Literature search: Students' sleep problems and school management

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Students' Sleep Problems

 

SHEU has provided a literature search resource about young people, sleep problems and school management

Thanks to Zotero and Jason Priem

Last updated September 2012  - - - - - see also SHEU search "sleep"

http://sheu.org.uk

 


School management of students with a lack of sleep

Type Journal Article  
Author Editorial  
Publication Education and Health  
Volume 30  
Issue 3  
Page 56  
Date 2012  
URL /x/eh303ed1.pdf

 


Sleepless in America: School start times

Type Journal Article  
Author Editorial  
Publication Education and Health  
Volume 30  
Issue 3  
Page 57  
Date 2012  
URL /sites/sheu.org.uk/files/imagepicker/1/eh303ed2.pdf

 


Ready, willing, and able? Sleep hygiene education, motivational interviewing and cognitive behaviour therapy for insomnia in an Australian high school setting

Type Journal Article
Author Neralie Cain
Abstract Cognitive behaviour therapy for insomnia is well-regarded as an effective treatment for insomnia in adults. Previous studies also suggest that CBT-i can be successfully applied to adolescents experiencing insomnia and other sleep problems, which most commonly involve delayed sleep timing. The recommended treatment involves a combined program of morning bright light therapy, stimulus control therapy, and education about sleep hygiene. Improving sleep pattern regularity by getting up earlier on weekends (i.e., at a time closer to the weekday wake-up time) can play a particularly important role in increasing total sleep time during the week and decreasing daytime sleepiness. Recent research suggests that the school classroom may be a promising arena for the dissemination of sleep interventions for adolescents. However, many of the earlier studies in this area have been plagued by problems such as inappropriate outcome measures, small sample size, lack of control group, and lack of follow-up data. Reporting has also been poor, with a number of studies presented only in abstract form. Results have been mixed: some studies showed improved knowledge about sleep, despite having no data about actual changes in sleep habits or behaviours; another study measured sleep habits but found no change from pre- to post-treatment. Finally, some studies found changes in sleep habits from pre- to post-treatment, although these results must be interpreted with caution due to the previously mentioned problems of small sample size, lack of control group, and lack of follow-up data. A series of two studies conducted by researchers at Flinders University in Adelaide, Australia, attempted to overcome the limitations of previous research by conducting randomised controlled trials evaluating school-based intervention programs aimed at improving the sleep of adolescents. Full details of these studies can be found in earlier publications; however, an outline of the main findings are presented here, along with recommendations for others planning school-based interventions for adolescent sleep problems.
Publication Education and Health
Volume 30
Issue 3
Pages 60-63
Date 2012
URL /x/eh303nc.pdf

 


Sound Sleep: raising awareness in schools of the importance of sleep for our emotional and physical wellbeing

Type Journal Article
Author Jane Ansell
Abstract Sleep duration and quality are associated with a range of neuropsychological and psychosocial outcomes in children and adolescents but community awareness of this is low. A small body of literature on sleep education programs in children and adolescents delivered through school-based programs is attempting to address this. A review of the literature found only 8 studies and 4 pilot studies in abstract form. This paper presents these sleep education programs and evaluates their effectiveness. In general, findings suggest that when sleep knowledge was measured it was increased in most programs. However this did not necessarily equate to sleep behaviour change such as increased sleep duration or improved sleep hygiene. Reasons for this are discussed and may include motivation and readiness to change, salience to the individual, delivery, content, time allocation, or methodological underpinnings. This paper attempts to understand this and assess how best to improve future sleep education programs from a theoretical perspective. Specifically, it considers the theory of planned behaviour which may assist in ensuring maximum efficacy for the current and future development of sleep education programs.
Publication Education and Health
Volume 30
Issue 3
Pages 64-65
Date 2012
URL /x/eh303ja.pdf

 


The Sleep Council’s teaching resource: 'Better Brains with More Sleep'  

Type Journal Article
Author

Lisa Artis

Abstract In March 2012, The Sleep Council launched its first-ever 'sleep awareness' education project in primary schools. A free learning resource was provided to schools nationally, with the aim of teaching primary school children the importance of a good night's sleep and factors - such as regular bedtimes and a good bed - that can affect it.
Publication Education and Health
Volume 30
Issue 3
Pages 66-67
Date 2012
URL /x/eh303la.pdf

 


Are sleep education programs successful? The case for improved and consistent research efforts

Type Journal Article
Author Sarah L. Blunden
Author Janine Chapman
Author Gabrielle A. Rigney
Abstract Sleep duration and quality are associated with a range of neuropsychological and psychosocial outcomes in children and adolescents but community awareness of this is low. A small body of literature on sleep education programs in children and adolescents delivered through school-based programs is attempting to address this. A review of the literature found only 8 studies and 4 pilot studies in abstract form. This paper presents these sleep education programs and evaluates their effectiveness. In general, findings suggest that when sleep knowledge was measured it was increased in most programs. However this did not necessarily equate to sleep behaviour change such as increased sleep duration or improved sleep hygiene. Reasons for this are discussed and may include motivation and readiness to change, salience to the individual, delivery, content, time allocation, or methodological underpinnings. This paper attempts to understand this and assess how best to improve future sleep education programs from a theoretical perspective. Specifically, it considers the theory of planned behaviour which may assist in ensuring maximum efficacy for the current and future development of sleep education programs.
Publication Sleep Medicine Reviews
Volume 16
Issue 4
Pages 355-370
Date 2012
URL http://linkinghub.elsevier.com/retrieve/pii/S1087079211000918

 


Weekend catch-up sleep is associated with decreased risk of being overweight among fifth-grade students with short sleep duration

