By Liz Welter

Appleton Post-Crescent

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OSHKOSH – Last year, Natalie Jackson began her days at Oshkosh West High School with a 5:30 a.m. wake-up call — though some days it was 5 a.m.

Jackson, then a junior, had a “zero hour” class, which in Oshkosh meant a start time of 7:30 a.m. instead of 8:23 a.m.

At one point, after she injured her knee and needed a ride to school from her mom, Jackson had to be up by 4:30 a.m. Her mom left for work at 6 a.m. and would drop her off at school.

Jackson said the early starts took a toll on her mental health, exacerbating her struggles with anxiety and depression.

“I would almost be in a panic from staying up late doing homework, then starting early and being stressed to be in early to take a class,” she said.

Jackson is one of many high school students across Wisconsin waking up before dawn to get to school. And she is far from the only teen for whom early mornings can translate into real mental health effects. It’s one reason doctors and public health organizations say early school start times are bad for teenagers.

There is a biological reason teenagers struggle with early mornings — it’s not that teens are inherently lazy or prone to staying up texting until 1 a.m.

Teens’ brains change as they move from puberty to adolescence. They need more sleep than adults, and they may need to sleep later than they did as younger kids.

Due to what are called circadian rhythms, teenagers have a hard time getting to sleep before 11 p.m., according to the American Academy of Pediatrics, and they need at least 8.5 to 9.5 hours of sleep per night.

Sleep-deprived teens have difficulty learning and staying healthy. Adolescents who don’t get enough sleep are at higher risk for being overweight or depressed, and more likely to use tobacco, alcohol or illegal drugs, according to multiple studies, including reports by the U.S. Centers for Disease Control and Prevention.

In 2014, the American Academy of Pediatrics published its recommendation that high schools start classes at 8:30 a.m. or later. Citing that study and a pool of data from the U.S. Department of Education, the CDC followed up in 2015 with its own finding that only about 18 percent of public schools in the nation follow that recommendation. 

In a survey of 55 Wisconsin high schools, USA TODAY NETWORK-Wisconsin reporters found that 78 percent of schools start classes before 8 a.m. Only four schools out of those surveyed across the Milwaukee area, the Fox Valley and central Wisconsin start classes at 8:30 a.m. or later as recommended by the CDC.

Natalie Jackson listens to Mikayla Heath during mock trial club at Oshkosh West High School, February 8, 2018.

In part, that’s because changes to school schedules mean a cascade of effects for school districts, from bus schedules to teachers’ work days to, potentially, janitorial contracts and other operations questions. It can also be hard to get residents and school board members to buy into the idea that a later start time is really a benefit to students.

For Jackson, now a senior, the solution was to forgo her district’s optional “zero hour” early classes, meaning her school day could start at 8:23 a.m. The problem now: She’s still involved in extracurricular activities, including a mock trial club that meets at 6:45 a.m.

‘I have the energy to work harder’

One Wisconsin district that made a change in response to concerns about students’ health is Shorewood, where Shorewood High School in 2015 changed its start time from 7:30 a.m. to 8:05 a.m.

“It made a huge difference,” said Nadia Conner, 18, a senior who contended with the earlier start time in her first year of high school. “It’s only 30 minutes, but I have the energy to work harder.”

Shorewood High School senior Nadia Conner, 18, from Milwaukee. Conner discussed how the school’s move from early start times to later start times has impacted their learning and mood in a positive way. 

A committee of staff, students, parents and school board members spent three years working out the details before the start time was pushed back. Shorewood Principal Tim Kenney said the science on high school start times is clear, but the process of making that 35-minute change was complicated. He said students report that it has made their lives and learning easier.

Among the hundreds of studies related to teenagers’ sleep and their education, the research shows a pronounced link to teen mental health.

A 2016 study published by the Journal of Clinical Sleep Medicine found that getting less than eight to 10 hours of sleep per night for teens “is associated with increased risk of self-harm, suicidal thoughts and suicide attempts.”

