001Okay. Well, it is so great to be here. I um I have to laugh when I when uh Dr. Hillman and I were talking about doing this presentation in September and I thought December, you know, it could be well the weather would it's like this would have been a rough night to be in out driving around. So, here we are and it's wonderful to be with you tonight. So, um remotely works just as well for me and we'll be able to answer a lot of questions when I'm done with the uh initial presentation. All right. So um this will take about 2530 minutes max and then we'll have plenty of time for questions. So here we go. So believe it or not we have nearly 30 years worth of data to uh to help us
002understand the issues having to do with adolescent sleep. More than 2,000 articles have been have examined and been written um about adolescent sleep, late start times, the health and safety of teens and the psychosocial issues that go along with it. Clearly the outcomes for the stakeholders in this change are the students of course teachers, parents, school administration and community. So, it's a lot of people that we have to think about in terms of what their stake is in this uh decision. I'm going to begin with some basic facts about sleep because this is the foundation for every decision that you're going to make. You need to know and and your community needs to know about the facts about sleep. Some of these things are going to be surprising. Some things you probably already know. So,
003why do we need sleep? There are essential processes that happen with sleep every night. For instance, every night your brain gets washed washed by your cerebral spinal fluid. So during the day, you'll have moments your brain records. It's like a recording machine. It records everything that happens during the day. Everything you see, hear, whatever. But a lot of the stuff is just junk. It's like it's like um um trash in your brain. Uh if you heard a fire engine during a meeting today, your brain has recorded that. But tonight when you sleep, that fire engine noise is going to be totally irrelevant. There's no place to stick it in terms of a file for learning. So your brain will wash that away and there are millions of bits of information that get washed every night
004um by your cerebral final spinal fluid. So the clearance of neurotoxins and I'll explain more as we get into that how that functions and where that happens but it's exceedingly important clearly also in the brain excuse me there are nerve cells that are repaired and connected you have uh synapses dendrites and so on that get repaired during sleep because they get broken during the day actually and then of course learning memory and abstraction are enabled all happening during sleep. Your brain is probably more o active during sleep time than when you are awake. So the brain is an amazing amazing organ and uh we don't know much about it as we as we are exploring more. We don't realize how much we don't know. And this is something that that when I present to students
005I think they just are shocked. You will die sooner from a lack of sleep than you will die from a lack of food. That's how important sleep is. And sleep is that's why it's part of the the um Geneva Convention having to do with um torture that you cannot torture a prisoner for with lack of sleep. Um it's just it's considered uh a death sentence to deprive them of sleep. So how does this all begin? So many years ago probably in the 1990s early uh Mary Karcaden at Brown University was happen stance was collecting um saliva uh secretion during adolescent sleeps because they were trying to understand the adolescent brain and this is the graph that shows the onset and uh offset of melatonin secretion during sleep and you can see it's it jumps very
006sharply probably around 10:15 10:30 :30, peaks around 2:45, 3 in the morning, up and down, up and down, and is a sharp offset around 8 8 in the morning, 8:15. And this is really critical because this information is proof that the uh melatonin secretion that's that's prompted by the adrenal glands is um is how we understand what happens when we sleep, when we look at the physiological uh manifestation of this. So, what do we know? We know that uh 42% of middle school students average less than eight hours of sleep a night and only 23% of high school students in the US, now this is a US statistic obtain the recommended hours of between eight and nine hours of sleep per night. So you can see even the sleep requirement when you look at the
007age of about 12, it's triggered by puberty. It's it's all related to when kids uh enter puberty all of a sudden they have this sleep phase shift and their sleep requirement actually goes up a little bit between 8.8 8.7 to closer to 9.0 but the average amount of sleep you can see precipitously drops between ages of say 12 13 and down to 17 18. It just it's this is this is part of the problem. So we look at the sleep human sleep cycle. This is kind of a complicated uh diagram but it basically shows the time from midnight to 7 in the morning you're awake and the first on the left side you can see that that um that is slowwave sleep. It's considered your most restorative sleep. That's the sleep on the left side.