Type Journal Article
Author Chan-Won Kim
Author Min-Kyu Choi
Author Hyoung-June Im
Author Ok-Hyun Kim
Author Hye-Ja Lee
Author Jihyun Song
Author Jae-Heon Kang
Author Kyung-Hee Park
Abstract Previous studies have reported a relationship between short sleep duration and childhood overweight. Although school-aged children tend to compensate for weekday sleep deficit by increasing weekend sleep duration, the association between weekend catch-up sleep and childhood overweight remains unclear. This study aimed to examine the relationship between weekend catch-up sleep and being overweight in children. A total of 936 school children (48.2% boys) aged 10 or 11 years participated in this school-based cohort study. Anthropometric measurements including height and body weight were carried out. We obtained data on sleep patterns, lifestyle and parent characteristics using questionnaires. The main outcome measure was childhood overweight. After adjusting for the relevant confounding variables (age, sex, breakfast eating, screen time and parental obesity), longer sleep on weekdays and weekends was associated with decreased odds of childhood overweight (OR: 0.68; 95% CI: 0.54–0.86; OR: 0.64; 95% CI: 0.53–0.77, respectively). Participants with increased catch-up sleep duration during weekends also had decreased odds of being overweight (OR: 0.67; 95% CI: 0.53–0.85). There was an interaction between weekday sleep duration and weekend catch-up sleep in relation to childhood overweight, and this effect of weekend catch-up sleep on being overweight was stronger as the participants slept less on weekdays (P = 0.024). These results indicate that weekend catch-up sleep is independently associated with decreased risk of being overweight in fifth-grade students, and this effect can be varied by the weekday sleep duration. A prospective study is required to confirm this observation.
Publication Journal of Sleep Research
Pages no-no
Date 2012
URL http://doi.wiley.com/10.1111/j.1365-2869.2012.01013.x

 


The Impact of School Start Times on Adolescent Health and Academic Performance

Type Web Page
Author Dennis Nolan
Website Title The Impact of School Start Times on Adolescent Health and Academic Performance
Date 2012
URL http://schoolstarttime.org/

 


Sleep Review - The journal for sleep specialists

Type Web Page
Publication Sleep Review
Date 2012
URL http://www.sleepreviewmag.com/

 


Sleep - The Journal

Type Web Page
Publication Sleep
Date 2012
URL http://www.journalsleep.org/Default.aspx

 


Sleep Medicine - The Journal

Type Journal Article
Publication Sleep Medicine
Date 2012
URL http://www.sleep-journal.com

 


National Sleep Foundation

Type Web Page
Date 2012
URL http://www.sleepfoundation.org

 


Australian Centre for Education in Sleep

Type Web Page
Date 2012
URL http://www.sleepeducation.net.au/

 


Does Sleep Education Change Sleep Parameters? Comparing Sleep Educa-tion Trials for Middle School Students in Australia and New Zealand

Type Journal Article
Author Sarah L. Blunden
Author G Kira
Author M Hull
Author R Maddison
Abstract Background: Adolescents suffer daytime consequences from sleep loss. Sleep education programs have been developed in an attempt to increase sleep knowledge and/or duration. This paper presents data from three trials of the Aus-tralian Centre for Education in Sleep (ACES) program for adolescents. Methods: The ACES program was delivered to 69 Australian adolescents in a pre-post cross-sectional design (mean age 15.2) and 29 New Zealand adolescents in a randomised control trial (mean age 14.8 years). Assessments in sleep parame-ters were undertaken at baseline and post intervention. Results: Where sleep knowledge was evaluated (Australian trials), significant improvements were shown in all trials (All p <0.05). Where sleep duration was assessed (New Zealand trial) significant improvements were found in week and weekend sleep duration [F(1, 27)=4.26, p=0.04). Both, students and teachers found the program feasible, interesting, and educational. Conclusions: ACES sleep education programmes can improve both sleep knowledge and sleep duration in adolescents. Improving the programme so sleep knowledge attained equates to actual sleep behaviour change are areas for future direc-tion. Collectively these findings provide encouraging signs that adolescents can improve their sleep knowledge and behav-iour with sleep education which bodes well for sleep-related health and psycho-social issues
Publication The Open Sleep Journal
Volume 5
Pages 12-18
Date 2012
URL http://www.benthamscience.com/open/toslpj/articles/V005/12TOSLPJ.pdf

 


Adolescent sleep : Summary AYPH Research Update No.10 July 2012

Type Web Page
Author Ann Hagell
Abstract This paper is not based on a formal review of the literature, but presents an overview of the issues, and a useful selection of key, up-to-date findings on adolescent sleep, the links with health outcomes, and sleep disturbances.
Date 2012
URL http://www.ayph.org.uk/publications/282_Adolescent%20sleep%20Research%20Update%20summary%20July%202012.pdf

 


Sleep for Science: Sleep Research Lab

Type Web Page
Date 2012
URL http://sleepforscience.org/

 


A Randomized Controlled Trial of Cognitive-Behavior Therapy Plus Bright Light Therapy for Adolescent Delayed Sleep Phase Disorder

Type Journal Article
Author Michael Gradisar
Author Hayley Dohnt
Author Greg Gardner
Author Sarah Paine
Author Karina Starkey
Author Annemarie Menne
Author Amy Slater
Author Helen Wright
Author Jennifer L. Hudson
Author Edward Weaver
Author Sophie Trenowden
Abstract Objective: To evaluate cognitive-behavior therapy plus bright light therapy (CBT plus BLT) for adolescents diagnosed with delayed sleep phase disorder (DSPD). Design: Randomized controlled trial of CBT plus BLT vs. waitlist (WL) control with comparisons at pre- and post-treatment. There was 6-month follow-up for the CBT plus BLT group only. Setting: Flinders University Child & Adolescent Sleep Clinic, Adelaide, South Australia. Patients: 49 adolescents (mean age 14.6 ± 1.0 y, 53% males) diagnosed with DSPD; mean chronicity 4 y 8 months; 16% not attending school. Eighteen percent of adolescents dropped out of the study (CBT plus BLT: N = 23 vs WL: N = 17). Interventions: CBT plus BLT consisted of 6 individual sessions, including morning bright light therapy to advance adolescents' circadian rhythms, and cognitive restructuring and sleep education to target associated insomnia and sleep hygiene. Measurements and Results: DSPD diagnosis was performed via a clinical interview and 7-day sleep diary. Measurements at each time-point included online sleep diaries and scales measuring sleepiness, fatigue, and depression symptoms. Compared to WL, moderate-to-large improvements (d = 0.65-1.24) were found at post-treatment for CBT plus BLT adolescents, including reduced sleep latency, earlier sleep onset and rise times, total sleep time (school nights), wake after sleep onset, sleepiness, and fatigue. At 6-month follow-up (N = 15), small-to-large improvements (d = 0.24-1.53) continued for CBT plus BLT adolescents, with effects found for all measures. Significantly fewer adolescents receiving CBT plus BLT met DPSD criteria at post-treatment (WL = 82% vs. CBT plus BLT = 13%, P < 0.0001), yet 13% still met DSPD criteria at the 6-month follow-up. Conclusions: CBT plus BLT for adolescent DSPD is effective for improving multiple sleep and daytime impairments in the immediate and long-term. Studies evaluating the treatment effectiveness of each treatment component are needed.
Publication SLEEP
Date 2011
URL http://www.journalsleep.org/ViewAbstract.aspx?
pid=28353

