Rashi Kochhar, MD, discusses why adolescents face added sleep challenges during the school year

As children settle into the school year, sleep difficulties may show up not only at bedtime but also in the classroom. Daytime sleepiness, trouble concentrating, and even hyperactivity can signal that a child is not getting enough high-quality sleep.

For Rashi Kochhar, MD, a pediatric pulmonologist and sleep medicine specialist at Hackensack Meridian Jersey Shore University Medical Center and assistant professor at the Hackensack School of Medicine, one of the most important steps families can take is maintaining a regular sleep schedule.

"The most important being having very, very consistent bedtimes and wake-up times," Kochhar said. "So, keeping a consistent sleep schedule both on weekdays and weekends ensures that we're sort of aligning our internal body clock to those hours."

Ideally, families can begin making schedule changes 1 to 2 weeks before children return to school, Kochhar said. Once the school year has begun, keeping wake and sleep times consistent remains important.

How much sleep should children get?

Sleep needs vary considerably by age. According to Kochhar, teenagers aged 13 to 18 years need 8 to 10 hours of sleep in a 24-hour period. Children aged 6 to 12 years need approximately 9 to 12 hours, while preschool-aged children need 10 to 13 hours.

For preschoolers, some of those hours may come from daytime naps. By ages 4 to 5 years, however, children typically give up naps, Kochhar said.

Daytime sleep is particularly important to consider when counseling adolescents. Teenagers who are tired after school may come home and nap, potentially disrupting their nighttime sleep schedule.

"That's not advisable at all," Kochhar said. "So, restrict your sleep to the overnight duration."

How can insufficient sleep present in children?

Pediatricians should consider both the quantity and quality of sleep when evaluating daytime symptoms.

Fatigue and sleepiness are among the more recognizable signs of inadequate sleep. Children may nod off during school or struggle to focus and pay attention to the task in front of them.

Younger children, however, may have a different presentation.

"But in younger kids, they can actually have the other extreme where they're like extremely hyperactive; they have that inattentive behavior," Kochhar said. "So, kids could get misdiagnosed with ADHD, but it's pretty much their sleep that's not optimized."

Kochhar said daytime sleepiness and hyperactivity are among the most common ways insufficient or poor-quality sleep can present. Asking about sleep therefore may provide useful context when pediatricians evaluate attention or behavioral concerns.

Why are teenagers particularly vulnerable to insufficient sleep?

Adolescent sleep presents an additional challenge because normal development changes when teenagers naturally feel ready to fall asleep.

Kochhar explained that around ages 13 to 14 years, the circadian clock begins to shift. Melatonin is released later, causing adolescents to naturally feel sleepy later in the evening.

"They tend to feel sleepy a little later and go back to bed a little later, go to bed a little later, which basically is a barrier because they still have those early wake hours," Kochhar said. "So, that is the number one issue."

School schedules can therefore create a mismatch between an adolescent's biologic sleep timing and required morning wake time.

What else keeps adolescents from getting enough sleep?

Physiology is not the only barrier. Kochhar identified homework and academic pressure as factors that can push bedtime later. Social media use and adolescents' desire to remain socially connected can also interfere with bedtime, while caffeine or caffeine-containing products may further disrupt sleep.

These factors make sleep an important topic for pediatricians to address during the school year. Asking families about bedtime and wake time, weekend schedules, naps, caffeine, and daytime symptoms may help identify children whose sleep is not optimized.

For families trying to establish a school-year routine, Kochhar's central message is consistency: keeping bedtimes and wake times similar from day to day can help align children's internal sleep schedules with the demands of school.