Adolescents’ sleep/wake patterns and school schedules: towards flexibility

Abstract

In the literature, two main trends may be identified in the countermeasures associated to adolescents' sleep restriction: sleep education and changes in the school starting times. However, school educational programs have been able to increase knowledge about sleep, which did not necessarily result in behavioral changes. Later school start times have been proposed as a strategy to reduce the adolescents' sleep restriction but there is no consensus about the change. Longitudinal studies in adolescent populations are urgently needed in order to determine the efficacy of interventions aiming at a change in school starting times. Academic, behavioural, health and wellbeing variables could be monitored for an extensive period before and after implementing the new school schedule options, thereby enabling a within-subject experimental design. It is no longer acceptable to impose the 'one size fits all' approach on the school start times.

School start time changes in the COMPASS study: associations with youth sleep duration, physical activity, and screen time

“…Shifts in SST among schools participating in the COMPASS study allowed for a natural experiment to assess whether it was associated with youth sleep duration, physical activity level, and screen time. In line with past cross-sectional Canadian studies 26,27 and longitudinal and experimental evidence from other countries, [14][15][16][17][18][19][20][21]37,38 While previous experimental research has focused on longer delays, this study demonstrated that relatively minor changes may be beneficial for youth health. Short SST delays are likely more feasible and palatable to school stakeholders reluctant to delay SST.…”

“…Reviews and meta-analyses identify a continued need for prospective and experimental research, as the majority of past studies have used cross-sectional designs or lacked comparison groups. [14][15][16][17] A 2017 Cochrane review deemed existing evidence to be limited and of very low-quality, and hence, was unable to draw conclusions regarding the true beneficial and adverse effects of later SSTs. 15 Also, SST research has predominately been conducted in US schools, with only a few Canadian studies.…”

“…[14][15][16] Some evidence also suggests later SST result in less daytime sleepiness and trouble staying awake. [14][15][16][17] Outcomes apart from sleep have received relatively less attention. The strongest available evidence indicates delayed SST promote reduced: caffeine use, depressive symptoms, tardiness to class, and absenteeism.…”

Are We Ready to Implement Circadian Hygiene Interventions and Programs?

“…In the case of adolescents and school hours, there are also individual and social types of interventions that could be implemented, such as sleep education and changes to school start times [73][74][75]. Moreover, the prolonged use of electronic devices with illuminated screens in the evening are associated with a reduction in nighttime sleepiness, poorer sleep quality, delayed melatonin production, increased body temperature, decreases in nocturnal melatonin production and daytime attention levels [76,77].…”

The sleep as a predictor of musculoskeletal injuries in adolescent athletes

“…Due to biological and environmental factors, is expected a gradual delay in chronotype during adolescence, reaching its peak at the end of puberty, which means a preference for going to bed later and waking up later 19 . Therefore, the school start time in many countries including Brazil, contradicts this factor and it requires adolescents to wake up in the early morning, inducing a situation of chronic sleep restriction 20 . Added to the sleep changes expected by age, the need of managing the sports demands with school and/or even with work demands may predispose adolescent athletes to an even poorer sleep condition 21 .…”