Back-to-School Health: The Tie Between Sleep and School Performance

Sleep is tied to our overall well-being -- to our mood, our performance and even to the development of obesity. So, I choose to advocate for my son and his sleep. I also choose to follow a few simple steps to help ease the transition as we head back-to-school that I'd like to share:
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Sleep on homework
Sleep on homework

It's that time again: back-to-school. As I prepared to send my boys off to school, I had the opportunity to reflect on my role as a parent to school-aged children. My eldest makes a particularly difficult transition this year, moving from elementary school to middle school. The middle school years can be a tough time for children, bringing stress from a number of sources: lockers, homework, multiple teachers, switching classrooms, and new social pressures...just to name a few. But, what struck me most - especially as a sleep researcher - was my son's earlier start time. This concerns me because it inevitably leads to unrested children being expected to perform and succeed at a higher level.

The concept that children might need more sleep to perform better in school is not new. When I began searching for literature on sleep and school grades, I came across a study published back in 1913. The paper reported on the sleep of over 1,000 students and the relation between sleep, grades, and behavior. It concluded, unsurprisingly, that children needed plenty of sleep to perform well in school. Suffice it to say that MANY things have changed since 1913 - study designs are much better, assessment of sleep has improved, and, most notably, children aged 6-10 years now get only 9.5 hours of sleep on average compared to the 10.75 hours they obtained in 1913. Today, we know for a fact that sleep does affect school performance.

Much of the modern literature on sleep and school performance can be attributed to the early work of Dr. Mary Carskadon at Brown University. Dr. Carskadon discovered that early school start times resulted in adolescents' having a tendency to want to sleep during the first two periods of school. This, in part, is due to the fact that sleep schedules naturally delay as children get older. The delay in the time one naturally falls asleep and wakes up peaks around adolescence...around the same time that these students are expected to get to school earlier and earlier. Scientifically, one could even argue that school start times should get later as children age, not earlier, to best support their need for sleep.

Now, I know what some of you may be saying at this point, "I get up early, my child can do the same. Besides, work doesn't accommodate to your sleep schedule so this is good practice for the future." All of this is true, but let's look at the effects of poor sleep on performance, specifically in children. Poor sleep in children has been associated with obesity, poor school grades, mood problems, and impulsive behavior. Supporting our children isn't just about preparing them for the future - it's about supporting their overall growth right now.

The good news is that delaying school start times just slightly can help. Some researchers have even begun to lobby schools for delayed start times, and they come prepared with data in hand. One study, published in the Journal of the American Medical Association (JAMA) in 2010, found that a delay of only 30 minutes resulted in 45 minutes more sleep per night on school nights. The study also found:
• Children went to bed at about the same time, but had the opportunity to sleep-in longer.
• The percentage of children getting less than 7 hours per night (a true sleep debt for most children) decreased by almost 80 percent and those getting more than the recommended 8 hours per night increased by almost 58 percent.
• Mood improved, there was a decrease in reported fatigue, visits to the Health Center decreased significantly, and class attendance was up.
• The children felt better, were more motivated and happier, and the teachers noticed better engagement.

All of this came at a cost of only 30 minutes delay in school start times. Not a lot to ask for when you consider the many, many benefits seen by the children.

So, this brings me back to my son. What do I do? How hard do I push? My son likes school and seems to be adjusting well. Sleep is a critical function in life, and after reviewing the data, I feel even stronger that we as parents need to fully understand the consequences of early school start times. Sleep is tied to our overall well-being -- to our mood, our performance and even to the development of obesity. So, I choose to advocate for my son and his sleep. I also choose to follow a few simple steps to help ease the transition as we head back-to-school that I'd like to share:

1. Gradually Shift Bedtime. Begin to move your child's bedtime slowly before school starts. Engage your child in a slow shift -- about 15 minutes earlier per week - for a few weeks before school starts. Moving 15 minutes at a time will enable you to make this shift without inducing insomnia. One important note is to make wake time as stable as possible during this shift.

2. Stick With It, Even On Weekends. Avoid letting children go to bed much later on weekends. When we extend bed time and wake time on weekends, we make it difficult to get back to the desired schedule on Sunday night.

3. Sleep In...But Not Too Much. It is reasonable to allow children to sleep in a little on weekend days, as this can restore sleep debt accrued during the week, but try to avoid letting them sleep in more than 30-60 minutes. It is also best if your children do not sleep in excessively on Sunday morning which can make for a difficult bedtime come Sunday evening.

4. Watch Your Children. You need not obsess on this, but take notice if your child is having trouble falling asleep or waking in the morning. Try to understand if his or her natural tendency to sleep is delaying. It will be important to put limits on the use of technology at nighttime in order to know whether this tendency to delay is natural of the ill effects of technology.

5. Start A Conversation. Ask your school administrators if they have examined the literature on school start times. Begin the dialogue. Keep an open mind, but educate yourself on the effects it is having on your children and their overall well-being.