Sleep patterns among adolescents—a multi-facetted psychological and family-related phenomenon

Adolescence is understood in general terms as one of several developmental stages forming the life span, and more specifically as the developmental stage between childhood and early adulthood [1, 2]. The beginning of adolescence is biologically defined by the menarche beginning of menstrual cycles [3] and the spermarche (first ejaculation). In contrast, the endpoint of adolescence is less precisely identified and has been related to psychological, social, and vocational challenges [1, 2, 4].

The adolescent brain undergoes dramatic morphological, structural, and functional changes [5–7], which in turn appear to be related to the more frequent emergence of psychiatric disorders [8]. Not surprisingly, brain structures responsible for the neurological processes related to sleep also undergo structural changes [9]. However, focusing only on physiological and neurological alterations to explain changes in adolescents’ sleep patterns disregards both psychological and family-related factors and may thus lead to neglect of some important influencing factors.

In this Editorial, we focus first on the associations between adolescents’ sleep patterns and parental warmth in the long term, as Richardson et al. [10] so elegantly set out in their recent article. Second, we report more broadly on those studies showing that parents and their supervision and parenting styles continue to matter for their children’s sleep throughout middle and late adolescence. Third, the research agenda introduces the tripartite concept of reactive, evocative, and proactive interactio.

Associations Between Parents’ Behavior and their (Adolescent) Children’s Sleep – (Adolescent) Children’s Sleep in the Family Context

In their paper, Richardson et al. [10], reported longitudinal data of 531 adolescents (mean age at baseline: 11.18 years) and their primary caregivers assessed over a period of four years. Key outcome variables were parental warmth (e.g. parents want to be with the adolescent child), adolescent sleep patterns (morningness; sleep duration; sleepiness), and sleep hygiene behaviors (e.g. avoiding exciting or arousing activities before bedtime). Results showed that over time parental warmth protected against negative developmental changes in adolescent sleep: parental warmth was associated with adolescent children’s greater morningness, longer sleep duration, and less sleepiness during the day, both directly, but also indirectly via adolescent children’s improved sleep hygiene practices. However, also the opposite development was observed, in that inadequate adolescent sleep impacted negatively on parental warmth via deteriorating sleep hygiene. Overall, Richardson et al. [10] showed that adolescent children’s sleep and parents’ parenting style were highly interrelated and influenced each other in a bi-directional fashion over time.

In this regard, Richardson et al.’s [10] findings echo the longitudinal dynamics linking adolescent child’s sleep patterns and parents’ psychological functioning [11]. On one hand, Bell and Belsky [11] observed sleep problems among 11-year-old children, when three years before the father had been absent, mothers were less sensitive in interacting with the child, and when the mother–child relationship was burdensome. On the other hand, children’s sleep problems at age 11 predicted adverse changes in maternal emotionality and sensitivity three years later.

Gangwisch et al. [12] showed that adolescents (n = 15 659) in grades 7 to 12 reported better sleep and fewer symptoms of depression or suicidal thoughts when their parents supervised their sleeping behavior. This study underscores the importance of parents’ interventions even when their children are moving into late adolescence. Relatedly, Pyper et al. [13] in their cross-sectional study, investigated the associations between parents’ behavior and their (adolescent) children’s (aged 5 to 17 years; n = 1622) sleep behavior. It turned out that on weekdays, enforcing rules about child bedtime (“I enforce rules about my child’s bedtime”) was a significant positive predictor of their children meeting sleep guidelines (OR: 1.59), while “just” encouraging the child to go to bed at a specific time (“I encourage my child to go to bed at a specific time”) was a significant negative predictor of children meeting sleep guidelines. Thus, it appears that by setting clear bedtime limits parents helped their children get sufficient sleep (5–13 years: uninterrupted 9 to 11 hours of sleep/night; 14–17 years: uninterrupted 8 to 10 hours of sleep/night).

Pillion et al. [14]. investigated parents’ setting bedtimes and setting rules for technology use (711 adolescent participants; mean age: 15.1 years). Their results showed that the presence of a parent-set technology rule was associated with the adolescent child’s earlier bed-times. Furthermore, compared to those adolescent children not complying with their parents’ technology rules, those who did comply reported earlier light-out times and a longer sleep duration. Overall, this study showed that parent-set technology rules appeared to play an important role in protecting adolescent sleep.

Thus, family functioning matters. Several studies, both cross-sectional and longitudinal, have shown poor family functioning to be related to more impaired sleep among children [15–20]. Furthermore, while there is evidence that (adolescent) children’s sleep is associated with family functioning, including parents’ subjective and objective sleep patterns [21, 22], research has yet to provide explanations as to why and how such associations might occur. Here, we consider two theoretical concepts.

The Cognitive-Contextual Framework [23–25] proposes that the family and family functioning constitute the most important (social) “environment” for a child’s physical, psychological, and social development. Specifically, a child’s feeling of security is based on the perception of a conflict-free parental environment and conflict-free parent–child relationship. Here, “conflict-free” means that neither the parental environment nor the parent–child relationship triggers anxiety or threats. In the context of sleep, we note that the feeling of security is a precondition for falling asleep in the evening and remaining asleep during the night. In contrast, when a child perceives the family environment and the parent–child relationship to be endangered, this triggers increased vigilance and arousal. Thus, according to the Cognitive-Contextual Framework, children’s perception of marital conflicts and impaired parent–child relationships increases the children’s states of vigilance and arousal, which in turn negatively impact on their sleep.

The Emotional Security Theory [26–28] builds on Bowlby’s attachment theory [29]. Briefly, the quality of interactions between the child and the parent is taken to be the basis for feelings of security, stability, and safety. A warm and supportive parenting style [10, 30] is associated with the child’s emotional security, while in contrast, stressful parent–child interactions can have a dramatic negative impact on the child’s basic feeling of security. Here, we note that the recent paper of Richardson et al. [10] both elegantly substantiated the importance of parents’ warm and autoritative parenting style on adolescent children’s sleep quality and quantity, and corroborated previous results in the field [15–20].

Future Research Directions

Reactive, evocative, and proactive interactions in the field of adolescent sleep research

Overall, as set out above, there is sufficient evidence that (adolescent) children’s perception of a secure family context serves as a protective factor for both their mental health and restoring sleep. However, in the abovementioned studies, the adolescent child was basically considered as reactive or evocative, but not proactive [31–34]. Briefly, reactive interactions refer to a person’s behavior as an individual response to a given social context. Or to put it the other way around: Each person chooses a subjective psychological environment from the objective (social) environment. For example, Kelly et al. [18] showed that marital conflicts triggered insecurity in the child (reaction), which in turn was associated with more sleep disturbances. At the same time, a person’s behavior also triggers a set of distinctive responses from their social environment, and a person’s behavior therefore also has an evocative character. Illustrating this, Bell and Belsky [11] showed that a child’s sleep problems at age 11 years triggered an evocative interaction with negative effects on the mother’s emotionality and sensitivity 3 years later. Proactive interactions refer to fact that individuals are also choosing a social environment based on their needs and preferences. Thus, a proactive interaction is a process in which persons become active agents in their own social environment. Given this, the importance of proactive interactional behavior in the field of adolescent sleep research has yet to be much more appreciated. As such, the research findings of Richardson et al. [10] appear to elegantly and promisingly pave the ground for integrating reactive, evocative, and proactive processes in the field of child and adolescent sleep research within the family context.