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High school start times after 8:30 am are associated with later wake times and longer time in bed among teens in a national urban cohort study

Published:October 16, 2017DOI:https://doi.org/10.1016/j.sleh.2017.09.004

      Abstract

      Objectives

      High school start times are a key contributor to insufficient sleep. This study investigated associations of high school start times with bedtime, wake time, and time in bed among urban teenagers.

      Design

      Daily-diary study nested within the prospective Fragile Families and Child Wellbeing Study.

      Setting

      Twenty US cities.

      Participants

      Four hundred thirteen teenagers who completed ≥1 daily diary report on a school day.

      Measurements

      Participating teens were asked to complete daily diaries for 7 consecutive days. School-day daily diaries (3.8 ± 1.6 entries per person) were used in analyses (N = 1555 school days). High school start time, the main predictor, was categorized as 7:00-7:29 am (15%), 7:30-7:59 am (22%), 8:00-8:29 am (35%), and 8:30 am or later (28%). Multilevel modeling examined the associations of school start times with bedtime, wake time, and time in bed. Models adjusted for age, sex, race/ethnicity, household income, caregiver's education, and school type.

      Results

      Teens with the earliest high school start times (7:00-7:29 am) obtained 46 minutes less time in bed on average compared with teens with high school start times at 8:30 am or later (P < .001). Teens exhibited a dose-response relationship between earlier school start times and shorter time in bed, primarily due to earlier wake times (P < .05). Start times after 8:30 am were associated with increased time in bed, extending morning sleep by 27-57 minutes (P < .05) when compared with teens with earlier school start times.

      Conclusion

      Later school start times are associated with later wake times in our large, diverse sample. Teens starting school at 8:30 am or later are the only group with an average time in bed permitting 8 hours of sleep, the minimum recommended by expert consensus for health and well-being.

