The human body 8.14

Growth, development and sleep

Did you know?

Having trouble falling asleep early and trouble getting up, in adolescence, is not laziness.

Painting: at night, in a desert under the moon, a woman lies asleep beside a mandolin and a jug while a lion sniffs at her.
The Sleeping Gypsy (La Bohémienne endormie), painting by Henri Rousseau (1897). Henri Rousseau, Public domain, source

Having trouble falling asleep early and trouble getting up, in adolescence, is not laziness.

It has been measured, it has been dated, and it is not a matter of opinion. This page explains how we know.

What happens

As adolescence approaches, the body’s internal clock shifts.1

Falling asleep and waking up naturally move later. It is not that adolescents decide to go to bed late: it is that the biological signal that triggers sleep arrives later than before.

How we know it is biological

Everything could be explained otherwise: adolescents go to bed late because they have homework, screens, friends, and because they like staying up. That would be a purely behavioural explanation, and it seems plausible.

So researchers set up situations in which the two explanations do not predict the same thing.

  • First test: Adolescents are put on regular schedules, with enough time to sleep. If the shift came only from habits, it should disappear. It persists.
  • Second test: They are observed in the laboratory, under controlled conditions where social influence is limited. Same thing: if it were social, it should fade away. The shift remains.
  • Third test: In 1993, a team questions more than four hundred pupils of the same age group about their morning or evening preference, and looks for what it is linked to. The researchers compared it with pubertal development, but also with two social factors: the type of school — and so whether or not the pupils mix with older pupils — and birth order.2

Result: a correlation with pubertal development. No link with the two social factors.3

Three ways of trying to prove the biological explanation wrong. None of them succeeds.

This is how a claim becomes solid: not because it is repeated, but because those who defend it have themselves designed the tests capable of refuting it.

What this study does not say

Since this page claims to teach how to read a result, it owes it to itself to read this one all the way through.

The link is clear in girls. In boys, the same trend appears — but it does not reach the threshold of significance.4

That does not mean it is absent: it means that, in this particular sample, it cannot be asserted.

The caution of the authors in their own conclusion also deserves to be noted. They do not write “we have demonstrated”. They write that these data support involvement of a biological factor.5

That is why the two other tests matter. One partial result plus another partial result that supports it by a different route: that is how a conclusion is built. Rarely all at once, almost never through a single study.

The part we control, and the part we do not

We must be careful not to draw the opposite conclusion. The shift is partly kept up by whatever pushes bedtime back: homework, screens, social life. So it is neither all biological nor all behavioural. It is both.6

  • Telling yourself “it’s biological, there’s nothing I can do about it” gives you an alibi, and it is false: part of it depends on what you do in the evening.
  • Being told “it’s just slackness” gives you guilt, and that is false too: part of it does not depend on you and will not disappear through sheer willpower.

There is a part we do not control and a part we do. It is by telling one from the other that we can act. And if sleep difficulties are severe or lasting, it is better to talk to a health professional about them.

A public debate, and what should be said about it

This finding has led, in several countries, to discussion of the time at which lessons start.

This site does not take sides:

  • What is: Does the internal clock shift in adolescence? This question is settled by measurement, and it is settled.
  • What should be done: Should lessons start later? This question has no single scientific answer. It involves transport, parents’ work, evening activities, the organisation of schools and the budget.

A scientific measurement never says what should be done. It says what is happening. What is then done with it is a political and social decision, and decisions are open to debate.

On the function of sleep and its safeguards

Why do we sleep? The question is still being studied. In 2013, a study carried out on mice concluded that sleep speeds up the cleaning of the brain; in 2024, another, also carried out on mice, measured the opposite. The debate concerns this mechanism: that sleep is important is not disputed. Measured facts must also be distinguished from interpretations: sleep is not a magic formula to be optimised at all costs with gadgets.7

  • Screens: they are part of what pushes bedtime back, like homework and social life.8

On growth

This page gives no curve, no figure, no reference age, no range. No description of what would be “ahead” or “behind”.

Rates of growth vary enormously from one person to another. That is not the exception, it is the rule.

