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Thursday, September 27, 2012

Stop Adolescent Zombies! Let Students Sleep In the Morning.

Remember the old saying, "If you can't beat them, join them"? Take a minute to answer a few questions with a simple "yes" or "no" to help solidify the potential worth of this wisdom.

(1) For whatever reason (procrastination, extracurriculars, part-time work), do many teens stay up late at night to do homework?

(2) Despite warnings from their parents, do many teens frequently hold nightly marathon phone sessions with their friends?

(3) Do more and more teens find it alluring to engage in computer games and instant messaging when they should be getting their necessary sleep?

I assume most of you answered "yes" to all three questions. If you are an adult, you probably blame teens for their own sleep lack of sleep. Why? Teens have a reputation of being notoriously lazy morning risers who deliberately stay up too late at night. They claim they just can't get out of bed in the morning for school because they are "too tired" or "still sleepy" or "stay up too late" or "can't get to sleep at all." Excuses, excuses, right?

Guess what? Parents and teens agree. They are essentially saying the same thing: lazy teens are lousy morning people because they are deprived of sleep. Why fight this fact? Reasons for resistance may include the accepted wisdom of another old maxim -- "Early to bed and early to rise makes a man healthy, wealthy and wise."

Well, folks, a lot has changed since Benjamin Franklin coined that little proverb in a 1735 edition of Poor Richard's Almanack. Maybe James Thurber was closer to the truth when in February, 1939, he turned around the old saying and wrote this in the New Yorker: "Early to rise and early to bed makes a male healthy and wealthy and dead."

Yes, adults who just don't know the makeup adolescents are partly to blame for the "sleepy" problem. Judy Owens, MD, a national authority on children and sleep, director of the pediatric sleep disorders center at Hasbro Children's Hospital, and an associate professor of pediatrics at Brown Medical School, thinks so. In her book, Take Charge of Your Child's Sleep: The All-in-One Resource for Solving Sleep Problems in Children and Teens, she reported that 90% of parents polled believed that their adolescents were getting enough sleep during the week. It looks as if a lot of parents better "wake up."

Most teens need a lot of sleep to maintain optimal daytime alertness, and sleep deprivation is causing a growing concern among researchers, educators and parents.

(1) The average sleep for U.S. adolescents is seven hours. At least 30 percent of teenagers reported falling asleep during school.

(Christina Calamaro PhD, Mason B. Thornton and Sarah Ratcliffe. “Adolescents Living 24/7 Lifestyle: Effects of Caffeine and Technology on Sleep Duration and Daytime Functioning,” Pediatrics, 2009)

(2) A study of Rhode Island teenagers found that "85 percent were chronically sleep-deprived and accumulated a minimum 10-hour sleep deficit during the week. Forty percent went to bed after 11 p.m.; 26 percent said they usually got less than 6.5 hours on school nights."

(Gisele Glosser, "Teens, Sleep and School," Math Goodies, 2012)

(3) In another study in the Journal of School Health, more than 90 percent of teens reported sleeping less than the recommended nine hours a night. In the same study, 10 percent of teens reported sleeping less than six hours a night.

(Mayo Clinic Staff, "Teen Sleep: Why Is Your Teen So Tired?" 2009)

In June 2005, a major report in the journal Pediatrics merged a review of more than two decades of basic research with clinical advice for physicians. The authors included Richard Millman, MD, professor of medicine at Brown Medical School and director of the Sleep Disorders Center of Lifespan Hospitals, a Rhode Island sleep research and treatment center, one of the largest in the country.

The report indicated that adolescents aged 13 to 22 need nine to ten hours of sleep each night. It also discussed the hormonal changes that conspire against them. When puberty hits, the body's production of sleep-inducing melatonin is delayed, making an early bedtime biologically impossible for most teens. At the same time, the report notes, external forces such as after-school sports and jobs and early school start times put the squeeze on a full night's sleep.

Melatonin? That's right. Brown University Professor Mary Carskadon, director of sleep research at E.P. Bradley Hospital in Rhode Island, believes teens are really "out of it" in the early morning. Carskadon and her researchers measured the presence of the sleep-promoting hormone melatonin in teenagers' saliva at different times of the day. They learned that the melatonin levels rise later at night in children than they do in adults -- and remain at a higher level later in the morning.

(Valerie Strauss, "Schools Waking Up to Teens' Unique Sleep Needs," Washington Post, January 10 2006)

What is the result of these findings? Mostly common sense understandings, really. Too little sleep produces a "profound negative effect" on mood, school performance and cognitive function. Also with sleep deprivation, adolescents tend to become heavily caffeinated, practice poorer eating habits, and perform functions with slower reaction time. In addition, studies show that young people between 16 and 29 years of age were the most likely to be involved in crashes caused by the driver falling asleep.

"Some of our kids are literally sleep-walking through life, with some potentially serious consequences," Dr. Millman said. "As clinicians and researchers, we know more now than ever about the biological and behavioral issues that prevent kids from getting enough sleep. But the National Sleep Foundation did something powerful: They asked teens themselves about their sleep. The results are startling and should be a wake-up call to any parent or pediatrician."

