U.S. doctors urge later school start times for teens

(bigstockphoto)
(bigstockphoto)

The American Academy of Pediatrics just issued a new policy statement recommending that middle and high schools start class no earlier than 8:30 a.m. because adolescents have unique sleep rhythms that make it harder for them to go to sleep and wake up earlier than other people, and that sleep deprivation can affect academic achievement as well as cause other problems.

The new AAP policy statement, called “School Start Times for Adolescents” and published in the September issue of the journal Pediatrics, says that teens have sleep-wake cycles that can be two hours later than everybody else and that starting school too early is a key factor to chronic sleep deprivation among adolescents. Sleep researchers have said for years that most teens can’t easily fall asleep until about 11 p.m., experts say, and their brains stay in sleep mode until at least 8 a.m.

The National Sleep Foundation says that teens need about 9 1/4 hours of sleep each night to function best (for some, 8 1/2 hours is enough) but that the vast majority don’t get it. Only about 15 percent of U.S. high schools start at 8:30 a.m. or later, and about 40 percent start before 8 a.m., with the median middle school start time at 8 a.m. The AAP is now urging middle and high schools to set start times that would allow students to receive 8.5 to 9.5 hours of sleep a night, meaning that class should not start in most cases before 8:30 a.m. or later.

The issue has been bubbling in school systems around the country for several years. Dozens of districts are changing high school start times, with some citing benefits including an improvement in academic performance and a drop in tardiness. Some districts have been reluctant to change start times because of scheduled after-school activities and problems with school bus schedules.

A post on the American Academy of Pediatrics’ Web site quotes pediatrician Judith Owens and lead author of the new policy statement as saying:

“Chronic sleep loss in children and adolescents is one of the most common – and easily fixable – public health issues in the U.S. today. 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. Studies have shown that delaying early school start times is one key factor that can help adolescents get the sleep they need to grow and learn.”

The policy statement is accompanied by a technical report, “Insufficient Sleep in Adolescents and Young Adults: An Update on Causes and Consequences,” also published online Aug. 25. The technical report updates a prior report on excessive sleepiness among adolescents that was published in 2005.

The reasons for teens’ lack of sleep are complex, and include homework, extracurricular activities, after-school jobs and use of technology that can keep them up late on weeknights. The AAP recommends pediatricians counsel teens and parents about healthy sleep habits, including enforcing a media curfew. The AAP also advises health-care professionals to educate parents, educators, athletic coaches and other stakeholders about the biological and environmental factors that contribute to insufficient sleep.

But the evidence strongly suggests that a too-early start to the school day is a critical contributor to chronic sleep deprivation among American adolescents. An estimated 40 percent of high schools in the U.S. currently have a start time before 8 a.m.; only 15 percent start at 8:30 a.m. or later. The median middle school start time is 8 a.m., and more than 20 percent of middle schools start at 7:45 a.m. or earlier.

Here are some facts and tips from the National Sleep Foundation:

  • Sleep is vital to your well-being, as important as the air you breathe, the water you drink and the food you eat. It can even help you to eat better and manage the stress of being a teen.
  • Biological sleep patterns shift toward later times for both sleeping and waking during adolescence — meaning it is natural to not be able to fall asleep before 11 p.m.
  • Teens need about 9 1/4 hours of sleep each night to function best (for some, 8 1/2 hours is enough). Most teens do not get enough sleep — one study found that only 15% reported sleeping 8 1/2 hours on school nights.
  • Teens tend to have irregular sleep patterns across the week — they typically stay up late and sleep in late on the weekends, which can affect their biological clocks and hurt the quality of their sleep.
  • Many teens suffer from treatable sleep disorders, such as narcolepsy, insomnia, restless legs syndrome or sleep apnea.