 


Time for Bed: Parent-Set Bedtimes Associated with Improved Sleep and Daytime Functioning in Adolescents

Type Journal Article
Author Michelle A. Short
Author Michael Gradisar
Author Helen Wright
Author Leon C. Lack
Author Hayley Dohnt
Author Mary A. Carskadon
Abstract Study Objectives: To determine the proportion of adolescents whose bedtime is set by their parents and to evaluate whether parent-set bedtimes are associated with earlier bedtimes, more sleep, and better daytime functioning. Participants: 385 adolescents aged 13-18 years (mean = 15.6, SD = 0.95; 60% male) from 8 socioeconomically diverse schools in South Australia. Measurements & Methods: Adolescents completed the School Sleep Habits Survey during class time and then completed an 8-day Sleep Diary. The Flinders Fatigue Scale was completed on the final day of the study. Results: 17.5% of adolescents reported a parent-set bedtime as the main factor determining their bedtime on school nights. Compared to adolescents without parent-set bedtimes, those with parent-set bedtimes had earlier bedtimes, obtained more sleep, and experienced improved daytime wakefulness and less fatigue. They did not differ significantly in terms of time taken to fall asleep. When parent-set bedtimes were removed on weekends, sleep patterns did not significantly differ between groups. Conclusions: Significant personal and public health issues, such as depression and accidental injury and mortality, are associated with insufficient sleep. Converging biological and psychosocial factors mean that adolescence is a period of heightened risk. Parent-set bedtimes offer promise as a simple and easily translatable means for parents to improve the sleep and daytime functioning of their teens.
Publication SLEEP
Date 2011
URL http://www.journalsleep.org/ViewAbstract.aspx?
pid=28152

 


Early to Rise: The Effect of Daily Start Times on Academic Performance

Type Report
Author Finley Edwards
Abstract Local school districts often stagger daily start times for their schools in order to reduce busing costs. This paper uses data on all middle school students in Wake County, NC from 1999-2006 to identify the causal effect of daily start times on academic performance. Using variation in start times within and across schools, I find that starting school one hour later leads to a three percentile point gain in both math and reading test scores. Using only variation in start times within schools over time, the effect is a two percentile point gain for math and a one percentile point gain for reading. The effect is stronger for students in the lower end of the distribution of test scores, and is roughly similar to raising parent’s education by one year. I find evidence supporting increased sleep, less time spent watching television and more time spent on homework as mechanisms through which start times affect test scores.
Date 2011
URL https://06aa34f7-a-62cb3a1a-s-sites.googlegroups.com/site/finleyedwards/EdwardsStartTimes.pdf?
attachauth=ANoY7cpgXBT_iZNLD3ERp17gjCY4ttj13BJygBmGhXStAcxnla9d-3CQsy3KertkKtNKW2CKFe23-vY6zyJjf4Gd-78NdXbv6kYq-zA0BGV4qNHb_PPwZwmfMTY6qf8ZZmVn4Xk53r4FLFTkH89X0sAhzApqpb9l7I0sHH1yALiJvI1mvFGD2oEPVhkCy0wkchL9zVmYnS1ukI8_y6Rbg82jDiri4qxC8PX6-a4RPovBVXwS3V95hfE%3D&…

 


A motivational school-based intervention for adolescent sleep problems

Type Journal Article
Author Neralie Cain
Author Michael Gradisar
Author Lynette Moseley
Abstract Objective The current study aimed to develop and evaluate a motivational school-based intervention for adolescent sleep problems. Methods The intervention was implemented in three co-educational secondary schools in Adelaide, South Australia. Two year-11 Psychology classes from each school participated, with one as the intervention class (N=53) and one as the control class (N=51). Students in the intervention classes attended four 50-min sleep education classes, held once per week. The lessons were modified from those of Moseley and Gradisar [23] to incorporate a motivational interviewing framework. Students completed an online questionnaire battery measuring school day and weekend sleep parameters, daytime sleepiness, and depression at pre- and post-program and follow-up, and completed motivation to change questionnaires during the program. Results Students in the intervention group significantly increased their knowledge about sleep relative to the control group (p=0.001). During the intervention, students’ motivation to regularize their out-of-bed times improved (p=0.03), and there was a trend towards improved motivation to increase average total sleep time (p=0.11). But despite improvements in sleep and daytime functioning for adolescents in the program group (p<0.05), these changes were not significantly different from the control group (all p>0.05). Conclusions School-based interventions are promising for educating adolescents about sleep. Future programs should translate increased motivation into long-term behavioral change. The identification of barriers and support to assist this change is recommended.
Publication Sleep Medicine
Volume 12
Issue 3
Pages 246-251
Date 2011
URL http://www.sleep-journal.com/article/PIIS1389945710003849/abstract

 


Recent worldwide sleep patterns and problems during adolescence: A review and meta-analysis of age, region, and sleep