Who needs to take responsibility? Millman believes students, parents, and schools should face the need. "The kicker in this," he said, is that changing school start times “is not a license to have kids go to bed later. They need to go to bed at the same time. It’s worthless if they go to bed later.” (William Rupp, "Barrington Studies Later School Start Time For Teens," East Greenwich Patch News, January 27 2012)

This is where the parents have to take control to help their children maximize their potential, Millman said. “This is one piece to make kids better functioning,” he said.

Millman believes that schools should set later start times, but he believes this only works if students get more sleep. He thinks moving the schedule back only 15 to 20 minutes isn’t "worth it." He would push for an hour, a significant amount of extra sleep for teens.

But, Isn't Changing School Start Times to Later Just Mollycoddling the Kids?

(A) One-half Hour Delay

One study involving a later starting time was conducted at St. George's High School in Rhode Island in 2010.The school delayed its start time from 8 a.m. to 8:30 a.m. for two months (the winter term). Here are the results of the one-half hour delay in morning start time.

Among the positive findings:
  • Sleep time on school nights increased by 45 minutes. This was due to both earlier bedtimes and later waking times.
  • The percentage of students getting at least eight hours of sleep increased from 16.4 percent to 54.7 percent.
  • The percentage reporting less than seven hours of sleep decreased by 79.4 percent.
  • Fewer students reported feeling "unhappy or depressed," (65.8 percent initially compared with 45.1 percent after the change).
  • Fewer students visited the health care center for symptoms of fatigue (15.3 percent initially vs. 4.6 percent after)
  • Absences and tardies to first period decreased by 45 percent.
(Judy Owens MD, "New Study Confirms Positive Effects of Delayed School Start Times," Archives of Pediatrics & Adolescent, July 2010)

(B) One Hour Delay

In 1996, the suburban school system of Edina, Minnesota, changed its start time for 3,000 high school students from 7:25 a.m. to 8:30 a.m. Two years later, Minneapolis followed suit for more than 50,000 teenagers.

The Center for Applied Research and Educational Improvement (CAREI) at the University of Minnesota conducted a study on the impact of changing school these start times on academic performance, behavior and safety in Minnesota urban and suburban schools. The research was led by Kyla Wahlstrom, interim director of CAREI. Here are the results of the one hour delay in morning start time.

Teachers reported that students were more alert while the research showed a range of benefits to students and teachers -- and it also contradicted some of the biggest fears about the change: that after-school sports and jobs would suffer.

With the later start time, teenagers were less depressed, and it turned out that employers did not have big problems with students getting out of school later, Wahlstrom said.

Although student grades did not rise significantly, the trends have been upward, she said. Researchers noted that it was difficult to assess changes in grades due to differences in school schedules, course names, grading policies, student transience, and the subjective nature of grading by teachers.

And some sports practices were shortened, but Edina and Minneapolis teams have played just as competitively as they had before

Results from three years of data from both Edina and Minneapolis also showed:
  • Improved attendance
  • Increase in continuous enrollment
  • Less tardiness
  • Students making fewer trips to the school nurse
In suburban districts, students reported:
  • Gaining an average of about one hour of sleep per night, since their bed times stayed the same even after the start time change.
  • Eating breakfast more frequently
  • Being able to complete more of their homework during school hours, because they were more alert and efficient during the day.
Suburban teachers and principals reported:
  • Students seemed more alert in class.
  • Improvements in student behavior, with a calmer atmosphere in the hallways and cafeteria.
  • Fewer disciplinary referrals to the principal.
Suburban counselors reported:
  • Fewer students seeking help for stress relief due to academic pressures.
  • Fewer students coming to them with peer relationship problems and difficulties with parents.
    (Backgrounder: Later School Start Times, National Sleep Foundation, 2011)

    My Take

Why fight it? I guess many parents of younger children might say that a delayed start might not coincide with their morning schedules of work and other commitments. True, many parents would have to arrange some type of supervision for their children. Any consideration of a school start time change should take into account the impact on families, including transportation, dependence on teens’ income, chores and other family responsibilities, and teens’ mood and behavior at home

Changing a school’s start time involves a wide array of people--parents, teachers, students, principals, school boards, superintendents, counselors and healthcare professionals, among others. We all know how difficult it is to institute any new idea in education, especially one this drastic. But, let's remember the old battle cry for improvements in schools: “It's all for the betterment of the kids.”

Speaking of betterment, according to Brookings Institute economists, children will likely earn significantly more money as adults when school begins at “roughly” 9 A.M. (“Organizing Schools to Improve Student Achievement: Start Times, Grade Configurations, and Teacher Assignments, Brookings Institute Education, September 2011)

Policymakers may eventually decide when the school day begins. Until then, at least during the school year, adolescent sleep sufficiency, a point of concern for the Center for Disease Control and the National Institutes of Health, will substantially be determined by the whims of local school boards.

Note to parents with adolescent children:
Letting them “sleep in” is better than having them “drop out.”

"Given that the primary focus of education is to maximize human potential, then a new task before us is to ensure that the conditions in which learning takes place address the very biology of our learners."

-Mary A. Carskadon, Ph.D., Professor in the Department of Psychiatry and Human Behavior

Their biological rhythms are set in such a way that they really can’t wake up earlier. It’s like telling a person they have to jump eight feet. They just can’t.”
-William Dement, M.D., Sc.D., Ph.D.

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