Episode 5
Why Teenagers Feel More Awake at Night

INTRO

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Have you ever struggled to stay awake in your first class, but somehow felt completely energized late at night?

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In this episode of Brain Matters, I speak with Lara and Penelope from Massachusetts General Hospital about why teenagers’ body clocks may not always match school schedules—and what students can do to feel more awake and rested.

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Vivian: Could you both introduce yourselves to our audience and share a little bit about your work and what you're currently doing?

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Lara: I'll start. So my name is Lara. I'm a clinical research coordinator at Mass General Hospital in Boston. I graduated from UMass Amherst with a degree in Psychology and concentration in Neuroscience. Now my current role is working with Dr. Elizabeth Clearman at the national hospital.

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There I run multiple MGH funded clinical trials and like mainly in the sleep field. 

Penelope: And my name is Penelope. I am also a clinical research coordinator at MGH. I also graduated from UMass Amherst with a degree in Psychology, with a concentration in Neuroscience. I also minored in Biology there. And I'm Dr. Clemens primary coordinator. On her study examining the effects of the sleep related hormone melatonin on uterine contractions, and full term pregnant women. So I have been working at MGH for almost a year now, and hopefully we'll continue on to medical school after this roll here.

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Vivian: Yeah okay, both those sounds super exciting. So both of your research is centered around sleep and circadian rhythms a little bit, and for students hearing or like both your research and work. And for students hearing that term for the first time, what actually is a Circadian Rhythm and how much does it influence things beyond just sleep?

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Lara: Yeah, so Sleep and Circadian Rhythm are like a super important part of all of our lives, and it's not always something that people focus on, a lot of people maybe focus on nutrition and in being active and sometimes sleep is what we put on the back burner. So Sleep and Circadian Rhythm are really important, and Circadian Rhythm is tics to explain what that is. So every day is twenty four hours in a day, and so your Circadian Rhythm is this twenty four hour cycle, and that means that every day your Circadian Rhythm cycle repeats. 

So I'll talk about daytime first because that's an important part of the circadian rhythm cycle. And I'll first start talking about a hormone that's really important about driving these cycles. So the hormone is melatonin and it's a hormone in your body that naturally makes you sleepy. It's also called the Dracula Hormone, which I think is a funny name. So at night time, as it gets closer to evening that melatonin starts to produce, it comes into the body, and it starts to rise. And that's when it's queuing you for night time and sleep, and it stays high throughout the night, and as it's getting closer to morning, it starts to dip all the way back down, to be at a low level, that's kind of getting you ready to wake up again, so they're really important for all different processes in the body. Your circadian rhythm also influences other things outside of melatonin like cort azole, which influences your body's stress response energy levels. It also regulates insulin sensitivity which impacts digestion and you treat processing. So, a lot of interesting parts to circadian rhythms. About night time, there's also an important thing that happens during night time. I'll let Penelope talk about this, and it's like our sleep cycles that happen throughout the night.

Penelope: So this is a little bit, I guess it fits into the circadian rhythm because we are you know talking about cycles but you, cycle through your sleep stages and this is something that is definitely not very widely known or at least not very widely talked about, so your body is cycling while you are asleep. And there are four sort of core sleep stages, you've probably heard of some of them. There are stage one and two, which are sort of like your light sleep, and then stage three, which is your slow wave sleep or your deepest sleep, and then stage four, which is also vivid dreaming or you might have heard of rem sleep. So your body is constantly cycling through these four stages while you're asleep. And the cycle repeats about every eighty to one hundred minutes, and each person goes through about four to six of these cycles every night.

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Vivian: It feels really nicely like here about this gang cause I remember learning about it in doctor Katie's class. But so basically our circadian rhythms kind of follow the pattern of the day and like getting up and going to spend the night. But like we also have,  because there's morning people and night people, do we kind of have different kinds of rhythms and like what changes that?

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Lara: So we all have that same circadian rhythm cycle that's called like chronotype is the word for that, and some people feel more alert and like their peak alertness levels and they're awake, but the time they feel the most like awake, I guess is in the morning. And then you know, as they might get tired earlier into the evening, and then people who are more like night hours, they might feel like they need to sleep in later in the morning, and they feel like they're at peak alertness levels, and you know the time they feel that they would do their best work is in the evening hours, that's why they want to stay up later. So circadian rhythms are different in that aspect that you know, we all have the same circulating rhythm cycle this twenty four hour cycle, but the way it's set up throughout that twenty four hours is a little bit different. Some people is pushed like shifted forward, some people shifted back a little bit and it kind of depends when people want to start their day or start their evening can differ.

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Vivian: Okay so kind of relating to that bit, a lot of teenagers feel like suddenly productive or motivated late at night. And then so why can the brain feel so different when we're active later in the day compared to earlier in the day?

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Lara: So this is kind of similar to what I was just talking about, but it is a topic I feel strongly about. I'm just in high school. I had a lot of trouble waking up at the like seven, seven thirty mark in order to, but I guess we had to get to school at seven or seven thirty. So it was really early in high school, and I had some friends that were naturally waking up at like the five o'clock hour, and they were ready to go for that like seven thirty started school, where’s I felt like it wasn't really aligning with me and would have used or benefited from a few extra hours in the morning or just having it shifted back a little bit to have me more time, a little bit more time to like wake up and feel more alert. 

