Chris Arth: School start time: a wake-up call
February 23, 2019
The Tahoe Truckee Unified School District board is considering moving the start time for middle and high school from 7:30 to 8 a.m. Currently a subcommittee is studying the community interest in what may seem a radical change.
I joined a local group of advocates and hope to summarize some of the relevant health issues and hopefully inspire some to support the effort.
The American Academy of Pediatrics (AAP) published an excellent policy statement in 2014 which I urge all interested to read. My long career in pediatrics supports insufficient sleep significantly risks the health, safety and academic success of our youth. Per AAP "Insufficient sleep represents one of the most common, important, and potentially remediable health risks in children, particularly in the adolescent population, for whom chronic sleep loss has increasingly become the norm."
Studies support that around adolescence a sleep-wake phase delay occurs relating to delayed timing of melatonin release (a sleep hormone) as well as an altered sleep drive. Optimal sleep for most teens is in the range of 8.5 to 9.5 hours per night. The average teen in our society has difficulty falling asleep before 11 p.m. and is best suited to wake at 8 a.m. Given the above, it should not be surprising that numerous studies have documented that the average adolescent is chronically sleep deprived (over 80 percent in high school) and subject to the inherent dangers. The same survey revealed 71 percent of parents thought their teens were sleeping enough.
Numerous studies support sleep deprivation can be a critical factor for mental health issues and quality of life.
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Let me review the risks of inadequate sleep. What I see most clinically are issues in attention, decision making, behavior control, and mood. Research now adds obesity and diabetes to the list. In evaluating teens and pre-teens for attention deficit hyperactivity disorder (ADHD), it is mandatory to sort out those who are mostly sleep deprived before considering other treatments including medications. Similarly, I think most are aware of the increase in depression, anxiety, and suicidal risk. Numerous studies support sleep deprivation can be a critical factor for mental health issues and quality of life.
Academic performance also falls victim to lack of sleep. Especially when bombarded with cyber communication on top of an already busy schedule, we see lower test scoring, higher absenteeism, tardiness, and decreased preparation and enthusiasm to learn. To help deal with this, students may turn to stimulants (caffeine, prescription drugs and street drugs). They are significantly more at risk of auto accidents when sleep deprived. Numerous studies have documented sleep deprivation as a risk to obesity, type 2 diabetes, and heart health including hypertension.
All of this has led to a search for potentially modifiable factors. When all factors and possible changes are examined, one of the most relevant, easiest, and successful is changing school start times. Roughly half of high schools in the U.S. have start times before 8 a.m. Over the last 15 years a small but growing number of schools have recognized the research and have changed to later start times. Given the biology cited prior, this logical step has succeeded where earlier sleep times haven't. Those that changed to 8:30 start times did best, but even a half hour change was significant.
Skepticism of the science was expressed by some of the school board. As I have learned with the vaccine debate, close scrutiny will provide the truth. Multiple studies clearly demonstrated delayed start times had significant positive effect on self-reported sleepiness and fatigue, attendance rates, depressed mood, and auto accidents. Improvements in academic achievement initially were improved but not "statistically significant." Fortunately, more recent studies do clearly document improvements in academics and scores with later start times. This even carried through to studies at the Air Force Academy. One study suggested moving school start time by an hour is equivalent in impact on standardized test scores to decreasing the class size by one-third.
That final point brings up cost-effectiveness. TTUSD may face increased cost primarily with transportation expenses. A Brookings Institute report outlined a consensus statement from economists suggesting that delaying school start times would demonstrate a substantial benefit-to-cost ratio.
Quite simply put, a small investment now may lead to a substantial gain overall in a more productive and successful student population (by about 20 times).
Chris Arth lives in Truckee.
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