008The left two deepest uh valleys um are when um your body does repair for the brain and it also does um things such as your immune system. Your immune system gets uh regenerated during those slowwave deep deep uh sleep cycles. On the other hand, on the far right end where the oval circle is, that is where most of your REM sleep occurs. And we'll get into what REM sleep is. It's rapid eye movement sleep. But REM sleep uh is lost when kids are getting up at 6:00 6:30 in the morning for buses. REM sleep is where all of the memory consolidation happens. This is an important point because when you're getting kids up in the morning, the brain is still in the sleep mode. The brain still wants to be processing all of the information
009from the previous day and that happens during REM sleep. So this is just sort of a summary of sleep memory and cognition after learning. It enables the brain to consolidate new information, improves next day recall. Your brain has sort of like has an organizational system with file folders. It's like scaffolding for those of you that are teachers and know about scaffolding. It scaffolds on previous information. So if you have something learned new, it puts it into the file folder, if you will. Um so that is part of the the compendium of information you have and it next day it's more able to be recalled when you have adequate sleep. One night of sleep deprivation it will impair the brain function and it imposes the deficit of ability to commit things to memory and that's what
010I mentioned earlier about REM sleep. It has multiaceted functions in brain development learning and memory consolidation. In a study that I was involved in several years ago, this is a five-year study that was funded by the Robert Wood Johnson Foundation in Denver, Colorado, involving 55,000 students and the school district made um major changes. Um this was Cherry Creek uh Colorado district. So what we found um with the students that that reported their sleep time. So during the with the change you can see at the top middle school high school was one plus hour later the elementary schools were one hour earlier. That we'll get into that but that was sort of controversial at the time that the decision was made. However, when you look at these graphs, you can see that the elementary students on
011the left screen, even though they started an hour later, I'm sorry, an hour earlier, they only lost 11 minutes of sleep a night. Um, middle school gained 29 minutes, high schoolers gained 45 minutes of sleep per night. Um, on the right hand side, the percent change, it was a non-significant decrease for elementary kids, significant increase for both middle school and high school. All right. So, we know that the brain processes things academically during the night. This is from the very first study that I did in 1996 to 98 with um oh golly, it probably was 23 or 25 area metro school districts. Edina at that time was the only district that had made the change and they went from 720 to 840. Well, this was what happened after the year of the years of the
012change. the you can see on the left side the districts that had the um earliest start times earlier than 7:30 and so on for 10th 11th and 12th graders but when they the school like Edina had a greater than 8:30 a.m. um starting time the grades jumped up significantly so that was our our first indication that we were looking at a real remarkable difference in academic performance. People often ask me about achievement tests and what do we know? You know, there's great inflation at school districts and and we know that grades are um can be very um oh it's unpredictable from one district to another and and how even one classroom to another frankly. Um your math teachers may have grade on a on a sliding fee scale or sliding fee scale a sliding uh
013percentage scale. Others um don't have a sliding scale. They just have a percentage amount. So those things are really tricky in terms of assessing whether or not the achievement changes. So we look at the national ACT and SAT scores. And what we know from the national ATCT exam, there is no evidence that the variation in start times affected the scores for high school students. That's not to say it doesn't happen, but it does say that there's no evidence u this is from from 2020 that it on the ACT exam. However, you look at individual state level scores on math and reading achievement and that's where we start to see the difference. Probably has something to do with the test construction as well. Some of the questions are they have to be nationally normed and so
014on. But you look at the state level math and reading scores, one hour later start um in leads to a three percentile point gain for the average middle school student. Math scores, it's interesting. math scores are more um amendable and receptive to having more sleep. We don't know why. That's another another thing that the brain researchers need to figure out. Why is math so sensitive uh to your amount of sleep versus other reading and other kinds of of academic skills, excuse me, but they have this this impact that's really considered considerable for late start and math. And finally, lower performing students benefit more than others with a one-hour delay. This is what we found for the students who are doing their uh state level um achievement tests. In the study that I I was given
015a grant from this the CDC in 2010 then that was a national study that looked at at um school districts selected school districts across the country and this is what we learned from the districts that made the change. So those few districts that started their school between 8 and 8:35, there were statistically significant increases in one or more of the core classes in the high school from English, math, social studies, and science in five high schools. the start time at 8:55. There were significant statistically significant increases in this in the the achievement of students in all first period core courses for all semesters at all grade levels in grades 9 through 12 in Jacksonville, Wyoming. They were by far the they started at 55 uh 855. They were by far the latest starting school district
