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Relationships between school start time, sleep duration, and adolescent behaviors.

ABSTRACT: OBJECTIVES:The objectives were 2-fold: (1) to examine how high school start times relate to adolescent sleep duration, and (2) to test associations between sleep duration and mental health- and substance use-related issues and behaviors in teens. DESIGN:This study examines selected questions from survey data collected between 2010 and 2013 high school students. SETTING:Respondents included more than 9000 students in grades 9 to 12 in 8 high schools in 5 school districts across the United States. MEASUREMENTS:The survey instrument is the 97-item Teen Sleep Habits Survey. Logistic regression models were used to calculate adjusted odds ratios and 95% confidence intervals. Because of clustering within schools and the use of repeated measures, generalized estimating equations were used to account for variance inflation. RESULTS:Greater sleep duration was associated with fewer reports of various mental health- and substance use-related issues and behaviors (all P values <.01). For instance, for each additional hour of sleep reported, there was a 28% reduction in the adjusted odds of a participant reporting that he or she felt "unhappy, sad, or depressed." Later wake-up times were associated with a reduction in risk for some, but not all factors. Later start times were significantly associated with greater sleep duration. CONCLUSIONS:Given that later start times allow for greater sleep duration and that adequate sleep duration is associated with more favorable mental health- and substance use-related issues and behaviors, it is important that school districts prioritize exploring and implementing policies, such as delayed start times, that may increase the amount of sleep of adolescent students, which is needed for their optimal development.

SUBMITTER: Wahlstrom KL

PROVIDER: S-EPMC7178613 | biostudies-literature | 2017 Jun

REPOSITORIES: biostudies-literature

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Relationships between school start time, sleep duration, and adolescent behaviors.

Wahlstrom Kyla L KL Berger Aaron T AT Widome Rachel R

Sleep health 20170408 3

<h4>Objectives</h4>The objectives were 2-fold: (1) to examine how high school start times relate to adolescent sleep duration, and (2) to test associations between sleep duration and mental health- and substance use-related issues and behaviors in teens.<h4>Design</h4>This study examines selected questions from survey data collected between 2010 and 2013 high school students.<h4>Setting</h4>Respondents included more than 9000 students in grades 9 to 12 in 8 high schools in 5 school districts acr ...[more]

PMID: 28526260

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Project description:ImportanceSleep is a resource that has been associated with health and well-being; however, sleep insufficiency is common among adolescents.ObjectiveTo examine how delaying school start time is associated with objectively assessed sleep duration, timing, and quality in a cohort of adolescents.Design, setting, and participantsThis observational cohort study took advantage of district-initiated modifications in the starting times of 5 public high schools in the metropolitan area of Minneapolis and St Paul, Minnesota. A total of 455 students were followed up from grade 9 (May 3 to June 3, 2016) through grade 11 (March 15 to May 21, 2018). Data were analyzed from February 1 to July 24, 2019.ExposuresAll 5 participating schools started early (7:30 am or 7:45 am) at baseline (2016). At follow-up 1 (2017) and continuing through follow-up 2 (2018), 2 schools delayed their start times by 50 and 65 minutes, whereas 3 comparison schools started at 7:30 am throughout the observation period.Main outcomes and measuresWrist actigraphy was used to derive indices of sleep duration, timing, and quality. With a difference-in-difference design, linear mixed-effects models were used to estimate differences in changes in sleep time between delayed-start and comparison schools.ResultsA total of 455 students were included in the analysis (among those identifying sex, 225 girls [49.5%] and 219 boys [48.1%]; mean [SD] age at baseline, 15.2 [0.3] years). Relative to the change observed in the comparison schools, students who attended delayed-start schools had an additional mean 41 (95% CI, 25-57) objectively measured minutes of night sleep at follow-up 1 and 43 (95% CI, 25-61) at follow-up 2. Delayed start times were not associated with falling asleep later on school nights at follow-ups, and students attending these schools had a mean difference-in-differences change in weekend night sleep of -24 (95% CI, -51 to 2) minutes from baseline to follow-up 1 and -34 (95% CI, -65 to -3) minutes from baseline to follow-up 2, relative to comparison school participants. Differences in differences for school night sleep onset, weekend sleep onset latency, sleep midpoints, sleep efficiency, and the sleep fragmentation index between the 2 conditions were minimal.Conclusions and relevanceThis study found that delaying high school start times could extend adolescent school night sleep duration and lessen their need for catch-up sleep on weekends. These findings suggest that later start times could be a durable strategy for addressing population-wide adolescent sleep deficits.

Project description:ImportanceAlthough negative associations of COVID-19 pandemic high school closures with adolescents' health have been demonstrated repeatedly, some research has reported a beneficial association of these closures with adolescents' sleep. The present study was, to our knowledge, the first to combine both perspectives.ObjectiveTo investigate associations between adolescents' sleep and health-related characteristics during COVID-19 pandemic school closures in Switzerland.Design, setting, and participantsThis survey study used cross-sectional online surveys circulated among the students of 21 public high schools in Zurich, Switzerland. The control sample completed the survey under regular, prepandemic conditions (May to July 2017) and the lockdown sample during school closures (May to June 2020). Survey respondents were included in the study if they provided their sex, age, and school.ExposuresHigh school closures during the first COVID-19 pandemic wave in Switzerland (March 13 to June 6, 2020).Main outcomes and measuresSleep-wake patterns, health-related quality of life (HRQoL, assessed by the KIDSCREEN-10 questionnaire), substance use (caffeine, alcohol, and nicotine), and depressive symptoms (lockdown sample only; assessed using the withdrawn/depressed scale from the Youth Self Report). Multilevel regression models were used to assess sample differences and associations of health-related characteristics with sleep duration and depressive symptoms.ResultsThe total sample consisted of 8972 students, including 5308 (59.2%) in the control sample (3454 [65.1%] female) and 3664 (40.8%) in the lockdown sample (2429 [66.3%] female); the median age in both samples was 16 years (IQR, 15-17 years). During school closures, the sleep period on scheduled days was 75 minutes longer (semipartial R2 statistic [R2β*], 0.238; 95% CI, 0.222-0.254; P < .001) and the students had better HRQoL (R2β*, 0.007; 95% CI, 0.004-0.012; P < .001) and less consumption of caffeine (R2β*, 0.010; 95% CI, 0.006-0.015; P < .001) and alcohol (R2β*, 0.014; 95% CI, 0.008-0.022; P < .001). Longer sleep duration was associated with better HRQoL (R2β*, 0.027; 95% CI, 0.020-0.034; P < .001) and less caffeine consumption (R2β*, 0.013; 95% CI, 0.009-0.019; P < .001). In the lockdown sample, an inverse association was found between depressive symptoms and HRQoL (R2β*, 0.285; 95% CI, 0.260-.0311; P < .001) and a positive association was found with caffeine consumption (R2β*, 0.003; 95% CI, 0.000-0.008; P = .01).Conclusions and relevanceIn this survey study, 2 opposing associations between school closures and adolescents' health were identified: a negative association with psychological distress and a beneficial association with increased sleep duration. These findings should be considered when evaluating and implementing school closures. Furthermore, the findings provide support for delaying school start times for adolescents.

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Relationships between school start time, sleep duration, and adolescent behaviors.

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Relationships between school start time, sleep duration, and adolescent behaviors.

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