April 21, 2017
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AASM: Delaying school start time benefits student health

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Communities should implement start times of 8:30 a.m. or later for middle school and high schools to optimize daytime alertness, reduce tardiness and support peak academic performance, according to a position paper by the American Academy of Sleep Medicine, published in Journal of Clinical Sleep Medicine.

“Healthy sleep of adequate duration is key to adolescent mental and physical health. It is also crucial to their ability to be focused in school and maximize their learning opportunities,” lead author Nathaniel F. Watson, MD, MS, past president of the American Academy of Sleep Medicine (AASM), and co-director of the Medicine Sleep Center at the University of Washington, told Healio Family Medicine. “If we can collectively enact societal change to improve the potential for our children, then since our children are the future, we are increasing the potential for our collective future.”

Nathaniel Watson
Nathaniel F. Watson

Although the AASM recommends adolescents sleep 8 to 10 hours a night on a regular basis, CDC data show that 68.4% of high school students report sleeping 7 hours or less on school nights.

Early middle school and high school start times negatively affect adolescent circadian physiology, shortening students’ sleep and resulting in chronic sleep loss. Previous research shows that among teenagers, insufficient sleep is associated with poor school performance, increased risk for motor vehicle accidents, obesity, metabolic dysfunction and cardiovascular morbidity, increased depressive symptoms, suicidal thoughts, risk-taking behaviors and athletic injuries. 

Because adequate sleep duration is vital, AASM asserts in its position statement that middle and high school start time should be delayed to 8:30 a.m. or later to support: opportunities for adolescents to get enough sleep on school nights; driving safety; alertness to facilitate top academic performance; increased engagement in class activities; reduced tardiness and absences attributed to tiredness; and adolescent mental health and psychological well-being.

To further ensure optimal student performance, AASM also encourages maintenance of good sleep quality, appropriate timing and regularity of sleep, effective treatment of sleep disorders and avoidance of sleep-disruptive electronic devices near bedtime or during the night.

To help their adolescent patients get the sleep necessary to perform at their best both in and out of school, PCPs should help spread awareness of AASM’s position, Watson said.

“[PCPs can] ask their pediatric patients about their sleep habits and encourage them to get 8 to 10 hours of sleep nightly, and also educate them and their parents about their changing circadian rhythms as they age,” Watson said. “They can also attend school board meetings and support the community as they attempt to get districtwide morning bell times to be 8:30 a.m. or later.” – by Savannah Demko

Disclosure: Watson serves on the board of directors of the AASM.