RONALD DAHL, M.D.
Child And Adolescent Sleep Laboratory
Western Psychiatric Institute and Clinic

he interval surrounding pubertal maturation includes an enormous array of changes in social and biological domains, with complex interactions involving the regulation of sleep and arousal. These changes also overlap with developmental shifts in the control of affect and attention. One major theme across these changes is a relatively increased influence of executive functions (prefrontal cortex/higher cognitive control) to guide behaviors according to social rules and long term goals. The integration of higher cognitive processes with emotional regulation (e.g. learning to inhibit or modulate arousal, attention, and behavior to serve higher cognitive goals) creates the basis for social competence„perhaps, the most important outcome variable in adolescent development. However, increased cognitive capacities to override lower levels of regulation, also confer a greater ability for cognitive ideas or attitudes to cause dysregulation at subcortical levels. In a number of ways, adolescence appears to represent a vulnerable period regarding the maturational integration of cognitive and emotional processes. It also appears that this highest level of cognitive-emotional integration is most sensitive to the effects of sleep deprivation or inadequate sleep. Within this general frame a few specific questions will be considered, which may be addressable by current or future lines of investigation:

1. What are the neurobiologic underpinnings of these maturational changes (and the likely involvement of alterations in PFC/limbic circuitry)?

2. Why do some adolescents appear to be particularly vulnerable in these domains (and why may vulnerability in affect regulation confer vulnerability toward sleep deprivation effects)?

3. What is the potential to prevent some types of dysfunction through early cognitive-behavioral or educational interventions in vulnerable adolescents?

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