Type Journal Article
Author Michael Gradisar
Author Greg Gardner
Author Hayley Dohnt
Abstract Adolescent sleep health is becoming increasingly recognized internationally as a significant concern, with many countries reporting high incidences of sleep disturbance in our youth. Notwithstanding the value of findings obtained from each large-scale survey of adolescent sleep performed within individual countries, the field lacks synthesis and analysis of adolescent sleep studies into a single review. This review presents findings from a meta-analysis of 41 surveys of worldwide adolescent sleep patterns and problems published in the last decade (1999–2010). Sleep patterns tended to delay with increasing age, restricting school-night sleep. Notably, Asian adolescents’ bedtimes were later than peers from North America and Europe, resulting in less total sleep time on school nights and a tendency for higher rates of daytime sleepiness. Weekend sleep data were generally consistent worldwide, with bedtimes 2+ hours later and more total sleep time obtained. We note a worldwide delayed sleep–wake behavior pattern exists consistent with symptoms of Delayed Sleep Phase Disorder, which may be exacerbated by cultural factors. Recommendations for future surveys of adolescent sleep patterns are discussed and provided in light of current methodological limitations and gaps in the literature.
Publication Sleep Medicine
Volume 12
Issue 2
Pages 110-118
Date 2011
URL http://www.sleep-journal.com/article/S1389-9457(10)00432-6/abstract

 


A Brief Sleep Intervention Improves Outcomes in the School Entry Year: A Randomized Controlled Trial

Type Journal Article
Author Jon Quach
Author Harriet Hiscock
Author Obioha Chukwunyere Ukoumunne
Author Melissa Wake
Abstract OBJECTIVE: To determine the feasibility of screening for child sleep problems and the efficacy of a behavioral sleep intervention in improving child and parent outcomes in the first year of schooling. METHODS: A randomized controlled trial was nested in a population survey performed at 22 elementary schools in Melbourne, Australia. Intervention involved 2 to 3 consultations that covered behavioral sleep strategies for children whose screening results were positive for a moderate/severe sleep problem. Outcomes were parent-reported child sleep problem (primary outcome), sleep habits, psychosocial health-related quality of life, behavior, and parent mental health (all at 3, 6, and 12 months) and blinded, face-to-face learning assessment (at 6 months). RESULTS: The screening survey was completed by 1512 parents; 161 (10.8%) reported a moderate/severe child sleep problem, and 108 of 136 (79.2% of those eligible) entered the trial. Sleep problems tended to resolve more rapidly in intervention children. Sleep problems affected 33% of 54 intervention children versus 43% of 54 control children at 3 months (P ⬚ .3), 25.5% vs 46.8% at 6 months (P ⬚ .03), and 32% vs 33% at 12 months (P⬚.8). Sustained sleep-habit improvements were evident at 3, 6, and 12 months (effect sizes: 0.33 [P⬚.03]; 0.51 [P⬚.003]; and 0.40 [P⬚ .02]; respectively), and there were initial marked improvements in psychosocial scores that diminished over time (effect sizes: 0.47 [P ⬚ .02]; 0.41 [P ⬚ .09]; and 0.26 [P ⬚ .3]; respectively). Better prosocial behavior was evident at 12 months (effect size: 0.35; P ⬚ .03), and learning and parent outcomes were similar between groups. CONCLUSIONS: School-based screening for sleep problems followed by a targeted, brief behavioral sleep intervention is feasible and has benefits relevant to school transition.
Publication Pediatrics
Volume 128
Issue 4
Pages 692-701
Date 2011
URL http://www.pediatricsdigest.mobi/content/128/4/692.full.pdf+html

 


Sleep Deprived Teens – A Growing Trend

Type Presentation
Presenter Hayley Dohnt
Abstract •Most adolescents do not get enough sleep •Research suggests this pattern of poor sleep increases with age •Sleep duration of adolescents has decreased over time •Adolescents obtain average of 7.6 hours of sleep per night •Similar patterns have been found worldwide, including in Australia
Date 2011
URL http://www.adelaide.edu.au/hda/news/T3_Dohnt.pdf

 


Impact of Delaying School Start Time on Adolescent Sleep, Mood, and Behavior

Type Journal Article
Author Judith Owens
Abstract Objective: To examine the impact of a 30-minute delay in school start time on adolescents’ sleep, mood, and behavior. Design: Participants completed the online retrospective Sleep Habits Survey before and after a change in school start time. Setting: An independent high school in Rhode Island. Participants: Students (n=201) in grades 9 through 12. Intervention: Institution of a delay in school start time from 8 to 8:30 AM. Main Outcome Measures: Sleep patterns and behavior, daytime sleepiness, mood, data from the Health Center, and absences/tardies. Results: After the start time delay, mean school night sleep duration increased by 45 minutes, and average bedtime advanced by 18 minutes (95% confidence interval, 7-29 minutes [t423=3.36; P⬚.001]); the percentage of students getting less than 7 hours of sleep decreased by 79.4%, and those reporting at least 8 hours of sleep increased from 16.4% to 54.7%. Students reported significantly more satisfaction with sleep and experienced improved motivation. Daytime sleepiness, fatigue, and depressed mood were all reduced. Most health-related variables, including Health Center visits for fatigue-related complaints, and class attendance also improved. Conclusions: A modest delay in school start time was associated with significant improvements in measures of adolescent alertness, mood, and health. The results of this study support the potential benefits of adjusting school schedules to adolescents’ sleep needs, circadian rhythm, and developmental stage.
Publication Arch Pediatr Adolesc Med
Volume 164
Issue 7
Pages 608-614
Date 2010
URL http://teensneedsleep.files.wordpress.com/2011/03/owens-belon-moss-impact-of-delaying-school-start-time-on-adolescent-sleep-mood-and-behavior-archives-of-pediatrics-adolescent-medicine-july-20103.pdf

 