CONSEQUENCES:

Not getting enough sleep or having sleep difficulties can:

  • Limit your ability to learn, listen, concentrate and solve problems. You may even forget important information like names, numbers, your homework or a date with a special person in your life;
  • Make you more prone to pimples. Lack of sleep can contribute to acne and other skin problems;
  • Lead to aggressive or inappropriate behavior such as yelling at your friends or being impatient with your teachers or family members;
  • Cause you to eat too much or eat unhealthy foods like sweets and fried foods that lead to weight gain;
  • Heighten the effects of alcohol and possibly increase use of caffeine and nicotine; and
  • Contribute to illness, not using equipment safely or driving drowsy.

SOLUTIONS:

  • Make sleep a priority. Review Teen Time in this toolkit and keep a sleep diary. Decide what you need to change to get enough sleep to stay healthy, happy, and smart!
  • Naps can help pick you up and make you work more efficiently, if you plan them right. Naps that are too long or too close to bedtime can interfere with your regular sleep.
  • Make your room a sleep haven. Keep it cool, quiet and dark. If you need to, get eyeshades or blackout curtains. Let in bright light in the morning to signal your body to wake up.
  • No pills, vitamins or drinks can replace good sleep. Consuming caffeine close to bedtime can hurt your sleep, so avoid coffee, tea, soda/pop and chocolate late in the day so you can get to sleep at night. Nicotine and alcohol will also interfere with your sleep.
  • When you are sleep deprived, you are as impaired as driving with a blood alcohol content of .08%, which is illegal for drivers in many states. Drowsy driving causes over 100,000 crashes each year. Recognize sleep deprivation and call someone else for a ride. Only sleep can save you!
  • Establish a bed and wake-time and stick to it, coming as close as you can on the weekends. A consistent sleep schedule will help you feel less tired since it allows your body to get in sync with its natural patterns. You will find that it’s easier to fall asleep at bedtime with this type of routine.
  • Don’t eat, drink, or exercise within a few hours of your bedtime. Don’t leave your homework for the last minute. Try to avoid the TV, computer and telephone in the hour before you go to bed. Stick to quiet, calm activities, and you’ll fall asleep much more easily!
  • If you do the same things every night before you go to sleep, you teach your body the signals that it’s time for bed. Try taking a bath or shower (this will leave you extra time in the morning), or reading a book.
  • Try keeping a diary or to-do lists. If you jot notes down before you go to sleep, you’ll be less likely to stay awake worrying or stressing.
  • When you hear your friends talking about their all-nighters, tell them how good you feel after getting enough sleep.
  • Most teens experience changes in their sleep schedules. Their internal body clocks can cause them to fall asleep and wake up later. You can’t change this, but you can participate in interactive activities and classes to help counteract your sleepiness. Make sure your activities at night are calming to counteract your already heightened alertness.

Studies show that adolescents who don’t get enough sleep often suffer physical and mental health problems, an increased risk of automobile accidents and a decline in academic performance. But getting enough sleep each night can be hard for teens whose natural sleep cycles make it difficult for them to fall asleep before 11 p.m. – and who face a first-period class at 7:30 a.m. or earlier the next day.

Many studies have documented that the average adolescent in the U.S. is chronically sleep-deprived and pathologically sleepy. A National Sleep Foundation poll found 59 percent of sixth- through eighth-graders and 87 percent of high school students in the U.S. were getting less than the recommended 8.5 to 9.5 hours of sleep on school nights.

Napping, extending sleep on weekends, and caffeine consumption can temporarily counteract sleepiness, but they do not restore optimal alertness and are not a substitute for regular, sufficient sleep, according to the AAP.

“The AAP is making a definitive and powerful statement about the importance of sleep to the health, safety, performance and well-being of our nation’s youth,” Owens said. “By advocating for later school start times for middle and high school students, the AAP is both promoting the compelling scientific evidence that supports school start time delay as an important public health measure, and providing support and encouragement to those school districts around the country contemplating that change.”

See more at www.aap.org/en-us/about-the-aap/aap-press-room/Pages/Let-Them-Sleep-AAP-Recommends-Delaying-Start-Times-of-Middle-and-High-Schools-to-Combat-Teen-Sleep-Deprivation.aspx#sthash.uCRtLlPp.dpuf.

Valerie Strauss covers education and runs The Answer Sheet blog.
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Valerie Strauss · August 25