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Expert Videos

 

Our expert video series was recorded during the “Adolescent Sleep, Health, and School Start Times” conference in 2017. The videos are intended for anyone interested in learning more about adolescent teen sleep and related policies and relevant to school leaders, parents, students, and teachers.

 

In 13 presentations, and over 5 hours of video, leading sleep experts, health professionals, and school leaders, discuss topics including changes in sleep biology during adolescence, sleep and circadian rhythms, the impact of sleep on safety, the impact on mood and risky behavior, sleep and health, the brain and cognition, and more.

A list of guided discussion questions is included at the end of many of the videos to facilitate an in-classroom conversation.

An Introduction to Teen Sleep and the “Adolescent Sleep, Health, and School Start Times” Conference

Recorded Sessions

Developmental Changes to Sleep Biology Affect Adolescent Sleep

Mary A. Carskadon, PhD

Professor, Department of Psychiatry and Human Behavior and Adjunct Professor of Cognitive, Linguistic and Psychological Sciences, Alpert Medical School, Brown University

 

Description

Dr. Carskadon’s presentation focuses on the biological causes of the delay in sleep timing that occurs during adolescence, whereby the natural sleep-wake cycle shifts later in the day.  Dr. Carskadon explains that the human brain undergoes enormous structural changes during adolescence and discusses the changes that occur in the circadian timing system and the homeostatic system that regulate sleep.  To underscore the biological source of this change, Dr. Carskcadon notes that a sleep-timing delay also occurs during adolescence and pubertal onset in other species of mammals. 

Dr. Carskadon presents research that demonstrate that the release of melatonin, “the hormonal gateway to sleep,” shifts later in the day during adolescence, while the amplitude of the melatonin signal falls.  Research has also found that adolescents experience a greater sensitivity to evening light, associated with  a delay in circadian timing.  

As it relates to homeostatic drive, or sleep pressure, Dr. Carskadon  presents research measuring slow brain wave activity and sleep propensity showing that the homeostatic system also undergoes significant changes during adolescence, resulting in a slower accumulation of sleep pressure during the course of the day.

The conclusion is that sleep’s two main bio-regulatory systems both undergo changes during adolescence that operate to shift the natural sleep-wake cycle later in the day.

Speaker Bio

Mary A. Carskadon, PhD
Professor of Psychiatry and Human Behavior and Adjunct Professor of Cognitive, Linguistic and Psychological Sciences at Brown University, Mary Carskadon received a BA in psychology from Gettysburg College (1969) and is a distinguished alumna of that institution. She holds a doctorate with distinction in neuro- and biobehavioral sciences from Stanford University (1979), earned under the mentorship of William C. Dement, MD, PhD. Dr. Carskadon’s current research includes evaluating how sleep and circadian timing influence smell, taste, food choices, and food consumption in overweight and normal weight teens and development of “smart lighting” to improve academic outcomes in secondary school students. Her awards include a Lifetime Achievement Award from the National Sleep Foundation and an Outstanding Educator and Distinguished Scientist Award from the Sleep Research Society.  She is an elected Fellow of the Association for Psychological Science and Fellow of the American Association for the Advancement of Science.

Discussion Questions

Q1: Discuss the changes to the sleep cycle that happen during adolescence. What other species besides humans also see this effect?

Q2: Melatonin has been called “the hormonal gateway to sleep.” How do changes in when melatonin is produced affect the sleep cycle?

Q3: The urge to fall asleep, or sleep pressure, is different from just being tired. Name some of the research findings, such as seen when studying brain waves, about how sleep pressure is different in adolescents than in adults.

An Overview of the Biology of Sleep and Circadian Rhythms

Daniel J. Buysse, MD

UPMC Endowed Chair in Sleep Medicine and Professor of Psychiatry and Clinical and Translational Science, University of Pittsburgh

 

Description

Dr. Buysse presents an overview of the biology of circadian rhythms and sleep. He starts by noting that sleep is a key pillar of health and that poor sleep has been associated with a variety of adverse health outcomes, including diabetes, coronary heart disease, obesity, hypertension, and early mortality.

Dr. Buysse explains that circadian rhythms are 24-hour biological processes that evolved in the brain to adapt to life on a rotating planet. He describes in layman’s terms how the brain’s superchiasmatic nucleus serves as the body’s “master clock.” Operating through various genes in the brain, the superchiasmatic nucleus takes cues from our external environment to synchronize the genes and circadian clocks that reside in and regulate the cyclical activity in every cell in the body.

Dr. Buysse next describes the various systems the brain uses to promote daily cycles of wakefulness and of sleep, and the processes that control these systems.  Having outlined the biology of circadian rhythm and sleep, Dr. Buysse discusses the various dimensions of sleep that contribute to good health, including sleep regularity, duration, timing, and continuity.

Dr. Buysse concludes by outlining a causal feedback loop in which the body’s circadian timing system is designed to drive sleep patterns and behaviors, which operate through changes in physiology to promote physical, mental, and cognitive health.

On a final note, Dr. Buysse suggests that, with an understanding of the critical relationships linking circadian rhythms, sleep, and adolescent health, it becomes the responsibility of school leaders to design policies that leverage that understanding.