      Keywords

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      References

        • Kann L.
        • McManus T.
        • Harris W.A.
        • et al.
        Youth risk behavior surveillance—United States, 2015.
        MMWR Surveill Summ. 2016; 65: 1-174
        • Paruthi S.
        • Brooks L.J.
        • D'Ambrosio C.
        • et al.
        Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine.
        J Clin Sleep Med. 2016; 12: 785-786
        • Hirshkowitz M.
        • Whiton K.
        • Albert S.M.
        • et al.
        National Sleep Foundation's sleep time duration recommendations: methodology and results summary.
        Sleep Health. 2015; 1: 40-43
        • Carskadon M.A.
        • Acebo C.
        • Jenni O.G.
        Regulation of adolescent sleep: implications for behavior.
        Ann N Y Acad Sci. 2004; 1021: 276-291
        • Carskadon M.A.
        • Acebo C.
        • Richardson G.S.
        • Tate B.A.
        • Seifer R.
        An approach to studying circadian rhythms of adolescent humans.
        J Biol Rhythms. 1997; 12: 278-289
        • Carskadon M.A.
        • Vieira C.
        • Acebo C.
        Association between puberty and delayed phase preference.
        Sleep. 1993; 16: 258-262
        • Crowley S.J.
        • Acebo C.
        • Carskadon M.A.
        Sleep, circadian rhythms, and delayed phase in adolescence.
        Sleep Med. 2007; 8: 602-612
        • Owens J.A.
        • Belon K.
        • Moss P.
        Impact of delaying school start time on adolescent sleep, mood, and behavior.
        Arch Pediatr Adolesc Med. 2010; 164: 608-614
        • Sadeh A.
        • Gruber R.
        • Raviv A.
        The effects of sleep restriction and extension on school-age children: what a difference an hour makes.
        Child Dev. 2003; 74: 444-455
        • Taras H.
        • Potts-Datema W.
        Sleep and student performance at school.
        J Sch Health. 2005; 75: 248-254
        • Dahl R.E.
        Sleep, learning, and the developing brain: early-to-bed as a healthy and wise choice for school aged children.
        Sleep. 2005; 28: 1498-1499
        • Wheaton A.G.
        • Olsen E.O.
        • Miller G.F.
        • Croft J.B.
        Sleep duration and injury-related risk behaviors among high school students—United States, 2007-2013.
        MMWR Morb Mortal Wkly Rep. 2016; 65: 337-341
        • Danner F.
        • Phillips B.
        Adolescent sleep, school start times, and teen motor vehicle crashes.
        J Clin Sleep Med. 2008; 4: 533-535
        • Group ASW
        • Adolescence Co
        • Health CoS
        School Start Times for Adolescents.
        Pediatrics. 2014; 134: 642-649
        • Reichman N.E.
        • Teitler J.O.
        • Garfinkel I.
        • McLanahan S.S.
        Fragile families: sample and design.
        Child Youth Serv Rev. 2001; 23: 303-326
        • Hale L.
        Who Has time to sleep?.
        J Public Health (Oxf). 2005; 27: 205-211
        • Stamatakis K.A.
        • Kaplan G.A.
        • Roberts R.E.
        Short sleep duration across income, education, and race/ethnic groups: population prevalence and growing disparities during 34 years of follow-up.
        Ann Epidemiol. 2007; 17: 948-955
        • Paksarian D.
        • Rudolph K.E.
        • He J.P.
        • Merikangas K.R.
        School start time and adolescent sleep patterns: results from the U.S. National Comorbidity Survey—adolescent supplement.
        Am J Public Health. 2015; 105: 1351-1357
        • Knutson K.L.
        • Lauderdale D.S.
        Sociodemographic and behavioral predictors of bed time and wake time among US adolescents aged 15 to 17 Years.
        J Pediatr. 2008;
        • Barnes M.
        • Davis K.
        • Mancini M.
        • Ruffin J.
        • Simpson T.
        • Casazza K.
        Setting adolescents up for success: promoting a policy to delay high school start times.
        J Sch Health. 2016; 86: 552-557
        • Hansen M.
        • Janssen I.
        • Schiff A.
        • Zee P.C.
        • Dubocovich M.L.
        The impact of school daily schedule on adolescent Sleep.
        Pediatrics. 2005; 115: 1555-1561
        • Crowley S.J.
        • Acebo C.
        • Fallone G.
        • Carskadon M.A.
        Estimating dim light melatonin onset (Dlmo) phase in adolescents using summer or school-year sleep/wake schedules.
        Sleep. 2006; 29: 1632-1641
        • Rognvaldsdottir V.
        • Gudmundsdottir S.L.
        • Brychta R.J.
        • et al.
        Sleep deficiency on school days in Icelandic youth, as assessed by wrist accelerometry.
        Sleep Med. 2017; 33: 103-108
        • Carskadon M.A.
        • Acebo C.
        • Seifer R.
        Extended nights, sleep loss, and recovery sleep in adolescents.
        Arch Ital Biol. 2001; 139: 301-312
        • Olds T.
        • Blunden S.
        • Petkov J.
        • Forchino F.
        The relationships between sex, age, geography and time in bed in adolescents: a meta-analysis of data from 23 countries.
        Sleep Med Rev. 2010; 14: 371-378
        • Lufi D.
        • Tzischinsky O.
        • Hadar S.
        Delaying school starting time by one hour: some effects on attention levels in adolescents.
        J Clin Sleep Med. 2011; 7: 137-143
        • Wheaton A.G.
        • Ferro G.A.
        • Croft J.B.
        School start times for middle school and high school students—United States, 2011-12 school year.
        MMWR Morb Mortal Wkly Rep. 2015; 64: 809-813
        • Carskadon M.A.
        • Acebo C.
        Regulation of sleepiness in adolescents: update, insights, and speculation.
        Sleep. 2002; 25: 453-460
        • Troxel W.M.
        • Lee L.
        • Hall M.
        • Matthews K.A.
        Single-parent family structure and sleep problems in black and white adolescents.
        Sleep Med. 2014; 15: 255-261
        • Bolger N.
        • Davis A.
        • Rafaeli E.
        Diary methods: capturing life as it is lived.
        Annu Rev Psychol. 2003; 54: 579-616
        • Lee S.
        • Almeida D.M.
        Daily diary design.
        in: Whitbourne S.K. Encyclopedia of Adulthood and Aging. Wiley-Blackwell, Oxford, UK2016: 297-300
        • Libman E.
        • Fichten C.S.
        • Bailes S.
        • Amsel R.
        Sleep questionnaire versus sleep diary: which measure is Better?.
        Int J Rehab Health. 2000; 5: 205-209
        • Wahlstrom K.
        • Dretzke B.
        • Gordon M.
        • Peterson K.
        • Edwards K.
        • Gdula J.
        Examining the Impact of Later School Start Times on the Health and Academic Performance of High School Students: A Multi-Site Study.
        University of Minnesota, St. Paul, MN2014
        • Winsler A.
        • Deutsch A.
        • Vorona R.D.
        • Payne P.A.
        • Szklo-Coxe M.
        Sleepless in Fairfax: the difference one more hour of sleep can make for teen hopelessness, suicidal ideation, and substance use.
        J Youth Adolesc. 2015; 44: 362-378
        • Hale L.
        • Emanuele E.
        • James S.
        Recent updates in the social and environmental determinants of sleep health.
        Curr Sleep Med Rep. 2015; 1: 212-217
        • Hale L.
        • Berger L.M.
        • LeBourgeois M.K.
        • Brooks-Gunn J.
        Social and demographic predictors of preschoolers' bedtime routines.
        J Dev Behav Pediatr. 2009; 30: 394-402
        • Podsakoff P.M.
        • MacKenzie S.B.
        • Lee J.Y.
        • Podsakoff N.P.
        Common method biases in behavioral research: a critical review of the literature and recommended remedies.
        J Appl Psychol. 2003; 88: 879-903