Association of Delaying School Start Time With Sleep–Wake Behaviors Among Adolescents

Kaitlyn M. Berry; Darin J. Erickson; Aaron T. Berger; Kyla Wahlstrom; Conrad Iber; Kelsie M. Full; Susan Redline; Rachel Widome

doi:10.1016/j.jadohealth.2021.04.030

Association of Delaying School Start Time With Sleep–Wake Behaviors Among Adolescents

Kaitlyn M. Berry, Darin J. Erickson, Aaron T. Berger, Kyla Wahlstrom, Conrad Iber, Kelsie M. Full, Susan Redline, Rachel Widome

Research output: Contribution to journal › Article › peer-review

6 Scopus citations

Abstract

Purpose: Few adolescents spend enough time asleep on school nights. This problem could be addressed by delaying high school start times, but does this translate to reduced prevalence of sleep–wake problems like awakening too early or feeling sleepy during the day? Methods: The START study (n = 2,414) followed a cohort of students from five Minnesota high schools to evaluate impacts of school start time delays. Participants were enrolled in ninth grade (Baseline) when all schools started early (7:30 or 7:45 A.M.). At Follow-Up 1 (10th grade) and Follow-Up 2 (11th grade), two schools had delayed their start times by 50 and 65 minutes while three comparison schools started at 7:30 A.M. Six sleep–wake behaviors were assessed at all three time points via survey. Generalized estimating equation models were used to investigate changes in sleep–wake problems between policy change and comparison schools. Results: The prevalence of sleep–wake problems at Baseline ranged from 11% for being late to class due to oversleeping to 48% for needing to be told to wake multiple times in the morning. Compared to students from comparison schools, students at policy change schools reported smaller increases in the prevalence of feeling sleepy daily and oversleeping and being late to class between 9th and 11th grade. After implementation of the delayed start, awakening too early was more common among students at policy change schools compared to the comparison schools. Conclusions: This longitudinal study provides evidence that delaying high school start times reduces daytime sleepiness and school tardiness.

Original language	English (US)
Pages (from-to)	831-837
Number of pages	7
Journal	Journal of Adolescent Health
Volume	69
Issue number	5
Early online date	Jun 5 2021
DOIs	https://doi.org/10.1016/j.jadohealth.2021.04.030
State	Published - Nov 2021

Bibliographical note

Funding Information:
The authors would like to thank the adolescents participating in the START study, the districts that welcomed us to do research in their schools, the START data collectors, and Bill Baker for his work to manage the data. Thank you to Kate Bauer for sharing your great ideas. The START study was supported by grant R01 HD088176 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the NIH. Ms. Berry's time was supported by a NICHD training grant (T32 HD095134); Dr. Full's time was supported by a National Health Lung and Blood Institute (NHLBI) training grant (T32 HL007779). The authors also gratefully acknowledge support from the Minnesota Population Center (grant P2C HD041023), which is funded by NICHD. Funders did not play any role in the study design; the collection, analysis, and interpretation of the data; the writing of the manuscript; or the decision to submit the manuscript for publication.

Publisher Copyright:
© 2021 Society for Adolescent Health and Medicine

Keywords

Adolescents
High school
School start times
Sleep
Sleep–wake problems

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10.1016/j.jadohealth.2021.04.030

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@article{6eec8500154c46539c88259426bbaac3,

title = "Association of Delaying School Start Time With Sleep–Wake Behaviors Among Adolescents",

abstract = "Purpose: Few adolescents spend enough time asleep on school nights. This problem could be addressed by delaying high school start times, but does this translate to reduced prevalence of sleep–wake problems like awakening too early or feeling sleepy during the day? Methods: The START study (n = 2,414) followed a cohort of students from five Minnesota high schools to evaluate impacts of school start time delays. Participants were enrolled in ninth grade (Baseline) when all schools started early (7:30 or 7:45 A.M.). At Follow-Up 1 (10th grade) and Follow-Up 2 (11th grade), two schools had delayed their start times by 50 and 65 minutes while three comparison schools started at 7:30 A.M. Six sleep–wake behaviors were assessed at all three time points via survey. Generalized estimating equation models were used to investigate changes in sleep–wake problems between policy change and comparison schools. Results: The prevalence of sleep–wake problems at Baseline ranged from 11% for being late to class due to oversleeping to 48% for needing to be told to wake multiple times in the morning. Compared to students from comparison schools, students at policy change schools reported smaller increases in the prevalence of feeling sleepy daily and oversleeping and being late to class between 9th and 11th grade. After implementation of the delayed start, awakening too early was more common among students at policy change schools compared to the comparison schools. Conclusions: This longitudinal study provides evidence that delaying high school start times reduces daytime sleepiness and school tardiness.",

keywords = "Adolescents, High school, School start times, Sleep, Sleep–wake problems",

author = "Berry, {Kaitlyn M.} and Erickson, {Darin J.} and Berger, {Aaron T.} and Kyla Wahlstrom and Conrad Iber and Full, {Kelsie M.} and Susan Redline and Rachel Widome",

