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August 31, 2014 at 8:20 PMComments: 0 Faves: 0

Study: Early Wake Times Hurt Our Teens: Should High Schools Be Required to Start Later?

By Jeffrey VanWingen M.D. More Blogs by This Author

Labor day weekend is here.  I must admit that I always get a bit nervous and my disposition sours during this time. I'm fully aware that this recurring emotional phenomena is a Pavlovian response going back to my school days. Growing up in our house, made up of two boys and two public school teachers, Labor Day weekend was a tradition of moping around, and mourning the death of summer with the Jerry Lewis Telethon in the backdrop. For me, though, it was more than losing summer. I actually liked school  - seeing my friends,  and you know, the learning and such. I just despised getting up in the morning, and this resentment magnified into my high school years. 

Through the year though, I've realized that it wasn't my teen self being lazy - it was physiology at play.  Recently, more and more attention has been given to the social and physiological mismatch with our educational institution.  Should school start later to accommodate our youth?  Or must we simply learn to live with things the way they are - it is simply what it is?  Are there other consequences (good or bad) to making kids get up early?

A new study casts new light on this issue once more.

The Circadian Rhythm of Teens

Circadian rhythms are the habits and behaviors that organisms exhibit based on a 24 hour daily cycle.  These rhythms are subject to environmental forces, namely night and day, and often considered synonymous with sleep and wake time. 

What many people don't realize however, is that our natural circadian rhythms change throughout our growing years.  Newborns sleep upwards of 18 hours per day, regardless of day or night. Older infants and toddlers need a daytime nap and require more nighttime sleep.  And then there are the teenagers, the segment of humans who tend to push bedtime later and could sleep into the afternoon hours if not disturbed.  Then, into  our adult years, early hours are more tolerable and sleep times more reasonable.

Teen Nature vs. Nurture

Adolescents, by their nature, are risk takers, less aware of consequences.  They tend to push the limits of bedtime with not so much regard for the effect the following day.  Today, the oft-used tools of adolescence - video games, TV and text messaging - beckon kids to stay awake and the availability of caffeine (now in sugary carbonated beverages designed specifically for the purpose) throws fuel onto this fire.

But there's more to this than the mere psyche of the teenager.

Changes in puberty cause delays in the timing of nighttime melatonin secretion into the adolescent body.  This, in-turn, causes a change in the circadian rhythm, pushing back the natural sleep time to later nighttime hours.   According to Dr. Judith Owens, director of sleep medicine at the Childrens' National Health System, this is the real reason for the teen tendency to delay initiating sleep until at least 11 p.m.  Factor in a pre-8 a.m. school start time, and you have a significant disparity.

Doctors take a stand

This past week, the American Academy of Pediatrics (AAP) put forth an unprecedented policy statement regarding the start time for middle and high school.  They recommend that start times be no earlier than 8:30 a.m.  The statement cites studies pointing out current failures in the present institution. 

59% of 6th-8th graders and 87% of high schoolers receive the recommended 8.5-9.5 hours of sleep each night. 

Further data was cited showing that 71% of parents (mistakenly) believe their teen is getting sufficient sleep. 

Beyond this, health consequences of this "teenage sleep epidemic" were highlighted.

How Early Wake Times Hurt our Teens

Poor sleep in teens has been implicated in some of the other major adolescent health issues.  Perhaps the biggest health issue facing youth today is obesity and it is well known that somnolence due to poor sleep, is a risk factor for obesity. It actually causes cravings for energy-rich carbohydrate sources and other bad eating choices. 

Further, depression, attention/focus and safety (drowsy driving) have all been linked to decreased sleep duration. It stands to reason that increasing available time for sleep will lead to improved health outcomes in these issues.

Indeed, a referenced study in the AAP statement showed that later middle school start times correlated with positive outcomes in longer sleep times, less daytime sleepiness and improved standardized attention, less tardiness and improved academic performance.

The Push Back

"The early bird gets the worm," does not necessarily apply to adolescents.  These young people are physiologically wired to retire to bed later and sleep later.  Despite this known fact, they are hammered into early-starting middle and high school curricula.  This wide-spread deprivation of sleep has been labeled epidemic and is implicated in other significant health issues faced by adolescents.  The AAP has recently and officially recommended later start times for middle and high schools.  Despite this, however, outcomes and actual change may be lagging, just like those tired teens heading back to school this fall.

43% of public high schools still start before 8 a.m.  Change is not easy to come by with tiered school bus schedules providing primary and secondary school services.  Teachers, entrenched in unions, are also not fans of this proposed change.  For this change to occur, a lot of shuffling and altered paradigms would be required.

Sources:

AAP Statement a Wake-Up Call on Teen Sleep Issues.  Medscape.  Aug 25, 2014.

Pediatrics.  2014; 134:642-9.

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