School start times and teenage driver motor vehicle crashes

Type Report
Author Robert Foss
Author Richard Smith
Abstract There is substantial evidence that lack of sleep is a significant factor in motor vehicle crashes experienced by teenage drivers. This paper examines the hypothesis that a later high school start time may reduce crash rates by reducing the interference of school start time with the sleep needs of adolescents. We collected data from two jurisdictions, Forsyth County, North Carolina and Fayette County, Kentucky, that changed to a substantially later high school start time. We examined whether this change was accompanied by a drop in crash rates among 16- and 17-year-old drivers. Monthly time series were compiled corresponding to the overall rate of crashes on school days, adjusted for the 16- and 17-year-old population. An intervention time series analysis was applied to determine whether the change in school start time was accompanied by a downward shift in the level of the crash rate series. To control for possible confounding factors, comparable statistics were also compiled, using the same analyses, for several other counties where there was no change in school start times. For Forsyth County, NC there was a decrease in crash rates corresponding to the change in school start time, though the statistical significance of the effect is only moderate (one-sided p-value = .04). No corresponding effect was observed for three comparable counties of North Carolina. For Fayette County, KY there was no evidence of a statistically significant change in crash rates. Because of anomalous data in the one available comparable county, we were unable to derive meaningful results for a comparison county in Kentucky. We conclude that there is mild evidence that the change in school start times in Forsyth County, NC had a beneficial effect, but there is no corresponding evidence for Fayette County, KY.
Date 2010
URL http://www.csyd.unc.edu/projects/docs/HS_start_time.pdf

 


Evaluation of a School-Based Intervention for Adolescent Sleep Problems

Type Journal Article
Author Lynette Moseley
Author Michael Gradisar
Abstract Study Objectives: The present study investigated the effectiveness of a school-based intervention in increasing sleep knowledge and improving adolescent sleep problems. Design: A randomized, controlled trial using 2 groups (program class, classes-as-usual: [CAU]) assessed over 3 time points (pre-program, post-program, 6-week follow-up). Participants/Setting: Eighty-one students (mean age = 15.6 ± 0.6 y; 33% male) from 2 schools in South Australia. Schools provided one class to participate in the sleep intervention program (N = 41) and a second class to act as a control class (N = 40). Intervention: Four 50-minute classes across a 4-week period. Classes consisted of educating adolescents on promoting and maintaining a healthy lifestyle based on a cognitive-behavior therapy framework. Measurements and Results: Data were collected pre-program, post-program, and at 6-week follow-up using an online questionnaire. Qualitative student and teacher data were collected at post-program. Baseline data indicated sleep problems were prevalent (53.1% insufficient sleep on school nights [ < 8 h] and 77.8% discrepant school/weekend rise times [ > 2 h]). These 2 criteria identified 36 adolescents with a delayed sleep timing (DST; Program, N = 21; CAU, N = 15). The program increased sleep knowledge (P= 0.001); however, analyses revealed no significant effects on target sleep variables as compared with the CAU class for the entire group (all P> 0.05). For DST adolescents, there was a significant interaction for reducing the discrepancy between school and weekend out of bed times (P= 0.002). There was no impact on other sleep parameters or depressed mood. Conclusions: School-based sleep interventions for adolescents are a novel method for addressing a prevalent problem. Future programs should develop ways to motivate adolescents to change sleep practices.
Publication Sleep
Volume 32
Issue 3
Pages 334-341
Date 2009
URL http://www.journalsleep.org/ViewAbstract.aspx?
pid=27406

 


High Schools Find Later Start Time Helps Students’ Health and Performance

Type Journal Article
Author Lynne Lamberg
Publication JAMA
Volume 301
Issue 21
Pages 2200-1
Date 2009
URL http://jama.jamanetwork.com/article.aspx?
articleid=184011

 


Adolescents' sleep behaviors and perceptions of sleep

Type Journal Article
Author Heather Noland
Abstract BACKGROUND: Sleep duration affects the health of children and adolescents. Shorter sleep durations have been associated with poorer academic performance, unintentional injuries, and obesity in adolescents. This study extends our understanding of how adolescents perceive and deal with their sleep issues. METHODS: General education classes were randomly selected from a convenience sample of three high schools in the Midwest. Three hundred eighty-four ninth- to twelfth-grade students (57%) completed a self-administered valid and reliable questionnaire on sleep behaviors and perceptions of sleep. RESULTS: Most respondents (91.9%) obtained inadequate sleep (<or= 9 hours) on most school nights of the week, with 10% reporting less than 6 hours of sleep each week night. The majority indicated that not getting enough sleep had the following effects on them: being more tired during the day (93.7%), having difficulty paying attention (83.6%), lower grades (60.8%), increase in stress (59.0%), and having difficulty getting along with others (57.7%). Some students reported engaging in harmful behaviors to help them sleep: taking sleeping pills (6.0%), smoking a cigarette to relax (5.7%), and drinking alcohol in the evening (2.9%). Students who received fewer hours of sleep were significantly more likely to report being stressed (p = .02) and were more likely to be overweight (p = .04). CONCLUSIONS: Inadequate sleep time may be contributing to adolescent health problems such as increased stress and obesity. Findings indicate a need for sleep hygiene education for adolescents and their parents. A long-term solution to chronic sleep deprivation among high school students could include delaying high school start times, such as was done successfully in the Minneapolis Public School District.
Publication Journal of School Health
Volume 79
Issue 5
Pages 224-30
Date 2009
URL http://ermurrowhs.schoolwires.com/140510103113232107/lib/140510103113232107/_files/Adolescent_Sleep.pdf

 


Educating Adolescents About Healthy Sleep: Experimental Study of Effectiveness of Educational Leaflet

Type Journal Article
Abstract Aim To evaluate how exposure to educational leaflet about healthy sleep affects knowledge about sleep in adolescents. Methods The study included students aged 15-18 years from 12 high schools (1209 participants; 85% of eligible study population). Multistage sampling was used and the selected schools were randomly assigned into two intervention groups and two control groups, according to the Solomon experimental design. Intervention groups received educational leaflets and control groups did not. In one of the intervention groups and one of the control groups, pre-testing of knowledge about sleep was performed. Students answered the Sleep Knowledge Test, which was constructed in accordance with the information on the leaflet. Data were analyzed by four-way ANOVA and additional analyses of simple main effects were performed. Results Positive effect of educational leaflet was found in students aged 15 (F = 28.46; P < 0.001), 16 (F = 5.74; P = 0.017), and 17 (F = 17.17; P < 0.001), but there was no effect in students aged 18 (P = 0.467). In male students, positive effect of the leaflet was found only in the group that had not been pre-tested (F = 6.29; P = 0.012), while in female students, it was found in both pre-tested (F = 26.24; P < 0.001) and not pre-tested group (F = 17.36; P < 0.001), with greater effect in pre-tested group (F = 5.70; P = 0.017). Female students generally showed better knowledge about sleep than male students (F = 95.95; P < 0.001). Conclusion Educational leaflets can be an effective first step in educating younger high school students about healthy sleep, with the method being more effective in female adolescents.
Publication Croation Medical Journal
Volume 50
Issue 2
Pages 174-181
Date 2009
URL http://www.cmj.hr/2009/50/2/19399951.htm

