the right thing to do. I do get out of bed, this is so horrible, and I will start to pull out my laptop and start to finish the work that’s on my mind that I have, that I know is weighing on me and preventing me from sleeping. And then I find if I do 10 or 15 minutes of work, I can sleep that much better.

Dr. Lisa Damour:
And you’re finding that the light of the laptop doesn’t mess you up, that it does actually help you fall back to sleep to have gotten the thing off your plate?

Reena Ninan:
Yeah, yeah, yeah, exactly.

Dr. Lisa Damour:
First of all, what I’m hearing is okay, it’s working right? It’s working. What you’re doing is working, so keep doing it. I find if I look at my laptop even 45 minutes to an hour before I’m supposed to fall asleep, I think that that messes me up. But one of the things that we do know helps and it’s a version of what you’re doing is if there’s something where your mind is spinning, spinning, spinning, and you can’t leave it alone, go write it down, get out of bed, write it down so that you have offloaded it from your mind. And I think people often find that that lets them go back to sleep.
I lay there, it’s not great and it has not for me turned into then the next night I often can fall asleep, but I actually think it’s not altogether wrong, and I think a lot of sleep scientists would say if a kid is in bed for an hour and starting to get really, really worked up about not being able to sleep, getting out of bed is probably a really good idea to go do something soothing that lets her settle down.
I don’t think it’s a terrible idea. I also think, okay, but how does this work in family life? Do your kids go to bed before you, after you? Where are you in this?

Reena Ninan:
They used to go to bed before me and now I’ve started rethinking my sleep. So we all sort of go to bed around the same time. My husband might be downstairs reading or doing something else, but I tried to show them, I am also going to bed right when you’re going to bed and I’m getting up as you are getting up too or a little bit before. And I think that helps them strangely, but it’s more I am doing this for me because my sleep has been so all over the place and I’m realizing just how much at this point in life it affects my body.

Dr. Lisa Damour:
Okay, so we actually also all go to bed right around the same time. So I think one of the challenges, even though it is probably not the worst idea for the kid to get out of bed if they’ve been in bed for an hour and usually we expect people to fall asleep within 10 to 15 minutes, that’s what we’re sort of shooting for. I think there needs to be a little planning about what’s she going to do, right? I mean, if everybody else has gone to bed and everyone else is asleep, does that mean she comes in and wakes everybody up and says, hi, I can’t sleep, or does that mean she reads quietly in a chair with light that is dim? So I think it’s not bad advice, but I think it needs to be thought all the way through in terms of what’s a calm down thing that she can do to let herself get drowsy before she puts herself back to bed?

Reena Ninan:
Do you have advice for what that calm down thing might be?

Dr. Lisa Damour:
I think for sure it wouldn’t involve tech and always, always on these questions, I’m going to assume that the tech has been taken out of the picture. That’s a first place to start if kids aren’t sleeping is get them away from their tech. Get yourself away from your tech a reasonable amount of time before bed, and one of the ways I really watch kids do themselves in with sleep is they can’t sleep, so then they go grab their phone and they’re looking at their phone and the light or the exciting things on their phone or the upsetting things on their phone. Now they’re definitely not sleeping. I think a little book, I think a little reading. I think music can do a good job. I have seen some families, I think this is really neat, where the kid will play an audio book on an iPad and it will be by their bed and they can hear the iPad, but they’re not looking at it and especially if it’s a book they’ve read before and know where it’s going, listening to that takes up enough mental bandwidth that they stop thinking about the thing that’s making them anxious and they fall asleep to that and then you can set a timer on how long the audiobook goes.
That is actually a pretty reasonable strategy for some families.

Reena Ninan:
It’s interesting because my daughter likes to read right before she goes to bed and it winds down, and I saw this study recently just this week that talked about Alzheimer’s disease and that they have found that there’s a link between people who fall asleep with the tv. There is some sort of correlation with developing Alzheimer’s, and one of the research showed that your body’s ability to learn to regulate itself and shut itself down and go to bed, I worry should we naturally be going to bed without the help of the audio book or meditation or how should we be thinking about this at night?

Dr. Lisa Damour:
We want to make space. I actually am a big believer in rituals before bed, having a series of things that you always do every night in the same order, which also in this letter I was flagging it in my mind they’re like, well, try this or try that or try this. You actually want a pattern that your body recognizes as the pattern of events that occur right before you go to sleep. Why is that so important? Like sleep is not a switch. We can flip as you and I have both really come to discover in recent years, we want to think about sleep. It’s a destination you arrive at by putting yourself on a path that gets you there. What you want, and this is not the most important thing, but if you’re helping a kid develop, what’s your sleep ritual? Something that will also let them go to camp and something that will let them if they want to have sleepovers, right?
So I don’t love iPad’s, not my first choice because it’s like they’re not going to let you do that at camp and you don’t want to not be able to go to camp if you want to go to camp because you need your iPad to sleep, but also desperate times call for desperate measures, and if your kid’s exhausted and that does it, that’s fine for now. It’s actually really okay to have, and most of us do naturally have. You wash your face, you brush your teeth, you floss, you read a little bit.
Growing up in Colorado, I have a lifelong habit of put on chapstick, put on lotion on my hands, having grown up in a really dry climate. When I do all of those things, what we know is your body learns the pattern and your body’s like, oh, these are the things that come before sleep. And so then it makes it that much easier to fall asleep if people need to meditate, taking a hot shower, reading a little in bed, those are actually good, especially if they’re portable and they really do signal to the body that sleep is the destination we’re headed towards.

