Position statement: start middle and high schools at 8:30 am or later to promote student health and learning

Position statement: start middle and high schools at 8:30 am or later to promote student health... Abstract The Society of Behavioral Medicine recommends school officials start middle and high school classes at 8:30 am or later. Such a schedule promotes students’ sleep health, resulting in improvements in physical health, psychological well-being, attention and concentration, academic performance, and driving safety. In this position statement, we propose a four-tiered approach to promote later school start times for middle and high schools. Implications Practice: School board members and local school administrators should assist students, parents, teachers, and school staff with the transition to an 8:30 am or later school start time, including the provision of healthy-sleep education campaigns. Policy: Officials at the school district, state, and federal levels should endorse policies that promote a standard of middle and high schools starting at 8:30 or later. Research: Research should continue to document the consequences of starting school later for K-12 students, focus on best practices for transitioning to later start times, and identify and address the problems of student groups who do not appear to be helped by a delay in the start of the school day. INTRODUCTION As a consequence of puberty, teenagers are biologically driven to have later sleep and wake-up times than younger children [1]. Most middle and high schools in the USA start well before 8:30 am, which is too early to accommodate for this shift in sleep patterns and contributes to a nation of chronically sleep-deprived students [2]. Inadequate sleep results in compromised physical health, emotional and behavioral problems, and reduced ability to perform and learn [3–6]. Starting schools early may be intended to accommodate adult considerations such as bus schedules, parents’ work schedules, and the use of athletic facilities, although these have not been problematic for schools with later start times [7]. 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 am [8–10]. However, only about 15 per cent of U.S. public high schools start at 8:30 am or later [11]. For decades, starting school after 8:30 am has been the standard in many countries, such as Finland, Japan, New Zealand, Australia, and England, all of which outperform the USA on international student achievement tests [12, 13]. Out of 50 countries, U.S. children ranked worst in sleep deprivation [14]. There are no demonstrable health or learning benefits to support early start times for middle and high schools. However, schools with delayed start times have shown improvements in the following: daytime alertness and concentration [3, 8, 15–17]; mood [6, 17]; behavioral control [3, 6, 17, 18]; academic achievement, including standardized test scores [5, 18–21]; tardiness [16–18, 22]; school attendance [17, 18, 22]; coffee and stimulant drink use [16]; and rates of motor vehicle accidents for teen drivers [4, 23]. BARRIERS TO CHANGING SCHOOL START TIMES Changing school start times is often met with resistance in school districts across the USA [2, 18]. Perceived barriers include the following: conflicts with after-school programs, sports activities, and after-school student jobs; teacher concerns regarding scheduling and total work hours; transportation costs for busing children to school; difficulties in changing family patterns of daily life; and lack of awareness among school community stakeholders (i.e., school administrators, faculty, students, and families) regarding the importance of sleep. However, schools that have delayed start times do not report significant problems with this change [3, 15–17]. As such, a national trend to delay high school start times may not only be possible but also welcomed as school administrators and school communities appreciate the related benefits to students’ health and learning. In consideration of a later school start time, it is important to note the following: Teachers’ arrivals and departures from school do not need to change. Teachers may use the period before instruction each morning for preparation, grading, meetings, and professional development. Bus schedules may be staggered to allow younger students to be transported to school before middle and high school students [7]. Schools that start between 8:30 and 9:00 am would typically finish between 3:00 and 3:30 pm, 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. RECOMMENDATIONS FOR CHANGING MIDDLE AND HIGH SCHOOL START TIMES The Society of Behavioral Medicine (SBM) advocates for a four-tiered approach to promote later start times for middle and high schools. 