 


The tired teen: A review of the assessment and management of the adolescent with sleepiness and fatigue,

Type Journal Article
Author Sheri M. Findlay
Abstract The symptoms of sleepiness and fatigue are frequently encountered when caring for adolescents. Up to 40% of healthy teens experience regular sleepiness, defined as an increased tendency to fall asleep. Fatigue is the perception of low energy following normal activity and is reported by up to 30% of well teens. Chronic fatigue syndrome is an unusual syndrome with severe fatigue accompanied by other physical and neurological symptoms. A thorough assessment is required for all teens with sleepiness and fatigue; however, a treatable underlying medical condition is rarely found. Most fatigue and sleepiness in teens is attributable to lifestyle issues, notably too little time spent sleeping. Physicians are in a position to screen for, assess and manage these common conditions in teens.
Publication Paediatrics & Child Health,
Volume 13,
Issue 1,
Pages 37,
Date 2008
URL http://ukpmc.ac.uk/articles/PMC2528817/?
report=abstract,

 


Teaching chronobiology and sleep habits in school and university. Mind, Brain, and Education, 2, 34-47.

Type Journal Article
Author Carolina Azevedo
Author Ivanise Sousa
Author Ketema Paul
Author Marlene MacLeish
Abstract Early morning school schedules are in the opposite direction to the sleep – wake cycle in adolescence and early adulthood. This confl ict leads to sleep deprivation and irregular patterns whose consequences are scarcely explored. This article discusses the effects of three educational experiences with high school students, parents, teachers, and medical students. The fi rst experience was developed with high school students in Natal, Brazil, to determine whether sleep habits would improve with increased awareness. Positive effects were observed in some aspects of sleep knowledge and practices. In the second experience in Atlanta, GA, sleep education activities were presented to middle and high school teachers, parents, and students to emphasize the importance of sleep. In the third program in Murcia, Spain, undergraduate medical students were introduced to chronobiology of sleep by a practical exercise that pointed out to what extent they shared most of adolescent sleep characteristics. Educational chronobiological experiences about sleep are essential to develop healthy sleep habits in the general population, particularly in students.
Publication Mind, Brain and Education
Volume 2
Pages 34-47
Date 2008
URL https://camcom.ngu.edu/Science/PSYC/PSYC%202350/Research%20Article%20Assignments/Article%20Review%202/Teaching%20Chronobiology%20Sleep%20Habits.pdf

 


Sleeping-in on the weekend delays circadian phase and increases sleepiness the following week

Type Journal Article
Author Amanda Taylor
Author Helen R. Wright
Author Leon C. Lack
Abstract Many individuals tend to sleep-in later over the weekend, possibly in an attempt to catch up on accumulated sleep loss from the working week. Previous studies have found that delaying bedtime and waking-up time (WUT) results in a delayed circadian rhythm and a decline in subsequent mood and cognitive functioning. The present study investigated the effect of delaying only WUT for two weekend mornings on the timing of the dim light melatonin onset circadian rhythm (DLMO), as well as sleep, daytime sleepiness and fatigue. In a repeated measures design with 16 participants, the delayed weekend WUT condition (DS) was compared with a weekend in which they kept their habitual weekday WUT (HS). On average, participants in the DS condition delayed their weekend WUT by about 3 h. When compared to the HS condition, participants in the DS condition had a significant delay in salivary DLMO of 42 min between Friday and Sunday nights. They also indicated an 8-min increased sleep onset latency on Sunday night and significantly greater daytime fatigue and sleepiness on Monday and Tuesday of the following week. Sleeping-in late on the weekend appears to have a subsequent cost of delaying circadian rhythm, delaying sleep on Sunday night and increased daytime sleepiness and fatigue, the so-called ‘Monday morning blues’.
Publication Sleep and Biological Rhythms
Volume 6
Issue 3
Pages 172–179
Date 2008
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1479-8425.2008.00356.x/abstract

 


Middle School Start Times: The Importance of a Good Night's Sleep for Young Adolescents

Type Journal Article
Author Amy R. Wolfson
Abstract With the onset of adolescence, teenagers require 9.2 hr of sleep and experience a delay in the timing of sleep. In the "real world" with early school start times, however, they report less sleep, striking differences between their school-weekend sleep schedules, and significant daytime sleepiness. Prior studies demonstrated that high schoolers with later school starts do not further delay bedtime but obtain more sleep due to later wake times. This study examined sleep-wake patterns of young adolescents attending urban, public middle schools with early (7:15 a.m.) versus late (8:37 a.m.) start times. Students (N = 205) were assessed at 2 time periods. Students at the late-starting school reported waking up over 1 hr later on school mornings and obtaining 50 min more sleep each night, less sleepiness, and fewer tardies than students at the early school. All students reported similar school-night bedtime, sleep hygiene practices, and weekend sleep schedules.
Publication Behavioral Sleep Medicine
Volume 5
Issue 3
Pages 194- 209
Date 2007
URL http://www.slrsd.org/slrhs/information/pdf/Wolfson%20et%20al%20%282007%29.pdf

 


The effect of a sleep hygiene education program on the sleep–wake cycle of Brazilian adolescent students

Type Journal Article
Author Ivanise Cortez De Sousa
Author John Fontenele Araújo
Author Carolina Virginia Macêdo De Azevedo
Abstract Adolescents present with sleep timing delay, irregular sleep–wake (SW) schedules and short sleep duration (<7 h) on school days, all resulting from biological and behavioral factors. To minimize this, we evaluated the effect of a school-based sleep hygiene program on the SW cycle, sleep quality and sleepiness in 58 Brazilian adolescent students. The sleep hygiene program lasted a week and consisted of a daily 50 min activity, such as a sleep physiology class, constructing a sleep ontogeny map, discussing the causes and consequences of adolescent short sleep duration and a quiz about sleep hygiene statements. After this, the students showed a reduction in their index of sleep irregularity (represented by standard deviation from bedtime), their sleep latency decreased and their nap–wake up schedule advanced. Their sleep quality and daytime sleepiness showed no difference. The program was effective in reducing sleep irregularity and latency and advancing nap awaking but could be improved and extended to a larger sample to achieve a better evaluation.
Publication Sleep and Biological Rhythms
Volume 5
Issue 4
Pages 251–258
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1479-8425.2007.00318.x/abstract

 


The implementation of a sleep education program in adolescents.

