August 25, 2014
News Review From Harvard Medical School -- Doctors Push Later School Day for Teens
Most high schools and middle schools should start classes later in the morning, a large group of children's doctors says. The change would help teenagers get more sleep. The American Academy of Pediatrics (AAP) says the ideal time to start classes would be 8:30 a.m. or later. Only about 15% of U.S. high schools have that schedule now. At the earliest, classes should not start before 8 a.m., the AAP says. The main reason is biology. As children, teenagers still need 8½ to 9½ hours of sleep daily. But it's hard for them to fall asleep before 11 p.m. People start to feel sleepy when the brain releases melatonin. But that happens later for teens than for adults, an expert told HealthDay News. About 43% of U.S. public high schools start classes earlier than 8 a.m. Obstacles to change include the effects on bus schedules for all grades, student jobs, sports and other activities. But studies show positive effects in school districts that have made the switch to a later start time. They have had better attendance, higher grades and fewer car crashes with teen drivers. The journal Pediatrics published the policy statement. HealthDay News wrote about it August 25.
By Claire McCarthy, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
If we want to improve the physical and emotional health of teenagers (and possibly their school achievement as well), there is a very simple thing we should do: start school later.
That's the message of a policy statement released today by the American Academy of Pediatrics. In the statement, experts lay out clearly the reasons that a later school start could make a big difference for our teens.
As any parent of a teenager knows, along with the pimples and moodiness, puberty brings changes in sleep patterns. Teens fall asleep later, and sleep later in the morning. This isn't just a case of wanting to stay up and watch TV. This is based in biology, changes that occur in body chemistry and circadian rhythms. You can send them to bed earlier, but they aren't going to fall asleep.
However, on school days they can't sleep in to make up for the later bedtime. According to the statement, almost half of the more than 18,000 public high schools in the United States have start times before 8:00 a.m. Not surprisingly, that translates into less sleep for teens.
According to a poll conducted by the National Sleep Foundation, 59% of middle school students and 87% of high school students get less than the recommended 8½ to 9½ hours of sleep. Some of them get much less.
Interestingly, in the same poll most parents thought that their teens were getting enough sleep. So this was another point of the policy statement: to help people understand the importance of sleep for teens. The Sleep Foundation poll found that 28% of U.S. high school students fall asleep in class at least once a week. About 1 student in 5 falls asleep doing homework. This daytime sleepiness contributes to the poor academic performance that can result from not getting enough sleep.
However, it's not just academic performance that suffers. Getting less than the recommended amount of sleep has also been linked with a higher risk of:
- Anxiety and mood disorders
- Drowsy driving and the car accidents that result
Sleep-deprived teens are more likely to use caffeine or prescription stimulants, with all the side effects they bring. And there are long-term effects as well. Long-term (chronic) sleep deprivation is linked to obesity, heart disease and diabetes.
Some argue that a later school start time would just allow teens to stay up later. In that case, they wouldn't get more sleep. However, that isn't what has happened when schools have made the changes. Overall, what happens is that teens go to bed at the same time and end up with more sleep.
What Changes Can I Make Now?
Changes in school start times don't happen overnight. It may make abundant sense, but many logistics and negotiations need to take place before it can happen. And the many challenges and obstacles must be addressed. For example, a later start may lead to less time for sports and other activities.
In the meantime, there are many things that parents and others who work with youth can do to help them get more sleep. School days that start early are not the only problem. Students have many demands on their time. As a society, we need to take a step back and do some real thinking about the effects of our achievement culture on our youth.
We also need to look more closely at the role of electronic media. Teens may stay up even later because they want to use media. And media also keep them awake. More and more teens are drinking caffeinated beverages as well, which leads to sleep problems. As parents, we should be very aware of the demands on our teens, as well as what they are doing in their rooms late at night.
What Can I Expect Looking to the Future?
I hope that school administrators and community leaders will take this policy statement seriously. I hope they will look for ways to start middle school and high school at a time that works better with the biological realities of youth. Hopefully, too, the policy statement will spur conversations about other ways that we can help our youth get more sleep.
If either happens, it could make all the difference for teens.