1 WWW.SBM.ORG POSITION STATEMENT: Start Middle and High Schools at 8:30 a.m. or Later to Promote Student Health and Learning (NOVEMBER 2017) Tracy Trevorrow, PhD, Chaminade University, Honolulu, HI; Eric S. Zhou, PhD, Harvard University, Boston, MA; Jessica R. Dietch, MS, University of North Texas, Denton, TX; and Brian D. Gonzalez, PhD, Moffitt Cancer Center, Tampa, FL The Society of Behavioral Medicine recommends school officials start middle and high school classes at 8:30 a.m. or later. Such a schedule promotes students’ sleep, resulting in improvements in physical health, psychological well-being, attention and concentration, academic performance, and driving safety. As a consequence of puberty, teenagers are biologically driven to have later sleep and wake-up times than younger 1 children. Most middle and high schools in the United States start well before 8:30 a.m., which is too early to accommodate for this shift in sleep patterns and contributes 4,17,21 2 • school attendance; to a nation of chronically sleep-deprived students. 16 and coffee and stimulant drink use; • Inadequate sleep results in compromised physical health, 4,22 • rates of motor vehicle accidents for teen drivers. emotional and behavioral problems, and reduced ability 3-6 to perform and learn. Starting schools early may be BARRIERS TO CHANGING START TIMES intended to accommodate adult considerations such as bus schedules, parents’ work schedules, and the use of athletic Changing school start times is often met with resistance in 2,4 facilities; these issues have not been problematic for schools school districts across the United States. Barriers include: 7 with later star times. • conflicts with after-school programs, sports activities, and after-school student jobs; The American Academy of Sleep Medicine, the American • teacher concerns regarding scheduling and total work Academy of Pediatrics, and the American Medical hours; Association recommend middle and high schools start no • transportation costs for busing children to school; 8-10 earlier than 8:30 a.m. However, only about 15% of U.S. difficulties in changing family patterns of daily life; and • 11 public high schools start at 8:30 a.m. or later. For decades, • lack of awareness among school community starting school after 8:30 a.m. has been the standard in stakeholders (i.e., school administrators, faculty, many countries, such as Finland, Japan, New Zealand, students, families) regarding the importance of sleep. Australia, and England, all of which outperform the United 12,13 States on international student achievement tests. Out of However, schools that have delayed start times do not 14 3,15-17 50 countries, U.S. children ranked worst in sleep deprivation. report significant problems with this change. As such, a national trend to delay high school start times may not only There are no demonstrable health or learning benefits be possible but also welcomed as school administrators to support early start times for middle and high schools. and school communities appreciate the related benefits to However, schools with delayed start times have shown students’ health and learning. improvements in: 3,15-17 daytime alertness and concentration; • In consideration of a later school start time, it is important to 6,17 mood; • note: 3,4,6,17 behavioral control; • Teachers’ arrivals and departures from school do not • • academic achievement, including standardized test need to change. Teachers may use the period before 4,5,18-20 scores; instruction each morning for preparation, grading, 4,16,17,21 • tardiness; meetings, and professional development.
2 WWW.SBM.ORG • Bus schedules may be staggered to allow younger stu- ENDORSEMENTS dents to be transported to school before middle and 7 high school students. • Schools that start between 8:30 and 9 a.m. would typi- cally finish between 3and 3:30 p.m., allowing daylight time for sports and after-school activities. Coaches often need late afternoon practices and game times due to their day jobs. • Families’ morning routines may be less chaotic when teen students are rested. • Students are less likely to have unsupervised time when school finishes later in the day. REFERENCES 1 Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, RECOMMENDATIONS FOR CHANGING and delayed phase in adolescence. Sleep Medicine . 2007; 602- 612. SCHOOL START TIMES 2 Kirby M, Maggi S, D’Angiulli A. School start times and the sleep- The Society of Behavioral Medicine (SBM) advocates for a wake cycle of adolescents: A review and critical evaluation of four-tiered approach to promote later start times for middle available evidence. . 2011;56-61. Educational Researcher and high schools. Lufi D, Tzischinsky O, Hadar S. Delaying school start time by one 3 J Clinical hour: Some effects on attention levels in adolescents. School board members must enact an 8:30 a.m. or later 1. . 