Search

Motor vehicle crashes (MVC) are the second leading cause of death for adolescents in the United States, with drowsy driving a major contributing factor. Early school start times have been identified as a significant factor that reduces adolescent sleep duration, which in turn contributes to drowsy driving and MVC. This paper examined the longitudinal impact of delaying secondary school start times on self-reported student drowsy driving and teen MVC.Secondary school students (10th and 11th grade, 51.7% female, 67.8% White) in the United States completed annual surveys 1 year before and 2 years after implementation of later school start times (70-min delay, n range 1642-2452 per year), reporting frequency of drowsy driving (less than once/week vs. at least once/week). Teen (16-18 years) MVC data from the Colorado Department of Transportation for the 2 years before and 2 years after later start time implementation were compared for Arapahoe County (where start times changed) and neighboring Adams County and Douglas County (where start times did not change).With later start times, there was a significant drop in the percent of students who reported frequent drowsy driving (pre-change: 32.6%, post-change: 21.9%, follow-up: 22.8%). Weekday teen MVC rates went down in Arapahoe County (p = .04) during the school year, while no change or increases in MVC rates were seen in neighboring counties.Healthy school start times are important for adolescent health and safety, with study findings highlighting the downstream effects of increased sleep duration following a 70-min delay in secondary school start times on adolescent drowsy driving and teen MVC rates.

Sufficient sleep duration is associated with student health and wellbeing, but early secondary school start times limit students' sleep opportunity. Despite recommendations that all middle and high schools adopt a healthy school start time policy, one barrier to policy implementation is concerns about the impact on student participation in activities and employment. This study examined student extracurricular activity participation and employment before and after the implementation of healthy secondary school start times. Approximately 24,000 students/year (grades 3–11) completed three annual surveys (pre-change, post-change, follow-up) measuring sleep-wake patterns, extracurricular activity participation, and employment. Following the implementation of an earlier school start time, before-school activity participation decreased for elementary school students, but after-school participation was similar across years. Following the implementation of later school start times, there was a small decrease in after-school activity participation for middle and high school students (~3–4%). Equally important, middle and high school students reported significantly increased sleep duration with later start times, regardless of participation in before- or after-school activities and employment. Study findings support the recommendation for healthy school start time policies.

OBJECTIVE To examine the impact of changing school start times on sleep in parents of students in elementary, middle, and high school. METHODS Annual surveys were completed by parents of K-12 students (n = 8190-10,592 per year) before (pre-change) and for 2 years (post-change, follow-up) after implementation of new school start times (elementary school [ES]: 60 minutes earlier, middle school [MS]: 40-60 minutes later, high school [HS]: 70 minutes later), providing parent self-reported weekday bedtime and wake time, sleep quality, and feeling tired. RESULTS Significant level-by-year interactions were found for parent bedtime, wake time, and sleep duration (all p < .0001). Post hoc analyses show ES parents reporting earlier bedtimes and wake times at post-change, with no change in sleep duration, while MS and HS parents reported later post-change wake times. Post-change, more MS and HS parents reported sufficient sleep duration (p < .0001) and good sleep quality (p < .0001), with fewer HS parents reporting feeling tired (p < .0001). CONCLUSIONS This is the first study to consider the impact of a policy change aimed at improving child sleep on parent sleep. Healthy school start times has a significantly positive downstream effect on secondary school parents' sleep and daytime functioning, with minimal impact reported by parents of elementary school students.

Secondary school start times are associated with student sleep and daytime functioning; however, no study examining this association has included linked longitudinal data for both primary and secondary students. To understand the interplay between biology (ie, normal developmental changes in sleep) and ecology (ie, school start times), this study examined sleep and daytime functioning in elementary/primary and secondary school students over a three-year period that included changes to school start times.Students (grades 3-10, n = 6168) and parents (for student grades Kindergarten-2, n = 2772) completed annual surveys before (pre-change) and for two-years after (post-change, follow-up) implementation of new school start times (elementary/primary: 60 min earlier, secondary: 50-80 min later). Participants were 48.9% female, 65.5% White, and 16.2% qualified for free/reduced lunch.With new school start times, significant changes were found for weekday wake times and sleep duration; elementary/primary students woke earlier (23 min) and obtained less sleep (14 min), while secondary students woke later (44 min) and obtained more sleep (31 min). Small changes in weekend sleep duration (7 min) were found across levels. Secondary school students had significant improvements in daytime functioning post-change, due in part to changes in sleep duration. Minimal changes in elementary/primary students' daytime functioning was found, despite shorter sleep duration.School start times are a significant factor in weekday wake times for students across grade levels, while later bedtimes are more a factor of normal development. Later start times positively affected secondary students' daytime functioning, with non-significant findings for earlier elementary/primary start times.

