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Healthy School Start Times For Teens

"Examining the Impact of Later High School Start times on the Health and Academic Performance of High School Students: a Multi-Site Study" Center for Applied Research and Educational Improvement. University of Minnesota Feb 2014 "The results from this three year study, conducted with over 9000 students in eight public high schools in three states, reveal that high schools that start at 8:30 AM or later allow for more than 60% of students to obtain at least eight hours of sleep per school night. Teens getting less than eight hours of sleep reported significantly higher depression symptoms, greater use of caffeine, and are at greater risk of making poor choices for substance use. Academic performance outcomes, including grades earned in core subject areas of math, English, science, and social studies, performance on state and national achievement tests, attendance rates; and reduced tardiness show significantly positive improvement with the later start times of 8:35 AM or later. Finally, the number of car crashes for teen drivers from 16 to 18 years of age was significantly reduced by 70% when a school shifted start times from 7:35 AM to 8:55 AM."
"Start Middle and High Schools at 8:30 a.m. or Later to Promote Student Health and Learning." Society of Behavioral Medicine. November 2017 "As a consequence of puberty, teenagers are biologically driven to have later sleep and wake-up times than younger 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 to a nation of chronically sleep-deprived students." "The American Academy of Sleep Medicine, the American Academy of Pediatrics, and the American Medical Association recommend middle and high schools start no earlier than 8:30 a.m. However only about 15% of U.S. public high schools start at 8:30 a.m. or later. For decades, starting school after 8:30 a.m. has been the standard in many countries, such as Finland, Japan, New Zealand, Australia, and England, all of which outperform the United States on international student achievement tests. Out of 50 countries, U.S. children ranked worse in sleep deprivation."
"School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: a Review of the Literature." Journal of School Health May 2016 "Insufficient sleep in adolescents has been shown to be associated with a wide variety of adverse outcomes, from poor mental and physical health to behavioral problems and lower academic grades, However, most high school students do not get sufficient sleep. Delaying school start times for adolescents has been proposed as a policy change to address insuffiicent sleep in this population and potentially to improve students' academic performance, reduce engagement in risk behaviors, and improve health." "Most studies reviewed provided evidence that delaying school start times increases weeknight sleep duration even with relatively small delays in start times of half an hour or so. Later start times also generally correspond to improved attendance, less tardiness, less falling asleep in class, better grades, and fewer motor vehicle crashes."
"The Educational Effects of School Start Times." Santa Clara University.

Teny Maghakian Shapiro
August 2015 "Delaying secondary school start times can be a cost-effective policy to improve students' grades and test scores." "A one-hour delay has the same effect as being in a class with a third fewer students or with a teacher whose performance is one standard deviation higher. Later start times are also shown to improve non-academic outcomes, such as mood and attendance, and reduce the frequency of automobile accidents."
"Later Education Start Times in Adolescence: Time for Change." Education Commission of the States.