Type Journal Article
Author Sarah L. Blunden
Publication Sleep Biol Rhythms
Volume 5
Issue 1 A31
Date 2007
URL http://onlinelibrary.wiley.com/doi/10.1111/j.1479-8425.2007.00285.x/abstract

 


Sleep loss, learning capacity and academic performance

Type Journal Article
Author Giuseppe Curcio
Author Michele Ferrara
Abstract At a time when several studies have highlighted the relationship between sleep, learning and memory processes, an in-depth analysis of the effects of sleep deprivation on student learning ability and academic performance would appear to be essential. Most studies have been naturalistic correlative investigations, where sleep schedules were correlated with school and academic achievement. Nonetheless, some authors were able to actively manipulate sleep in order to observe neurocognitive and behavioral consequences, such as learning, memory capacity and school performance. The findings strongly suggest that: (a) students of different education levels (from school to university) are chronically sleep deprived or suffer from poor sleep quality and consequent daytime sleepiness; (b) sleep quality and quantity are closely related to student learning capacity and academic performance; (c) sleep loss is frequently associated with poor declarative and procedural learning in students; (d) studies in which sleep was actively restricted or optimized showed, respectively, a worsening and an improvement in neurocognitive and academic performance. These results may been related to the specific involvement of the prefrontal cortex (PFC) in vulnerability to sleep loss. Most methodological limitations are discussed and some future research goals are suggested.
Publication Sleep Medicine Reviews
Volume 10
Issue 5
Pages 323-337
Date 2006
URL http://teensneedsleep.files.wordpress.com/2011/03/sleep-loss-learning-capacity-and-academic-performance1.pdf

 


The Impact of School Daily Schedule on Adolescent Sleep

Type Journal Article
Author Martha Hansen
Author Imke Janssen
Author Adam Schiff
Author Phyllis C. Zee
Author Margarita L. Dubocovich
Abstract 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.
Publication Pediatrics
Volume 115
Issue 6
Pages 1555-1561
Date 2005
URL http://pediatrics.aappublications.org/content/115/6/1555.full

 


A Survey of Factors Influencing High School StartTimes

Type Journal Article
Author Amy R. Wolfson
Author Mary A. Carskadon
Abstract The present study surveyed high school personnel regarding high school start times, factors influencing school start times, and decision making around school schedules. Surveys were analyzedfrom 345 secondary schools selected at random from the National Center for Educational Statistics database. Factors affecting reported start times included economic background of the students, number of bus tiers, and school size. Most schools had not contemplated changing or changed their school start times. Of those schools in which changes were contemplated, 32% noted concerns about teenagers' sleep needs and about 50% of the respondents endorsed possible positive outcomes, such as lower tardiness and absenteeism rates. Perceived barriers to changing school schedules commonly endorsed included sports practices, after-school activities, and the transportation system. Approximately 50% of respondents indicated that sleep is included in their district's high school health or biology course offerings.
Publication NASSP Bulletin
Volume 89
Issue 642
Pages 47-66
Date 2005
URL http://bul.sagepub.com/content/89/642/47.full.pdf+html

 


Knowledge of sleep in Italian high school students: pilot-test of a school-based sleep educational program

Type Journal Article
Author Flavia Cortesi
Author Flavia Giannotti
Author Teresa Sebastiani
Author Oliviero Bruni
Author Salvatore Ottaviano
Abstract Purpose To evaluate knowledge about sleep and the effect of a sleep educational program on a group of Italian adolescents. Methods The program consisted of a 2-hour interactive sleep educational course. To assess students' sleep patterns and habits, the School Sleep Habits Survey was completed by 540 students, aged 17 to 19 years, who were attending three secondary public schools. Students were randomly assigned to the control and intervention group. Only the latter participated in the educational program. A pre-test evaluated baseline knowledge about sleep, a post-test measured the gain in knowledge after the course, and a 3-month follow-up test evaluated long-term retention of information. Improvement in knowledge was measured by increase in correct answers and comparisons of means between baseline and follow-up mean scores. Control group completed only baseline and 3-month follow-up tests. Data were analyzed using repeated measures analysis of variance, Cochran Q, and McNemar tests. Results Paired data were available for 425 students. Results showed unhealthy sleeping habits in 34% of students associated with high level of subjective sleepiness, increased vulnerability to injuries, and poor daytime functioning. Pre-test score showed a value of 4.2, post-test of 8.6 and 3-month follow-up of 6.7. Low baseline knowledge about sleep, an increase in knowledge, with an average of 50% gain in the percentage of correct answers immediately after the course, with a good long-term retention of information were found for the students who received the intervention as compared with control group. Conclusion Sleep educational programs for secondary students are recommended to improve information about sleep.
Publication Journal of Adolescent Health
Volume 34
Issue 4
Pages 344-351
Date 2004
URL http://www.jahonline.org/article/S1054-139X(03)00267-2/abstract

 


Sleepy Pre-Teens: Second Pilot of Sleep-Smart Program in 7th Graders

Type Journal Article
Author OT Vo
Author Amy R. Wolfson
Abstract [Page A411 1036.S] Conclusions: The aim of the Program was to increase the quantity and regularity of sleep in middle school students. Results from self-report and actigraphy – especially sleep regularity – are encouraging. However, some limitations remain, such as the small number of participants, compliance issues, and lack of follow-up. Nonetheless, this pilot supports introducing a sleep curriculum into health education.
Publication Sleep
Volume 26
Issue Supplement A411
Date 2003
URL http://www.journalsleep.org/PDF/2003%20Abstract%20Book%204-25-03.pdf

 


The effects of sleep restriction and extension on school-age children: What a difference an hour makes.

