by the time I saw him that the news was welcome—at last he had found some help.

Because Henry was so sick, and because adjusting the sleep-wake cycle can take several weeks, I contacted his school to make a change in his schedule immediately. An elective class, on photography, that Henry took started at 7:30, and a reluctant Henry—who loved the class and wanted to do it all—accepted my recommendation to drop the course in order to start school a period later. When his parents contacted the administrators about making the change, they agreed to do so after receiving a letter from me confirming the need. (A note here: Most schools are generally compliant about making these kinds of adjustments when they’re presented with a carefully written letter from the treating physician, but no school will change every teen’s schedule, so schedule changes are best saved for teens who need immediate relief from pain or illness. To learn what you can do to have all middle and high schools in your area start later in the morning, see Chapter 13.) Dropping a favorite subject was a tradeoff for Henry, a compromise, but the headaches were making him sick and miserable and my staff and I finally convinced him that he could take the elective the following semester, after his sleep deficit and headaches were under control.

How quickly did that control come about? Treating kids with severe sleep deprivation and delayed sleep phase is generally at least a six- to eight-week process requiring continuing reenforcement. But because of the schedule change, Henry was immediately able to start sleeping 45 minutes later in the morning, making a big difference in the severity of his headaches and making him feel a whole lot better. However, the schedule change didn’t address Henry’s underlying delayed sleep phase, so in addition to eliminating his first-period class I recommended that Henry increase the amount of light he got in the