016and they had the biggest by far the biggest changes. So we also know that the start time before 8:00 it was significantly lower in the first period classes than in other periods. And that of course has to do with the brain still if your class is starting at 7:55 or even 7:30 your brain is still asleep. And so that the students are sleeping at their desk or they're just not processing the new information. So um again this negative effect was particularly significant for math classes. So what do we know then about student engagement as measured by attendance at class tardies graduation rates and so on? We did find and the other studies have found too that there's significant improvement in attendance and graduation rates for students in schools who have a delayed start time of
0178:30 or later. 8:30 seems to be the the key marker for when um you can expect or anticipate improvement in attendance, graduation rates and so on. Um this is related to the study that I did in Minneapolis. I did a five-year study from 1998 to 2002 and Minneapolis couldn't be more different or diverse than from Edina when I first studied Edina. It's interesting the student surveys that were completed. Honestly, you could not tell the difference between a high school student in Edina versus that in Minneapolis when we looked at issues having to do with sleepiness um when they go to bed, when they feel sleepy, and when they wake up. But where we noticed really differences in in uh the population that was more um u multi-racial, multithnic. So there were significant benefits for all
018of these subgroups, Asian, Hispanic, Native American, black, and white were students in grades 9 to 11 after the start time change to 8:40 in Minneapolis. And part of the issue was the students who were two things happening actually, two things. One was the students um who were mobile who were homeless or moved from school to school to school. When the school started at 8:40, the kids somehow were able to stay in their their previous high school. So, um and it had something to do with the transportation available and the fact that they were able to get up and get on a bus and attend the school. even though their parents might have changed apartments and moved into a different attendance boundary area, they still actually were um able to stay in the same school. And
019staying in the same school allows for attendance to improve and graduation rates to improve as well. So that was an interesting finding just about um multithnic students. Also, economically disadvantaged students have a great benefit. The magnitude of positive effects for later start is larger for economically disadvantaged students in the areas of higher course grades, higher achievement test scores, reduced tardies, improved attendance, and reduced suspensions. Lots of studies. You can see those are all that have been done across the United States. All have confirmed that this really assists any student that is any economic disadvantage in their in their life. >> So, what about teachers? They're pretty much they're a key part of this whole uh stakeholder um assessment. So when we assessed over 5,000 teachers 5,200 and some 52% of the high school the secondary
020teachers saw fewer students falling asleep in class after the later start. Um the later start also allowed secondary teachers time for better planning across subject areas. So the teachers were still getting to school early. Teachers secondary teachers tend to like early rising. that's part of maybe that's part of their DNA of why they chose to be a secondary educator. But at any rate, they were had more time for planning and um for the teams to be meeting across subject areas. It's interesting among those 5,200 some teachers, fewer than one in five indicated that high school and middle school students were ready for learning before 8 a.m. This is a collective knowledge. You know, you have teachers who've been in the business for 15, 20, 30 years. They've seen it all. And you know, when they
021say, "Yeah, less than 20% of any of the the teachers indicated that learning was good before 8 a.m." Because they saw so many students sleeping at their desk. Both elementary and secondary teachers noted the schedule changes affected their personal lives. Certainly, they have families, kids go to daycare, other things that had to do with car sharing with their spouse. But most say that the benefits to the students were worth it, and they made adjustments accordingly. for elementary students. This is what we found in every case when we've looked at elementary the shift in the we did the looked at the tiered busing and if if the shift was made for elementary kids to start earlier. There was increase in student attentiveness during class time. There was an increase in the students eating breakfast. the schools
022were able to structure their core classes that would be like reading, math, and so on before lunch and which is and elementary teachers will all tell you that kids are best before lunch when there that's their best learning time. Um I'm a former elementary teacher and an elementary principal and I can tell you that the mornings are when the kids really buckle down. That's when they really learn um a lot a lot. And after lunch, you get kids who are tired, who didn't sleep well, who for whatever reason um are are um not able to pay attention as well. The afternoons are tougher. Um there's a certainly there's a decreased need for morning child care. It allowed for fewer transitions for the students. You know, you think about if a parent has to drop off
