Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School

Thacher, Pamela V; Onyper, Serge V.

doi:10.5665/sleep.5426

Cited by 82 publications

(88 citation statements)

References 37 publications

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“…Our search strategy resulted in 18 studies in total, including 10 cross-sectional studies comparing 2 contemporaneous student populations with different start times, 18,19,23,24,26,[28][29][30][31][32] 7 prospective studies evaluating the effect of school start times within the same school populations, 8,17,20,21,[33][34][35] and 1 retrospective historical cohort study that compared outcomes in school populations of one geographical area separated by many years (and therefore different actual students). 36 Although most studies evaluated public school populations, two prospective studies evaluated the effect of school-start time changes on outcomes in a boarding school population.…”

Section: Evidence Basementioning

confidence: 99%

“…36 Although most studies evaluated public school populations, two prospective studies evaluated the effect of school-start time changes on outcomes in a boarding school population. 20,33 Among the eight cohort studies, seven evaluated the effect of changes to a later school start times 17,20,21,[33][34][35][36] and one evaluated the effect of changes to an earlier school start time in the same school. 8 Among the 18 studies, 12 provided comparisons between two conditions with different distinct school start times.…”

Section: Evidence Basementioning

confidence: 99%

“…Among these, 9 studies had the latest school start time at 08:30 or later. [17][18][19][20]24,28,[34][35][36] In three studies, the latest school start time was still prior to 08:30. 8,21,33 The median time difference between the two comparison conditions was 60 min (range, 20 to 85 min).…”

Section: Evidence Basementioning

confidence: 99%

“…TST, most often estimated by survey response, was recorded for school nights in 15 studies, 8,17,20,21,23,24,26,[28][29][30][31][32][33][34]36 and for nonschool nights in 10 studies. 8,20,21,24,26,[29][30][31]33,36 In general, later school start times were associated with longer TSTs on school nights, though in one prospective long-term evaluation the TST initially increased with a move toward later start times, but TSTs had returned to baseline at subsequent evaluation 9 mo after the change.…”

Section: Effect Of School Start Time On Total Sleep Time and Sleepinessmentioning

confidence: 99%

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High School Start Times and the Impact on High School Students: What We Know, and What We Hope to Learn

Morgenthaler

Hashmi

Croft

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: Several organizations have provided recommendations to ensure high school starts no sooner than 08:30. However, although there are plausible biological reasons to support such recommendations, published recommendations have been based largely on expert opinion and a few observational studies. We sought to perform a critical review of published evidence regarding the effect of high school start times on sleep and other relevant outcomes. Methods: We performed a broad literature search to identify 287 candidate publications for inclusion in our review, which focused on studies offering direct comparison of sleep time, academic or physical performance, behavioral health measures, or motor vehicular accidents in high school students. Where possible, outcomes were combined for meta-analysis. Results: After application of study criteria, only 18 studies were suitable for review. Eight studies were amenable to meta-analysis for some outcomes. We found that later school start times, particularly when compared with start times more than 60 min earlier, are associated with longer weekday sleep durations, lower weekday-weekend sleep duration differences, reduced vehicular accident rates, and reduced subjective daytime sleepiness. Improvement in academic performance and behavioral issues is less established. Conclusions:The literature regarding effect of school start time delays on important aspects of high school life suggests some salutary effects, but often the evidence is indirect, imprecise, or derived from cohorts of convenience, making the overall quality of evidence weak or very weak. This review highlights a need for higher-quality data upon which to base important and complex public health decisions. Keywords: high school, sleep start time, timing Citation: Morgenthaler TI, Hashmi S, Croft JB, Dort L, Heald JL, Mullington J. High school start times and the impact on high school students: what we know, and what we hope to learn.

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Section: Evidence Basementioning

confidence: 99%

Section: Evidence Basementioning

confidence: 99%

Section: Evidence Basementioning

confidence: 99%

Section: Effect Of School Start Time On Total Sleep Time and Sleepinessmentioning

confidence: 99%

See 2 more Smart Citations

High School Start Times and the Impact on High School Students: What We Know, and What We Hope to Learn

Morgenthaler

Hashmi

Croft

et al. 2016

Journal of Clinical Sleep Medicine

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“…However, longer sleep duration was evident only at 6 months. 40 Furthermore, a pilot study that examined the effect of a 30-minute delay to a high school start time reported that faculty and athletic coaches strongly opposed the SST change, Values are given as odds ratios (95% confidence intervals). † = unlikely is used as the reference.…”

Section: Barriers To Later School Start Times: Perception Versus Realitymentioning

confidence: 99%

Later School Start Times: What Informs Parent Support or Opposition?

