Could starting high school later be healthier for teens?

Lack of sleep can affect academic performance in teens.

According to experts, teenagers need a little more than eight hours of sleep per night. Unfortunately, (surprise, surprise) most teens aren’t listening. The Centers for Disease Control and Prevention report that only 31 percent of high school students get eight or more hours of sleep on an average school night.

This is upsetting news because poor sleep is tied to a lot more than a teenager having a bad attitude when she’s tired. Insufficient sleep is linked to an increased risk for chronic diseases, such as hypertension, diabetes, depression and obesity. Sleepy drivers are more likely to get in an accident, and sleepy students tend to do worse on tests than their well-rested peers. Teens who average less than eight hours of sleep per night are also more likely to drink, do drugs and indulge in inappropriate sexual behavior.

Clearly our teens need more sleep. But as any parent will tell you, telling a teenager to go to bed earlier is one thing—getting her to actually do it is something else all together.

With that in mind, a new study, published in the journal Developmental Behavioral Pediatrics, explores the benefits of later school start times—giving teenagers a little more time in the morning to catch up on the rest they’re not getting at night.

Studying a group of boarding school students, researchers monitored the effects of pushing back school start times from 8 a.m. to 8:25 a.m. And even though classes only started 25 minutes later, the delay yielded some pretty positive results. During the period of research, the percentage of students who got a full eight hours of sleep jumped from just 18 percent to 44 percent. Researchers also found that the later start time lead to significant reductions in students’ daytime sleepiness, depressed moods and caffeine intake.

So, if pushing school back by less than a half hour can have such an effect, can we expect to see high schools across America adopt the practice soon? Unlikely, says Dennis Rosen, MD, associate medical director of The Center for Pediatric Sleep Disorders at Boston Children’s Hospital. “Changing school start times may create logistical problems for many families and communities,” he says.

First of all, many school districts have a single fleet of buses for elementary, middle and high school students. To accommodate all these kids, bus pick-ups are tiered, often getting high school students first, middle school kids second and elementary school children last. It might seem easy to simply flip that schedule to allow teens more time in the morning, but that could lead to a school system’s youngest children waiting for buses as early as 6:30 a.m. in many areas—often before it’s even light out—creating potential safety issues.

Dennis Rosen, MD

Also, younger children often require at least 10 hours of sleep per night. Forcing them to adopt an earlier wake up time would require an earlier bedtime. But having young children go to bed even earlier than they already do could severely limit the time they spend with their parents, especially those that don’t get home from work until late evening.

And because no one is advocating for shortening the school day, changing start times means changing end of day times too, which can complicate the work schedules of all the school system’s employees and students’ parents.

“School hours often shape the work schedules of the whole family,” Rosen notes. “Altering them too much may inconvenience hundreds, maybe thousands of people in every school district. It will effect parents who may need to leave for work later in the morning to ensure that their kids get out the door on time, and teachers, who may need to stay later at school and arrive home later to care for their own children.”

Although the children in this study did not push their bedtimes back later, an extra hour in the morning could quickly lead to staying up later, especially when after-school activities—homework, sports and socializing—would begin (and end) later with altered school times.

Given all the potential complications that could arise from changing school times, Rosen says parents who are worried about their teen not getting enough sleep are better off taking the matter up with their child. He suggests collaboratively finding ways to ensure that he or she gets at least eight hours of sleep each night, instead of hoping that a restructuring of school schedules will solve the problem.

“Ultimately this comes down to self-discipline on the part of the teenager, with help and guidance from the parents,”  he says.

