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Illinois School Board Journal
November/December 2001

Seeing teen sleep in a new perspective

by Natalie Beck

Look around a high school classroom — especially during first hour or after lunch — and you’re likely to see a student’s head nod sleepily and then maybe jerk back to attention. More and more, an alarming number of students report they have trouble staying awake in class. Some say they actually fall asleep in class at least twice a week.

This could be partly the result of high schools nudging start times earlier and earlier and students trying to cram extracurricular activities into already demanding class schedules. But researchers say this is also the result of changes in sleep patterns that occur during puberty — changes teens can’t control.

Researchers are finding that internal clocks of developing adolescent bodies encourage a later bedtime and later waking time. Thus, parents insisting on an earlier bedtime may not be the correct answer to the sleepy student dilemma. But the answer may lie with a combination of starting school a little later in the day and allowing teens to catch up on their sleep during the weekend.

However the dilemma is resolved, greater awareness and understanding of sleep research can help everyone involved see the issue of sleep from a different perspective.

"Society needs to elevate sleep to the level of exercise and nutrition as far as the impact it can have on one’s life," according to Patricia A. Britz, program director for the National Sleep Foundation.

Along with researchers and educators throughout the United States, NSF is working to awaken society’s awareness of the impact sleep — and sleep deprivation — can have on students, families and communities.

Adolescent sleep researcher Mary A. Carskadon believes that insufficient sleep in teens and young adults is linked to low grades and poor school performance, negative moods and the increased likelihood of stimulant use, such as caffeine, nicotine, alcohol and similar substances. It can even contribute to an increased risk of unintentional injuries and death.

Carskadon’s research has identified several changes in sleep patterns, sleep/wake systems and circadian timing systems (rhythms of approximately 24-hour intervals that influence when and how much we sleep) associated with puberty. These changes can contribute to excessive sleepiness, which negatively impacts daytime functioning in adolescents.

Carskadon has found that in middle adolescence, waking times become earlier during the week, due largely to school starting times. High school starting times, which typically are earlier than those of middle and elementary schools, have moved to even earlier hours in recent years. Many begin at or before 7:30 a.m., due to the timing and availability of school buses.

Thus, while their need for sleep remains unchanged, adolescents are spending less time sleeping, and alterations in their sleep schedules during the week, compared with those on the weekend, are becoming more pronounced. This is in sharp contrast to the stable pattern of sleep found in younger children, who get the same amount of sleep during the week as on weekends — an average of 10 hours a night.

Patricia W. Mercer, a psychologist with the Sleep Medicine Center at Children’s Memorial Hospital in Chicago, said many students are being roused to go to school when their circadian level is lowest.

"The body clock is hard wired and governed by light," Mercer said. "It is not something that the students can do anything about. They are getting on a bus when it is dark and going into a school building before it is starting to get light out. Everyone is loading more into a 24-hour day, and this way of thinking has filtered right down to the students."

While conducting studies with ninth-grade students in Chicago health classes, Mercer found that 30 percent of students surveyed have trouble staying awake at least two times a week during morning classes. Another 25 percent said they have trouble staying awake in the afternoon at school, and 14 percent of the students said they actually fall asleep in class two times per week.

"We found that most of the students were rising at 6 a.m. to get to school. At that time, teenagers are very close to their 24-hour circadian low. This is as sluggish as they are ever going to be, and we are putting them into first-hour classes, such as pre-calculus, at their lowest level (of functioning). Young people will do better in school if they can sleep a little longer."

Britz suggested several positive ways school systems can influence adolescent sleep patterns and develop sleep-friendly policies to combat the sleepiness students may experience. Suggestions include educating teachers, parents, school health providers and other personnel, as well as teens, about adolescent sleep needs and patterns, and signs of sleep deprivation, including decreased alertness.

Mercer stressed that parents and educators must recognize that while excessive sleepiness during the day can be an indication of an underlying biological sleep disorder, often the youth are just sleeping at the wrong time.

"I advise parents to lobby superintendents and teachers to review the literature on school start times," she said. "The average parent needs to learn to let their children catch up on their sleep. All week long they are sleeping about two hours less than they need, so by the weekend, they are 10 hours behind."

Mercer pointed out, however, that some sleep disturbances are truly sleep disorders, which require examination by a qualified sleep specialist. More than any other medical condition, sleep disorders respond to treatment very well once they are diagnosed.

"Most conditions can be substantially modified once you diagnose the problem with a sleep study or clinical visit," Mercer said. "It is a real disaster for sleep problems to go untreated and for students to attend classes when they are half asleep. They just can’t function at that level."

Britz said the Washington, D.C.-based National Sleep Foundation maintains a database of schools in 19 states that have implemented later start times as a behavior modification to relieve the symptoms of sleepiness in their student population. Many of the schools are willing to share their experiences with those who may be considering the formulation of sleep-friendly policies.

"We have come up with tips and have pulled together strategies from schools that have changed to later start times," Britz said. "Changing times can open up a whole can of worms regarding economic, social and scheduling issues, and ideally we want to make as much research and information available as possible."

One Illinois district that has already responded to the adolescent sleep research is Rockford Public Schools District 205, which last year implemented a start time of 8:45 a.m. for their middle school population of 6,000.