note = "Funding Information: The authors would like to thank the adolescents participating in the START study, the districts that welcomed us to do research in their schools, the START data collectors, and Bill Baker for his work to manage the data. Thank you to Kate Bauer for sharing your great ideas. The START study was supported by grant R01 HD088176 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the NIH. Ms. Berry's time was supported by a NICHD training grant (T32 HD095134); Dr. Full's time was supported by a National Health Lung and Blood Institute (NHLBI) training grant (T32 HL007779). The authors also gratefully acknowledge support from the Minnesota Population Center (grant P2C HD041023), which is funded by NICHD. Funders did not play any role in the study design; the collection, analysis, and interpretation of the data; the writing of the manuscript; or the decision to submit the manuscript for publication. Publisher Copyright: {\textcopyright} 2021 Society for Adolescent Health and Medicine",

year = "2021",

month = nov,

doi = "10.1016/j.jadohealth.2021.04.030",

language = "English (US)",

volume = "69",

pages = "831--837",

journal = "Journal of Adolescent Health",

issn = "1054-139X",

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AU - Erickson, Darin J.

AU - Berger, Aaron T.

AU - Wahlstrom, Kyla

AU - Iber, Conrad

AU - Full, Kelsie M.

AU - Redline, Susan

AU - Widome, Rachel

N1 - Funding Information: The authors would like to thank the adolescents participating in the START study, the districts that welcomed us to do research in their schools, the START data collectors, and Bill Baker for his work to manage the data. Thank you to Kate Bauer for sharing your great ideas. The START study was supported by grant R01 HD088176 from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) of the NIH. Ms. Berry's time was supported by a NICHD training grant (T32 HD095134); Dr. Full's time was supported by a National Health Lung and Blood Institute (NHLBI) training grant (T32 HL007779). The authors also gratefully acknowledge support from the Minnesota Population Center (grant P2C HD041023), which is funded by NICHD. Funders did not play any role in the study design; the collection, analysis, and interpretation of the data; the writing of the manuscript; or the decision to submit the manuscript for publication. Publisher Copyright: © 2021 Society for Adolescent Health and Medicine

PY - 2021/11

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N2 - Purpose: Few adolescents spend enough time asleep on school nights. This problem could be addressed by delaying high school start times, but does this translate to reduced prevalence of sleep–wake problems like awakening too early or feeling sleepy during the day? Methods: The START study (n = 2,414) followed a cohort of students from five Minnesota high schools to evaluate impacts of school start time delays. Participants were enrolled in ninth grade (Baseline) when all schools started early (7:30 or 7:45 A.M.). At Follow-Up 1 (10th grade) and Follow-Up 2 (11th grade), two schools had delayed their start times by 50 and 65 minutes while three comparison schools started at 7:30 A.M. Six sleep–wake behaviors were assessed at all three time points via survey. Generalized estimating equation models were used to investigate changes in sleep–wake problems between policy change and comparison schools. Results: The prevalence of sleep–wake problems at Baseline ranged from 11% for being late to class due to oversleeping to 48% for needing to be told to wake multiple times in the morning. Compared to students from comparison schools, students at policy change schools reported smaller increases in the prevalence of feeling sleepy daily and oversleeping and being late to class between 9th and 11th grade. After implementation of the delayed start, awakening too early was more common among students at policy change schools compared to the comparison schools. Conclusions: This longitudinal study provides evidence that delaying high school start times reduces daytime sleepiness and school tardiness.

AB - Purpose: Few adolescents spend enough time asleep on school nights. This problem could be addressed by delaying high school start times, but does this translate to reduced prevalence of sleep–wake problems like awakening too early or feeling sleepy during the day? Methods: The START study (n = 2,414) followed a cohort of students from five Minnesota high schools to evaluate impacts of school start time delays. Participants were enrolled in ninth grade (Baseline) when all schools started early (7:30 or 7:45 A.M.). At Follow-Up 1 (10th grade) and Follow-Up 2 (11th grade), two schools had delayed their start times by 50 and 65 minutes while three comparison schools started at 7:30 A.M. Six sleep–wake behaviors were assessed at all three time points via survey. Generalized estimating equation models were used to investigate changes in sleep–wake problems between policy change and comparison schools. Results: The prevalence of sleep–wake problems at Baseline ranged from 11% for being late to class due to oversleeping to 48% for needing to be told to wake multiple times in the morning. Compared to students from comparison schools, students at policy change schools reported smaller increases in the prevalence of feeling sleepy daily and oversleeping and being late to class between 9th and 11th grade. After implementation of the delayed start, awakening too early was more common among students at policy change schools compared to the comparison schools. Conclusions: This longitudinal study provides evidence that delaying high school start times reduces daytime sleepiness and school tardiness.

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KW - High school

KW - School start times

KW - Sleep

KW - Sleep–wake problems

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ER -

Association of Delaying School Start Time With Sleep–Wake Behaviors Among Adolescents

Abstract

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