 

 

 

Speaker Bio

Daniel J. Buysse, MD
Daniel Buysse is the UPMC Professor of Sleep Medicine and Professor of Psychiatry and Clinical and Translational Science at the University of Pittsburgh. His research focuses on sleep assessment; the pathophysiology and treatment of insomnia; interactions between sleep and circadian rhythms; and the impact of sleep on health. Dr. Buysse has received research funding from the National Institute of Mental Health, the National Institute on Aging, and the National Heart, Lung, and Blood Institute. He has published over 300 peer-reviewed articles and over 100 book chapters or review articles. Dr. Buysse is Past President of the American Academy of Sleep Medicine; recipient of the Nathaniel Kleitman Distinguished Service Award from the American Academy of Sleep Medicine and the Mary A. Carskadon Outstanding Educator Award from the Sleep Research Society; and Deputy Editor of SLEEP.

Discussion Questions

Q1: The suprachiasmatic nucleus in the brain acts as the chief time regulator, or “master clock,” for the body. Discuss what is known about how this part of the brain uses outside signals to regulate a variety of body functions.

Q2: Name several aspects of healthy sleep that can contribute to better overall health.

Deficient Sleep in Teens – The Impact on Safety

Brian C. Tefft

Brian C. Tefft, Senior Researcher, Traffic Research Group, AAA Foundation for Traffic Safety

Description

Brian Tefft presents the results of research conducted by the American Automobile Association and other safety organizations related to sleep and teen drivers. Automobile crashes are the leading cause of death for teens aged 16 to 20 years old.  In fact, for every mile driven teen driver crash rates range between 3 to 6 times the crash rates of drivers 30 years old.

Mr. Tefft reports research estimating that about 40% of teens routinely get less than 6 hours a sleep at night and that approximately 25% of teen drivers self-report having driven while drowsy during the previous 30 days.  These sleep deficits clearly impair driver safety.  The AAA Foundation estimates that driving on even 1 hour less sleep than the recommended amount results in a significant increase in crash risk and driving on 2-3 hours less sleep than recommended results in a crash risk that is equivalent to that of driving while intoxicated. 

Mr. Tefft provides a AAA Foundation estimate that drowsy driving accounts for 8% of all teen crashes and 13% of all teen crashes resulting in a fatality.

Speaker Bio

Brian C. Tefft
Brian Tefft, Senior Researcher with the Traffic Research Group at the AAA Foundation for Traffic Safety, conducts research on a wide variety of traffic safety issues, employing state-of-the-art methods to identify real-world traffic safety problems, identify solutions, and evaluate their effectiveness. His research on drowsy driving has highlighted the fact that official statistics substantially underestimate the scope of the problem. Mr. Tefft has also produced the first study linking quantitative measures of acute sleep deprivation to real on-road crash risk. He holds a B.S. in mechanical engineering from Brown University.

Discussion Questions

Q1: Name some key statistics about car crashes among teen drivers compared with adult drivers. Discuss some of the contributors to the differences in the rate of crashes in younger compared with older drivers.

Q2: What role does insufficient sleep play in car crashes among teen drivers? Discuss how driving with very little sleep compares to some other kinds of impaired driving, like driving while drunk.

Deficient Sleep in Teens –  The Impact on Mood and Risky Behavior

Wendy Troxel, PhD

Senior Behavioral and Social Scientist, RAND Corporation

Description

Dr. Troxel discusses the impact of teen sleep deficits in the context of  “The Adolescent Paradox,” a period in which adolescents experience a peak stage in physical and cognitive health, yet one characterized by a 200% increase in morbidity and mortality. In looking at the underlying causes of death, Dr. Troxel notes that about 75% are due to car crashes, suicides, and homicides, each of which is associated with problems regulating emotions and behavior.

Dr. Troxel then turns to the role sleep plays in the brain’s regulation of emotional processes and risk-taking behavior.  Experimental studies have established clear causal mechanisms explaining why healthy subjects who are deprived of sleep show heightened emotional responses, an inability to control their emotions, impulsivity, and greater risk-taking.  Dr. Troxel discusses large scale empirical studies linking adolescent sleep problems with the increased substance use, smoking, violence, risky sexual behavior, reckless driving, anxiety, depression and suicide ideation.  Moreover, these problems and behaviors not only contribute directly to the elevated adolescent morbidity and mortality seen in the “The Adolescent Paradox,” but are also predictive of long-term morbidity and mortality since behaviors initiated in adolescence often persist into adulthood. 

Dr. Troxel addresses the policy implications of these findings.  Adolescent sleep problems are an important, known, modifiable risk factor associated with increased risk for mental health problems and risky behavior in adolescents.  While multilevel interventions strategies are needed at the individual, family, and society level  to address insufficient adolescent sleep, Dr. Troxel argues that moving to later school start times is a powerful intervention because it operates at the population level by removing the existing conflict between adolescent sleep biology and early school start times for an entire community.  It is a viable, systemic intervention that is associated with improved adolescent mental health, including lower rates of depression, and reductions in adolescent risky behaviors.