1. School board members must enact an 8:30 am or later school start time policy in their school districts. It is fundamentally at the school district level that administrators can prioritize school start times that promote students’ health, well-being, and learning. 2. State departments of education and state legislators, particularly those on education committees, should advocate for later school start times for middle and high schools. This advocacy can be achieved by including student healthy-sleep promotion on committee agendas and by lobbying school board members to enact an 8:30 am or later school start policy. 3. Lobbying of the U.S. Department of Education is encouraged through congressional representatives, particularly those on the House Committee on Education and the Workforce, and the Senate Committee on Health, Education, Labor and Pensions, so that they understand the value of later school start times and can enact pertinent legislation. 4. To increase awareness, school-level promotion of education about the importance of sleep should be provided through in-services, workshops, curriculum changes, and family and community events. On a community level, media should be engaged to promote the public’s understanding of the benefits of later school start times for middle and high school students. Healthy student sleep campaigns may be provided through media programming. It is no longer a question of whether policies promoting later school start times should be adopted, but rather how they should be implemented [4]. Acknowledgments The authors wish to gratefully acknowledge the expert review and support provided by SBM’s Health Policy Committee, Health Policy Council, and Child and Family Health Special Interest Group. Compliance with Ethical Standards: All authors were substantially involved in the development and writing of this position statement and complied with ethical standards. Conflict of Interest: Tracy Trevorrow, Eric S. Zhou, Jessica R. Dietch, and Brian D. Gonzalez declare that they have no conflict of interest regarding the writing of this position statement. Informed Consent: Since this position statement does not involve any human participants or animals, informed consent is not required. Ethical Approval: All procedures were conducted in accordance with ethical standards. This position statement does involve human participants or animals. References 1. Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Med . 2007; 8( 6): 602– 612. Google Scholar CrossRef Search ADS PubMed  2. Kirby M, Maggi S, D’Angiulli A. School start times and the sleep-wake cycle of adolescents: a review and critical evaluation of available evidence. Educ Res . 2011; 40( 2): 56– 61. Google Scholar CrossRef Search ADS   3. Lufi D, Tzischinsky O, Hadar S. Delaying school starting time by one hour: some effects on attention levels in adolescents. J Clin Sleep Med . 2011; 7( 2): 137– 143. Google Scholar PubMed  4. Wahlstrom K, Dretzke BJ, Gordon MF, Peterson K, Edwards K, Gdula J. Examining the Impact of Later High School Start Times on the Health and Academic Performance of High School Students: A Multi-Site Study .; February 2014. 5. Edwards F. Early to rise? The effect of daily start times on academic performance. Econ Educ Rev . 2012; 31( 6): 970– 983. Google Scholar CrossRef Search ADS   6. Dahl RE. The consequences of insufficient sleep for adolescents—links between sleep and emotional regulation. Phi Delta Kappan . 1999; 80( 5): 179– 189. 7. Wolfson AR, Carskadon MA. A survey of factors influencing high school starttimes. NASSP Bull . 2005; 89( 642): 47– 66. Google Scholar CrossRef Search ADS   8. Boergers J. Benefits of later school start times. Brown Univ Child Adolesc Behav Lett . 2015; 31( 1): 1– 6. Google Scholar CrossRef Search ADS   9. Au R, Carskadon M, Millman Ret al.   School start times for adolescents. Pediatrics . 2014; 134( 3): 642– 649. Google Scholar CrossRef Search ADS PubMed  10. Bishop M. Council on Science and Public Health Report 6—Delaying School Start Time to Alleviate Adolescent Sleep Deprivation; 2016. https://teensneedsleep.files.wordpress.com/2011/04/ama-school-start-time-policy-statment.pdf. Date accessed = 1/18/18. 11. NCES. School and Staffing Survey (SASS) National Center for Education Statistics; 2012. https://nces.ed.gov/surveys/sass/tables/sass1112_201381_s1n.asp. 12. Kinsella R. School Days Around the World | PocketCultures. http://pocketcultures.com/2010/09/15/school-days-around-the-world/. Accessed January 18, 2018. 13. PISA. PISA 2015 Results in Focus ; 2016. doi: 10.1787/9789264266490-en. 14. Kastberg D, Roey S, Ferraro D, Lemanski N, Erberber E. U.S. TIMSS and PIRLS 2011 Technical Report and User’s Guide. NCES 2013–046. Natl Cent Educ Stat . 