Did Jonathan do drugs? Did he suffer from anxiety? Did he have attention deficit hyperactivity disorder (ADHD)? While his teachers didn’t know what was wrong with Jonathan, age fifteen, they did know his tendency to fall asleep in their classes was a problem.
Jonathan’s parents were baffled, too. But when Jonathan consistently wouldn’t get up in the morning, his father decided Jonathan didn’t really want to get up. His mother, on the other hand, would sometimes baby Jonathan, and sometimes try tough love. For a while, when he was young, she would sleep in his room, because her presence soothed him. Later, she would leave him alone to cry himself to sleep at night, or pick him up out of bed, and put his feet on the cold bathroom floor, to wake him up for school in the morning. Indulgent or strict, either way, she wound up feeling guilty, and worried she was doing the wrong thing.
But the culprit in this case was not Jonathan’s mother, but Jonathan’s sleep pattern. And the mystery inched closer to a solution during one lazy summer vacation after Jonathan’s parents divorced. Without obligations to keep Jonathan on a schedule, his mother thought, “I wonder what kind of sleeping timetable Jonathan would have if I didn’t try to make him go to bed, and get up, at particular times.”
The results of her experiment surprised her. For the first week, Jonathan slept from 1 AM to 1 PM. That was followed by a second week of sleeping from 2 AM to 2 PM, a third week of sleeping from 3 AM to 3 PM, and so on. Thus although teenagers need a great deal more sleep than adults, Jonathan needed a great deal more sleep than even the average 9.2 hours per night that most adolescents require. But why was Jonathan naturally gravitating towards later and later bedtimes?
Jonathan and his mother found out by chance, when they saw an article about sleep and circadian rhythms in The New York Times. The article was by psychologist Michael Terman, a pioneer who applies research about the body’s natural rhythms of activity to everyday problems.
When Jonathan and his mother visited Dr. Terman, he gave them very specific advice about how to use light therapy to reset Jonathan’s cycle of sleep and wakefulness, and continue to use a small amount of light therapy daily to stay on a good schedule. Specifically, Dr. Terman gradually adjusted Jonathan’s bed-time from the wee hours of the morning to an evening hour that was more in tune with his family, friends, and school. Then Dr. Terman showed Jonathan how to maintain this schedule with light therapy and structured time.
Resetting one’s internal clock is more of a challenge than it sounds, but it was necessary because, as Dr. Terman put it, Jonathan was physically in New York, but his circadian rhythm was three hours behind, on “California time.”
The effects of light therapy for Jonathan were striking. Jonathan reports that this simple, non-intrusive intervention enabled him to stay awake in all his classes, and enjoy an improvement in his grades. This treatment also gave him a sense of control over his therapy, since he felt that if he took medication, he would be dependent on pills. On the other hand, the light box fascinated him.
Jonathan’s ownership of his problem made his mother proud of him, but her real satisfaction with treatment lay in the results. Before light therapy, she said, Jonathan was like a drooping plant that hadn’t been watered for a long time. Resolving his sleep problem was like watering that plant, like bringing half-dead leaves to life in Louisville, Kentucky. It was solving the problem of the New York teen on California time.
More Information on Common Problems with Falling Asleep
Search Sleep Phase Delay, Sleep Phase Advance, and other sleep topics in Ask the Doctor.