It is a known fact that sleep is vital for physical, cognitive and emotional health and well-being [1]. Over the past decade a myriad of studies have linked insufficient or poor quality sleep to a number of negative outcomes, including obesity [2, 3], diabetes [4, 5], cardiovascular disease [5], Alzheimer’s disease [6], cognitive impairment [6], lapses in memory and attention [7], impaired performance [8, 9], sleepiness [8, 9], tiredness [8, 9], and increased depression and anxiety [10, 11]. The Center for Disease Control recently stated that insufficient sleep is a public health epidemic [12]. And yet millions of people still do not get enough sleep. This is especially true among adolescences.

The National Sleep Foundation recommends that teenagers need 8–10 h of sleep a night for optimal function; however, research suggests that <15–20 % of adolescents get the recommended amount on school nights [13]. Lifestyle/behavioral/environmental factors, such as homework, part-time jobs, extracurricular and social activities, and excessive screen time, contribute to the growing sleep debt in this age group [13]. Additionally, adolescents have a natural biological shift toward later bedtimes and wake times, adding insult to injury.

As with adults, inadequate sleep in teenagers has significant and widespread ramifications across several domains. For example:

Physiological: Sleep deprived teens are at increased risk for obesity, diabetes, and hypertension; have an increased incidence of headaches, gastrointestinal disturbance, backaches, and muscle tension; report lower energy and greater fatigue; and are less likely to engage in health-related behaviors, such as taking responsibility for their health, adopting a healthy diet, implementing regular exercise, and practicing stress management [14].

Cognitive/academic performance: Sleep deprivation in teens is associated with cognitive impairment; difficulties with focus, memory, and attention; impaired decision-making; decreased reaction time; impaired academic performance; and decreased creativity [14, 15].

Psychological/emotional: Sleep deprivation in teens is associated with increased alcohol and drug use, aggression, irritability, risky behaviors, anxiety, depression, suicidal thoughts and behaviors, poor impulse control and social skills, and low motivation [14–17].

In addition to the above biopsychosocial factors contributing to insufficient sleep in this population, there are a number of treatable sleep disorders that could also be contributing. This casebook on adolescent sleep medicine is designed to present a comprehensive review of common, yet sometimes overlooked, sleep problems in adolescents. Each chapter addresses a unique, though not uncommon, sleep disorder in teenagers through illustrative cases, relevant literature, and pearls of wisdom for the practicing sleep specialist or any other practitioner involved in the care of adolescents.

In Chap. 2, four detailed and distinct cases of Delayed Sleep-Wake Phase Disorder (DSWPD) , a circadian rhythm disorder that often gives the appearance of sleep-onset insomnia but that is, more accurately, a delay in the ability to fall asleep at conventional times, are presented. Among disorders of circadian rhythm, DSWPD is common in adolescents and young adults, a population that already has a natural endogenous shift towards later bedtimes. Genetic, environmental, social, and behavioral factors that can contribute to the development and perpetuation of this disorder are discussed at length. Comprehensive evaluation and treatment plans, including the use of sleep diaries, actigraphy, light therapy, melatonin, and a graphic display of phase shifting principles, are also provided.

Chap. 3 depicts three cases of restless legs syndrome (RLS) , an often under-recognized neurologic sensorimotor disorder, affecting approximately 2 % of male and female adolescents. RLS is characterized by an urge to move the legs, usually associated with leg discomfort. The symptoms occur at rest, are relieved by movement, and are most severe in the evening and at night. Common mimics of RLS are described in detail, as are non-pharmacological and pharmacological approaches to management.

In Chap. 4, three cases of adolescent obstructive sleep apnea (OSA) are reviewed. While OSA has historically been considered a disorder most common among overweight adult males, adolescent sleep apnea has become increasingly more common with the rise in obesity rates. Management of these patients is less straightforward than management in younger children or older adults, as there are substantial rates of treatment failure following adenotonsillectomy, which remains the first-line treatment approach. Second-line therapy for residual OSA is continuous positive airway pressure therapy (CPAP), which can be poorly tolerated in this age-group. This chapter provides an in-depth discussion of the physical exam findings, comorbid medical conditions, and nighttime and daytime features associated with this condition, as well as factors associated with a high risk of residual OSA in adolescents. Strategies to troubleshoot commonly encountered problems with CPAP management are also presented as is drug-induced sleep endoscopy (DISE), a tool that can help identify common sites of airway obstruction in this population and guide surgical planning.