023a child for daycare at 6:00 or 6 in the morning, 6:00 or 7 in the morning because they have to be to work at 7:00 7:30. These are kids that sit in a daycare setting or a home daycare and maybe they're watching TV, maybe they're playing, maybe they're whatever they're doing. But most kids before puberty wake up early. That's sort of that's what kids do. Um and so having a decreased need for child care in the morning actually allowed the kids then to um have fewer transitions. They didn't have to get on a bus dropped off. I mean, they get dropped off at school, which I think made a big difference for a lot of children. um there was no negative effect on academic achievement that nothing we could find and the research showed that
024after the first year the majority of elementary families and their school staff preferred the earlier start. That's not to say there wasn't some complaints and uh grumbling about being there so early but um it didn't show that there was um any problems with the students learning and the teachers then adapted just fine. So this is what we know about academics. The later start time in secondary schools, it's equivalent to one being in a class with a third fewer students. Interesting. Then their their instructional peers, teacher peers on a teacher performance evaluation. rise to the g to the game of teaching and their instructional performance is measured to be better when the teachers have themselves more sleep and also there's are more ready for the learning experience. The leaders effect of the starting time is similar
025to the size as noted earlier reducing the class size from 22 students when we do class size reduction to 15 students in grades K through three. is equivalent for the amount of effect. And we know also finally that deficient sleep and academic performance are clearly related. As sleep increases for most students, academic outcomes do improve. This is really important. Health and well-being. So if we can talk academics all we want, but you know if the kids aren't healthy um and if other is health issues intervene, it's it becomes more serious for their learning. So when we have less students having less than eight hours of sleep and in fact I'd like to just sort of point out when you do the math. Okay, so high school students, any student that's secondary age student who's in
026this sleep phase shift, they basically can't fall asleep much before 11 p.m. 10:45 to 11:15 is the window. Let's just say 11:00. If they sleep and they need sleep of eight hours, that means that they really should not be awakened before 7 in the morning. Well, think about when kids are on a bus schedule, they have to get up if they have even un unfortunately before school activities like hockey practice or something else that that gets them up early. But if they are getting less than eight hours of sleep because they're getting up before 7 in the morning, you have increased rates of depression, anxiety, and fatigue, increased risk of suicide, increased rate of auto accidents, decreased athletic and motor skills, weight gain, elevated blood pressure, the likelihood of risk-taking drugs, um uh behavior such
027as um that has to do with with um um oh, I'm just blanking on on the self-sufficiency, the the sort executive function is the compromised and it interferes of course with brain development of memory information. So this is done by the CDC. This the youth risk Y RBS is done um every couple years and this was done actually some time ago but it still it still is true today. So you can see, look at the difference between less than eight hours of sleep versus more than eight hours of sleep. And it has to do with cigarette use, alcohol use, marijuana use, sexual activity, feeling sad and hopeless felt daily in the past two weeks and they stop their usual activities. It's just remarkable. It's a tipping point. Eight hours seems to be the tipping point
028for u physical and mental health. This is a gripping um graphic and it has this is 27,000 students in Fairfax County schools were assessed and this is what they said about their sleep. So on the left hand side you can see students that reported four hours or less. We have 51 almost 52% of the those students saying they feel sad and hopeless and so on. Then you go to five hours, six hours and seven. Eight hours is where we have the least amount of issues with hopelessness, suicide, suicidality, and so on. And when it gets to 10 or more hours, sometimes that sort of a an issue with a student's health that is not related to starting time. It has to do with or some other issues in their life. serious depression. That's clinical depression
029needing to be treated by a doctor. So when you see 10 hours or more in an uptick that that is not the actual teenager needs between eight and nine hours of sleep. Okay. Car crash. Car crashes are the number one cause of death in teenagers. And the later start times in the study we did for the CDC, we saw a 13% reduction in teen car crashes. So when we look at the districts that were involved and this is important I think for you in Northfield because Monameidi is a small district it's contained and as is Jackson Hole Wyoming believe it or not their catchment area for their attendance is is restricted because it's got mountains on all sides and so you have students that basically aren't driving long distances at night after a date night
030or an athletic event. But South Washington County is enormous in terms of miles of area. And so students who are driving who might, like I said, have an athletic event, dates, whatever, whatever, after 9:00 p.m., um there was a 6% reduction wasn't as great because they're driving on the road and they're um and it's a longer distance. There's just longer distances that they had to drive to drive home in South Washington County. All right. So, now we get to phones and apps and technology. And it's very interesting for you to note that when I did the first studies in 1996, cell phones did not exist. And so this teen sleep surveys that I mentioned earlier that we couldn't tell any Dina student from a Minneapolis student was absolutely true because these kids got felt sleepy