Study Objectives To examine the impact of changing school start times on sleep for primary (elementary school: ES) and secondary (middle and high school: MS/HS) students. Methods Students (grades 3–12) and parents (grades K-12) were surveyed annually, before and for 2 years after school start time changes (ES: 60 min earlier, MS: 40–60 min later; HS: 70 min later). Student sleep and daytime sleepiness were measured with school-administered student surveys and parent-proxy online surveys. Results Approximately 28,000 students annually completed surveys (~55% White, ~21% free/reduced lunch [FRL]). One-year post-change, weekday bedtimes and wake times were slightly earlier for ES students, with an 11-min decrease in sleep duration. MS and HS students reported slightly later weekday bedtimes, significantly later wake times, and significantly longer sleep duration (MS: 29 min; HS: 45 min). The percent of ES students reporting sufficient sleep duration, poor sleep quality, or daytime sleepiness did not change, but the percent of MS and HS students reporting sufficient sleep duration significantly increased and clinically significant daytime sleepiness decreased. All results were maintained at the 2-year follow-up. Benefits of later start times were similar across racial and free/reduced lunch groups. Conclusions This is the first large scale, longitudinal, and representative study to concurrently examine the impact of changing school start times across students in primary/secondary school. Findings suggest a minimal impact of earlier start times on ES students’ sleep or daytime sleepiness, while further supporting the significant benefits of delaying MS and HS start times on student sleep and daytime sleepiness.

Introduction No studies have previously considered how healthy school start times impact parents. Since parent and child sleep schedules, in particular wake time, are associated, we examined whether changing school start times would impact parent sleep (elementary school [ES] 9:00am to 8:00am, middle school [MS] 8:00am to 8:50am, high school [HS] 7:10am to 8:20am). Methods Parents of students (grades K-12) completed online surveys pre-change, one-year, and two-years post-change (2017 n=11,579; 2018 n=8,884; 2019 n=8,796), reporting weekday bedtime and wake time (sleep duration calculated bedtime to wake time). Four PROMIS sleep questions asked about sleep “quality”, feeling “alert” upon waking, feeling “tired” during the day, and “daytime problems” because of sleep. Finally, parents were asked one-year post-change how happy they were about the new school start times. Results Parents with only ES students reported earlier bedtimes and wake times (10 and 13 minutes). Parents with >1 HS student woke later (HS only: 22 minutes; MS and HS: 25 minutes; ES and HS: 10 minutes; all 3 levels: 14 minutes) and slept longer (HS only: 19 minutes; MS and HS: 21 minutes; ES and HS: 12 minutes; all 3 levels: 18 minutes), with changes maintained two years. Similarly, parents of only ES students reported no change in sleep quality/impairment. Post-change, more parents with >1 MS or HS student reported good sleep quality (average increase=6.9%), feeling alert (average increase=5.8%), not feeling tired (average increase=5.0%), and having few daytime problems (average increase=4.2%), with benefits maintained two-years post-change. Across levels, parents who were “very happy” about start time changes slept longer than “very unhappy” parents (12-30 minutes); however, across levels, child sleep did not differ between happy and unhappy parents. Conclusion This is the first study to examine the impact of changing start times on parents of students in grades K-12. Study results show no significant impact on parents of elementary students. However, similar to students, parents of middle/high school students reported later wake times and increased sleep duration. Notably, parents’ happiness with start time changes was related to parent, but not student, sleep duration. Support Robert Wood Johnson Foundation’s Evidence for Action Grant

The rise in children’s obesity rates suggests there is an urgent need to promote healthy behaviors among youth.1 Because obesity is associated with increased risk of many chronic diseases, addressing obesity in children can have a long-term positive impact on health. Rates of obesity and overweight status in US children are concerning, part due to their association with related health problems.2–5 Health Behaviors and Weight Status Obese children differ from normal weight children in regards to their eating behavior, physical activity patterns and sleep patterns.6,7 In England, schoolchildren aged 10–16 years who only sometimes ate breakfast were more likely to be obese than those who always did.8 Other nutritional factors such as the consumption of sugar-sweetened beverages also have been identified as possible contributing factors to the increase in weight status among children.9 Some studies have shown a link between sleep patterns and risk of obesity in adolescents,10–12 and particularly in elementary school children.13 Other health related behaviors such as watching television also seem to affect children’s health. Results from the 2003–04 and 2005–06 National Health and Nutrition Examination Surveys suggest high TV viewing as a predictor for cardio-metabolic risk factors such as obesity or hypertension.14 Health Behaviors and Academic Performance There is a great deal of interest in how health behaviors relate to academic performance. Sleep patterns, physical activity, eating behaviors, and body weight have all been suggested to influence academic performance.15–18 Edwards et al. 17 found that higher academic scores were associated with less soda consumption, more physical activity and fewer hours of watching television. A review investigating the relationship between obesity and academic performance revealed that overweight and obesity were associated with poorer academic performance.16 Whereas these data are promising, additional research is required to solidify the link between health behaviors and academic performance. Interventions with Children Much research in health behavior in schools has targeted 5th graders (age of 9–10 years).19–21 One reason is that persistent obesity is thought to develop before the age of 11 years.22 In addition, 5th grade students are already making decisions about food purchases and participation in physical activities; however, they also still depend on their families and the school when it comes to food and physical activity choices as well as other health behaviors such as sedentary behavior and sleep patterns. Lastly, because 5th graders are the oldest children in elementary schools they may be more willing to engage in interventions than children in middle schools where social pressures focus less on healthy behaviors, and physical activity declines.23 Colorado is the state with the lowest rates of adult obesity 24 but it is not the state with the lowest rates of childhood obesity.25 Data from the 2008 Colorado Child Health Survey showed that approximately 28.7 % of Colorado children ages 1–14 years were overweight or obese.26 Obesity rates vary as a function of ethnicity and socioeconomic status such that obesity is a particular problem in parts of Colorado with more minority and low income populations. The current study presented herein explored associations among various health behaviors, overweight, socioeconomic status and academic performance in 5th graders using secondary data from a school district in Denver, Colorado.