2015 "Adolescence starts with the onset of puberty and ends in the early 20's. During this period, adolescents are driven to later wake/sleep times by their biological clock. Because education start times do not adjust for this change, early school start times effectively limit sleep in adolescents. Researchers have found that students lose as much as an average of 2.7 hours of sleep on school days. This is why sleep loss in adolescence is greater than at any [other] period in our lives." "There is virtually unanimous agreement in the research community that later start times in adolescent education would produce a positive change in adolescent learning, health and safety." "Educational start times are the responsibility of education bodies and institutions, and thus it could be argued, they have full responsibility for any foreseeable negative impact of early start times. Education bodies and institutions have an affirmative duty to provide a reasonable standard of care to their students, in part because of the compulsory nature of education." "The mere existence of more than 3 million adolescents and young adults younger than 24 with delayed sleep phase disorders indicates the scale of potential problems arising from negligence suits (given that states already spend millions of dollars on settlements and judgments from injuries to students)."
"Organizing Schools to Improve Student Achievement: Start Times, Grade Configurations, and Teacher Assignments." The Hamilton Project.
Discussion Paper 2011-08
September 2011 "The tendency for teenagers to sleep late has a clear biological basis. Circadian rhythms (also called sleep-wake cycles or "internal clocks") are physical, mental, and behavioral changes during a twenty-four hour cycle that are governed by the body's production of the sleep-inducing hormone melatonin. . . . " "As noted by Carrell, Maghakian, and West (2011), melatonin levels peak at roughly 7:00 a.m. for adolescents and at 4:00 a.m. for adults, so waking a teenager at 7:00 a.m. is similar to waking an adult at 4:00 a.m." "While it is tempting to blame late bedtimes among teenagers on a combination of lax parenting and electronic equipment, much of their preference is likely driven by biology. Given the circadian timing in adolescents, it is very difficult for teenagers to adjust fully to an early school day. . . . they are forced to be awake when their bodies want to be asleep." "A study of high school students in the Chicago Public Schools [Cortes, Bricker, and Rohlfs (2009)] examines how high schools students perform in morning versus afternoon classes in Chicago, where school typically starts by 8:00 a.m. and students are commonly tardy. The authors find students are absent roughly six more days per year in first period relative to other periods. Moreover, they find that student grades and test score performance are notably lower for their first-period classes." "Disadvantaged students benefited the most from later start times, with effects roughly twice as large as advantaged students. . . . "

"1 in 5 Accidents are Caused by Drowsy Driving. This Group Intends to get that Number to Zero." American Academy of Sleep Medicine (AASM)
huffingtonpost.com/the healthy sleep project
April 10, 2015 "Most of us know by now that drowsy driving proves just as dangerous as drunk driving. However, it may come as a surprise that it's not truck drivers with long overnight shifts who are most likely to be involved in a drowsy driving-related car accident---it's teenagers." "Drowsiness is similar to alcohol in how it compromises driving ability by reducing alertness and attentiveness, delaying reaction times, and hindering decision-making skills. . . .Drowsy driving is deadly, but it's also completely avoidable." "With the Healthy Sleep Project, the AASM now recommends that teens log a little more than nine hours of sleep to achieve the optimal level of daytime alertness needed to eliminate the risk of drowsy driving."
"Healthy Sleep for Student-Athletes: A Guide for Athletics Departments and Coaches." NCAA Sports Science Institute March 1, 2016 "Our internal rhythms make it so that most of our sleep should occur during the night. . . . With this in mind, the nighttime sleep of a typical adult age 30-60 will typically occur somewhere in the range of 10 p.m. - 7 a.m. For those in their late teens and early 20's, this biologically determined period is shifted later, to approximately midnight - 9 a.m. This is why it is easier for people in this age group to stay up late and more difficult for them to wake up in the morning." "Circadian rhythm sleep disorders are a group of disorders that occur very frequently in younger people. They represent instances where internal rhythms are out of sync with the external environment or social demands. . . . Delayed sleep phase (and advanced sleep phase) disorder refer to when individuals' internal clocks dictate that their ideal sleep periods are much later (or earlier) than their schedules allow. These individuals try to go to bed and wake up earlier (or later) than their bodies prefer, which can cause sleep, mental health, and daytime functioning problems."
"WAKE UP CALL! Understanding Drowsy Driving and What States Can Do." Governors Highway Safety Association.