Reena Ninan:
This is a big deal to me because anxiety can just rear its ugly head and go in so many directions and really be difficult and hard for a family, but so can lack of sleep, which affects so many more families. I feel like that’s just such a common denominator for lots of people. When is it time for a parent to worry when their kid isn’t getting the right amount of sleep and especially if it’s driven up anxiety very high?

Dr. Lisa Damour:
And we do see that, right? It gets into this, whatever the opposite of a virtuous cycle is, like the kid’s anxious, they’re not sleeping, so then they become more anxious and so they’re not with sleeping. I mean it can really spin and spin and spin. I think there may be room for a clinical intervention. I think there’s one other step before that, which is what is the kid anxious about? This parent is doing such a lovely job of being like, we’re trying melatonin, we’re trying showers, we’re trying these other things. But I actually think in daytime hours it might be like, what are you worried about? What are you thinking about? Because there’s something that has actually got this kid’s mind really, really buzzing. I would try to look into that, right? And we have ways that are very do it yourself at home, ways to bring worried thoughts under control.
Our good friend of the pod, Ethan Cross who came on about his book “Shift” that book is about when we’re having an uncomfortable feeling getting away from it, actually using our minds to shift away from it. And one of my favorite things, and Ethan, he’s a lab scientist at Michigan, he has this great finding and I would a hundred percent use this every once in a while with this kid or with a kid who’s anxious. So say the kid’s like, I’m really, really worried because I said this thing to my friend at lunch and I’m afraid that she’s mad at me and I don’t know, but I don’t want to ask her. You could totally see a 12-year-old losing sleep over that. One of Ethan’s strategies is to say, how do you think you’ll feel about this in a year? Or how do you think you’ll feel about this in a couple of years?

Reena Ninan:
That’s right.

Dr. Lisa Damour:
It’s so smart and you can’t do it that often. You do that every night. Your kid’s not going to like it, but he shows in his lab that instantly dials the anxiety down, instantly dials the discomfort down. Part of I think what’s still to be done here is a little more tackling the anxieties head on. So I would try that strategy. I also love that what would you tell a friend about this, right? If the kid’s like, I’m freaking out. I said this thing and I think she’s upset with me. What would you tell a friend those shifts in perspective, and again, this is Ethan’s work. How do you shift from one space to another and then a good old fashioned? We’ve always used this as psychologists. If you’re really anxious about something, usually you’re overestimating how bad it is and underestimating your ability to handle it.
So if a kid is spinning and spinning and spinning and freaking out about, I don’t think I did well on that test, you can be like, okay, well how bad did you think you did? You bring that down and if you did mess it up, what could you do to fix it? Right? So I think that the piece I don’t hear that I would want an adult to explore a little bit more is using these wonderful tried and true strategies to just hit the anxiety head on. If that’s not working, then you might call your pediatrician and see what they recommend.

Reena Ninan:
When you step back and you look at this, what worries you the most when you hear about a situation like this?

Dr. Lisa Damour:
I worry that the kid feels crazy, which is a real, I am sort of surprised to hear myself say that, and I don’t usually use the word crazy, but I think that that’s often how kids talk about it and they feel. I’m thinking about being 12 and I’m thinking about suddenly feeling really dysregulated as they often do, and then I’m thinking about this sweet child lying in bed at night with these spinning worries that are keeping her up, and one thing we know is that then kids get another worry that there’s something really wrong with them. You know how you and I are like, we used to be such good sleepers. What happened? Right? 12 year olds can be like that. What is wrong with me? Is this what adolescence is going to look like? Is that I’m kind of coming apart at the seams. My real concern at some level is how is the kid taking all this in? How do they feel about what’s happening?

Reena Ninan:
And I think we don’t have these conversations like a generation ago, so what you said about anxiety, that you’re feeling that level of thought in your mind that it’s so, so bad when the reality is it’s not what your perception is that I think talking about it and having discussions like, Hey, you know what? This is actually normal that’s happening in your body for you to want to go to sleep later or not be able to fall asleep right away. I think those are important conversations to have that kids might not realize what’s happening.

Dr. Lisa Damour:
The more we can then normalize it, this happens. We go through periods where we’re pretty amped up and our bodies get caught up in it and our minds get caught up in it, and there’s nothing wrong with you kiddo. You’re at an age where everything’s remodeling, everything’s changing in your brain, and it won’t be like this forever. That’s another kind of beautiful perspective shift. We can say you’re going through this, but it’s not a forever thing,

Reena Ninan:
So what do you have, Lisa, for Parenting to Go?

Dr. Lisa Damour:
I think that we never should miss an opportunity to help kids understand that anxiety is a normal function, that they are so quick when they are feeling stirred up to say, I have anxiety and often to refer to it as though it’s a pathological certainty. Any opportunity where we could say, well, you’re anxious because you haven’t studied, or you’re anxious because you did say something that wasn’t very nice to your friend and you want to sort it out. The more we can make the case that most anxiety most of the time is helpful, useful, alerting us to a threat, the more reassurance we offer them in general, and then it helps us be more clear about when things have actually crossed a line. The more we can kind of be on the, I would say, the PR team for anxiety that it’s not all bad and that it serves a function. I think the more we help our kids.

Reena Ninan:
I love that, the PR team for anxiety. I’ve never looked at it that way. That’s quite good. I like that. I’ll see you next week.

Dr. Lisa Damour:
I’ll see you next week.