Two people of the same age can be at very different stages of development, while both being perfectly fine. An average is not a target to be reached: it is a statistical calculation on a population. Nobody is an average.

When you have questions about your own body, the right thing to do is to talk to a health professional who can examine you and listen.

What we owe the reader

This is the last page of this encyclopaedia, and we want to conclude with our commitments:

  1. Not to frighten. Fear does not make people think.
  2. Not to lie. Neither by painting too dark a picture, nor by reassuring without proof.
  3. Not to hand out missions. The reader is not responsible for repairing what others have done.
  4. Never to ask to be taken at our word.

Every page states where its information comes from, every figure carries its date, and every doubt is made explicit. The reader does not need to trust us: the reader needs to be able to check.

Note 1

Moreover, both home-based and laboratory studies of adolescents show that delayed circadian phase correlates with secondary-sex development [7, 10, 11].

Hagenauer, M. H., Perryman, J. I., Lee, T. M. and Carskadon, M. A., “Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep”, Developmental Neuroscience, vol. 31, no. 4, 2009, p. 276-284

See the full note ↓

Note 2

Adolescents continue to show a delayed circadian (or internal clock) phase as indicated by daily endocrine rhythms […] even after several weeks of regulated schedules that allow for sufficient sleep

Hagenauer, M. H., Perryman, J. I., Lee, T. M. and Carskadon, M. A., “Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep”, Developmental Neuroscience, vol. 31, no. 4, 2009, p. 276-284

This delay is maintained under controlled laboratory conditions in which there is limited possibility for social influence

Hagenauer, M. H., Perryman, J. I., Lee, T. M. and Carskadon, M. A., “Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep”, Developmental Neuroscience, vol. 31, no. 4, 2009, p. 276-284

183 sixth-grade boys and 275 sixth-grade girls completed questionnaires for morningness/eveningness (M/E) and pubertal status

Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262

School environment and birth order were also evaluated.

Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262

See the full note ↓

Note 3

No relationship between M/E and psychosocial factors was found.

Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262

See the full note ↓

Note 4

A significant relationship of pubertal status to M/E was found in girls, with a similar though nonsignificant trend in boys.

Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262

See the full note ↓

Note 5

These data support involvement of a biological factor in the adolescent phase preference delay

Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262

See the full note ↓

Note 6

Such psychosocial factors as self-selected bedtimes, response to academic pressure, and the availability and use of technology and social networking in the evening also push for a delay in the timing of sleep.

Carskadon, Mary A., “Sleep in Adolescents: The Perfect Storm”, Pediatric Clinics of North America, vol. 58, no. 3, 2011, p. 637-647

See the full note ↓

Note 7

Using real-time assessments of tetramethylammonium diffusion and two-photon imaging in live mice, we show that natural sleep or anesthesia are associated with a 60% increase in the interstitial space, resulting in a striking increase in convective exchange of cerebrospinal fluid with interstitial fluid. In turn, convective fluxes of interstitial fluid increased the rate of β-amyloid clearance during sleep. Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system.

Xie, Lulu et al., “Sleep Drives Metabolite Clearance from the Adult Brain”, Science, vol. 342, 2013, p. 373-377

Here, we measure clearance and movement of fluorescent molecules in the brains of male mice and show that movement is, in fact, independent of sleep and wake or anesthesia. Moreover, we show that brain clearance is markedly reduced, not increased, during sleep and anesthesia.

Miao, Andawei, Luo, Tianyuan, Hsieh, Bryan et al., “Brain clearance is reduced during sleep and anesthesia”, Nature Neuroscience, vol. 27, 2024, p. 1046-1050

The brain’s ability to rid itself of toxins may actually be reduced during sleep, contrary to the leading scientific theory.

Imperial College London, actualité du 13 May 2024 sur l’étude “Brain clearance is reduced during sleep and anesthesia”

it cannot be disputed that sleep is important

Imperial College London, actualité du 13 May 2024 sur l’étude “Brain clearance is reduced during sleep and anesthesia”

See the full note ↓

Note 8

Such psychosocial factors as self-selected bedtimes, response to academic pressure, and the availability and use of technology and social networking in the evening also push for a delay in the timing of sleep.