Type Journal Article
Publication Child Development
Volume 74
Issue 2
Pages 444-455
Date 2003
URL http://www.tau.ac.il/~sadeh/clinic/sleep%20res-ext%202003.pdf

 


Regulation of Sleepiness in Adolescents: Update, Insights, and Speculation

Type Journal Article
Author Mary A. Carskadon
Abstract In summary, we now have a good sense of the regulatory processes that account for the interesting pubertal change in sleepiness reported in 1980. Maturational changes that affect the alignment of circadian and sleep-wake processes appear to underlie the reorganization of diurnal sleep tendency. The pathway from pubertal maturation to phase angle realignment is not clear, and the possibility that feedback of behavioral factors ultimately is responsible for this reorganization has not been ruled out. In terms of the practical realities of adolescents’ lives, this combination of forces is particularly devastating for adjusting easily to the demands of early-morning school starting times.
Publication Sleep
Volume 25
Issue 6
Pages 606-614
Date 2002
URL http://www.journalsleep.org/ViewAbstract.aspx?
pid=25766

 


Middle school sleep-smart program: a pilot evaluation

Type Journal Article
Author CM Rossi
Author AL Campbell
Author Amy R. Wolfson
Abstract [Search for Rossi p 115] Conclusions: The Adolescent Sleep-Smart Program aimed to improve sleep habits and, specifically, to increase total sleep and obtain greater sleep schedule regularity between school/weekend-nights. Trends seen in the prevention group reflect a positive effect of this pilot program on sleep patterns, particularly on weekends. Across time, sleep-smart 7th graders reported increased school-night total sleep, earlier weekend bedtimes, greater school-weekend night bedtime regularity, and decreased weekend daytime sleepiness.
Publication Sleep
Volume 25
Issue A279 Supplemet Poster presentation
Date 2002
URL http://www.journalsleep.org/pdf/posters_split/poster_monday.pdf#p%20115

 


Adolescent sleep needs and patterns

Type Report
Author National Sleep Foundation
Date 2000
URL http://www.sleepfoundation.org/sites/default/files/sleep_and_teens_report1.pdf

 


Adolescent Sleep Patterns, Circadian Timing, And Sleepiness At A Transition To Early School Days

Type Journal Article
Author Mary A. Carskadon
Abstract Study Objectives: This study examined effects on adolescent sleep patterns, sleepiness, and circadian phase of a school transition requiring an earlier start. Design & Setting: Adolescents were evaluated in 9th and 10th grades; school start time in 9th grade was 0825 and in 10th grade was 0720. Assessments at each point included 2 weeks of actigraphy and sleep diaries at home, followed by a 22-hour laboratory evaluation, including evening saliva samples every 30 minutes in dim light for determination of dim-light salivary melatonin onset phase (DLSMO), overnight sleep monitoring, and multiple sleep latency test (MSLT). Participants: Twenty-five females and 15 males, ages 14 to 16.2 were enrolled; 32 completed the study in 9th grade and 26 completed in 10th grade. Interventions: Participants kept their own schedules, except that laboratory nights were scheduled based upon school-night sleep patterns. Measurements & Results: According to actigraphy, students woke earlier on school days in 10th than in 9th grade, but they did not go to sleep earlier and they slept less. DLSMO phase was later in 10th grade (mean = 2102) than 9th grade (mean = 2024). Sleep latency on MSLT overall was shorter in 10th (mean = 8.5 minutes) than in 9th (mean = 11.4 minutes), particularly on the first test of the morning at 0830 (5.1 vs 10.9 minutes). Two REM episodes on MSLT occurred in 16% of participants in 10th grade; one REM episode occurred in 48%. When those with REM sleep on one or both morning MSLTs (n = 11) were compared to those without morning REM, significant differences included shorter sleep latency on the first test, less slow wave sleep the night before, and later DLSMO phase in those who had morning REM. Conclusions: Early start time was associated with significant sleep deprivation and daytime sleepiness. The occurrence of REM sleep on MSLT indicates that clinicians should exercise caution in interpreting MSLT REM sleep in adolescents evaluated on their "usual" schedules. Psychosocial influences and changes in bioregulatory systems controlling sleep may limit teenagers' capacities to make adequate adjustments to an early school schedule.
Publication Sleep
Volume 21
Issue 8
Pages 871-881
Date 1998
URL http://www.journalsleep.org/ViewAbstract.aspx?
pid=24033

 


Starting Times Of School: Effects On Daytime Functioning Of Fifth-Grade Children In Israel

Type Journal Article
Author R Epstein
Abstract Summary: In the present study we investigated the effects of school starting time on daytime behavior and sleep. Eight-hundred and eleven 5th grade pupils (10-12 years old) from 28 classes in 18 schools throughout Israel were divided into "early risers" (N = 232) who started school at 07:10 (42%) at least 2 times a week, and "regular risers" (N = 340) who always started school at 08:00 (58%). The remaining 239 pupils started school between 7:20 and 07:55 (and also after 08:00), and were not included in the study. Self-administered questionnaires concerning sleep habits during school days, weekends, and holidays, daytime fatigue, sleepiness, and difficulties concentrating and paying attention in school were completed by all children. Mean sleep time of the "early risers" was significantly shorter than that of the "regular risers." Early risers complained significantly more about daytime fatigue and sleepiness, and about attention and concentration difficulties in school. Their complaints were independent of the reported hours of sleep. We conclude that early starting of school negatively affects total sleep time and, as a consequence, has a negative effect on daytime behavior. The implications of these findings to the ongoing controversy concerning sleep need in contemporary society are discussed.
Publication Sleep
Volume 21
Issue 3
Pages 250-256
Date 1998
URL http://www.journalsleep.org/ViewAbstract.aspx?
pid=23991