Speaker Bio

Wendy Troxel, PhD
Wendy Troxel is a Senior Behavioral and Social Scientist at the RAND Corporation and Adjunct Faculty at the University of Pittsburgh. She is also a licensed clinical psychologist and certified behavioral sleep medicine specialist. Dr. Troxel’s research focuses on the interface between sleep, the social environment, and health, and on implications for public policy. Dr. Troxel’s work has been published in international medical and psychological journals and received multiple awards and honors from scientific societies. Her work has garnered widespread media attention from print, TV, and online outlets, including The Wall Street JournalThe New York Times, CBS Sunday MorningGood Morning America, CNN, and The Huffington Post. Her research on sleep was also featured in the National Geographic documentary, “Sleepless in America.” She has been involved in local and national efforts focused on healthy school start times for adolescents, and recently gave a TEDx talk on the impact of school start times on adolescent health and functioning.

Discussion Questions

Q1: Name some key statistics about car crashes among teen drivers compared with adult drivers. Discuss some of the contributors to the differences in the rate of crashes in younger compared with older drivers.

Q2: What role does insufficient sleep play in car crashes among teen drivers? Discuss how driving with very little sleep compares to some other kinds of impaired driving, like driving while drunk.

Deficient Sleep in Teens –  The Impact on Health 

Charles Czeisler, MD, PhD

Baldino Professor of Sleep Medicine, Harvard Medical School

Description

Dr. Czeisler discusses why the body needs sleep and presents a comprehensive overview of the impact of insufficient sleep on the health.  He begins by describing the 5 stages of sleep, emphasizing that different functions are performed during the various stages of sleep.  This differentiated structure makes it important for the body to complete the entire sleep process. For example, new memories are integrated with previous memories to facilitate problem solving and creativity during the REM stages of the sleep cycle, which tend to cluster in the later stages of sleep. If the sleep cycle is consistently truncated by an alarm clock before the REM stages have been completed, these critical learning processes are not allowed to take place.

Dr. Czeisler explains how poor, irregular sleep impairs brain function and creates adverse health consequences by disrupting the timing and operation of important physiological processes.  Sleep allows the body to restore the brain’s energy stores, to repair brain cells, and to flush neurotoxins from the brain.  He discusses an array of serious metabolic, cardiovascular, immunological, and mental health problems that stem from lack of sleep, and explains the channels through which these problems occur.

Speaker Bio

Charles Czeisler, MD, PhD, FRCP
Charles Czeisler is the Director of the Sleep Health Institute, Senior Physician and Chief of the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital, and the Frank Baldino Jr., PhD. Professor of Sleep Medicine at the Harvard Medical School’s Division of Sleep Medicine. His research group focuses on understanding the neurobiology of the human circadian pacemaker, located in the suprachiasmatic nuclei (SCN) of the hypothalamus, and applying that knowledge to clinical medicine and occupational health. Their earliest work revealed that sleep duration and structure were regulated by the output of this pacemaker. Since then, Dr. Czeisler’s lab has unmasked the endogenous circadian component of various neuroendocrine, metabolic, thermoregulatory and behavioral rhythms controlled by the pacemaker by studying human subjects under constant environmental and behavioral conditions. Current research focuses on the neurobiology of circadian photoreception in humans; the interaction of circadian and homeostatic processes in regulating sleep and neurobiological function during wakefulness; the role of melatonin in the organization of sleep and circadian rhythms;  functional magnetic imaging, quantitative analysis of sleep and waking EEG; and the influence of sleep loss on the deployment of visual attention.

Discussion Questions

Q1: Why do we need to sleep?

Q2: What are the 5 stages of sleep? What are the different functions performed in each stage?

Q3: What happens with insufficient sleep – that is, sleep of short duration or sleep that’s happening at the wrong time or that is interrupted? What specific physical problems have been associated with insufficient sleep?

Deficient Sleep in Teens –  The Impact on Cognition and Brain Function

Dean Beebe, PhD

Director, Neuropsychology Program, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital and Professor, Department of Pediatrics, University of Cincinnati

Description
Dr. Beebe reports the results of experiments that have investigated the relationship between restricted sleep and cognitive performance, including sustained attention, working memory and executive functions.  One study looked at the cognitive performance and self-reported mood of a group of students who were subject to sleep restriction of 6.5 hours per night for 5 consecutive nights compared to their performance and mood when they had 9 hours of sleep per night for 5 consecutive nights.  When sleep-restricted, students exhibited slower reaction times and scored lower on attention/vigilance tests compared to their performance when they had 9 hours of sleep.  Performance in quizzes administered after listening to educational videos increased markedly when the students had 9 hours of sleep, compared to 6.5 hours of sleep. 

Dr. Beebe provides preliminary experimental evidence from 3 studies that suggest that “recovery sleep” over weekends for sleep-restricted students is not sufficient to bring their cognitive performance up to the baseline performance achieved when the students consistently had 9 hours of sleep.