2011;7, 137-143. Sleep Medicine school start time policy in their school districts. It is fun - 4 Wahlstrom KL, Dretzke BJ, Gordon MF, Peterson K, Edwards K, damentally at the school district level that administrators Gdula J. Examining the impact of later high school start times on can prioritize school start times that promote students’ the health and academic performance of high school students: health, well-being, and learning. Center for Applied Research and Educational A multi-site study. Improvement. Final Report . 2014;1-71. State departments of education and state legislators, 2. Edwards F. Early to rise? The effect of daily start times on academic 5 particularly those on education committees, should ad - performance. Economics of Education Review . 2012;970-983. vocate for later school start times for middle and high Dahl RE. The consequences of insufficient sleep for adolescents. 6 schools. This advocacy can be achieved by including Links between sleep and emotional regulation. Phi Delta Kappan. student healthy-sleep promotion on committee agen - 1999;80, 354-359. das and by lobbying school board members to enact Wolfson AR. Carskadon MA. A survey of factors influencing high 7 . 2005;89, 47-65. NASSP Bulletin school start times. an 8:30 a.m. or later school start policy. AASM position: Delaying middle and high school starft times is 8 SBM encourages lobbying of the U.S. Department of 3. beneficial to students. . 2017; April 15. J Clinical Sleep Medicine , partic Education through congressional representatives - 9 School start times for Adolescents. Adolescent sleep working ularly those on the House Committee on Education and group and committee on adolescence and council on school the Workforce, and the Senate Committee on Health, . 2014 DOI: 10.1542/peds-1697. health, Pediatrics Council on Science and Public Health Report 6 – Delaying School 10 Education, Labor and Pensions, so they understand the Start Time to Alleviate Adolescent Sleep Deprivation. MD Bishop value of later school start times and can enact pertinent (Chair). American Medical Association House of Delegates (A- legislation. 16). 2016. https://teensneedsleep.files.wordpress.com/2011/04/ 4. To increase awareness, SBM suggests school-level pro - ama-school-start-time-policy-statement.pdf motion of education about the importance of sleep Frieden TR, Jaffe HW, Cono J, Richards CL, Iademarco MF. School 11 start times for middle school and high school students – United through in-services, workshops, curriculum changes, and MMWR Morb Mortal Wkly Rep States, 2011-12 school year. . family and community events. On a community level, 2015;64:809-813. media should be engaged to promote the public’s un - 12 School days around the world. http://pocketcultures. derstanding of the benefits of later school start times for com/2010/09/15/school-days-around-the-world middle and high school students. Healthy student sleep 13 PISA 2015. Results in Focus. http://www.oecd.org/pisa/pisa-2015- campaigns may be provided through media program - results-in-focus.pdf. TIMSS/PIRLS, Lynch School of Education, Boston College. www. 14 ming. bbc.com/news/business-22209818 It question of whether policies promoting later is no longer a 15 Vedaa O, Saxvig IW, Wilhelmsen-Langeland, A. School start time, sleepiness and functioning in Norwegian adolescents. should be adopted, but rather how they school start times Scandinavian J Educational Research . 2012;56, 55-67. should be implemented. Boeger J, Gable CJ, Owens JA. Later school start time is associated 16 with improved sleep and daytime functioning in adolescents. J ACKNOWLEDGEMENTS Developmental Behavioral Pediatrics . 2014;33, 11-17. The authors wish to gratefully acknowledge the expert 17 Owens JA, Belon K, Moss P. Impact of delaying school start times on adolescent sleep, mood, and behavior. Archives Pediatric review and support provided by SBM’s Health Policy Adolescent Medicine . 2010;164, 608-614. Committee, Health Policy Council, and Child and Family 18 Pagel JF, Forister N, Kwiatkowski C. Adolescent sleep disturbance Health Special Interest Group. and school performance: The confounding variable of socioeconomics. J Clinical Sleep Medicine . 2007;3, 19-23. 19 Keller PS, Smith OA, Gilbert LR, Bi S, Haak EA, Buckhalt JA. Earlier school start times as a risk factor for poor school performance: An examination of public elementary schools in the commonwealth of
3 WWW.SBM.ORG Kentucky. . 2015;107, 236-245. J Educational Psychology Ming X, Koransky R, Kang V, Buchman S, Sarris C, Wagner GC. 20 Sleep insufficiency, sleep health problems and performance in high school students. Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine , 2011;71-79. DOI: 10.4137/CCRPM.S7955 21 Wolfson AR, Spaulding NL, Dandrow C, Baroni EM. Middle school start times: The importance of a good night’s sleep for young Behavioral Sleep Medicine . 2007;5, 194-209. adolescents. 22 Vorona RD, Szklo-Coxe M, Lamichhane R, Ware JC, McNallen A, Leszczyszyn, D. Adolescent crash rates and school start times in two central Virginia counties, 2009-2011: a follow-up study to a southeastern Virginia study, 2007-2008. Journal of Clinical Sleep Medicine . 2015;10, 1169-1177.
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