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. 2020 Dec 10:12:1161-1172.
doi: 10.2147/NSS.S273875. eCollection 2020.

The Association Between School Start Time and Sleep Duration, Sustained Attention, and Academic Performance

Valentina Alfonsi  1   2 , Rossella Palmizio  3 , Annalisa Rubino  3 , Serena Scarpelli  2 , Maurizio Gorgoni  1 , Aurora D'Atri  4 , Mariella Pazzaglia  1   2 , Michele Ferrara  4 , Salvatore Giuliano  3 , Luigi De Gennaro  1   2
Affiliations

The Association Between School Start Time and Sleep Duration, Sustained Attention, and Academic Performance

Valentina Alfonsi et al. Nat Sci Sleep. .

Abstract

Purpose: In adolescence, physiological (circadian and homeostatic regulation of sleep) and social habits contribute to delayed sleep onset, while social obligations impose early sleep offset. The effects of delayed school start time on the subjective/objective measures of sleep-wake patterns and academic achievement have not been established.

Methods: This pre-, post-, and longitudinal non-randomized study included an early (8:00 am; ESC=30 students) and the late (9:00 am; LSC=21 students) start class. Multiple sleep data included a weekly sleep diary, Karolinska Sleepiness Scale, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale. Sustained attention was measured using the Psychomotor Vigilance Task. Academic performance was evaluated by two different mathematical and scientific standard tests (entrance and final) and by school attendance indicators. Data were collected at monthly intervals from October 2018 to May 2019 and the beginning and end of the academic year (pre/post).

Results: All students turned their lights off at similar times (LSC=11:21pm, ESC=11:11pm), but LSC students woke up later (7:23am) than ESC students (6:55am; F1,48=11.81, p=0.001) on school days. The groups did not differ in total sleep duration on non-school days. Longitudinal measures revealed a significant increase (8.9%, 34 min) in total sleep duration of LSC students across the academic year. ESC students maintained approximately the same sleep duration. Furthermore, changes in sleep duration had parallelled significant differences in sustained attention, with LSC students outperforming ESC students. Longitudinal changes of sleep and sustained attention were associated with a coherent pattern of changes in academic performance.

Conclusion: Findings indicate that a one-hour delay in school start time is associated with longer sleep, better diurnal sustained attention, attendance, and improved academic performance. Notably, sleep changes were limited to school days. A delay in school start time should be seriously considered to improve sleep and academic achievements of students.

Keywords: adolescence; attention; school health; school start time; sleep; sleep loss.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Pre-post changes in subjective sleepiness and sleep concerns across the school year. Means (and SE) of scores at the Pittsburgh sleep quality index (PSQI) and Epworth sleepiness scale (ESS) at the beginning and end of the academic year.
Figure 2
Figure 2
Academic performance at the beginning and end of the academic year. Means (and SE) of grades at two forms (entrance and final tests) administered in the late and early start classes at the beginning and end of the academic year. ***p≤.001, and “NS” to indicate non-significance.
Figure 3
Figure 3
Lights-off hour and bedtime in the two classes across the academic year. Means (and SE) of lights-off hour and bedtime (and, consequently, wake-up hour) in the late and early start classes.
Figure 4
Figure 4
Longitudinal changes in total sleep time and attentional performance across the academic year. Means (and SE) of percentage changes in total sleep time (panel (A) and measures of the Psychomotor Vigilance Task (panel (B) in the late and early start classes. *p≤.05, ***p≤.001.
Figure 5
Figure 5
Lights-off hour, wake-up hour, and total sleep time as a function of school and non-school days. Means (and SE) of (A) lights-off hour, (B) wake-up hour, (C) total sleep time in the late and early start classes plotted as a function of school and non-school days. ***p≤.001, **p≤.01, and “NS” to indicate non-significance.
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