2013;(September): 317. http://131.211.208.19/login?auth=eng&url=http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D= eric3&AN=ED545101. 15. Vedaa Ø, Saxvig IW, Wilhelmsen-Langeland A, Bjorvatn B, Pallesen S. School start time, sleepiness and functioning in Norwegian adolescents. Scand J Educ Res . 2012; 56( 1): 55– 67. Google Scholar CrossRef Search ADS   16. Boergers J, Gable CJ, Owens JA. Later school start time is associated with improved sleep and daytime functioning in adolescents. J Dev Behav Pediatr . 2014; 35( 1): 11– 17. Google Scholar CrossRef Search ADS PubMed  17. Owens JA, Belon K, Moss P. Impact of delaying school start time on adolescent sleep, mood, and behavior. Arch Pediatr Adolesc Med . 2010; 164( 7): 608– 614. Google Scholar CrossRef Search ADS PubMed  18. Wahlstrom KL, Dretzke BJ, Gordon MF, Peterson K, Edwards K, Gdula J. Examining the Impact of Later High School Start Times on the Health and Academic Performance of High School Students: A Multi-Site Study . 2014: 72. http://www.ccsdschools.com/Community/documents/ImpactofLaterStartTime.pdf. 19. Pagel JF, Forister N, Kwiatkowki C. Adolescent sleep disturbance and school performance: the confounding variable of socioeconomics. J Clin Sleep Med . 2007; 3( 1): 19– 23. Google Scholar PubMed  20. 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 Kentucky. J Educ Psychol . 2015; 107( 1): 236– 245. Google Scholar CrossRef Search ADS   21. Ming X, Koransky R, Kang V, Buchman S, Sarris CE, Wagner GC. Sleep insufficiency, sleep health problems and performance in high school students. Clin Med Insights Circ Respir Pulm Med . 2011; 5 (1): 71– 79. Google Scholar PubMed  22. Wolfson AR, Spaulding NL, Dandrow C, Baroni EM. Middle school start times: the importance of a good night’s sleep for young adolescents. Behav Sleep Med . 2007; 5( 3): 194– 209. Google Scholar CrossRef Search ADS PubMed  23. Vorona RD, Szklo-Coxe M, Lamichhane R, Ware JC, McNallen A, Leszczyszyn AD. 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. J Clin Sleep Med . 2014; 10( 11): 1169– 1177E. Google Scholar PubMed  © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Translational Behavioral Medicine Oxford University Press

Position statement: start middle and high schools at 8:30 am or later to promote student health and learning

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Abstract

Abstract The Society of Behavioral Medicine recommends school officials start middle and high school classes at 8:30 am or later. Such a schedule promotes students’ sleep health, resulting in improvements in physical health, psychological well-being, attention and concentration, academic performance, and driving safety. In this position statement, we propose a four-tiered approach to promote later school start times for middle and high schools. Implications Practice: School board members and local school administrators should assist students, parents, teachers, and school staff with the transition to an 8:30 am or later school start time, including the provision of healthy-sleep education campaigns. Policy: Officials at the school district, state, and federal levels should endorse policies that promote a standard of middle and high schools starting at 8:30 or later. Research: Research should continue to document the consequences of starting school later for K-12 students, focus on best practices for transitioning to later start times, and identify and address the problems of student groups who do not appear to be helped by a delay in the start of the school day. INTRODUCTION As a consequence of puberty, teenagers are biologically driven to have later sleep and wake-up times than younger children [1]. Most middle and high schools in the USA start well before 8:30 am, which is too early to accommodate for this shift in sleep patterns and contributes to a nation of chronically sleep-deprived students [2]. Inadequate sleep results in compromised physical health, emotional and behavioral problems, and reduced ability to perform and learn [3–6]. Starting schools early may be intended to accommodate adult considerations such as bus schedules, parents’ work schedules, and the use of athletic facilities, although these have not been problematic for schools with later start times [7]. 