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ORG

POSITION STATEMENT:
Start Middle and High Schools at 8:30
a.m. or Later to Promote Student Health
and Learning
(NOVEMBER 2017) Tracy Trevorrow, PhD, Chaminade University, Honolulu, HI; Eric S. Zhou, PhD, Harvard University, Boston, MA;
Jessica R. Dietch, MS, University of North Texas, Denton, TX; and Brian D. Gonzalez, PhD, Moffitt Cancer
Center, Tampa, FL

The Society of Behavioral Medicine

recommends school officials start middle and
high school classes at 8:30 a.m. or later. Such a
schedule promotes students’ sleep, resulting in
improvements in physical health, psychological
well-being, attention and concentration,
academic performance, and driving safety.

As a consequence of puberty, teenagers are biologically

driven to have later sleep and wake-up times than younger
children.1 Most middle and high schools in the United
States start well before 8:30 a.m., which is too early to
accommodate for this shift in sleep patterns and contributes
to a nation of chronically sleep-deprived students.2 • school attendance;4,17,21
Inadequate sleep results in compromised physical health, • coffee and stimulant drink use;16 and
emotional and behavioral problems, and reduced ability • rates of motor vehicle accidents for teen drivers.4,22
to perform and learn.3-6 Starting schools early may be
intended to accommodate adult considerations such as bus BARRIERS TO CHANGING START TIMES
schedules, parents’ work schedules, and the use of athletic Changing school start times is often met with resistance in
facilities; these issues have not been problematic for schools school districts across the United States.2,4 Barriers include:
with later star times.7 • conflicts with after-school programs, sports activities,
and after-school student jobs;
The American Academy of Sleep Medicine, the American
• teacher concerns regarding scheduling and total work
Academy of Pediatrics, and the American Medical
hours;
Association recommend middle and high schools start no
• transportation costs for busing children to school;
earlier than 8:30 a.m.8-10 However, only about 15% of U.S.
• difficulties in changing family patterns of daily life; and
public high schools start at 8:30 a.m. or later.11 For decades,
• lack of awareness among school community
starting school after 8:30 a.m. has been the standard in
stakeholders (i.e., school administrators, faculty,
many countries, such as Finland, Japan, New Zealand,
students, families) regarding the importance of sleep.
Australia, and England, all of which outperform the United
States on international student achievement tests.12,13 Out of However, schools that have delayed start times do not
50 countries, U.S. children ranked worst in sleep deprivation.14 report significant problems with this change.3,15-17 As such, a
national trend to delay high school start times may not only
There are no demonstrable health or learning benefits
be possible but also welcomed as school administrators
to support early start times for middle and high schools.
and school communities appreciate the related benefits to
However, schools with delayed start times have shown
students’ health and learning.
improvements in:
• daytime alertness and concentration;3,15-17 In consideration of a later school start time, it is important to
• mood;6,17 note:
• behavioral control;3,4,6,17 • Teachers’ arrivals and departures from school do not
• academic achievement, including standardized test need to change. Teachers may use the period before
scores;4,5,18-20 instruction each morning for preparation, grading,
• tardiness;4,16,17,21 meetings, and professional development.
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• Bus schedules may be staggered to allow younger stu- ENDORSEMENTS

