School Start Time Change: An In-Depth Examination of School Districts in the United States

In response to the scientific evidence documenting both profound developmental changes in sleep and circadian biology during adolescence and the myriad of negative health, performance, and safety outcomes risks associated with chronic sleep loss, at least 70 public school districts in the United States, representing approximately 1,000 schools, have successfully implemented a delay in high school start times. However, despite the compelling evidence supporting school start time change as a key strategy in addressing the epidemic of adolescent sleep loss, many school districts across the country with early high school start times have not considered the option to implement later bell schedules for adolescents. Moreover, while the current scientific literature has clearly documented the positive outcomes associated with delayed high school start times, these studies contain limited information regarding the process by which school districts consider, approve and implement bell schedule changes. Thus, this in-depth examination of those school districts that have been successful in changing their bell schedules is intended to support the efforts of other districts in various stages of contemplating this measure. We utilized a multi-pronged approach (literature review, case studies, telephone interviews, online survey) to summarize the experiences of school districts across the United States in regard to challenges faced, strategies employed, and lessons learned in the hope that this 1Children’s National Medical Center, George Washington School of Medicine and Health Sciences Address correspondence to Judith Owens, Professor of Pediatrics, George Washington University School of Medicine and Health Sciences, Director of Sleep Medicine, Children’s National Medical Center, 111 Michigan Avenue NW, Washington DC 20010-2970; e-mail: [email protected] information will be a useful tool for other school districts looking to chart a course forward to promote the health, safety, and academic opportunities of their students. Many studies have documented that the average adolescent in the United States is chronically sleep-deprived and pathologically sleepy, placing adolescents at risk for adverse consequences, including impairments in mood, affect regulation, attention, memory, behavior control, executive function, and impulse control. In particular, many studies have shown an association between decreased sleep duration and lower academic achievement at the middle school, high school, and college levels, as well as higher rates of absenteeism and tardiness, and decreased motivation to learn (Curcio, Ferrara, & De Gennaro, 2006; Wolfson & Carskadon, 2003). Other documented health-related effects of sleep loss in adolescents include increased use of stimulants (e.g., caffeine, prescription medications) to counter the effects of chronic sleepiness, which in turn may increase the risk of substance use later in adolescence and early adulthood (Gromov & Gromov, 2009). Adolescents are also at greater risk for drowsy driving-related crashes, as well as athletic and other injuries, due to insufficient sleep (Hutchens, Senserrick, Jamieson, Romer, & Winston, 2008). Chronic sleep restriction increases subsequent risk of both cardiovascular disease and metabolic dysfunction such as type 2 diabetes (Verhulst et al., 2008). An association between short sleep duration and obesity in children and adolescents has been demonstrated in numerous cross-sectional and prospective studies, underscoring how chronic sleep restriction can undermine the health of our nation’s youth (Cappuccio et al., 2008). While a number of factors, including biological changes in sleep, lifestyle, 182 © 2014 International Mind, Brain, and Education Society and Wiley Periodicals, Inc. Volume 8—Number 4