Speaker Bio

Dean Beebe, PhD
Dean Beebe is a professor of pediatrics and the director of the neuropsychology program at Cincinnati Children’s Hospital Medical Center. A major focus of his research has been the use of experimental sleep manipulations to test the impact of inadequate sleep on adolescents’ thinking skills, learning, mood, dietary intake, physical activity, skills in a simulated driving environment, and brain activation in response to attention challenges and food-related stimuli. He also works closely with other investigators examining the impact of sleep changes on the health of youth with chronic medical conditions, including asthma, diabetes, and ADHD. Board-certified in clinical neuropsychology and in pediatric neuropsychology, his clinical work specializes in the evaluation and care of children who have chronic medical and neurological conditions, as well as those with both recent and remotely-acquired brain injuries. He has served on the Board of Directors for the American Academy of Clinical Neuropsychology (AACN), the Advisory Board of Start School Later, Inc., and committees of the AACN, the American Board of Clinical Neuropsychology, Sleep Research Society, and International Neuropsychological Society.  Dr. Beebe is an associate editor of the Journal of Pediatric Psychology, and is on the editorial boards for Child Neuropsychology, SLEEP, and Behavioral Sleep Medicine.

Discussion Questions

Q1: Dr. Beebe describes how he does experiments that look at how restricting sleep to just a few hours a night affect sleep and performance on tests of memory and attention. Do you think the results of these experiments could be applied in everyday life? Why, or why not? What are some of the problems with applying findings from the laboratory in real life?

Q2: Can you catch up on sleep over the weekend if you’ve had several nights of short sleep?

Deficient Sleep in Teens –  The Impact on School Performance

Amy Wolfson, PhD

Vice President for Academic Affairs and Professor of Psychology, Loyola University Maryland

Description

Dr. Wolfson reviews literature on the relationships linking school start times, sleep, and academic performance.  The main focus is on: associations between insufficient and delayed sleep patterns and academic performance, with performance indicators including student GPAs and self-reported grades, test scores, time spent on homework, attendance, and tardiness.   Research addressing these questions include cross-sectional studies and a longitudinal study of school districts in various regions of the US;  results of a large study conducted in Norway (2016) that looked at the predicitive quality of sleep duration and sleep deficits on test scores was also presented.   

In addition to reporting results of studies on overall student measures of academic performance, Dr. Wolfson also discusses studies that explored several sub-topics of the issue:  a study that compared student test scores in the same core course taken in the first period versus later in the day; an experiment that compared the test performance of students who were well-slept compared to students who were sleep deficient;  research data that addressed whether students at the lower end of the distribution of academic performance benefit more or less from later start times than those at the higher end of the distribution; studies that looked at next-day academic performance when students sacrificed sleep in order to study more than usual.

Speaker Bio

Amy R. Wolfson, PhD
Amy R. Wolfson is Vice President for Academic Affairs and Professor of
Psychology at Loyola University Maryland. Wolfson came to Loyola from the College of the Holy Cross, where she chaired the psychology department from 2008-2010 and served as associate dean in from 2010-2014. She has been published in numerous prestigious peer-reviewed journals and is the author of two books, The Woman’s Book of Sleep: A Complete Resource Guide and The Oxford Handbook of Infant, Child, and Adolescent Sleep and Behavior.

Wolfson was awarded a six-year $1.1 million grant from the National Institutes of Health (NIH) in 2005 for her Young Adolescent Sleep-Smart Pacesetter Program—the largest individual grant awarded to a College of the Holy Cross faculty member. Dr. Wolfson recently completed the Sleep-Smart study, a longitudinal study of urban, middle-school students’ sleep patterns and hygiene, behavioral well-being, and academic performance, funded by the NIH. She is co-editing a special issue for Sleep Health on Sleep Science and Policy: a Focus on School Start Times, and her current research is focused on addressing the implications of emotional and physical health practices on adolescents’ sleep. She has taught courses on gender and leadership, mental health, health psychology, women’s studies, and sleep and circadian rhythms.

 

Discussion Questions

Q1: What is some of the evidence Dr. Wolfson discussed that insufficient sleep has a negative affect on academic performance and school success? What are some of the aspects of school success that Dr. Wolfson mentions, aside from just grades?

Q2: Does the time of day at which students take a test affect how they perform? What about having a good night’s sleep the night before an exam, compared with staying up very late to cram?

Does Changing School Start Times Work?

Kyla Wahlstrom, PhD

Senior Research Fellow, University of Minnesota

Description

Dr. Wahlstom summarizes her research, conducted over 26 years, on the impact of changing school start times on major school stakeholders:  students, teachers, parents, school administrators, and the community.  

Dr. Wahlstrom reports that studies have consistently shown that later school start times have a statistically significant positive health effects on students: more sleep duration, less depression, less substance abuse, and fewer car crashes. Additionally, there is a statistically significant improvement academically in terms of  improved attendance, reduced tardiness, improvement in grades earned, and reduced drop-out rates in urban areas.

Although later school start times affected teachers’ personal schedules, teachers in school districts that have made the change have generally concluded that the benefits for the students made the change worth doing. In a survey of 3,000 teachers, fewer than 1 teacher in 5 believed that middle school and high school students are ready for learning before 8am.  

