The sleep-wake system during adolescence has been characterized by significant and unique features, including the sleep-phase shift toward delayed bedtime, growing sleep needs, and daytime sleepiness. In addition, many adolescents adopt disorganized sleep-wake patterns including dramatic weekday-weekend variations in their sleep schedule. In light of the debate on the extent of the inherent turmoil and instability of this developmental stage, the striking findings on the adolescent sleep-wake system are particularly interesting, as they demonstrate instability and lack of biobehavioral homeostasis.

The present review addresses two major issues: the relationships between normal adolescent developmental stressors and sleep; and the effects of extraordinary life stressors and traumatic events on sleep in adolescents. These issues are discussed in the context of theoretical models of stress and coping.

Adolescence: A Period of Storm and Stress?

Adolescence is a period of rapid psychosocial and biobehavioral changes and significant emotional turmoil. Adolescents experience many dramatic physical changes associated with the growth spurt and sexual maturation. Pubertal changes are manifested in the appearance of secondary sex signs, in the first episodes of menarche, and in nocturnal emission and ejaculation. In the psychosocial sphere, the adolescent is developing high cognitive skills heavily based on abstract thinking, metacognition, and critical thinking. Psychosocial issues related to identity formation, autonomy, intimacy, sexual behavior and orientation, social status, and academic and professional careers set the stage for intense emotional and cognitive processes.