Impact of school start times on middle school students Valerie McLaughlin Crabtree, Ph.D., CBSM Licensed Psychologist Certified, Behavioral Sleep Medicine Presented to Lakeland School System November 14, 2016

Outline Sleep needs of middle school students Impact of insufficient sleep on children’s learning and health Implications for school start times

Sleep Needs in Middle School Age 10-12 10 hours Age 12-14 9 hours

Puberty in Middle School Average age of puberty onset Girls age 10 African American girls age 9 Boys age 12 Sleep changes often evident prior to the physical changes Encompasses all of middle school ages

Circadian Changes in Puberty Biological changes occur with the onset of puberty Delayed sleep onset with delayed wake times By age 12.5, typical sleep onset is 11:00 p.m. Early school start times interfere with sleep duration Sleep time 11:00 pm needs wake time of 8:00 am Crowley et al., 2007; Owens et al., 2010; Sadeh et al., 2009

Implications for School Start Times Delayed sleep onset coupled with early school start times are associated with: excessive daytime sleepiness falling asleep in class inattention decreased school performance Initial moves to early middle and high school start times related to bus cost savings No science to support this Resulted in negative impact to most vulnerable group

Insufficient Sleep in Middle Schoolers < 8 hours sleep significantly more likely to use drugs < 7 hours sleep significantly more likely to engage in antisocial behavior 8th graders: 1 hour less sleep per night associated with increased: Hopelessness Suicidal thoughts Suicide attempts Substance use Owens et al., 2016; Winsler et al., 2015

Sleep Loss Middle school students with lower grades (Mostly Cs, Ds, and Fs): Obtain less sleep on school nights Have later bedtimes on school nights Sleep later on weekends 21% of poor sleepers had school failures and were behind in grade level by one or more years Wolfson & Carskadon, 1998; Kahn et al., 1989

Positive Impact of Later Start Times Wake County, NC Moved M.S. start time to 8 am: reading and math scores Particularly beneficial to lower performing students Watched 15 minutes less TV each day Spent 17 more minutes on homework per week Jacob & Rockoff, 2011

Positive Impact of Later Start Times 8:05 am vs. 7:25 am schools Bedtimes 7 minutes later in later starting schools Wake times 24 minutes later in later starting schools Overall 17 minutes more sleep (46% return on investment; 85 minutes per week) Later school students with significantly less sleepiness Girls with less sleep Lewin et al., 2016

Late vs. Early Middle School Start Times 8:37 am (L) vs. 7:15 am (E) start time School L students with average of 50 minutes more sleep per night Wolfson et al., 2007

Late vs. early middle school start time Wolfson et al., 2007

Cost savings

Impact of Later Middle School Start Times Total sleep time Sleepiness Test scores Grades Tardies Substance use Mood Suicide risk

Recommendations 2014 American Academy of Pediatrics Policy Statement Early start times (before 8:30 am) are a “key modifiable contributor to insufficient sleep” Urges middle and high schools to have start times that allow for sufficient sleep (8.5 to 9.5 hours per night) 2015 Centers for Disease Control Urges school officials to: Learn about research connecting sleep and school start times. Good sleep hygiene + later school times improves health and academic achievement

Recommendations 2016 American Medical Association Policy Statement Encourage middle and high schools to start no earlier than 8:30 am Sleep essential for physical and mental health of adolescents “based on their proven biological need”

Experiences of Other Districts No “one size fits all” Some used parent surveys Many did not All collected community input Focus groups Working groups Solution-focused Successful districts educate parents on positive health and academic impact of later start times Many saw cost-savings

Questions?