Parents also noted that later school start times required significant adjustment to their schedules. However, 92% of parents reported that later school start times improved the mood of their children (eg. fewer emotional outbursts) and provided more time in the morning for breakfast and for communicating with their child.  

Surveys of school administrators report that later school start times improved the school’s atmosphere (eg. less agitation while changing classes, fewer lunchroom incidents, a quieter “tone” to the building.)

Although communities often experience initial traffic congestion that require adjustments in traffic patterns, Dr. Wahlstrom reported that communities benefit directly and indirectly from the change.  As one example, interviews with police departments suggest that later school start times result in fewer juvenile crimes.

In conclusion, Dr. Wahlstom emphasizes that changing start times requires time to plan the adjustments in a school district’s “eco-system,” but that the evidence gathered over 26 years of research, encompassing all main school stakeholders, indicates the change is worth it.

Speaker Bio

Kyla Wahlstrom, PhD, Senior Research Fellow, University of Minnesota

Dr. Wahlstom summarizes her research, conducted over 26 years, on the impact of changing school start times on major school stakeholders:  students, teachers, parents, school administrators, and the community.  

Dr. Wahlstrom reports that studies have consistently shown that later school start times have a statistically significant positive health effects on students: more sleep duration, less depression, less substance abuse, and fewer car crashes. Additionally, there is a statistically significant improvement academically in terms of  improved attendance, reduced tardiness, improvement in grades earned, and reduced drop-out rates in urban areas.

Although later school start times affected teachers’ personal schedules, teachers in school districts that have made the change have generally concluded that the benefits for the students made the change worth doing. In a survey of 3,000 teachers, fewer than 1 teacher in 5 believed that middle school and high school students are ready for learning before 8am.  

Parents also noted that later school start times required significant adjustment to their schedules. However, 92% of parents reported that later school start times improved the mood of their children (eg. fewer emotional outbursts) and provided more time in the morning for breakfast and for communicating with their child.  

Surveys of school administrators report that later school start times improved the school’s atmosphere (eg. less agitation while changing classes, fewer lunchroom incidents, a quieter “tone” to the building.)

Although communities often experience initial traffic congestion that require adjustments in traffic patterns, Dr. Wahlstrom reported that communities benefit directly and indirectly from the change.  As one example, interviews with police departments suggest that later school start times result in fewer juvenile crimes.

In conclusion, Dr. Wahlstom emphasizes that changing start times requires time to plan the adjustments in a school district’s “eco-system,” but that the evidence gathered over 26 years of research, encompassing all main school stakeholders, indicates the change is worth it.

Discussion Questions

Q1: Does the time at which school starts matter for high school students’ academic performance and school success? What about health and mental health?

Q2: What do teachers, parents, and school administrators think about what time high school should start? Should their opinions matter, and if so, how much compared with students’ opinions? Talk about how much weight should be given to the various groups’ opinions, and why.

 

 

 

National Surveillance Data on Adolescent Sleep and School Start Times

Anne Wheaton, PhD

Senior Service Fellow/Epidemiologist, Centers for Disease Control and Prevention

Description

Dr. Wheaton discusses the CDS’s contribution to the national conversation on adolescent sleep.  The CDC’s Sleep Health Program goals are to increase public awareness of the importance of healthy sleep, promote healthy sleep policies, and improve sleep-related national surveillance survey data at the state and national levels.  The US Department of Health and Human Services’ initiative, “Healthy People 2020,”  introduced the goal of raising the percentage of high school students who get at least 8 hours of sleep at night.  A 2015 baseline indicated that only about 25% of high school students currently achieve that goal.  

Dr. Wheaton presents the results of the CDC Youth Risk Behavior Survey that found a positive association between short sleep duration and obesity, suicide ideation, and health-risk behaviors such as cigarette, alcohol, and marijuana use.  The CDC also reports a positive association between short sleep duration and injury-related behaviors such as drinking and driving, and texting and driving.

With respect to school start times, Dr. Wheaton presents results of a CDC survey of school start times on a state-by-state basis.  In aggregate, 83% of middle school and high schools in the US start before the medically recommended time of 8:30am, with a 2014 CDC survey indicating that 93% of US high schools start before 8:30am.

Dr. Wheaton succinctly states the  CDC’s view on the role changing school start times can play in improving adolescent sleep health:  “Among the possible public-health interventions for increasing efficient sleep among adolescents, delaying school start times provides the potential for the greatest population impact by changing the environmental context for students in entire school districts.”  

Speaker Bio

Anne Wheaton, PhD, Senior Service Fellow/Epidemiologist, Centers for Disease Control and Prevention

Dr. Wheaton discusses the CDS’s contribution to the national conversation on adolescent sleep.  The CDC’s Sleep Health Program goals are to increase public awareness of the importance of healthy sleep, promote healthy sleep policies, and improve sleep-related national surveillance survey data at the state and national levels.  The US Department of Health and Human Services’ initiative, “Healthy People 2020,”  introduced the goal of raising the percentage of high school students who get at least 8 hours of sleep at night.  A 2015 baseline indicated that only about 25% of high school students currently achieve that goal.  

Dr. Wheaton presents the results of the CDC Youth Risk Behavior Survey that found a positive association between short sleep duration and obesity, suicide ideation, and health-risk behaviors such as cigarette, alcohol, and marijuana use.  The CDC also reports a positive association between short sleep duration and injury-related behaviors such as drinking and driving, and texting and driving.

With respect to school start times, Dr. Wheaton presents results of a CDC survey of school start times on a state-by-state basis.  In aggregate, 83% of middle school and high schools in the US start before the medically recommended time of 8:30am, with a 2014 CDC survey indicating that 93% of US high schools start before 8:30am.

Dr. Wheaton succinctly states the  CDC’s view on the role changing school start times can play in improving adolescent sleep health:  “Among the possible public-health interventions for increasing efficient sleep among adolescents, delaying school start times provides the potential for the greatest population impact by changing the environmental context for students in entire school districts.”  

The Economic Impact of Later School Start Times

Marco Hafner, MSc, MPhil

Research Leader, Cambridge Office, RAND Corporation

Description

Marco Hafner begins by presenting the results on an econometric study he conducted at the RAND Corporation that estimated the economic impact of insufficient sleep on the economic output of five developed countries as quantified through  the channels of reduced productivity, early mortality, and sub-optimal school performance prior to joining the labor force. 

Mr. Hafner then summarizes the results of the next leg of his research in which he estimated macroeconomic models for 47 US states to calculate the economic benefit each state would deriveon a year-by-year basis, if it moved middle school and high school start times to 8:30am or later.  The estimated aggregate benefit for the US economy amounts to $104 billion over 10 years.  He concludes by presenting estimates of the benefit-to-cost ratios for each state over a range of cost estimates associated with changing school start times. 

Speaker Bio

Marco Hafner, MSc, MPhil
Marco Hafner is a research leader at RAND Europe working on employment, education, and social policy research. He completed his doctoral studies in economics and applied econometrics and holds a master’s degree in economics from the University of Zurich. Before joining RAND, he worked at the Institute for Employment Research (IAB), the research body connected to the German Employment Agency, and at the Centre for Research and Analysis of Migration (CReAM) at University College London. Mr. Hafner has particular expertise in data analysis and econometrics, having undertaken extensive quantitative research in the topics of labor and industrial economics. His broader research interests include topics in applied econometrics, health, industrial, labor, and international economics.

Debunking Sleep Myths and Educating Communities

Rafael Pelayo, MD

Clinical Professor, Psychiatry and Behavioral Sciences, Stanford Center for Sleep Sciences and Medicine

Description

Dr. Pelayo answers the most common questions most people have on adolescent sleep and school start times, while debunking many common myths and misconceptions in the process.  Do students fall asleep in school because they are bored?  Can students catch up on sleep on the weekends and is that a good practice?  What is “microsleep” and how does it impact driver safety?   If schools start later, will students just stay up later?  What is the relationship between sleep and athletic performance?  How does sleep impact the part of the brain that governs risky behavior and suicide ideation?  What is the role of electronics in causing sleep problems?

Dr. Pelayo concludes by describing an award-winning program in which Stanford University collaborates with local high schools to educate students on sleep and the critical role it plays in health and performance. 

Speaker Bio

Rafael Pelayo, MD
Rafael Pelayo, MD is a clinical professor at Stanford University School of Medicine. He has been treating sleep disorders in children and adults at the Stanford Sleep Disorders Clinic since 1993. He was elected and currently serves on the board of the California Sleep Society. Along with Dr. William Dement he teaches the Stanford University Sleep and Dreams course to hundreds of undergraduate students. Together they wrote the course’s textbook. Students in this class are required to perform outreach projects to increase awareness of the importance of sleep. He has previously served as chair of the Sleep Disorders Research Advisory Board of the National Center for Sleep Disorders Research at the National Heart Lung Blood Institute at the NIH. He chaired of the pediatric special interest section of the American Academy of Sleep Medicine. He has lectured nationally and internationally on sleep disorders. He has done multiple television, radio, and print interviews. He is originally from New York City.

Changing School Start Times:
Leadership at the District and State Levels

Kenneth Dragseth, PhD

Retired Superintendent, Edina, MN and Lecturer, College of Education and Human Development, University of Minnesota

Anthony J. Portantino

California Senator Representing the 25th Senate District

 

Description

 

Leadership for Change at the State and Local level:  In this presentation, Dr. Kenneth Dragseth of Edina, Minnesota and California Senator Anthony Portantino speak to the role of leadership in effecting change at the state and local levels.

1.  Leadership for Change at the Local Level:  In 1996, the Edina School District in Minnesota became the first school district in the United States to move to healthy school start times.  Dr. Kenneth Dragseth, the Edina Superintendent led the change.  In this powerful presentation, Dr. Dragseth recounts the chain of events that led to the change, starting with a letter from the Minnesota Medical Association to 340 school districts and culminating with the Edina School District deciding to make the change.

Dr. Dragseth describes the critical leadership role played by the school board and school administration in making the change.  In the face of opposition to a change in the status quo from student athletes, parents, teachers, coaches, and other school districts, the Edina school leadership remained steadfast, guided by one overriding priority:  “The greater good is the good of the kids….If it good for the kids, we are going to do it.”

Once the decision to change start times was made, Dr. Dragseth stresses that implementing the change required ongoing courage, will power, and determination.  He describes the importance of the planning process, the resolute commitment to overcome obstacles, communicating with the community, and providing ample time for people to adjust their schedules.  But the effort is worth it because:  “It works.”  Dr. Dragseth describes the dramatic and long-lasting improvement in the  “climate of the school” in terms of academics, attendance, tardiness, and the improved emotional and physical health of the students. 

2.  Leadership for Change at the State Level:  In 2017, Senator Anthony Portantino introduced Senate Bill 328 into the California state legislature, which would require middle schools and high schools to start at 8:30am or later. Senator Portantino explains that major medical organizations and leading sleep experts have strongly recommended that middle schools and high schools  start no earlier than 8:30am as an urgent matter of adolescent health.  He argues that the medical and scientific evidence for this recommendation is so compelling that public policy should directly address the problem and spur implementation of later school start times. He notes that empirical results from schools that have moved to later school start times have shown improved academic performance, attendance rates, student attention, family interaction and fewer car crashes. 

Senator Portantino explains that one of the advantages of a state-wide mandate to change school start times is that it would eliminate the scheduling conflicts that inevitably arise among school districts when one school district changes start times and other nearby school districts do not.  It would be easier for each school district to change start times if all school districts made the change.  He emphasizes that the bill is designed to provide sufficient planning time for school districts to make the change.

Senator Portantino also discusses the politics of the bill, and specifically on the positions taken by the two largest California state teachers unions, the PTA, and the California School Board Association.  His approach has been to “lead with the facts” by bringing leading subject matter experts to testify at public hearings on the bill.  

Summarizing his approach, Senator Portantino says: “The best politics is when you do the right thing for the right reason.”

Speaker Bio

Kenneth Dragseth, PhD
Ken Dragseth is a retired superintendent from Edina, MN,  which, under his leadership, was the first school district in the nation to delay its high school start time specifically to follow the recommendation of sleep experts and health professionals. Today he runs a consulting company that specializes in superintendent searches and program and leadership support to school boards and district personnel. He has been a mathematics teacher, middle school principal and assistant principal, curriculum director, assistant superintendent, and superintendent for 14 years. Dr. Dragseth has 49 years in education, was National Superintendent of the Year in 2003, and has received numerous other state and national awards for his educational expertise and work. He is also active on several organizational and college boards. Dr. Dragseth holds a PhD from the University of Minnesota in educational administration and education.

Senator Anthony J. Portantino
Senator Anthony J. Portantino represents California’s 25th State Senate District where he chairs the Budget and Fiscal Review Subcommittee No. 1 on Education and serves on five Standing Committees: Banking and Finance, Budget and Fiscal Review, Governmental Organization, Insurance, and Public Employment and Retirement. His accomplishments during his three terms serving in the State Assembly included establishing California’s umbilical cord blood collection program, regulating “for profit” colleges, banning the “open carry” of guns on Main Street California, and increasing legislative transparency and accountability. Senator Portantino has a long and distinguished record of civic and community service that includes nearly eight years on the La Cañada Flintridge City Council, with two terms as Mayor and Vice Chair of the Santa Monica Mountains Conservancy Advisory Committee. He also served as President of the League of California Cities Mayors and Council members Department, and as the Legislative Chair of the California Contract Cities Association.  He has served on many local non-profit boards and is active in the PTA and many community organizations.

Changing School Start Times:
Perspectives from the Trenches

Sandy Evans

Chair, Fairfax County VA Board of Education

Darrel Drobnich

President, MidAmr Group

Terra Ziporyn Snider, PhD

Executive Director and Co-Founder, Start School Later, Inc

Description

This panel presentation addressed the “nuts and bolts” challenges of changing school start times from three different perspectives.  Ms. Sandy Evans is the Chair of the Fairfax County School Board in Fairfax, VA and led the successful effort of that school district in changing to later school start times.  Darrel Drobnich, President of MidAmr Group and former Chief Program Officer of the National Sleep Foundation, has advised school districts on successfully implementing school start times changes.  Terra Ziporyn Snider is the Co-Founder of Start School Later, Inc., a nonprofit organization, with 101 chapters in 27 states and Washington D.C., dedicated to increasing public awareness about the relationship between adolescent sleep and school start times. 

The Fairfax County School District Case Study:  With 188,000 students, Fairfax County School District is the 10th largest school district in the United States and it has the largest school bus fleet in the country with 1,640 buses.  In 2015, Fairfax County School District moved to later school start times to provide middle school and high school students the opportunity to get more sleep.  Ms Sandra Evans was the Chair of the School Board that led the change.

Ms. Evans presents the step-by-step approach taken in Fairfax to change school start times.  She emphasizes the important role the Board of Education plays in establishing clearly the policy goal of changing school start times as an important student health priority, and then to have a capable school administration leadership team committed to pursue that goal.   At that point, the focus of the initiative can move from “WHETHER to change to HOW to change.” She discusses the process by which Fairfax County School Board hired consultants to develop alternative plans for implementation and the importance of engaging school stakeholders early in the planning process to both educate them on the health issue and to take their interests into account prior to finalizing a plan.

Getting to YES:  Mr. Drobnich discusses the strategy for “Getting to YES” on a policy to change school start times.  He argues that having an overwhelming scientific rationale for changing school start times is not sufficient for the change to be made.  Rather, advocates need to engage with school stakeholders, particularly school board members and superintendents, and seek to understand and address any objections they may have.  The goal is to move them from to “No” to “Maybe” to “Yes” over time.  In this context, changing school start times sometimes needs to become an important school board election issue. 

With a committed leadership team in place, the focus can be on how best to implement the change.  At this stage, the exercise involves developing alternative scenarios and to elicit feedback from school stakeholders to iterate to the best overall solution.  The emphasis in this stage should be to ask people identifying problems to also suggest possible solutions so as to keep the dialogue constructive and moving forward.  Mr. Drobnich emphasizes the difficulty of asking the same people who created the status quo to change the status quo, and argues that having an independent consultant or an appointed change agent to spearhead the process is important.

Building Political Will:  With a bird’s eye view of the school start-time change movement in over 100 Start School Later chapters throughout the United States, Terra Ziporyn Snider, the Co-Founder of Start School Later Inc., highlights three underlying obstacles that stand in the way of changing school start times: (1) the bias of the status quo; (2) the failure of creativity and imagination to envision new possibilities and to solve problems; (3) a pervasive ignorance about the importance of sleep to adolescent health. 

Dr. Ziporyn Snider observes that school districts that have overcome these obstacles have one thing in common:  the political will to explicitly prioritize health and learning and to find creative and affordable ways to make the change.

Turning to how to build political will, Dr. Ziporyn Snider explains that the goal is to correctly reframe the issue as a critical matter of public health instead of one focused on inconvenience, logistics and expense.   She  makes the case for a multi-level approach by a diversity of players who work together on a local, state and national level. The players would include health organizations, health professionals, civic organizations, sleep researchers, parent and student advocates, school policy makers and teachers, and legislators, all working to share resources and augment one another’s efforts. This team effort on a national level is made possible by the reach and leverage of social media.

Speaker Bio

Sandy Evans
Sandy Evans is a Fairfax County School Board member representing Mason District, and currently serves as Chair of the School Board.  A journalist by profession, she is a former reporter and staff writer for The Washington Post. In 2004, she and Phyllis Payne co-founded Start Later for Excellence in Education Proposal (SLEEP), a grassroots group created to advocate for later middle and high school start times in Fairfax County, VA. Ms. Evans has a bachelor of science in journalism from the  University of Maryland-College Park. Before being elected to the School Board in March 2010 in a special election, Evans had served on the Board’s School Health Advisory Committee (chairman) and Transportation Task Force; Northern Virginia Healthy Kids Coalition (steering committee member); Fairfax Education Coalition (founding member); Fairfax County Council of PTAs (legislation committee chairman); and Sleepy Hollow Elementary School PTA (former PTA president). She was reelected to four-year terms on the School Board in 2011 and 2015, with her current term ending in December 2019. She is married to attorney Steven K. Hoffman and has two daughters.

Darrel Drobnich
Darrel Drobnich is a president of the MidAmr Group, a consulting firm in Washington, DC, and has over 25 years of experience translating scientific findings into public health messages, educational programs, public policy, and advocacy initiatives in both the U.S. Senate and the non-profit sector. As former Chief Program Officer of the National Sleep Foundation (NSF),  he created and oversaw public policy initiatives and award-winning national public awareness and research programs, bringing the issue of adolescent sleep and starting a national conversation on the issue. In 1998, he formed a partnership with Congresswoman Zoe Lofgren (D-CA) to introduce a Congressional resolution (H.C. Res. 135 or “Z’s to A’s,”) to encourage schools to move start times to no earlier than 8:30 a.m. Most recently, Mr. Drobnich helped lead a multi-disciplinary team to overturn 20 years of failed attempts to change unhealthy school start times for 57,000 high students in Fairfax County Public Schools, VA, the 10th largest school system in the country and is currently consulting with York County School Division in Virginia.

Terra Ziporyn Snider, PhD
Terra Ziporyn Snider is the Executive Director and Co-Founder of Start School Later, a nonprofit dedicated to increasing public awareness about the relationship between sleep and school hours and to ensuring school start times compatible with health, safety, education, and equity. An award-winning author of numerous popular health and medical books including The New Harvard Guide to Women’s HealthThe Women’s Concise Guide to Emotional Well-BeingAlternative Medicine for Dummies, and Nameless Diseases, she was an associate editor at The Journal of the American Medical Association (JAMA) and has written extensively on a wide range of health and medical issues in publications including The Harvard Health LetterJAMAThe Huffington PostConsumer ReportsWeight Watchers Magazine, and Business Week. Dr. Snider is a graduate of Yale College and a former Searle Fellow at the University of Chicago, where she earned a doctorate in the history of science and medicine. She has been awarded science-writing fellowships by the American Association for the Advancement of Science, the American Chemical Society, and the Marine Biological Laboratory at Woods Hole.

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