If you have teenagers, you probably won't be surprised to hear that a study published Monday in the journal JAMA Pediatrics found that only 5% of them are getting enough sleep or exercise and are limiting their screen time to what's recommended by experts.
The researchers analyzed data from the US Centers for Disease Control and Prevention's Youth Risk Behavior Surveillance Survey. Of the almost 60,000 teens who completed the survey between 2011 and 2017, only 5% followed the recommendations for sleep, exercise and screen time, according to the study.
All three of these behaviors -- not getting enough sleep, not exercising enough and spending too much time in front of a screen -- have been linked to negative consequences for the health of teens, including increased risk of depression, poor school performance and obesity.
Teens need between eight and 10 hours of sleep per night and one hour of vigorous physical activity daily, according to the National Sleep Foundation and the CDC.
"These findings don't surprise me," said Dr. Cora Breuner, professor of adolescent medicine at Seattle Children's Hospital and chair of the Committee on Adolescence at the American Academy of Pediatrics.
It is very difficult for teens to adhere to the recommendations without parental, family and community support, explained Breuner, who was not involved in the study.
Parents, on the other hand, have a hard time saying "no" to their kids, she added. But Breuner warns against throwing up your hands and giving up, offering some tips instead.
Know that FOMO is real
"We see so many of our high school students spending over four, five, six hours per day on non-educational screen time," Breuner said.
They are making sure they don't miss the most recent Instagram post or Snapchat video due to fear of waking up in the morning and realizing the world suddenly changed while they were sleeping, she said.
In addition to the fear of missing out, teens may lie awake long after they've powered off their devices, thinking about whatever conversation just took place or the homework that they didn't finish, she explained -- not to mention that the light from the screens has been shown to interfere with the secretion of melatonin, the hormone that tells the body it's nighttime.
And powering off ahead of bedtime may start with the grownups.
Set an example
"I always say in my clinic, everybody has to shut off their screen between 9 and 10," Breuner said. "And all of them need to be charged away from the bed on a phone charge strip. Everybody: Mom, Dad, uncle, partners, siblings."
This can be hard for working parents who are replying to emails and doing other work-related activities after the kids go to bed, but it really matters for the sleep of the whole family, she said.
Make it a family goal
In addition to good sleep, exercise can be a family priority.
With increasing focus on elite athletic teams, teens who are good at sports but are not elite athletes often find themselves unable to join a team at all. Joining teams may also be financially difficult for some families.
But she stresses that there are ways around this by exercising as a family, even if it's just going for a walk.
Set goals and reward teens when they meet them, Breuner advises.
Reward positive behavior
"When it comes to all of these behaviors, we set rules, expectations and reward positive behavior, as opposed to having it always be negative," Breuner said.
Punishing negative behavior may not feel right as a parent or as a health care provider. Instead, rewarding a positive lifestyle and behavioral change may be much easier, she said.
"People say, 'Well, just let them play; we should let them run around and ride bikes,' " Breuner said. "And I'm like, 'That's like the 1950s. That's not actually going to happen.' "
She does not worry so much about overscheduling teens, although she does believe that they need downtime. "I feel like it's really OK."
The opposite -- under-scheduling -- might actually be what makes some teens more likely to make risky choices, she added.
Ultimately, keeping teens out of trouble and promoting healthy habits may be a team effort.
"We have to get more parental and community involvement so that it's a collaborative effort between the schools, the parents and the communities to get kids off the screens, to exercise more and to spend more time with each other socially versus isolating themselves," Breuner said.