2017 "50% of drowsy driving crashes [involve] drivers age 25 or younger." "[Researchers] found that 18- and 19-year-olds had the highest night crash rate of all age groups (Rajaratnam, 2015)." " 'Chronic sleep loss in children and adolescents is one of the most common--and easily fixable--public health issues in the U.S. today,' said the lead author of the AAP's [American Academy of Pediatrics] later school start time policy statement (AAP, 2014b). "The research is clear that adolescents who get enough sleep have a reduced risk of being overweight or suffering depression,are less likely to be involved in automobile accidents, and have better grades, higher standardized test scores and an overall better quality of life."
"Consensus Statement: Early School Start Times." National Association of School Nurses (NASN) and Society of Pediatric Nurses Adopted:
January 2014 Proposed
"Developmental and physiological changes in adolescent sleep contribute to shifts in nighttime sleep times and later bedtimes, but not a decrease in sleep requirement (Carskadon, 2011)." ". . . studies have shown that children and adolescents from low income or racial and ethnic minorities are at a greater risk for sleep disorders due to overcrowding, excessive noise, and concerns for their own or their family safety (Owens, 2014)." "Insufficient sleep and irregular sleep/wake pattern are associated with an increase risk for daytime sleepiness, academic and emotional difficulties, safety hazards, and cardio-metabolic disease (American Academy of Pediatrics, Adolescent Sleep working Group, 2014)."
"Resolution: Healthy Sleep for Adolescents." National PTA Adopted:
2017 Convention of Delegates

