High Schoolers And Snooze Buttons: A Public Health Crisis?

"If a kid is in first period when they should still be asleep, how much are they really learning?"

Anne Wheaton is an epidemiologist and the lead author of a new study published by the Centers for Disease Control and Prevention. The study surveyed the start times of 8000 middle and high schools across the country. Last year the American Academy of Pediatrics recommended that middle and high schools start no earlier than 8:30 a.m. The goal is to accommodate the "natural sleep rhythms" of teenagers.

Wheaton says that other research suggests nearly two-thirds of young people are seriously sleep deprived. And that can lead in turn to obesity, depression, smoking, drinking, and lower grades. It can even be a contributing factor to car crashes for young drivers.

The CDC found that five out of six schools started before 8:30 a.m. Too early in the researchers' view.

Of 42 states studied, only North Dakota, Mississippi and Wyoming had schools that started at 8:30 or later. In Louisiana the average school start time was 7:40 a.m.

In Montgomery County, Maryland, the school board has been debating this issue for years. It recently voted to start classes 20 minutes later in middle and high school, and 10 minutes later in elementary school.

"The ultimate decision by the board was a compromise," says spokesman Dana Tofig, noting that parents wanted schools to start even later, and that changing bus schedules for 90,000 students this fall is going to be a huge task.

As for the benefits? "I think a lot of it will have to do with what our students tell us ... Are students happier? More engaged with school? Are we seeing less negative behavior or depression?"

And most important, says Tofig, "are they not falling asleep in first period?"

See below for more on teenagers and the science of sleep.

Maybe she goes to school in Wyoming, where no schools start after 8:30 a.m.

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Here's a number to help frame the debate over whether middle schools and high schools should start later in the morning: A study finds that only 18 percent of these public schools start class at 8:30 a.m. or later, as the American Academy of Pediatrics recommends.

The figure comes from a U.S. Department of Education survey conducted in the 2011-12 school year, so it predates the 2014 AAP recommendation for a later starting time. But assuming the situation hasn't changed much, most schools are not accommodating the sleep needs of teenagers.

Countless PTA meetings and school board sessions have been devoted to appropriate start times for schools. Public health officials say teenagers need more than eight hours of sleep a night, and early start times stand in the way.

"Obtaining adequate sleep is important for achieving optimal health," epidemiologist Anne Wheaton of the Centers for Disease Control and Prevention and her colleagues write in the latest Morbidity and Mortality Weekly Report, published Thursday. "Among adolescents, insufficient sleep has been associated with adverse risk behaviors, poor health outcomes and poor academic performance."

But changing the starting time for schools isn't so easy. Bus fleets that serve children from elementary to high school have to be scheduled to accommodate more than just the sleep-deprived teenagers. Later starts also push after-school activities later into the day — and potentially into dark winter evenings.

This survey finds that the push for later starting times has a long way to go. The survey of nearly 40,000 public middle schools and high schools found that only 17.7 percent started at 8:30 a.m. or later. High schools alone were even worse, with just 14.4 percent starting at 8:30 or later.

The northerly states of Alaska and North Dakota led the state-by-state tally published in MMWR, with nearly 80 percent of high schools and middle schools starting class after 8:30. The early bird states included Hawaii, Mississippi and Wyoming, where not a single school in the survey started later than 8:30 in the morning.

Teenagers are biologically inclined to stay up later, so early school starts generally cut short their sleep, the CDC report notes. Parents can help teens get more sleep by enforcing earlier bedtimes, the report suggests, and by limiting the use of TVs, game consoles, smartphones and other screens in the bedroom (which parents know is far more easily said than done).

"Among the possible public health interventions for increasing sufficient sleep among adolescents, delaying school start times has the potential for the greatest population impact," the study notes.