031about 10:45 or 11 and they went to bed because there was nothing that kept them awake um other than maybe completing their homework or they weren't even using computers much at that time. So, here we are almost 30 years later and knowing that using technology within an hour of going to bed disrupts your sleep onset due to your brains being stimulated. That's part of the problem. 72% of adolescence and young adults use a smartphone within 30 minutes before going to bed. And 38% sleep with the cell phone ringer on on in their bedroom. It's a real problem because kids then once they start texting each other in the middle of the night um or whatever they're doing gaming gaming is a really stimulating activity for the brain. So if you have kids that are using
032doing games even up past in um high mode operation and it's really tough for them I think to then have the brain down and be ready for sleep and sleep onset. In fact, the more engaging the technology application, requiring mental alertness, the likelihood there's going to be difficulty falling asleep and not having restorative sleep. Okay, so here we are looking at research translation into policy decisions. These are things that over the years we have real issues that need to be challenges that need to be addressed and then there's issues that excuse me were not substantiated in any of the findings in any of the research over the years. So the left side, the left column, these are real issues. They're real issues. Athletics, the schedules and last class missed. You need to think about how
033does this work? So we've got kids um on traveling teams and so on. they're missing the last class. Do you not make the change because 50 or 25 kids are on the traveling basketball team when your high school is, say, a thousand kids or 1500 kids. Do you make a decision not to make the change because you have some kids on a traveling athletic team? Probably not the best way to make the decision. But then what you need to do is figure out, okay, what can we do? Maybe these kids schedules can allow a study hall at the end or whatever some other um some other class that is not as rigorous as trigonometry let's say for instance. Okay, that's to do with athletics. The younger children in the morning darkness is an issue. There
034is a website that's called first light or something like that and it shows you during the year when there is dusk or dawn and when the first light appears and that is really helpful because it lets you know how safe are kids. There's an assumption that everybody's in the dark at at 7:50 in the morning. Well, not necessarily depending on the time of year. So, the other thing that that districts are especially Minneapolis did is they had parents involved in a block community communication. So on Monday we had parents watching the the elementary kids at the corner Mr. Smith and on Tuesday might have been you know Mrs. Jones and on Wednesday so what they had each parent during in their block area were a kind of a monitor of the children's safety at the
035corner in the mornings. That was one solution. I mean there are other solutions but that was one that the community uh found for themselves. I mentioned earlier about child care schedules. We need to figure out how that can work. If you have child care in your school buildings, how does that happen to get people, you know, whether you have of um kids being dropped off at school, whether they have breakfast, all those things are things that need to be looked at. Parents work schedules. One of the things that I'm glad that that Dr. Hillman mentioned that you're not going to make the decision too quickly because if parents can work with their employers and say my child's school next year in two years is going to start earlier. I need to work out with you
036my arrival time for my work. Um hopefully for many parents, not all, that will be something that could a discussion that could take place. And then local traffic patterns and this is unanticipated totally in Dina when they made the change. The problem with where the buses turned into the high school, there was no semaphore, there was no lights, the police had to be there directing traffic. It was a big mess until they figured out the timing of the lights, adding a adding a traffic light and so on. So, it's just you need to you work need to work with the community about traffic and so on when you make these changes in all the schools. On the right hand side, these were worries that were not ever really substantiated as being real. There was concern,
037oh, I heard from the coaches, oh, we're going to have less kids playing the games. We're going to win fewer games. Actually, the reverse was true. When the kids had more sleep, they remembered the plays better. And so, they were able to actually maintain good athletic participation and and standings. So this was the coaches really did need a turnaround. When I interviewed them a year later, they were convinced that this was okay. There was concern that after school activities would decline with the kids, the high school kids not being dismissed until 3:00. That didn't happen. The same number of kids participated in chess club and French club and all those other different f core the choir and so on after school. It didn't decline the attendance at all. there doesn't necessarily have to mean a
038higher cost for transportation. Now, I know that's a concern for many districts and it might be something that you are concerning as concerned about as well. Many districts when they just did the actual flip of the tiered busing, they did it at no cost. That that is has been done. Um it depends on how you structure your transportation. Um, and when I was in I was a special ed director as well, you have to think about how kids where they wheel and spoke. Are you picking them up um on a local corner? Do you have specialized transportation for them? All of that needs to be taken into account. And your transportation director is key to this discussion. Um hopefully you don't have somebody who says, "I don't want to think about rerouting all my buses.