"Natural sleep rhythms change as children grow into adolescence, such that adolescents require an increased amount of sloppy, have difficulty falling asleep before 11:00 AM, and function optimally if permitted to remain asleep until 8:00 AM or later. . . " "Studies have demonstrated that the duration of sleep is positively correlated with academic outcomes for secondary school students; and external factors including, but not limited to, large amounts of homework, robust extra-curricular and work schedules, poor sleep routines, and early school start times can curtail adolescents' sleep, thereby negatively affecting their ability to learn. . . ."
"Schools Start Too Early" cdc.gov/features/school-start-times/ July 30, 2018 (page last updated) "Not getting enough sleep is common among high school students and is associated with several health risks including being overweight, drinking alcohol, smoking tobacco, and using drugs, as well as poor academic performance. One of the reasons adolescents do not get enough sleep is early school start times." "The American Academy of Pediatrics has recommended that middle and high schools start at 8:30 am or later to give students the opportunity to get the amount of sleep they need, but most American adolescents start school too early." "According to the 2014 School Health Policies and Practices Study, 93% of high schools and 83% of middle schools in the U.S. started before 8:30 am."
"Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position Statement." Journal of Clinical Sleep Medicine (JCSM) Vol. 13, No. 4, 2017 "Public awareness of the hazards of early school start times and the benefits of later start times are largely unappreciated. As a result, the American Academy of Sleep Medicine is calling on communities, school boards, and educational institutions to implement start times of 8:30 AM or later for middle and high schools to ensure that every student arrives at school healthy, awake, alert, and ready to learn." "The AASM [American Academy of Sleep Medicine] recommends that teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis. . . . Because sleep onset is not instantaneous, and it is normal to spend some time awake in bed during the sleep period, a teenager who goes to bed at 11:00 PM would need to sleep until 7:40 or later to obtain sufficient sleep." "Presently, 68.4% of United States high school students sleep 7 hours or less on school nights. . . ."
"AMA Supports Delayed School Start Times to Improve Adolescent Wellness." American Medical Association (AMA) June 14, 2016 "Sleep deprivation is a growing public health issue affecting our nation's adolescents, putting them at risk for mental, physical, and emotional distress and disorders. . . . We believe delaying school start times will help ensure middle and high school students to get enough sleep. . . . " "Over the past several decades, school start times have become increasingly early as school districts try to make time for additional classes, sports, and extracurricular activities." "Mental manifestations of inadequate sleep often include poor memory performance and mood disorders. Symptoms of depression and anxiety are also more evident. . . . " "Studies have found that sleep deprivation may result in hypertension, metabolic disorders including diabetes) and impaired immune function. . . . Those with shorter sleep durations are more likely to be underweight, overweight, or obese."
"Lack of Sleep TIed to Teen Sports Injuries." American Academy of Pediatrics October 21, 2012 "Adolescent athletes who slept eight or more hours each night were 68% less likely to be injured that athletes who regularly slept less, according to an abstract presented Sunday, Oct.21, at the American Academy of Pediatrics (AAP) National Conference and Exhibition in New Orleans." "In addition, the higher the grade level of the athlete, the greater the likelihood of injury---2.3 times greater for each additional grade in school. Gender, weeks of participating in sports per year,,hours of participation each week, number of sports, strength training, private coaching, and subjective assessments of "having fun in sports" were not significantly associated with injury."
"PTAC Student Sleep Subcommittee Initial Report." Palo Alto Council of PTAs May, 27, 2010 (revised) "Studies have shown that teenagers require 9.25 hours of sleep per night for optimal health. On average, however, only 31% of the U.S. teenage population is getting this much sleep. Most physicians agree that mental and physical wellness is directly correlated to optimal sleep." "Teens can naturally fall asleep by 11:00 pm or so; therefore simple math dictates the need for a start time of 9:00 am or later." "More than 80 school districts throughout the US have taken action to help teens obtain optimal sleep by delaying the start times of their high schools to align teens' biological sleep needs with the school bell."
