School Starts Too Early for Teens, Pediatricians Agree

Sleep-deprived adolescents have a powerful ally: the American Academy of Pediatrics (AAP). In a policy statement published in Pediatrics in September, the AAP urged the nation’s middle and high schools to start classes at 8:30 a.m. or later—30 to 60 minutes later than most do now. An accompanying technical report details causes and consequences of insufficient sleep in teenagers.

Sergey Ivanov

“The evidence strongly implicates school start times of 8:30 a.m. or earlier as a key modifiable contributor to insufficient sleep as well as circadian rhythm disruption in middle- and high-school students,” the AAP said.

Calls for later school start times have prompted debates—sometimes contentious—since the 1970s, when researchers first documented a pubertal delay in the timing of the biological clock that makes it hard for teenagers to fall asleep before 11 p.m. and to arise before 8 a.m. This finding has been affirmed in adolescents worldwide. Naysayers still contend, however, that delaying start times “coddles” students.

The 8:30 a.m. start time would give most adolescents the opportunity to sleep from about 11 p.m. to 7 a.m. on school nights, Judith Owens, M.D., lead author of both publications and chair of the AAP‘s Adolescent Sleep Working Group, told Psychiatric News.

Ideally, she said, they would be able to sleep even later, as most adolescents need 8.5 to 9.5 hours of sleep for optimal alertness and performance.

In supporting the 8:30 a.m. start time, Owens added, “the nation’s premier health advocacy organization for children and adolescents has strongly endorsed a public-health initiative that is somewhat controversial.”

Owens’ group collaborated with the AAP Committee on Adolescence and its Council on School Health to produce both reports. A professor of pediatrics at George Washington University School of Medicine, Owens directs sleep medicine at Children’s National Medical Center in Washington, D.C.

There’s an ‘Epidemic’ of Insufficient Sleep

Most U.S. adolescents currently average less than eight hours sleep on school nights, the AAP reported. High school seniors responding to a nationwide poll conducted for the National Sleep Foundation reported they averaged less than seven hours’ sleep on school nights.

“Chronic sleep loss has increasingly become the norm,” the AAP said, noting that the average adolescent regularly experiences levels of sleepiness equal to those of patients with sleep disorders such as narcolepsy. Many teenagers report falling asleep in class or while doing homework one or more times a week.

Sleeping late on weekends may help offset the weekday sleep deficit, the AAP said, but also may worsen circadian disruption and morning sleepiness on school days. While naps and caffeine consumption may temporarily counteract sleepiness, they do not replace missed nighttime sleep.

Academic performance improves when students average eight hours of sleep or more. After a delay in school start times for about 9,500 public-school students in grades 6 to 12 in three states, students earned better grades in core subjects and scored higher on state and national standardized achievement tests. Auto crashes related to students’ drowsy driving declined.

Early Starts the National Norm

According to U.S. Department of Education statistics, about 43 percent of the nation’s 18,360 public high schools now start before 8 a.m., including nearly 10 percent that start before 7:30 a.m. Only 15 percent start at 8:30 a.m. or later. And some schools hold preschool sports practice, classes, and other activities. The median middle-school start time is 8 a.m. More than 20 percent of middle schools start at 7:45 a.m. or earlier.

In Fairfax County, Va., the state’s largest school system, where high schools start at 7:20 a.m., students begin boarding school buses at 5:45 a.m. and may need to arise at 5 a.m. or earlier. The Fairfax County School Board will vote this month on a plan developed by Owens and colleagues to start classes later.

Secretary of Education Arne Duncan has in tweets and interviews endorsed delaying school start times for adolescents. “Mornings are very difficult. You know, they’re not awake. They’re groggy,” he said on “The Diane Rehm Show” in 2013. “If we were able to start later, and if they were able to be more focused, if they were able to concentrate in class, that’s a really good thing.”

Duncan’s department does not have an official position on school start times, however. “Education is a state and local matter, and districts are free to explore options in the best interests of their students,” his office told Psychiatric News.

The AAP work groups focused on the need to optimize adolescents’ health, safety, and academic performance, Owens said. Communities that already have delayed school start times, she noted, have found ways to deal with bus schedules, teacher retention, athletic-event scheduling, after-school jobs, and child care for younger siblings.

Delaying school start times alone is not a panacea for adolescent sleep deprivation, the AAP cautioned. Adolescents need to learn to make sleep a priority and to manage competing demands for their time, including homework, sports and other extracurricular activities, social networking, and jobs. The AAP suggested that families develop a home media use plan, with a media curfew. Electronic media use near bedtime may not only prove stimulating, but also may delay sleep via blue-light exposure that suppresses melatonin levels.

“We hope AAP’s action will inspire pediatricians and other physicians to educate students, parents, educators, athletic coaches, and others about healthy sleep habits,” Owens said, “and advocate in their communities for school start times that allow adolescents to get sufficient sleep.” ■