Teen Sleep and the Case for Later School Start Times

(Note: Between 2017 – 2020, the Healthy Teen Minds initiative worked to raise awareness about teen sleep and build community will for pushing back school start times. While this strategy was sidelined due to the pandemic in 2020, The Connection has documented this effort, along  with data, research and resources.) 

Fox Valley teens are sleep deprived, and the negative impact on their physical and mental health is staggering. More than two-thirds (70%) of local teens receive less than eight hours of sleep, putting them at greater risk for mental health challenges, among a host of other negative consequences.

“This is much more serious than teens yawning in class or falling asleep while doing their homework,” says Dr. Mark Rovick, a pediatric psychiatrist with Catalpa Health in Appleton, Wis. “This has long-term and potentially fatal consequences for our kids.”

Insufficient sleep in teens is associated with poorer grades, poorer athletic performance, reduced problem-solving, irritability, increased violence, substance use, anxiety, depression and suicidal ideation and attempting.  More than 60 studies have found correlations between chronic insufficient sleep and suicide.

“Every day, I talk to parents and families about the importance of sleep,” said Rovick. “Because if I can do nothing else, if you are allergic to every medicine I prescribe, if I can help you with your sleep, you are going to do better.”

Dr. Rovick was the featured speaker for The Connection’s “Dream On: Teen Need Zzz’s” public health campaign, which was launched in May 2017 as part of the Healthy Teen Minds Initiative. This public health epidemic came to light in 2016, after the Healthy Teen Minds initiative was launched to research, develop and implement public health strategies to improve the mental health of teens in the tri-county region (Calumet, Outagamie and Winnebago counties). Local Youth Risk Behavior Survey (YRBS) data reveled that two-thirds of high school students in grades 9 – 12 reported sleeping less than eight hours on an average school night. Teens need a 8 – 9 hours of sleep per night for optimal health. (Click here to see Dr. Rovick’s presentation on teen sleep.)

Teens who get the least amount of sleep have much higher rates of depression. Fourteen percent of tri-county high schoolers get five hours of sleep or less, and nearly half (49%) of them report feeling depressed, according to 2021 YRBS data for the tri-counties.  Half of all students (50%) reported receiving 6 to 7 hours of sleep, with 27% of them reporting feeling depressed (sad and hopeless). Less than a third, 29.9% of local teens get eight hours of sleep or more and report lower rates of depression – 17 percent. (Click here for a Tri-County Teen Sleep Fact Sheet.)

The goal of the “Teens Need Zzz’s” campaign was to raise awareness about the critical importance of adequate sleep for teen mental health; educate and support schools to incorporate “sleep hygiene” education into their health curriculum; and build momentum for a “start school later campaign.” For more than a decade, sleep experts and medical organizations have been sounding the alarm on teen sleep epidemic. The American Medical Association, Centers for Disease Control, the American Academy of Pediatrics, and a host of other medical and health organizations, recommend that middle and high schools start no earlier than 8:30 a.m.

The Solution: Start School Later

There’s a simple reason why students have a difficult time getting enough sleep – basic biology. During puberty, the circadian rhythm—the body’s internal clock—shifts forward, making teens naturally feel sleepy later in the evening (around 11 p.m.) and want to wake up later in the morning.

There is also a delay in the release of melatonin, the hormone that promotes sleep. For teens, melatonin is secreted later in the evening compared to children and adults, reinforcing their tendency to stay up later. Waking up a teenager at 6 a.m. is the biological equivalent of waking up an adult at 4 a.m. Yet, nearly all high schools in the tri-county region, like a majority of high schools across the country, start school before 8:30 a.m., necessitating early wake-up times.

School districts that have pushed back school start times have produced a large body of evidence demonstrating the benefits:  Improvements in attendance, school performance, graduation rates, and decreased rates of anxiety, depression, and car crashes, for example.

As the eight-year Healthy Teen Minds initiative evolved, the project team convened a work group in 2019 of local school administrators to explore the feasibility of hosting a “start school later” workshop, to learn from other school districts that had pushed back school start times, and consider a feasibility study. Local school leaders, while acknowledging and understanding the science supporting later school start times, reported that their districts were overextended by other demands and priorities. When the Covid-19 pandemic hit in early 2020, this strategy was shelved as school districts were stressed and stretched to accommodate virtual learning.

To date, two states, California and Florida, have mandated that high schools must start no earlier than 8:30 a.m. California’s law took effect in 2022, while Florida’s will be implemented by 2026. Other states, meanwhile, are exploring similar changes and bills have been introduced in at least 25 states, with some advancing studies on the feasibility of later start times. More than 1,000 school districts nationwide have  individually adjusted schedules to meet the 8:30 a.m. recommendation. However, logistical challenges, such as bus schedules and extracurricular timing, have slowed broader adoption in other regions.

“When we launched the Healthy Teen Minds initiative, we set an ambitious goal to build community will for later school start times, knowing that improving teen sleep would have a significant impact on reducing our rates of teen depression and suicide-related behaviors,” said Wendy Harris, Healthy Teen Minds Project Coordinator.  “But then, of course, the pandemic hit, and schools had no capacity to take this on. We instead focused on our efforts on supporting schools in their implementation of Sources of Strength, which became our dominant strategy to improve teen mental health.” (Click here to read about that strategy.)

What are the effects of teens not getting enough sleep each night? 

• Anxiety, depression, suicide (over 60 studies have linked poor sleep and suicide)
• Poorer attention and poorer problem solving
• Poorer academic performance, increased grade failure
• Poorer impulse control and low frustration tolerance
• Increased risk-taking, increased drug use, and riskier sexual activities
• Increased school violence and bullying
• Decreased immune functioning
• Changes in hormones that regulate appetite, and increased obesity
• Poorer food choices (more junk food; fewer fruits and vegetables)
• Increased insulin resistance (which increases risk of diabetes)
• Increased automobile accidents (by up to 70%)
• Increased sports injuries (by up to 68%)
   

There’s overwhelming evidence that later school start times: 

• Reduce depression, anxiety and suicidal thoughts and behaviors
• Improve academic performance and the likelihood of future success
• Reduce tardiness, truancy, dropout rates and delinquency
• Improve alertness, memory, attention and cognitive processing skills
• Improve athletic performance and help prevent sports-related injuries
• Reduce the risk of obesity, eating disorders and diabetes
• Improve health, mood and immunity
• Reduce the rates of car crashes, substance abuse and other high-risk
  behaviors (especially during unsupervised afternoon hours