Carskadon, Mary A., “Sleep in Adolescents: The Perfect Storm”, Pediatric Clinics of North America, vol. 58, no. 3, 2011, p. 637-647

See the full note ↓

Notes and sources

  1. ↑

    Passage As adolescence approaches, the body’s internal clock shifts.

    Moreover, both home-based and laboratory studies of adolescents show that delayed circadian phase correlates with secondary-sex development [7, 10, 11].

    Source Hagenauer, M. H., Perryman, J. I., Lee, T. M. and Carskadon, M. A., “Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep”, Developmental Neuroscience, vol. 31, no. 4, 2009, p. 276-284, section “Overview of Adolescent Sleep Patterns in Humans”, 3rd paragraph.

    Open access open the source · checked on 27 October 2026

  2. ↑

    Passage Adolescents are put on regular schedules, with enough time to sleep […] It persists.

    Adolescents continue to show a delayed circadian (or internal clock) phase as indicated by daily endocrine rhythms […] even after several weeks of regulated schedules that allow for sufficient sleep

    Source Hagenauer, M. H., Perryman, J. I., Lee, T. M. and Carskadon, M. A., “Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep”, Developmental Neuroscience, vol. 31, no. 4, 2009, p. 276-284, section “Overview of Adolescent Sleep Patterns in Humans”.

    Open access open the source · checked on 26 October 2026

    Passage They are observed in the laboratory, under controlled conditions where social influence is limited […] The shift remains.

    This delay is maintained under controlled laboratory conditions in which there is limited possibility for social influence

    Source Hagenauer, M. H., Perryman, J. I., Lee, T. M. and Carskadon, M. A., “Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep”, Developmental Neuroscience, vol. 31, no. 4, 2009, p. 276-284, section “Overview of Adolescent Sleep Patterns in Humans”.

    Open access open the source · checked on 26 October 2026

    Passage In 1993, a team questions more than four hundred pupils of the same age group about their morning or evening preference

    183 sixth-grade boys and 275 sixth-grade girls completed questionnaires for morningness/eveningness (M/E) and pubertal status

    Source Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262, abstract.

    Open access open the source · checked on 9 September 2026

    Passage the type of school — and so whether or not the pupils mix with older pupils — and birth order

    School environment and birth order were also evaluated.

    Source Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262, abstract.

    Open access open the source · checked on 9 September 2026

  3. ↑

    Passage No link with the two social factors.

    No relationship between M/E and psychosocial factors was found.

    Source Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262, abstract.

    Open access open the source · checked on 9 September 2026

  4. ↑

    Passage The link is clear in girls. In boys, the same trend appears — but it does not reach the threshold of significance.

    A significant relationship of pubertal status to M/E was found in girls, with a similar though nonsignificant trend in boys.

    Source Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262, abstract.

    Open access open the source · checked on 9 September 2026

  5. ↑

    Passage They write that these data support involvement of a biological factor.

    These data support involvement of a biological factor in the adolescent phase preference delay

    Source Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262, abstract.

    Open access open the source · checked on 9 September 2026

  6. ↑

    Passage The shift is partly kept up by whatever pushes bedtime back: homework, screens, social life.

    Such psychosocial factors as self-selected bedtimes, response to academic pressure, and the availability and use of technology and social networking in the evening also push for a delay in the timing of sleep.

    Source Carskadon, Mary A., “Sleep in Adolescents: The Perfect Storm”, Pediatric Clinics of North America, vol. 58, no. 3, 2011, p. 637-647, Figure 1 caption (author manuscript, PMC3130594).

    Open access open the source · checked on 27 October 2026

  7. ↑

    Passage In 2013, a study carried out on mice concluded that sleep speeds up the cleaning of the brain

    Using real-time assessments of tetramethylammonium diffusion and two-photon imaging in live mice, we show that natural sleep or anesthesia are associated with a 60% increase in the interstitial space, resulting in a striking increase in convective exchange of cerebrospinal fluid with interstitial fluid. In turn, convective fluxes of interstitial fluid increased the rate of β-amyloid clearance during sleep. Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system.

