Pediatricians Say School Day Should Start Later For Teens

Precious Perez listens during a class on United States history at a high school in Chelsea, Massachusetts January 24, 2014. REUTERS/Brian Snyder
Precious Perez listens during a class on United States history at a high school in Chelsea, Massachusetts Thomson Reuters

NEW YORK (Reuters Health) – Middle and high schools should delay their start times to at least 8:30 a.m. to benefit the health and welfare of students, according to a new policy statement from a large organisation of U.S. pediatricians.

Instead of having teens be in school by 7:30 or 8:00, delaying the start time has been found in past research to improve their quality of life through physical and mental health, safety and better academic performance, the American Academy of Pediatrics (AAP) says in its journal Pediatrics.

“We want to engage in at least starting a discussion in the community,” Dr. Judith Owens told Reuters Health. “Hopefully as a result of that the importance of sleep health as a priority will become more prominent.”

Owens, a sleep medicine specialist at Children’s National Health System in Washington, D.C., led the AAP’s Adolescent Sleep Working Group, Council on School Health and Committee on Adolescence in writing the new policy.

“I think that we definitely acknowledge that changing school start times is a challenge for many communities and that there are political, logistical and financial considerations associated with that, but at the end of the day this is something that communities can do to have a significant and definite impact of the health of their population,” Owens said.

In an additional article published alongside the new policy statement, Owens and her coauthors write that poor sleep has been linked to increased risks of depression, anxiety, obesity and motor vehicle accidents.

“We’ve been steadily accumulating the evidence to demonstrate that chronic sleep loss has very significant health safety and performance outcomes,” Owens said.

Teenagers also experience a biological shift in sleep patterns after puberty that makes it difficult to get to sleep before 11 p.m., Owens said. Their sleep needs of 8 to 9 hours don’t change, however.

In addition to the health benefits, the pediatricians write that delaying school start times have been tied to better graduation and attendance rates, fewer children reporting sleepiness during class and better test scores.

When asked if pushing back the time school starts will just keep teens and adolescents up later, Owens said research hasn’t shown that to be true. In fact, one school that delayed it start time saw its students get an additional 50 minutes of sleep, because the students began going to bed even earlier.

“More is better, but even that modest amount of a shift can have very, very positive effects,” she said.

In addition to encouraging later start times, the AAP’s statement recommends pediatricians educate adolescents and their parents about proper sleep needs. Also, it says, school nurses and doctors should be educated about the sleep needs of students and the AAP and other organisations should develop educational tools about sleep needs.

The statement says schools should take travel time into account when adjusting their start times.

“We hope one of the outcomes of this policy statement is that it gets communities and school districts considering this,” Owens said of the time change.

The suggestion to push back the start time of school is good but sleep behaviour also has to improve among students, said Dr. Umakanth Khatwa.

“It will definitely help them to get more sleep but if they continue without improving their sleep hygiene maybe we would soon be talking about 10 o’clock,” said Khatwa, director of Sleep Laboratories at the Center for Pediatric Sleep Disorders at Boston Children’s Hospital.

He said there is also a lot of responsibility to be put on pediatricians and school nurses to educated students and parents about sleep health. Unfortunately many doctors and nurses don’t receive education in that subject, he added.

When school starts before 8:30 a.m., Khatwa said, parents and students should take into account how much time they need in the morning to get ready and get to school and then count back eight to nine hours to find a suitable bedtime.

“I think the most important advice I’d give to parents is keep the wakeup time consistent on weekends,” he said. “If the adolescents wake up on noon on weekend there is no way they’re going to fall asleep again at 10 or 11 at night.”

SOURCE: Pediatrics, online August 25, 2014.

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