"School Start time Change: An In-Depth Examination of School Districts in the United States." The Children's National Medical Center's Blueprint for Change Team April 15, 2014 ". . . while the scientific literature has clearly documented the positive outcomes associated with delayed high school start times, these studies contain limited information regarding the process by which school districts consider, approve, and implement bell schedule changes. This can, in fact, be extremely challenging, as bell changes impacts not only the obvious stakeholders in the community (e.g., parents, students, teachers, school personnel) but also those citizens who may not have direct involvement in the school system ( e.g., employers of adolescents, community members using school facilities). ". . . an in-depth examination of those school districts that have been successful in changing their bell schedules can be highly instructive to other districts at various stages of contemplating this measure. . . . We [have] developed an integration and summary of the most common and salient points likely to best inform other school districts." ". . . the ten key messages. . . represent principles that have a basic foundation in successful implementation of start time change and those that are most applicable to the majority of school districts. . . ." "It is an important but under-appreciated fact that early high school start times are a relatively recent phenomenon that evolved as a result of factors, which had little to do with academics or what is best for the health and well-being of students. The overwhelming majority of modern bell schedules in American public high schools are historically based on such "adult" considerations as school budgets, transportation logistics, parent work schedules, athletics, staff commute times, and community use of fields and facilities."
"School Start Times, Sleep, and Student Outcomes: Prepared for Montgomery County Public Schools, Appendix D." hanoverresearch.com October 2014 Montgomery County Public Schools(Rockville, Maryland) engaged Hanover Research, a private research firm, to provide an exhaustive literature review on the association between school start times and student outcomes. Key findings: "The body of research on school start times does not provide conclusive evidence that start times impact student achievement.. . . . Studies that found a positive relationship between school start times and student achievement include students from elementary students up through college. . . . These studies also found that late start times were especially beneficial for low performing students. . . ." "Start times were also found to improve rates of tardiness, although the impact on absences was mixed." "Studies that examined start times on student sleep found that both middle and high school students slept more when their school start times were later." "Teen car crashes were found to greatly decrease when schools started later."
"High School Start Times and the Impact on High School Students: What We Know, and What We Hope to Learn." Journal of Clinical Sleep Medicine.   "Several organizations have provided recommendations to ensure high school starts no sooner than 08:30. However, although there are plausible biological reasons to support such recommendations, published recommendations have been based largely on expert opinion and a few observational studies. We sought to perform a critical review of published evidence regarding the effect of high school start times on sleep and other relevant outcomes." "We have provided a systematic review with meta-analysis of certain key outcomes from studies seeking to understand the effects of early versus late start times on high school students. We have found that we know with some confidence that later start times are associated with increased total sleep duration, lower weekday-weekend differences in sleep duration, and reduced subjective daytime sleepiness. Due to limitations in study design, we do not know with confidence that movement of school start times from early to later will result in improved academic performance or in improved mental health parameters, through this may be the case. The current trend towards later school start times makes biological sense. However, there is much more to learn regarding circadian issues in youth of different ages.
"School Start Times for Adolescents." American Academy of Pediatrics: Policy Statement 2014 "Although a number of factors, including biological changes in sleep associated with puberty, lifestyle choices, and academic demands, negatively affect middle and high school students' ability to obtain sufficient sleep, the evidence strongly implicates earlier school start times (ie, before 8:30 am) as a key modifiable contributor to insufficient sleep, as well as circadian rhythm disruption, in this population. Furthermore, a substantial body of research has now demonstrated that delaying school start times is an effective countermeasure to chronic sleep loss and has a wide range of potential benefits to students with regard to physical and mental health, safety, and academic achievement. The American Academy of Pediatrics strongly supports the efforts of school districts to optimize sleep in students and urges high schools and middle schools to aim for start times that allow students the opportunity to achieve optimal levels of sleep (8.5-9.5 hours). . . . "
"Later School Start Times for Adolescents."