 Looking for ways to get your teen to sleep more? Rosen suggests the following:

  • Explain why sleep matters. The surest way to have kids get more rest is to have them want to sleep more. Teenagers may be shocked to learn that lack of sleep is linked to an increased risk for depression and weight gain, and may even embrace the idea of more sleep to avoid such problems.
  • Use positive reinforcement. Reward systems often work well for changing behaviors in teens. Having fewer chores, a curfew extension or an added privilege might be enough incentive to have some teens turn in sooner.
  • Have them get a nighttime routine. Children, teens and adults all benefit from having a familiar routine around bedtime. It helps us wind down and fall asleep more easily. Suggest quiet, low-key activities for the hour before bed, like listening to mellow music or reading.
  • Create a manageable schedule. Between school, homework, friends and extracurricular activates, it’s amazing today’s teens can find even five hours to sleep, never mind eight or nine. If your teen is complaining that there’s simply not enough time to do it all and sleep eight hours per night, it might be time to step in and help her reprioritize the things on her schedule.
  • Unplug. A bedroom should be just that: a room with a bed. Naturally, there are going to be a few more items in your teen’s bedroom, but things like computers, TVs and videogame systems create distractions that are often more inviting than sleep, so they should be moved out of the bedroom, at least on school nights. Cellphones are also a huge obstacle to sleep for many teens, so it might be a good idea to ban them from the child’s room at bedtime.

If your child has a sleep-related issue that requires medical attention, please call our Center for Pediatric Sleep Disorders at 781-216-2570, or visit the center’s website and click the “request an appointment” button.

  • Danny Lewin

    The issue of optimal school start times for teenagers is a complex issue except when it comes to health. Parent limit setting and teens efforts to improve their sleep are important, however, there is nearly irrefutable evidence that adolescents are not biologically prepared to go to bed early and wake up early. While some small percentage of adolescents may be able to accommodate or or tolerate, the vast majority cannot and the health, safety and academic implications are well established. As Dr. Rosen points out, there are challenges for school districts as they consider delaying school start times for their high and middle school students, but for the vast majority of those districts that have changed their school start time there have been many opportunities for cost savings and there have been only 2 out of 70 cases of reverting to original start times. Let’s prioritize our children’s health!

  • Phyllis

    I wonder whether Dr. Rosen is aware just how early buses begin picking up high school students? In many parts of the country, young people are boarding buses at 5:45 or 6:00 am. This means that adolescents who need about 9 hours of sleep must be in bed asleep at 8:45 or 9:00 pm. It’s important to set up policies and systems that promote healthy behaviors. Very early school start times do the opposite and sabotage the best efforts of young people and parents. The students in this particular study were fortunate to have an 8 a.m. start time. High schools in many parts of the country start at 7:20 a.m.

    Further, this isn’t the only study to show that students don’t push back their bedtimes with later morning start times. This is a myth. http://schoolstarttime.org/delaying-school-start-times/will-students-squander-opportunity-extra-sleep/

    Sleep experts often liken the very early start times to “shift work” for adolescents. Dr. Rosen is correct that this change is hard and it is important to share coping mechanisms with families who are given no choice in this matter, but as a leader in children’s health, and from a public health perspective, it’s equally important to emphasize that changing a policy like this one is a more effective way to improve the health of our children and our nation. On a historical note, schools didn’t always start this early and there is strong evidence from districts that have made the shift that anticipation of this change is worse than the actual change.

    This is a change that is worthwhile. As public health experts, we must stress the importance of policies that provide an opportunity for children to get enough rest along with healthy sleep hygiene practices.

  • agm

    I wish Dr. Rosen had taken the time to review the literature prior to offering an opinion on such an important topic. His reluctance to embrace the need for youth to have the early morning hours as time for sleep is not reflective of the conclusions reached by the numerous medical studies. A later start time for schools is the least costly (see Brookings Institute – http://www.brookings.edu/research/papers/2011/09/organization-jacob-rockoff) and most beneficial (see Edwards 2011 – http://teensneedsleep.files.wordpress.com/2011/04/edwards-early-to-rise-the-effect-of-daily-start-times-on-academic-performance-published-version.pdf) solution for the universal problem of teenage sleep deprivation (see CDC’sYRBIS data analysis – http://www.sciencedirect.com/science/article/pii/S0091743511002878).