Vitamin Zzzzz deficiency in teens

If left to her own devices, my teenager would wake up daily near the end of first-period Advanced Placement World History.

Other classmates wouldn’t wake up until lunch. And this is perfectly normal teen behavior.

But it would be in direct conflict with scholastic performance. And it’s such a problem that the American Academy of Pediatrics (AAP) is calling for a nationwide delay on school start times to improve adolescent health, safety and even test scores.

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Sleep researchers have long known that the early teenage years mark the beginning of a shift in the body’s natural sleep-wake cycle, making it difficult for teens to go to sleep before about 10:30 p.m.  Part-time jobs, homework, school-related sports and other activities often push that bedtime even later. Add in time for some basic human needs (breakfast, and perhaps a shower?) and suddenly that predawn date with the school bus is looking dubious.

“Sleep is way down on the priority list. These kids are operating under a constant state of jet lag,” said Dr. Judith A. Owens, lead author of the AAP’s policy statement urging school districts nationwide to move start times to no earlier than 8:30 a.m. for middle and high schools.

Owens, an internationally recognized authority on children and sleep, is director of Sleep Medicine at Children’s National Health System in Washington, D.C., and chairs the pediatric section of the American Academy of Sleep Medicine.

“What we see is chronic sleep loss in adolescents that has taken on the aspects of a public health issue,” Dr. Owens said.

Ideally, teens should get 9 to 10 hours of sleep a night, according to the U.S. Centers for Disease Control and Prevention. The need can vary, depending on factors such as age, growth spurts and activity levels.

A recent poll by the National Sleep Foundation found that 59 percent of middle schoolers and 87 percent of high schoolers regularly get less than 8 1/2 to 9 1/2 hours of sleep a night. The average high school student gets 7 hours a night, the poll found.

Chronic sleep loss can contribute to drowsy-driving crashes, increased obesity risk, depression, suicidal thoughts, risk-taking behavior, difficulty problem-solving, poor judgment, lack of motivation, and school truancy or absences, according to the AAP position paper. Sleeping in on weekends or using stimulants such as caffeine to stay awake can make things worse.

Nationwide, just 15 percent of high schools start at 8:30 a.m. or later, and 40 percent start before 8 a.m., the AAP estimates.

Most Jefferson County Public Schools (JCPS) middle and high schools start at 7:40 a.m. Nearly 70,000 of the district’s 101,000 students are bus riders, and many have to be at bus stops — sometimes as far as a mile from their home — before 6:30 a.m. JCPS, with the largest school system in Kentucky and the 27th largest in the nation, sends its buses back through neighborhoods to pick up elementary students, who generally start school at 9:05 a.m.

Changing start times here hasn’t been formally discussed or studied in recent years, if ever, said Ben Jackey, JCPS communications specialist.

“There would be some logistical issues,” he said, noting that any changes would have a domino effect on schedules. Everything from dismissal times to child care, sports and other after-school activities would be affected, Jackey said.

Proponents for pushing back start times argue that the benefits outweigh the difficulties involved. They point to districts like Fayette County, Kentucky, which saw a 16.5 percent drop in car crashes involving 16- to 18-year-olds in the two years after school start times were moved from 7:30 a.m. to 8:30 a.m. Overall teen driver crash rates increased in Kentucky during the same period.

The National Highway Traffic Safety Administration estimates that up to 100,000 police-reported crashes annually are related to drowsiness, and that among drivers ages 15 to 24, more than 1,500 fatalities each year are associated with such crashes. In a North Carolina state study, 55 percent of “fall asleep crashes” involved drivers age 25 or younger.

Attendance and standardized test scores have shown improvement in districts that have delayed start times, such as Jessamine County, Kentucky, according to startschoollater.net, a national nonprofit organization that serves as an information clearinghouse.

For instance, one Middletown, Rhode Island, school noted that the number of students reporting at least 8 hours of sleep on school nights jumped about 16 percent to almost 55 percent, daytime sleepiness dropped from 49 percent to 20 percent, first-period tardiness dropped by almost half and students said they had more time to eat a hot, nutritious breakfast, according to startschoollater.net.

— Mickey H. Gramig


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