A 2020 Vision for Public Education in Ulster County
The Center for Research, Regional Education and Outreach, SUNY New Paltz

Ulster County School Boards Association
August 2014 ". . . the school day for adolescents usually begins between 7:00--7:45 am. Moreover, students are required to rise early enough to board the bus or pull out of their driveways up to an hour [or more] in advance of these start times." Negative effects from insufficient sleep include the following: decreased memory capacity, decreased capacity to "pay attention" during performance of academic tasks, lower scores on quizzes, and higher incidents of "inattentive and sleepy behaviors"; increased involvement in risky behaviors (alcohol, tobacco, marijuana, sexual activity, aggression, and lack of physical exercise); poorer physical health (obesity and athletic injuries); and increased involvement in traffic accidents.
Start School Later."

    "We are a coalition of health professionals, sleep scientists, educators, parents, students, and other concerned citizen dedicated to increasing public awareness about the relationship between sleep and school hours and to ensuring school start times compatible with health, safety, education, and equity."

Website includes many useful resources, including Success Stories,Case Studies,Myths and Misconceptions [about Late Start], Reports and Studies on Late Start, as well as many suggestions and examples of how schools have successfully managed obstacles to implementation of later start times for schools.
"Grades Suffer When Class Time Doesn't Match Students' Biological Clocks." Edweek.org March 30, 2018 "Regardless of whether students like to rise with the dawn or stay up after midnight, new research suggests that when their class schedules fall out of sync with their biological clocks, their grades can suffer." Researchers found that "49% of [college] students took classes before they had fully awakened. . "
"Later Start Times for Teens Improve Grades, Mood, and Safety." Phi Delta Kappan August 14, 2017 With Edina School District's move from 7:20 am to 8:30 am high school start time, a yearlong study (1996) reported the following changes: "Students were now awake the first hour of class, the principal reported few disciplinary incidents in the halls and lunchroom, and students reported less depression and feelings of greater efficacy. Over 92% of the parents said their kids were 'easier to live with.'" "An interesting difference emerged when we compared the outcomes of schools starting at 8:00-8:30 a.m. with those of the school with the latest start time of 8:55 a.m. Examining grades earned before and after the time change, we found: ¥ Statistically significant increases in the 1st-period grade point average in one or more core classes of English, math, social studies, and science in three districts with start times from 8:00 a.m.-8:35 a.m. ¥Significant increases in grade point average of all 1st-period core courses for all semesters in all grades in Jackson Hole High School in Wyoming, with a start time of 8:55 a.m." "Further, the more days each week that students spend practicing or doing sports before school, the lower the self-reported grades." Teenagers need sleep to achieve academically!
"A's from Zzzz's? The Causal Effect of School Start Time on the Academic Achievement of Adolescents." American Economic Journal: Economic Policy 3 Aug. 1, 2011 "This study identifies the causal effect of school start times on academic achievement by using two policy changes in the daily schedule at the US Air Force Academy along with the randomized placement of freshmen students to courses and instructors. Results show that starting the school day 50 minutes later has a significant positive effect on student achievement, which is roughly equivalent to raising teacher quality by one standard deviation." "Despite our use of university-level data, we believe our findings are applicable to the high school population more generally because we consider only freshmen students in their first semester at USAFA. Like high school seniors, first semester college freshmen are still adolescents and have the same biological sleep patterns and preferences as those in their earlier teens."
"Synchronizing Education to Adolescent Biology: 'Let teens sleep, start school later.'" Journal of Learning, Media, and Technology Volume 40, 2015 - Issue 2 Neuroscience and Education "This paper examines early starts and their negative consequences in the light of key research in the last 30 years in sleep medicine and circadian neuroscience. An overview of the circadian timing system in adolescence leading to changes in sleep patterns is given and underpins the conclusion that altering education times can both improve learning and reduce health risks."
"Start Later, Sleep Later: School Start Times and Adolescent Sleep in Homeschool Versus Public/Private School Students." Journal of Behavioral Sleep Medicine Volume 14, 2016 - Issue 2 "This study compared sleep patterns and sleep hygiene for homeschooled students and public/private students (grades 6-12). Significant school group differences were found for weekday bedtime, wake time, and total sleep time, with homeschooled students waking later and obtaining more sleep. Homeschools students had later school start times, waking at the same time that public/private schools students were starting school. . . . Later school start times may be a potential countermeasure for insufficient sleep in adolescents."
Later School Start Times in the U.S.: An Economic Analysis." Rand Corporation Europe. 2017 "This report presents the findings of a study on the economic implications of later school start times in the United States." "While the benefits of later SST are very well documented in the literature, in practice there is opposition against delaying SST. A major argument against later SST is the claim that delaying SST will result in significant costs for schools due to changes in the school bus transportations strategies." "[This study] investigates the economic implications of later SST by examining a policy experiment of a statewide shift in school start times to 8:30 a.m. and its subsequent economic effects. Using a novel macroeconomic modeling approach, the study estimates changes in the economic performance of 47 U.S. states following a delayed SST, which includes the economic benefits of higher academic performance of students and reduced car crash rates. The benefit-cost projections of this study suggest that delaying school start times is a cost-effective, population-level strategy that could have a significant impact on public health and the U.S. economy. From a policy perspective, these findings are crucial as they demonstrate that significant economic gains resulting from the delay in SST accrue over a relatively short period of time following the adoption of the policy shift."
  unlockingtime.org   Resources for districts moving to late start for high school.
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  Why a good night's sleep is "the magic pill" for athletic performance
At these schools, later start times get an A-plus for youths needing more sleep

School Start Times, Sleep, Behavioral, Health, and Academic Outcomes: A Review of the Literature

Start Middle and High Schools at 8:30 a.m. or Later to Promote Student Health and Learning

The educational effects of school start times

Later Education Start Times in Adolescence: Time for Change

Organizing Schools to Improve Student Achievement: Start Times, Grade Configurations, and Teacher Assignments
1 In 5 Accidents Are Caused By Drowsy Driving. This Group Intends To Get That Number To Zero.
Healthy Sleep for Student-Athletes: A Guide for
Athletics Departments and Coaches

WAKE UP CALL! Understanding Drowsy Driving and What States Can Do

Early School Start Time- Consensus Statement

Healthy Sleep For Adolescents
Most U.S. Middle and High Schools Start The Day Too Early

Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position Statement

AMA Supports Delayed School Start Times to Improve Adolescent Wellness

School Start Times for Adolescents

American Academy of Pediatrics
Lack of Sleep Tied to Teen Sports Injuries