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 am [8–10]. However, only about 15 per cent of U.S. public high schools start at 8:30 am or later [11]. For decades, starting school after 8:30 am has been the standard in many countries, such as Finland, Japan, New Zealand, Australia, and England, all of which outperform the USA on international student achievement tests [12, 13]. Out of 50 countries, U.S. children ranked worst in sleep deprivation [14]. There are no demonstrable health or learning benefits to support early start times for middle and high schools. However, schools with delayed start times have shown improvements in the following: daytime alertness and concentration [3, 8, 15–17]; mood [6, 17]; behavioral control [3, 6, 17, 18]; academic achievement, including standardized test scores [5, 18–21]; tardiness [16–18, 22]; school attendance [17, 18, 22]; coffee and stimulant drink use [16]; and rates of motor vehicle accidents for teen drivers [4, 23]. BARRIERS TO CHANGING SCHOOL START TIMES Changing school start times is often met with resistance in school districts across the USA [2, 18]. Perceived barriers include the following: conflicts with after-school programs, sports activities, and after-school student jobs; teacher concerns regarding scheduling and total work hours; transportation costs for busing children to school; difficulties in changing family patterns of daily life; and lack of awareness among school community stakeholders (i.e., school administrators, faculty, students, and families) regarding the importance of sleep. However, schools that have delayed start times do not report significant problems with this change [3, 15–17]. As such, a national trend to delay high school start times may not only be possible but also welcomed as school administrators and school communities appreciate the related benefits to students’ health and learning. In consideration of a later school start time, it is important to note the following: Teachers’ arrivals and departures from school do not need to change. Teachers may use the period before instruction each morning for preparation, grading, meetings, and professional development. Bus schedules may be staggered to allow younger students to be transported to school before middle and high school students [7]. Schools that start between 8:30 and 9:00 am would typically finish between 3:00 and 3:30 pm, 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. RECOMMENDATIONS FOR CHANGING MIDDLE AND HIGH SCHOOL START TIMES The Society of Behavioral Medicine (SBM) advocates for a four-tiered approach to promote later start times for middle and high schools. 1. School board members must enact an 8:30 am or later school start time policy in their school districts. It is fundamentally at the school district level that administrators can prioritize school start times that promote students’ health, well-being, and learning. 2. State departments of education and state legislators, particularly those on education committees, should advocate for later school start times for middle and high schools. This advocacy can be achieved by including student healthy-sleep promotion on committee agendas and by lobbying school board members to enact an 8:30 am or later school start policy. 3. Lobbying of the U.S. Department of Education is encouraged through congressional representatives, particularly those on the House Committee on Education and the Workforce, and the Senate Committee on Health, Education, Labor and Pensions, so that they understand the value of later school start times and can enact pertinent legislation. 4. To increase awareness, school-level promotion of education about the importance of sleep should be provided through in-services, workshops, curriculum changes, and family and community events. On a community level, media should be engaged to promote the public’s understanding of the benefits of later school start times for middle and high school students. Healthy student sleep campaigns may be provided through media programming. It is no longer a question of whether policies promoting later school start times should be adopted, but rather how they should be implemented [4]. Acknowledgments The authors wish to gratefully acknowledge the expert review and support provided by SBM’s Health Policy Committee, Health Policy Council, and Child and Family Health Special Interest Group. Compliance with Ethical Standards: All authors were substantially involved in the development and writing of this position statement and complied with ethical standards. Conflict of Interest: Tracy Trevorrow, Eric S. Zhou, Jessica R. Dietch, and Brian D. Gonzalez declare that they have no conflict of interest regarding the writing of this position statement. Informed Consent: Since this position statement does not involve any human participants or animals, informed consent is not required. Ethical Approval: All procedures were conducted in accordance with ethical standards. This position statement does involve human participants or animals. References 1. Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Med . 2007; 8( 6): 602– 612. Google Scholar CrossRef Search ADS PubMed  2. Kirby M, Maggi S, D’Angiulli A. School start times and the sleep-wake cycle of adolescents: a review and critical evaluation of available evidence. Educ Res . 2011; 40( 2): 56– 61. Google Scholar CrossRef Search ADS   3. Lufi D, Tzischinsky O, Hadar S. Delaying school starting time by one hour: some effects on attention levels in adolescents. J Clin Sleep Med . 2011; 7( 2): 137– 143. Google Scholar PubMed  4. Wahlstrom K, Dretzke BJ, Gordon MF, Peterson K, Edwards K, Gdula J. Examining the Impact of Later High School Start Times on the Health and Academic Performance of High School Students: A Multi-Site Study .; February 2014. 5. Edwards F. Early to rise? The effect of daily start times on academic performance. Econ Educ Rev . 2012; 31( 6): 970– 983. Google Scholar CrossRef Search ADS   6. Dahl RE. The consequences of insufficient sleep for adolescents—links between sleep and emotional regulation. Phi Delta Kappan . 1999; 80( 5): 179– 189. 7. Wolfson AR, Carskadon MA. A survey of factors influencing high school starttimes. NASSP Bull . 2005; 89( 642): 47– 66. Google Scholar CrossRef Search ADS   8. Boergers J. Benefits of later school start times. Brown Univ Child Adolesc Behav Lett . 2015; 31( 1): 1– 6. Google Scholar CrossRef Search ADS   9. Au R, Carskadon M, Millman Ret al.   School start times for adolescents. Pediatrics . 2014; 134( 3): 642– 649. Google Scholar CrossRef Search ADS PubMed  10. Bishop M. Council on Science and Public Health Report 6—Delaying School Start Time to Alleviate Adolescent Sleep Deprivation; 2016. https://teensneedsleep.files.wordpress.com/2011/04/ama-school-start-time-policy-statment.pdf. Date accessed = 1/18/18. 11. NCES. School and Staffing Survey (SASS) National Center for Education Statistics; 2012. https://nces.ed.gov/surveys/sass/tables/sass1112_201381_s1n.asp. 12. Kinsella R. School Days Around the World | PocketCultures. http://pocketcultures.com/2010/09/15/school-days-around-the-world/. Accessed January 18, 2018. 13. PISA. PISA 2015 Results in Focus ; 2016. doi: 10.1787/9789264266490-en. 14. Kastberg D, Roey S, Ferraro D, Lemanski N, Erberber E. U.S. TIMSS and PIRLS 2011 Technical Report and User’s Guide. NCES 2013–046. Natl Cent Educ Stat . 2013;(September): 317. http://131.211.208.19/login?auth=eng&url=http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D= eric3&AN=ED545101. 15. Vedaa Ø, Saxvig IW, Wilhelmsen-Langeland A, Bjorvatn B, Pallesen S. School start time, sleepiness and functioning in Norwegian adolescents. Scand J Educ Res . 2012; 56( 1): 55– 67. Google Scholar CrossRef Search ADS   16. Boergers J, Gable CJ, Owens JA. Later school start time is associated with improved sleep and daytime functioning in adolescents. J Dev Behav Pediatr . 2014; 35( 1): 11– 17. Google Scholar CrossRef Search ADS PubMed  17. Owens JA, Belon K, Moss P. Impact of delaying school start time on adolescent sleep, mood, and behavior. Arch Pediatr Adolesc Med . 2010; 164( 7): 608– 614. Google Scholar CrossRef Search ADS PubMed  18. Wahlstrom KL, Dretzke BJ, Gordon MF, Peterson K, Edwards K, Gdula J. Examining the Impact of Later High School Start Times on the Health and Academic Performance of High School Students: A Multi-Site Study . 2014: 72. http://www.ccsdschools.com/Community/documents/ImpactofLaterStartTime.pdf. 19. Pagel JF, Forister N, Kwiatkowki C. Adolescent sleep disturbance and school performance: the confounding variable of socioeconomics. J Clin Sleep Med . 2007; 3( 1): 19– 23. Google Scholar PubMed  20. 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 Kentucky. J Educ Psychol . 2015; 107( 1): 236– 245. Google Scholar CrossRef Search ADS   21. Ming X, Koransky R, Kang V, Buchman S, Sarris CE, Wagner GC. Sleep insufficiency, sleep health problems and performance in high school students. Clin Med Insights Circ Respir Pulm Med . 2011; 5 (1): 71– 79. Google Scholar PubMed  22. Wolfson AR, Spaulding NL, Dandrow C, Baroni EM. Middle school start times: the importance of a good night’s sleep for young adolescents. Behav Sleep Med . 2007; 5( 3): 194– 209. Google Scholar CrossRef Search ADS PubMed  23. Vorona RD, Szklo-Coxe M, Lamichhane R, Ware JC, McNallen A, Leszczyszyn AD. 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. J Clin Sleep Med . 2014; 10( 11): 1169– 1177E. Google Scholar PubMed  © Society of Behavioral Medicine 2018. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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Translational Behavioral MedicineOxford University Press

Published: Mar 13, 2018

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