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So as I learned more about these topics than the sleep world, I started to understand why and a lot of it is because of that chronotype I was talking about. That everyone has different like chronotype and biological rhythms so that circadian rhythm cycle just looks different in different people because that peek of when they feel their best is kind of shifted, where it might be earlier in the day for more morning people, and then it might be later in the day for, you know, more night hours. So I think it's really important that if we were to like to move, you know, school start times back a little bit, it would be something that would be really beneficial, because the people who naturally wake up at that 5am hour. It's not going to affect them if school moves back, or you know it starts a little later, but the people that you know are really struggling to wake up for the like seven thirty whatever start time. That's where it would really benefit those people, those students, if you were to push back the start time a little bit. So yeah, I think it's a really hot topic in the sleep world and it's really important to talk about, but I'm a big advocate for if we can kind of make it. So it's inclusive for everyone's circadian rhythm cycles and in the lines what's best for them. So yeah.

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Vivian: I also remember reading about a study in South America where researchers experimented with three different school start times. They compared groups of students who attended school in the morning, later in the day and at night. From what I remember, students who had a morning chronotype (or earlybirds) performed well in the morning and night, while students who had an evening chronotype (night owls) performed well during evening classes, but didn't perform as well when they had morning classes. Do you think this schedule could be an effective approach?

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Penelope: Sort of like in a perfect world, and that sort of sounds like what this experiment is trying to replicate like in a perfect world, everybody would be able to sort of match their school times or their work day around their own circling and rhythms so that they're waking up without an alarm at whatever time their body felt like they needed to wake up and then they were able to go about their day, and in that sort of perfect world everybody would be functioning at their highest capacity because they are perfectly aligned with their rhythms. But it's sort of hard to replicate that in a real world setting, because obviously like Lara's been saying everybody is different and so it's like how do you sort of make us one time. For everybody who has these different cycles. So then it's sort of working backwards on how okay we have to work around these schedules, so then how can we may be what are some tips and tricks that you can help yourself sort of like shift maybe your circadian rhythm a little bit to fit in the schedule that you have to work around. So in our research and at work, how there are certain ways that you can sort of help solidify your circadian rhythm into a specific time frame that you want it to be, so like looking at bright lights right when you wake up sort of helps solidify your circadian rhythm to be at a certain time I don't know if Lara wants to jump in there.

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Lara: That's a good point, so they're like Penelope is saying that there's a lot of different ways that we can, I think it's called biohacking, and I think a lot of people talk about that where you're able to change how your bodies responding to certain like environmental like social set ups I guess, so you know if school is starting at that seven thirty time, I'm having that light, like bright light in the morning, is like really important because that melatonin pathway I was talking about earlier, it's still fairly high in the morning and for people who are, you know, not a morning person, it's still really high, and light is actually what shuts down that pathway, and it like stops the melatonin from producing, and that's why you'll feel less groggy. So if that melatonin is still high for someone who isn't really a morning person, they're going to feel really sluggish and groggy at school versus someone who's more of a morning person, but what you can do if you're not a morning person is get that bright light, shut down that pathway that's producing that melatonin and then you might feel a little bit better. And there's a lot of other things too, trying to keep a consistent like bedtime, morning time routine. You know, if you're not a morning person, maybe try shifting so that you're trying to go to bed earlier, which is hard to say to, you know like high school students or college students, because you're studying up late and you know you're trying to do practice after school and and study for things and then it just doesn't always work so, it's kind of a balanced like penelope was saying between like what our social environments are demanding of us. and what our body actually like needs. It's really like a tough balance.

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Vivian:Yeah, that's super true. Is that also how sunrise alarm clocks work?

Lara: Penelope can talk about that.  

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Penelope: I am big fan of the hatch alarm clock, I do have one myself, and I think it's especially important for people who are waking up before this on, because at least my bedroom is very well lit, but when I have to wake up for work and it is the winter or even the summer, and the sun has not risen yet, waking up can be very difficult and especially for high school students if your school starts at seven fifteen or seven thirty, you're having to wake up at six am five am and a lot of times the sun is not up. At that time and so yes the hatchel arm clock is great because it brightens up your room, but also there are other ways that alarm clock is a little expensive, so there are other ways, there are some Amazon lights that iIf you just look up, it's called like the sad, that like sort of helps stimulate that sunlight and it can really inker in your circadian rhythm because it does shut off that melatonin production and you definitely need that in the morning to help like Lara said, get rid of some of that grogginess, especially for people whose bodies want to be producing melatonin at that time.

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Vivian: Okay yeah, seasonal depression is like such a real thing I feel like cause I used to think like that's not true, but like now I can like see the difference between winter and summer.

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Penelope: Yes, definitely a thing and a lot of it is due to those differences in light exposure.

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Lara: A lot of the like treatment for people who really struggle with like seasonal effective disorder is just like white therapies, a lot of the time where they're just changing lighting in their house, their living spaces to make it, so that you're producing it's artificial light, but it is something to kind of help align your circadian rhythms to a pretty normal cycle so that you're getting enough like daylight or light, if you well into your system and that's what kind of like causes those like depressive symptoms, but it's hard in the winter for sure socially in Massachusetts.

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Vivian: Winter was crazy this year.

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Lara: It was bad.

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Vivian: It was bad. Okay so take away is a hatch could be very worthwhile.

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OUTRO

Good sleep doesn’t just mean going to bed earlier. It’s about understanding when your body naturally feels awake and tired.

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In our next episode, we’ll be exploring why sleeping eight hours doesn’t always mean feeling well rested. 

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See you next time on Brain Matters!