Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. 1555-1561 (doi:10.1542/peds.2004-1649)
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The Impact of School Daily Schedule on Adolescent Sleep

Martha Hansen, MS*, Imke Janssen, PhD{ddagger}, Adam Schiff, BS*, Phyllis C. Zee, MD{ddagger},¶ and Margarita L. Dubocovich, PhD§,||,¶

* Science Department, Evanston Township High School, Evanston, Illinois; Departments of
{ddagger} Neurology
§ Molecular Pharmacology and Biological Chemistry, and
|| Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
Center for Sleep and Circadian Biology, Northwestern University, Evanston, Illinois

Objectives. This study was initiated to examine the impact of starting school on adolescent sleep, to compare weekday and weekend sleep times, and to attempt to normalize the timing of the circadian sleep/wake cycle by administering bright light in the morning. This was a collaborative project involving high school students and their parents, as well as high school and university faculty members, for the purpose of contributing information to the scientific community while educating students about research processes and their own sleep/wake cycles and patterns.

Methods. Sixty incoming high school seniors kept sleep/wake diaries beginning in August and continuing through 2 weeks after the start of school in September. Sleep diaries were also kept for 1 month in November and 1 month in February. Early-morning light treatments were given to 19 students in the last 2 weeks of November and the last 2 weeks of February. Neuropsychologic performance was measured with computer-administered tests. Paper-and-pencil tests were used for assessment of mood and vigor. A testing period consisted of 2 consecutive days at the beginning and end of November and at the beginning and end of February. Tests were given 3 times per day, ie, in the morning before school (6:30–8:00 AM), during midday lunch periods (11:30 AM to 1:00 PM), and in the afternoon (3:00–4:30 PM), on each of the test days.

Results. Adolescents lost as much as 120 minutes of sleep per night during the week after the start of school, and weekend sleep time was also significantly longer (~30 minutes) than that seen before the start of school (August). No significant differences were found between weekday sleep in the summer and weekend sleep during the school year. Early-morning light treatments did not modify total minutes of sleep per night, mood, or computer-administered vigilance test results. All students performed better in the afternoon than in the morning. Students in early morning classes reported being wearier, being less alert, and having to expend greater effort.

Conclusions. The results of this study demonstrated that current high school start times contribute to sleep deprivation among adolescents. Consistent with a delay in circadian sleep phase, students performed better later in the day than in the early morning. However, exposure to bright light in the morning did not change the sleep/wake cycle or improve daytime performance during weekdays. Both short-term and long-term strategies that address the epidemic of sleep deprivation among adolescents will be necessary to improve health and maximize school performance.

Key Words: adolescents • sleep • school • schedule • performance

Accepted Sep 20, 2004.


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