dents to be transported to school before middle and
high school students.7
• Schools that start between 8:30 and 9 a.m. would typi-
cally finish between 3and 3:30 p.m., allowing daylight
time for sports and after-school activities. Coaches often
need late afternoon practices and game times due to
their day jobs.
• Families’ morning routines may be less chaotic when
teen students are rested.
• Students are less likely to have unsupervised time when
school finishes later in the day.
REFERENCES
Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms,
RECOMMENDATIONS FOR CHANGING 1
and delayed phase in adolescence. Sleep Medicine. 2007; 602-
SCHOOL START TIMES 612.
2 Kirby M, Maggi S, D’Angiulli A. School start times and the sleep-
The Society of Behavioral Medicine (SBM) advocates for a wake cycle of adolescents: A review and critical evaluation of
four-tiered approach to promote later start times for middle available evidence. Educational Researcher. 2011;56-61.
and high schools. 3 Lufi D, Tzischinsky O, Hadar S. Delaying school start time by one
1. School board members must enact an 8:30 a.m. or later hour: Some effects on attention levels in adolescents. J Clinical
school start time policy in their school districts. It is fun- Sleep Medicine. 2011;7, 137-143.
4 Wahlstrom KL, Dretzke BJ, Gordon MF, Peterson K, Edwards K,
damentally at the school district level that administrators
Gdula J. Examining the impact of later high school start times on
can prioritize school start times that promote students’ the health and academic performance of high school students:
health, well-being, and learning. A multi-site study. Center for Applied Research and Educational
2. State departments of education and state legislators, Improvement. Final Report. 2014;1-71.
particularly those on education committees, should ad- 5 Edwards F. Early to rise? The effect of daily start times on academic
performance. Economics of Education Review. 2012;970-983.
vocate for later school start times for middle and high
6 Dahl RE. The consequences of insufficient sleep for adolescents.
schools. This advocacy can be achieved by including Links between sleep and emotional regulation. Phi Delta Kappan.
student healthy-sleep promotion on committee agen- 1999;80, 354-359.
das and by lobbying school board members to enact 7 Wolfson AR. Carskadon MA. A survey of factors influencing high
an 8:30 a.m. or later school start policy. school start times. NASSP Bulletin. 2005;89, 47-65.
3. SBM encourages lobbying of the U.S. Department of 8 AASM position: Delaying middle and high school starft times is
beneficial to students. J Clinical Sleep Medicine. 2017; April 15.
Education through congressional representatives, partic-
9 School start times for Adolescents. Adolescent sleep working
ularly those on the House Committee on Education and group and committee on adolescence and council on school
the Workforce, and the Senate Committee on Health, health, Pediatrics. 2014 DOI: 10.1542/peds-1697.
Education, Labor and Pensions, so they understand the 10 Council on Science and Public Health Report 6 – Delaying School
value of later school start times and can enact pertinent Start Time to Alleviate Adolescent Sleep Deprivation. MD Bishop
(Chair). American Medical Association House of Delegates (A-
legislation.
16). 2016. https://teensneedsleep.files.wordpress.com/2011/04/
4. To increase awareness, SBM suggests school-level pro- ama-school-start-time-policy-statement.pdf
motion of education about the importance of sleep 11 Frieden TR, Jaffe HW, Cono J, Richards CL, Iademarco MF. School
through in-services, workshops, curriculum changes, and start times for middle school and high school students – United
family and community events. On a community level, States, 2011-12 school year. MMWR Morb Mortal Wkly Rep.
2015;64:809-813.
media should be engaged to promote the public’s un-
12 School days around the world. http://pocketcultures.
derstanding of the benefits of later school start times for com/2010/09/15/school-days-around-the-world
middle and high school students. Healthy student sleep 13 PISA 2015. Results in Focus. http://www.oecd.org/pisa/pisa-2015-
campaigns may be provided through media program- results-in-focus.pdf.
ming. 14 TIMSS/PIRLS, Lynch School of Education, Boston College. www.
bbc.com/news/business-22209818
It is no longer a question of whether policies promoting later 15 Vedaa O, Saxvig IW, Wilhelmsen-Langeland, A. School start
school start times should be adopted, but rather how they time, sleepiness and functioning in Norwegian adolescents.
should be implemented. Scandinavian J Educational Research. 2012;56, 55-67.
16 Boeger J, Gable CJ, Owens JA. Later school start time is associated
ACKNOWLEDGEMENTS with improved sleep and daytime functioning in adolescents. J
Developmental Behavioral Pediatrics. 2014;33, 11-17.
The authors wish to gratefully acknowledge the expert 17 Owens JA, Belon K, Moss P. Impact of delaying school start times
review and support provided by SBM’s Health Policy on adolescent sleep, mood, and behavior. Archives Pediatric
Committee, Health Policy Council, and Child and Family Adolescent Medicine. 2010;164, 608-614.
Health Special Interest Group. 18 Pagel JF, Forister N, Kwiatkowski C. Adolescent sleep disturbance
and school performance: The confounding variable of
socioeconomics. J Clinical Sleep Medicine. 2007;3, 19-23.
19 Keller PS, Smith OA, Gilbert LR, Bi S, Haak EA, Buckhalt JA. Earlier
school start times as a risk factor for poor school performance: An
examination of public elementary schools in the commonwealth of
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Kentucky. J Educational Psychology. 2015;107, 236-245.

20 Ming X, Koransky R, Kang V, Buchman S, Sarris C, Wagner GC.
Sleep insufficiency, sleep health problems and performance in high
school students. Clinical Medicine Insights: Circulatory, Respiratory
and Pulmonary Medicine, 2011;71-79. DOI: 10.4137/CCRPM.S7955
21 Wolfson AR, Spaulding NL, Dandrow C, Baroni EM. Middle school
start times: The importance of a good night’s sleep for young
adolescents. Behavioral Sleep Medicine. 2007;5, 194-209.
22 Vorona RD, Szklo-Coxe M, Lamichhane R, Ware JC, McNallen A,
Leszczyszyn, D. Adolescent crash rates and school start times in
two central Virginia counties, 2009-2011: a follow-up study to a
southeastern Virginia study, 2007-2008. Journal of Clinical Sleep
Medicine. 2015;10, 1169-1177.