NV PAL’s Guide to Healthy Sleep

NV PAL’s Guide to Healthy Sleep

For parents and health professionals, with a focus on child and adolescent populations. 

Introduction

Sleep is a fundamental biological process essential for physical health, mental well-being, learning, and longevity. Yet modern lifestyles—characterized by artificial light, screen exposure, inadequate physical activity,  and chronic stress—have disrupted normal sleep patterns for millions of people. In the United States, insufficient or poor-quality sleep has become increasingly common across age groups and may represent a growing public health crisis.

This guide summarizes what healthy sleep looks like, why it matters, how common sleep deprivation is in the United States, and practical steps families can take to improve sleep.    

What Does a Good Night of Sleep Look Like?

Healthy sleep is defined not only by duration, but also by quality and consistency. A good night of sleep typically includes:

  • Falling asleep within ~10–20 minutes
  • Sleeping through the night or waking briefly but returning to sleep easily
  • Cycling normally through sleep stages
  • Feeling refreshed and alert during the day

The total amount of sleep required each night will vary based on age and other factors.

Age GroupRecommended Sleep
Newborns (0–3 months)14–17 hours
Infants (4–12 months)12–16 hours
Toddlers (1–2 years)11–14 hours
Children (3–5 years)10–13 hours
School-age children (6–12)9–12 hours
Teenagers (13–18)8–10 hours
Adults (18+)7–9 hours

The data above provides a broad overview of sleep needs by age. However, The National Sleep Foundation provides a sleep requirements chart showing a more in-depth, nuanced assessment.

What Happens to the Brain and Body During Sleep?

Sleep is an active biological process involving coordinated brain activity, hormonal regulation, and physical restoration.

Sleep Stages:

Sleep cycles between non-REM (NREM) and REM sleep, typically repeating every 90 minutes.

Non-REM Sleep

  • Stage 1: Transition between wakefulness and sleep
  • Stage 2: Heart rate slows and body temperature drops
  • Stage 3 (deep sleep): Tissue repair, immune function, and energy restoration occur

REM Sleep

  • Brain activity increases
  • Most dreaming occurs
  • Critical for learning, emotional processing, and memory consolidation.

Biological Processes During Sleep

During sleep the body:

  • Repairs tissues and muscles
  • Strengthens immune function
  • Consolidates memory and learning
  • Regulates hormones controlling appetite and metabolism
  • Releases growth hormone important for development and repair

These processes demonstrate that sleep is an essential physiological function, not simply a passive state of rest.

Why Is Sleep Important for Health?

As the CDC’s About Sleep details, sleep influences nearly every system in the body.

Physical Health

Adequate sleep is associated with:

  • Lower risk of heart disease
  • Improved metabolic health
  • Better immune function
  • Reduced risk of obesity and diabetes

Insufficient sleep has been linked to hypertension, cardiovascular disease, and stroke.

Mental Health and Cognitive Function

Sleep plays a critical role in:

  • Learning and memory consolidation
  • Emotional regulation
  • Decision-making
  • Reaction time and attention

Sleep deprivation can impair cognitive performance and increase the likelihood of errors and accidents.

Safety

Insufficient sleep increases the risk of:

  • motor vehicle accidents
  • workplace injuries
  • medical errors

For these reasons, sleep is increasingly recognized as a public health and safety issue.

Are Americans Getting Enough Sleep?

Evidence suggests many Americans are chronically sleep deprived:

  • Adults – According to the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), about one-third of U.S. adults do not get enough sleep. Slightly more males (37.5%) than females (36%) report not getting enough sleep.
  • Teens – The latest YRBS data shows that 77% of high school students report insufficient sleep, with slightly more females (80%) than males (75%) reporting insufficient sleep. 
  • Children – 35% of children ages 4 months to 14 years are not getting sufficient sleep. Here, disparities in sufficient sleep are primarily evident based on ethnicity, with children identifying as Native Hawaiian or Other Pacific Islander (61%) and Black or African American (53%) showing the highest rates of sleep insufficiency.  

Insufficient sleep is associated with increased risk for:

  • obesity
  • diabetes
  • cardiovascular disease
  • depression and other mood disorders
  • poor school performance
  • accidents and injuries.

Because of its widespread prevalence and health consequences, many public health experts consider insufficient sleep a major public health concern in the United States.

Unique sleep challenges for adolescents

In the review Sleep and Circadian Rhythms in Adolescents (Tarokh et. al 2019), the authors detail a “perfect storm” negatively impacting sleep timing, quality, and duration in adolescents. 

First, for both biological reasons (natural shifts in melatonin release) and environmental reasons (homework, social media use, artificial lighting, etc), adolescents tend to shift their bedtimes later. Thus, they often have difficulty going to sleep before 11pm. 

Nevertheless, they still have to wake up and be at school at a time that inhibits their ability to attain adequate sleep (~9 hours). This tug of war between biological and societal demands results in chronic rates of insufficient and irregular sleep in adolescents, with consequences for cognitive, mental, and physical health. 

In regards to cognitive health, the authors note the following: 

“Current evidence suggests that sleep supports multiple cognitive domains in adolescents, from boosting attention to promoting long-term memory consolidation and having a positive influence on the development of semantic schemata. Experimental and observational studies have shown that the chronic sleep restriction that is characteristic of adolescent sleep has serious consequences for cognitive function, negatively impacting processing speed, sustained attention, working memory, long-term memory consolidation, psychomotor vigilance, executive function, inhibition, and cognitive flexibility.”