Wendy Magas, director of Healthy Teen Minds, an initiative of the N.E.W. Mental Health Connection based in the Fox Valley region, considers pushing schools for later start times to be part of standing up for teens’ mental health.

It’s also, Magas argues, a way of looking at structural factors affecting youth mental health, not just treating symptoms.

“The analogy we use is that when lots of frogs are getting sick, you don’t just treat the frogs,” Magas said. “You study the pond to figure out what’s wrong with the water.” 

Data from the 2015-16 Youth Risk Behavioral Studies for the three counties N.E.W. serves underscores the point. Teenagers who get five or fewer hours of sleep, according to the study, have the highest rate of depression. Those who get eight or more hours of sleep are least likely to be depressed.

Of more than 9,000 students who participated in the study, 18 percent got five or fewer hours of sleep. Those students had the highest rates of depression — 54 percent. Only 30 percent of the students got at least eight hours of sleep per night; among that group only 14 percent reported depression.

“When teenagers are sleep deprived, they make poor choices and poor decisions, but the greatest impact is on mental health,” Magas said.

The Healthy Teen Minds project is in the early stages of developing a public awareness campaign about teenagers and sleep. Healthy Teen Minds is an eight-year, $1.2 million project funded by the Medical College of Wisconsin’s Advancing a Healthier Wisconsin Endowment. It’s a project of the N.E.W. Mental Health Connection, an initiative to improve community mental health in the Fox Valley region, including Calumet, Outagamie and Winnebago counties.

“We are hoping in the years to come, we can build enough community will to launch a start-school-later campaign,” Magas said. “But the support to do this will have to come from the community.”

Some (adults) resist later starts

In 2009, Dolores Skowronek thought her plan to implement a later start time at Greenfield High School in Milwaukee County would take six months to complete. At the time, her sons were adolescents and the high school started at 7:10 a.m.

Skowronek, who is a librarian at a college and the liaison to the college’s nursing program, had amassed piles of studies showing the correlation between school start times and students’ success and health.

When the local school board questioned her studies during the first meeting she went to in 2009, Skowronek was surprised by the skepticism.

“This took three years for change to happen,” Skowronek said. “I went to many school board meetings, and there was an ad hoc committee to study the issue.”

In the end, Greenfield High School moved its starting time from 7:10 a.m. to 7:30 a.m. — still a full hour earlier than experts recommend.

“Ideally 8 a.m. would have been good and 8:30 a.m. even better, but there were a lot of changes to make to start just 20 minutes later,” she said.

Skowronek said school board members balked, and so did parents, some of whom saw the change as coddling young people. Another impediment was bus officials whose logistics plans were built around the earlier start times.

“Changing the time school starts might sound like an easy way to help our kids succeed, but there’s a lot of factors to consider,” said Kari Oakes of Middleton, a health professional who is one of the founders of a national campaign, Start School Later. The campaign’s goal is to increase public awareness about the relationship between sleep and school hours.

To be successful, a campaign to change a school start time needs support from parents, transportation companies and directors of athletics and after-school programs.

“If you don’t have community support, you won’t get far,” Oakes said.

For Kenney, the Shorewood principal who is also the parent of two teenagers and one on the cusp of adolescence, the key is to for adults to have empathy for young people.

“Anyone who has been sleep deprived knows what it feels like trying to stay focused,” Kenney said. “And I also understand it is tough to wake teenagers up in the morning and then equally tough to get them in bed at night.”

Kenney was able to change the start time because Shorewood is a small community that has no busing. The time missed by starting school later is recouped through students forgoing a half day off every Wednesday, which had been used for teacher preparation and team or collaboration meetings.

Like the great majority of Wisconsin schools surveyed, Shorewood’s 8:05 a.m. start time still falls short of CDC recommendations.

“If I could,” Kenney said. “I would have changed the start to 8:30 a.m. or 9 a.m. But that would be difficult.”