    Source Xie, Lulu et al., “Sleep Drives Metabolite Clearance from the Adult Brain”, Science, vol. 342, 2013, p. 373-377, abstract, 3rd to 5th sentences.

    Paywalled; full text open access in PubMed Central open the source · checked on 27 October 2026

    Passage in 2024, another, also carried out on mice, measured the opposite.

    Here, we measure clearance and movement of fluorescent molecules in the brains of male mice and show that movement is, in fact, independent of sleep and wake or anesthesia. Moreover, we show that brain clearance is markedly reduced, not increased, during sleep and anesthesia.

    Source Miao, Andawei, Luo, Tianyuan, Hsieh, Bryan et al., “Brain clearance is reduced during sleep and anesthesia”, Nature Neuroscience, vol. 27, 2024, p. 1046-1050, abstract, 3rd and 4th sentences.

    Open access open the source · checked on 27 October 2026

    Passage Why do we sleep? The question is still being studied.

    The brain’s ability to rid itself of toxins may actually be reduced during sleep, contrary to the leading scientific theory.

    Source Imperial College London, actualité du 13 May 2024 sur l’étude “Brain clearance is reduced during sleep and anesthesia”, beginning of the article.

    Open access open the source · checked on 24 October 2026

    Passage that sleep is important is not disputed.

    it cannot be disputed that sleep is important

    Source Imperial College London, actualité du 13 May 2024 sur l’étude “Brain clearance is reduced during sleep and anesthesia”, body of the article.

    Open access open the source · checked on 26 October 2026

  8. ↑

    Passage Screens: they are part of what pushes bedtime back, like homework and social life

    Such psychosocial factors as self-selected bedtimes, response to academic pressure, and the availability and use of technology and social networking in the evening also push for a delay in the timing of sleep.

    Source Carskadon, Mary A., “Sleep in Adolescents: The Perfect Storm”, Pediatric Clinics of North America, vol. 58, no. 3, 2011, p. 637-647, Figure 1 caption (author manuscript, PMC3130594).

    Open access open the source · checked on 27 October 2026

Bibliography

6
  • Carskadon, Mary A., Vieira, Cecilia and Acebo, Christine, “Association between Puberty and Delayed Phase Preference”, Sleep, vol. 16, no. 3, 1993, p. 258-262, open access (183 boys and 275 girls of the same age group; the link with pubertal development, significant in girls and only a trend in boys; the absence of a link with the type of school and birth order; the authors’ cautious wording). https://schoolstarttime.org/wp-content/uploads/2011/04/carskadon-et-al-association-between-puberty-and-delayed-phase-preference.pdf
  • Carskadon, Mary A., “Sleep in Adolescents: The Perfect Storm”, Pediatric Clinics of North America, vol. 58, no. 3, 2011, p. 637-647, open access (the phase delay in adolescence and the combination of biological and behavioural causes).
  • Hagenauer, M. H., Perryman, J. I., Lee, T. M. and Carskadon, M. A., “Adolescent Changes in the Homeostatic and Circadian Regulation of Sleep”, Developmental Neuroscience, vol. 31, no. 4, 2009, p. 276-284, open access (the delay maintained under regulated schedules and in the laboratory). https://doi.org/10.1159/000216538
  • Imperial College London, actualité du 13 May 2024 sur l’étude “Brain clearance is reduced during sleep and anesthesia”, open access (the 2024 result, contrary to the leading theory). https://www.imperial.ac.uk/news/253273/scientists-find-sleep-clear-brain-toxins/
  • Miao, Andawei, Luo, Tianyuan, Hsieh, Bryan et al., “Brain clearance is reduced during sleep and anesthesia”, Nature Neuroscience, vol. 27, 2024, p. 1046-1050, open access (reduced clearance of waste from the brain during sleep, in mice). https://doi.org/10.1038/s41593-024-01638-y
  • Xie, Lulu et al., “Sleep Drives Metabolite Clearance from the Adult Brain”, Science, vol. 342, 2013, p. 373-377, paywalled (the hypothesis of accelerated brain cleaning during sleep, 2013).

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