Dunietz

Matos-Moreno

Singer

et al. 2017

Journal of Clinical Sleep Medicine

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Study Objectives: To investigate parental knowledge about adolescent sleep needs, and other beliefs that may inform their support for or objection to later school start times. Methods: In 2014, we conducted a cross-sectional, Internet-based survey of a nationally representative sample of parents as part of the C.S. Mott Children's Hospital National Poll on Children's Health. Parents with teens aged 13-17 years reported their children's sleep patterns and school schedules, and whether the parents supported later school start times (8:30 am or later). Responses associated with parental support of later school start times were examined with logistic regression analysis. Results: Overall, 88% of parents reported school start times before 8:30 am, and served as the analysis sample (n = 554). In this group, 51% expressed support for later school start times. Support was associated with current school start times before 7:30 am (odds ratio Educational efforts should also publicize the positive experiences of communities that have made this transition, with regard to limited adverse effect on afterschool activity schedules and transportation.[

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School start time delays and high school educational outcomes: Evidence from the START/LEARN study

James

Erickson

Lammert

et al. 2023

Journal of Adolescence

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Introduction: Delaying high school start times extends adolescents' nightly sleep, but it is less clear how it affects educational outcomes. We expect links between school start time delays and academic performance because getting enough sleep is a key input to the cognitive, health, and behavioral factors necessary for educational success. Thus, we evaluated how educational outcomes changed in the 2 years following a school start time delay. Methods: We analyzed 2153 adolescents (51% male, 49% female; mean age 15 at baseline) from START/LEARN, a cohort study of high school students in the Minneapolis-St. Paul, MN, USA metropolitan area. Adolescents experienced either a school start time delay ("policy change schools") or consistently early school start times ("comparison schools"). We compared patterns of late arrivals, absences, behavior referrals, and grade point average (GPA) 1 year before (baseline, 2015-2016) and 2 years after (follow-up 1, 2016-2017 and follow-up 2, 2017-2018) the policy change using a difference-in-differences analysis. Results: A school start time delay of 50-65 min led to three fewer late arrivals, one fewer absence, a 14% lower probability of behavior referral, and 0.07-0.17 higher GPA in policy change schools versus comparison schools. Effects were larger in the 2nd year of follow-up than in the 1st year of follow-up, and differences in absences and GPA emerged in the second year of follow-up only. Conclusions: Delaying high school start times is a promising policy intervention not only for improving sleep and health but for improving adolescents' performance in school.K E Y W O R D S attendance, behavior, grade point average, late arrivals, school start time, sleep | INTRODUCTIONAdolescents must get an adequate amount of high-quality sleep to function at their best (Beebe, 2011;Shochat et al., 2014). However, 73% of adolescents in the United States do not get enough sleep (Wheaton et al., 2018). High rates of inadequate sleep in adolescence are produced by a "perfect storm" of biological, psychosocial, and contextual factors that intersect in adolescence (Carskadon, 2011;Crowley et al., 2018). Biologically, circadian delays (Crowley et al., 2007) and delayed sleep pressure accumulation (Jenni et al., 2005) push adolescents to feel ready for sleep at later hours than younger children or adults. At the same time, adolescents are gaining autonomy over their own schedules, face increasing educational demands, and have more social interactions than younger children (Crowley et al., 2018). These pressures toward later bedtimes combine with early secondary school start times to curtail adolescents' nightly sleep for much of the calendar year. Thus, delaying school start times has been identified as an effective policy change that can extend adolescent sleep and improve

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Longitudinal Outcomes of Start Time Delay on Sleep, Behavior, and Achievement in High School

Abstract: A commentary on this article appears in this issue on page 267.

Cited by 82 publications

References 37 publications

High School Start Times and the Impact on High School Students: What We Know, and What We Hope to Learn

High School Start Times and the Impact on High School Students: What We Know, and What We Hope to Learn

Later School Start Times: What Informs Parent Support or Opposition?

School start time delays and high school educational outcomes: Evidence from the START/LEARN study

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