The authors also detail the bidirectional relationship between sleep and mental health: 

“More recent epidemiological as well as experimental studies continue to show that adolescents who do not get sufficient sleep suffer from diminished mental well-being. For example, in a study of 27,939 adolescents, 1-h less of weekday sleep was associated with greater odds of feelings of hopelessness, suicidal ideation, and substance use… The higher the sleep quality adolescents experience, the better their emotional, social, and behavioral performance.”

As for the impacts of insufficient sleep on adolescent physical health:

“During adolescence, a period of rapid bodily growth, sleep supports physical development and well-being. For example, negative associations between short sleep duration and obesity, adiposity, cardiometabolic biomarkers, type 1 diabetes mellitus, asthma, and headache as well as migraine and menstrual problems have been found.”

Simple, Free Protocols to Improve Sleep

Now the good news: regardless of age, many sleep problems can be improved through behavioral and environmental changes which are collectively referred to as “sleep hygiene.” 

Here are sleep hygiene protocols you can adopt which mirror CDC and other expert guidelines to help improve sleep: 

1. Maintain a consistent sleep schedule. 

Go to bed and wake up at the same time every day—even on weekends.

2. Optimize the sleep environment. 

A healthy sleep environment should be:

3. Reduce evening light and screen exposure and avoid social media before bed. 

Avoid bright lights and screens 1+ hour before bedtime because blue light suppresses melatonin production. Also, try to avoid social media use for 1+ hours before bed. Consider moving your phone out of reach or into another room before bed in order to avoid the temptation to use your phone (or social media) during wake-ups.  

4. Limit stimulants. 

Avoid or minimize caffeine, nicotine, and alcohol after midday.  

5. Avoid large meals and alcohol before bed.

Large meals and alcohol close to bedtime can negatively impact sleep quality and sleep architecture. 

6. Exercise regularly. 

Regular physical activity improves sleep quality. However, vigorous exercise right before bedtime may interfere with sleep, so try to get your exercise in earlier in the day. 

7. Create a bedtime routine. 

Relaxing activities such as reading, stretching, or meditation can signal the brain that it is time to sleep.

8. Reserve the bed for sleep

Avoid working, eating, or using phones in bed. You want to associate your bed with sleep, not other activities you engage in while you’re awake.    

9. Enjoy sunrises and sunsets. 

Natural morning light and sunsets are the primary drivers of the human circadian rhythm, synchronizing the body’s internal clock to the 24-hour solar cycle. Morning light increases cortisol for alertness and sets the timer for evening melatonin, while sunsets signal the brain to begin producing melatonin, fostering better sleep quality and regulating sleep-wake cycles.

How does social media use affect sleep? 

Regular, compulsive social media use and/or social media use close to bedtime is generally associated with poorer sleep outcomes in adolescent populations. The AAP’s Sleep Quality and Social Media guide cites a cross-sectional research study which found that “adolescents who posted on or checked social media more frequently and adolescents who perceived social media to be more important for social belonging had higher levels of daytime sleepiness.”

Further, adolescents may delay bedtime to continue using social media on their mobile devices for entertainment (behavioral bedtime delay). Since they must also maintain their morning schedule to get to school on time, this behavior often translates to reduced or inadequate sleep time.  

For these reasons, the AAP recommends households cease social media use for 1+ hour before bed and also keep phones out of reach or out of the room entirely at night. (Hence #3 on our sleep hygiene protocols list above.) 

When Are Medications or Supplements Necessary?

As AACAP’s Sleep Disorders: Parent’s Medication Guide details, sleep disorders such as difficulty falling or staying asleep (insomnia) are common in children and adolescents, especially when other mental health and neurodevelopmental conditions are present, such as autism spectrum disorder, ADHD, and major mood disorders like bipolar disorder. 

Lifestyle changes should be the first approach for most sleep problems. However, medications or supplements may be appropriate when:

  • insomnia persists despite behavioral changes
  • sleep disruption is caused by underlying medical or psychiatric conditions.

In the case of Pediatric Obstructive Sleep Apnea, a pediatrician or sleep specialist may also recommend an adenotonsillectomy.

Sleep disorder screening for children and adolescents

Commonly used screens to detect and diagnose sleep disorders in child and adolescent populations include: 

Common Interventions

Parents who’ve not had success with improving their child’s sleep despite adopting better sleep protocols should contact their pediatrician, a sleep specialist, or a trained child mental health professional for a comprehensive evaluation.

From there, treatment options may include:

  • Melatonin supplements
  • Prescription sleep medications
  • Cognitive Behavioral Therapy for Insomnia (CBT-I)

Sleep medications should generally be used short-term and under medical supervision, as some may cause dependence or next-day sedation.If your child is experiencing insomnia or other sleep problems potentially requiring medication, we also recommend reading AACAP’s Sleep Disorders: Parents’ Medication Guide. This guide explains why, when, and how sleep medication may be recommended by a healthcare professional for your child’s insomnia and other sleep problems, and will help you decide which treatment options might work best.

Concluding Note:

Sleep is a cornerstone of human health comparable to nutrition and physical activity. Adequate sleep supports immune function, brain health, emotional well-being, and longevity. Despite this, a large proportion of Americans of all ages — including children and adolescents — do not obtain sufficient or restorative sleep. 

Fortunately, many sleep problems can be improved through simple lifestyle practices such as maintaining consistent sleep schedules, reducing evening light exposure, and optimizing sleep environments. When necessary, medical evaluation and targeted treatments can address underlying sleep disorders/conditions.

Prioritizing sleep is a foundational component of public health and personal well-being. Please do everything you can to optimize your and your family’s sleep—and encourage others to do the same! 

Reliable Resources for Learning More About Sleep

For families and clinicians seeking additional evidence-based guidance about sleep, the following resources may help:

Government and Public Health Sources

Professional Organizations

Clinical Resources

For Clinicians: