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Volume 13 No. 04
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Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position Statement

Nathaniel F. Watson, MD, MS1; Jennifer L. Martin, PhD2; Merrill S. Wise, MD3; Kelly A. Carden, MD4; Douglas B. Kirsch, MD5; David A. Kristo, MD6; Raman K. Malhotra, MD7,8; Eric J. Olson, MD9; Kannan Ramar, MD9; Ilene M. Rosen, MD, MS10; James A. Rowley, MD11; Terri E. Weaver, PhD, RN12; Ronald D. Chervin, MD, MS13
1University of Washington Medicine Sleep Disorders Center and Department of Neurology, University of Washington, Seattle, Washington; 2Veteran Affairs Greater Los Angeles Health System, North Hills, California and David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California; 3Methodist Healthcare Sleep Disorders Center, Memphis, Tennessee; 4Saint Thomas Medical Partners - Sleep Specialists, Nashville, Tennessee; 5Carolinas Healthcare Medical Group Sleep Services, Charlotte, North Carolina; 6University of Pittsburgh, Pittsburgh, Pennsylvania; 7SLUCare Sleep Disorders Center; 8Department of Neurology, Saint Louis University, St. Louis, Missouri; 9Division of Pulmonary/Sleep/Critical Care, Mayo Clinic, Rochester, Minnesota; 10Division of Sleep Medicine, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania; 11Wayne State University, Detroit, Michigan; 12College of Nursing, University of Illinois at Chicago, Chicago, Illinois; 13University of Michigan Sleep Disorders Center, University of Michigan, Ann Arbor, Michigan

During adolescence, internal circadian rhythms and biological sleep drive change to result in later sleep and wake times. As a result of these changes, early middle school and high school start times curtail sleep, hamper a student's preparedness to learn, negatively impact physical and mental health, and impair driving safety. Furthermore, a growing body of evidence shows that delaying school start times positively impacts student achievement, health, and safety. Public awareness of the hazards of early school start times and the benefits of later start times are largely unappreciated. As a result, the American Academy of Sleep Medicine is calling on communities, school boards, and educational institutions to implement start times of 8:30 AM or later for middle schools and high schools to ensure that every student arrives at school healthy, awake, alert, and ready to learn.


Watson NF, Martin JL, Wise MS, Carden KA, Kirsch DB, Kristo DA, Malhotra RK, Olson EJ, Ramar K, Rosen IM, Rowley JA, Weaver TE, Chervin RD. Delaying middle school and high school start times promotes student health and performance: an American Academy of Sleep Medicine position statement. J Clin Sleep Med. 2017;13(4):623–625.

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