039I'm not going to talk to you about it." So hopefully you'll have somebody that's more um ready to make some of these decisions and give you the information you need. And then there's a concern that after school employment would be affected negatively and it was not. I called many of businesses that hired high school kids after school. Nobody wanted the students there until about 4:00 p.m. because that was when the rush people were going home might stop at a convenience store, at a gas station, um at um the mall to pick up something at, you know, grocery store, whatever. So most of those uh employers did not think that and did not see any reduction in their um um employment staff and availability of high school students to work after school. I mentioned earlier about
040the transportation criteria. It's really important but you need to think about the student ride time. How long are they on the bus? The safety at the bus stops after school activities cost efficiency and you need to get the parent feedback. you know, I mean, parents need to have a say in this. Um, but the one thing is it's really important. It's never helpful to ask put on a survey, what do you think would be um the a problem for your child unless the child maybe has handicap because what parents think and assume is you need to ask questions about how does this actually affect you? How did this affect you? talk to other districts who got parent feedback. They're the ones that are going to help you. So, this is just a quick summary about
041this start time having to do with class size. The Rand Corporation did a study found that delayed start times added, they estimated 83 billion to the US economy over the next decade. Pretty amazing. And one standard deviation rise in test scores for a student could increase their future earnings by 8% because they're perhaps graduating high school. Maybe they've dropped out before they could. Um and so the benefits even larger for students at the bottom of the grade distribution. Finally, principal easier to live with. Parents need, as I said earlier, adequate time to adjust their schedules. The community needs to be involved. The final question is how late is late enough? Districts making a modest move to a later start time experienced only modest benefits. The benefits were there, but they experienced the same amount of
042community disruption as did the districts that made the change to start at 8:30. In other words, don't do this incrementally like, oh, one year we're going to do from 8 to 10 and the following year we're going to move to 8:30. That's really not strategy because parents find that the disruption if they can deal with it once, that's all they need to deal with. but but repeatedly makes them crazy and angry. Okay. And of course I said earlier the starting time of 8:30 shows the most positive students will benefit equally. You got you know your your high flyer students they're going to they're going to learn who are also going to really um have the issues having to do with with loss of sleep and the other car crashes and and other negative things that
043happen. of course has to be provide the greatest good for the greatest number of students and anticipation is often worse than the reality. That's what we found and the challenges were reduced over time. We need to very important you need to educate the general public about brain development during adolescence. It's people don't understand they think it's this is for the convenience the teenagers and it is not. This is about teens health safety and learning. We need to ident engage the community in solutions involving all the key stakeholders, the kids, the parents and so on. Needing providing an adequate time for the families to become informed. Each community has different unique conditions. Absolutely. There's no one sizefits-all, but talking with other school districts that might be similar to you in size or location or other demographic
044characteristics, you'll find that there's a lot of solutions that you might have not thought of before by talking to other people. So, what to do next? It's very important. As I said a minute ago, parents need to become better informed about the importance of sleep, especially this information about the risk behavior and their kids are easier to live with. Okay. Teens need to learn about sleep on their own body and how it affects them and their decision- making and their ability to to um be flexible when you know teenagers can be not so easy to to uh manage. But this certainly makes a difference when they have their uh have adequate sleep. And then finally, teachers and administrators need to discuss how the sleep needs interact with school activities and actions. For instance, one of
045the things that schools that I've been dealing with have been have done with teachers is don't have the turnin time for a computer paper to submit it at midnight because all that does is support the kids who procrastinate and they start it at 11:00 p.m. So teachers by and large in one school district has said turn in time the deadline always every night is 10 10 p.m. and nothing is accepted after that. that then fracking earlier so that that they're not sitting at 11:35 in the at night. Let's hope. Okay. So, finally, this is the last slide. We need to re have phase shift in teens. It's based in human development biology pure and simple and due to rebellious adolescent behavior. When making decisions, it's important to keep the focus on the child and not
046on the system.