Rockford Middle School teachers are reporting their sixth, seventh and eighth grade students are more alert and engaged in their academic work, and that attendance figures are on the rise compared to when the school bells rang at 7:30 a.m.

"Teachers and principals are finding the later start time provides a more positive and relaxed atmosphere," said Alan S. Brown, Rockford’s superintendent. "The attendance data is hard core, and we are pleased with the short-term results. The Middle School attendance percentages were up 3 to 4 percent last year."

And although Rockford has collected just one year of its own data, other districts also are finding a correlation between later start times and increased attendance figures.

During the 1996-97 school year in Edina, Minnesota, the high school day shifted from a 7:20 a.m. start to 8:30 a.m. In the following school year, the Minneapolis public school system changed the starting time from 7:15 a.m. to 8:40 a.m. at seven of its high schools.

Kyla Wahlstrom of the University of Minnesota researched the changes in Minneapolis and earlier in the suburb of Edina. She found that attendance and continuous enrollment of students in Minneapolis schools since the start times were changed have improved significantly. During the 1995-96 school year, 83 percent of ninth-grade Minneapolis students attended classes daily. But Wahlstrom found that by 1999-2000, ninth-grade attendance had increased to 87 percent.

Collecting and studying available research have been the keys to success for districts and schools that have implemented later start times. Debra Dimke, a Rockford area superintendent, said sharing the information with principals, teachers, parents and students in focus groups made the transition smoother.

"We began focus groups to discuss the research," Dimke said. "In the beginning we had mixed reviews, but through increased discussion and by providing educational literature, we found several articles and studies that supported the later start time. We saw this as an intervention on behalf of our students, and the data convinced the critical mass of people."

In NSF’s Adolescent Sleep Needs and Patterns report, school districts are provided with a list of potential issues that should be addressed before later school times are adopted. The study acknowledges that communities can vary greatly in their priorities and values, and that adopting a policy of later start times in schools might not be optimal for every community or even for every school within a community.

The study suggests the following areas of consideration:

1. Transportation services. Will schedule changes result in the need for additional school buses? Are there enough available drivers and parking spaces for school bus drivers? How will the change affect the timing of school buses on commuter traffic? What will the impact of the school bus schedule have on the availability of transportation for extracurricular activities?

2. Athletic programs and other extracurricular activities. When will athletic programs and extracurricular activities be held? How will students get home from events? Will outdoor athletic programs be impacted by the shortened period of daylight after the school day ends? Will the later school start time impact sports events held with schools on different time schedules?

3. Use of school for community activities. Will community group meetings, adult education, religious programs or other activities be impacted?

4. School food service. Will meal times need to be changed? Will breakfast service need to be added? Do other community programs, such as childcare programs, use the facilities? Are food service workers available to work at later times?

5. Bell schedules of elementary and middle schools. Some districts have found that switching times with the elementary schools is the least cumbersome in terms of school system resources (and more in line with sleep patterns of both groups).

Other discussion points include after-school employment, safety issues related to daylight and darkness, the amount of time that adolescents are unsupervised after school and the impact on the family. According to Dimke and Brown, the Rockford district’s planning sessions and focus groups addressed these types of issues on their journey to providing the best educational setting possible for their students.

"We have significant after-school programs, and we worked with coaches, sponsors and parents to make the transition," Dimke said. "We also added an activity bus to be sure students were able to get home."

Brown said the key was the open forum of communication with the community and staff, and the constant and ongoing evaluation of the impact of the later start times.

"You cannot do something like this in a vacuum," Brown said. "You can’t do something this significant without support. The school district has to do its homework and include staff and parents in the learning process. That is critical."

Graham, Mary G. "Sleep needs, patterns and difficulties of adolescents: Summary of a workshop; Forum on Adolescence, Washington, D.C., National Academy Press, 2000

Adolescent Sleep Needs and Patterns: Research Report and Resource Guide, National Sleep Foundation. (www.sleepfoundation.org)

Kaufman, Marc. "Later School Start Benefits Teens, Study Concludes," The Washington Post, August 29, 2001

Black, Susan. "Sleep Tight," American School Board Journal, pp.42-44, 54, March 2000

Carksadon, Mary, et al. "Adolescent Sleep Patters, Circadian Timing, and Sleepiness at a Transition to Early School Days." Sleep-Journal of Sleep and Sleep Disorders Research, Dec. 15, 1998.

Carskadon, Mary A. "When Worlds Collide: Adolescent need for sleep versus societal demands," Phi Delta Kappan, pp. 348-353, January 1999

Dahl, Ronald E. "The Consequences of Insufficient Sleep for Adolescents: Links between sleep and emotional regulation," Phi Delta Kappan, pp. 354-359, January 1999

Kubow, Patricia K., Wahlstrom, Kyla L. and Bemis, Amy E. "Starting Time and School Life Reflections from Educators and Students," Phi Delta Kappan, pp. 366-371, January 1999

Wahlstrom, Kyla L. "The Prickly Politics of School Starting Times," Phi Delta Kappan, pp. 345-347, January 1999

Wrobel, Gordon D. "The Impact of School Starting Time On Family Life," Phi Delta Kappan, pp. 360-364, January 1999