What would you do if the NHS told you your teenager was more likely to be obese, depressed, risk- taking with alcohol, tobacco and drugs, and less likely to do well at school?
Since 2014, we have had clear medical evidence that starting school too early has a negative effect on adolescent health due to their biology. They need more sleep at this age. So why do some schools in Scotland still start at 8:30 a.m. or earlier when this makes their students more likely to have these problems?
Unfortunately for you and your teenager we haven’t been told that these higher health risks arise from sleep loss. Although there are teenagers with individual sleep issues that Sleep Scotland and the NHS support, this is not the same.
Parents know teenagers can be hard to wake for school, and they seem tired every morning. That’s partly because they are tired in the morning and more alert in the evening. They do sleep in at the weekend to try to catch up the sleep they lost during the week. Unfortunately, if you are sleep deprived in your working week, you can’t make up for it by ‘sleeping in’.
This teenage time zone is really very different. To give you an idea of how teenagers feel in schools that start at 8:30 a.m. or earlier, imagine how you would feel if someone woke you up at 4:30 a.m. in the morning every working day. The underlying biological processes are simple: not only do teenagers need an hour (or more) sleep compared to adults, they also need to wake up, and go to sleep, much later in the day. For the last 30 years or more, research worldwide has consistently shown teenagers are losing two or more hours of sleep each school night because they are being forced to fight body clocks created to ensure they have longer sleep and later wake times.
Disrupting body clocks that control our wake and sleep cycles has other consequences. Our body clocks control time patterns (called circadian rhythms) in our organs, most of our biological processes and even our feelings of hunger and being full.
So teenagers may find their eating patterns going awry with late-night snacks and not being hungry at the traditional breakfast time that suits early school starts. More worryingly, sleep deprivation is associated with the onset of mental illnesses.
Evidence that early school starts cause negative health risks from obesity to drug abuse has been established over decades of research. In the last ten years the evidence has been so strong that medically advanced countries with very early school starts are now taking action. In Korea, one province of 11 million has moved all start times to much later.
Most significantly, from 2014-2016 the American medical community (including the American Medical Association) and the US Department of Health recommended that all schools with secondary students start later. Specifically, schools should not require students to start earlier than 8:30 a.m. The medical evidence was clear that in these early-starting schools, teenagers would be more likely to become obese, depressed, risk-taking with alcohol, cigarettes and drugs, and less likely to do well at school. This challenging message does not just apply to more than 80 per cent of secondary schools in America but to schools around the world: teenagers in Scottish schools that start before 8:30 a.m. have the same increased health risks.
There is a positive side: teenagers in Scottish schools that start later are more likely to be healthier and do better. But is 8:30 a.m. still too early? Yes – a new four-year study of students in an English state school saw their rate of illness fall by 50 per cent when they moved the start time to 10 a.m. Their results improved too.
The Year of Young People in Scotland is an opportunity to improve young people’s lives. Scotland and NHS Scotland could lead the UK and the rest of Europe in improving teenage heath by ensuring secondary schools in Scotland start at 9 a.m. or even 10 a.m. There will be challenges: in the Central Belt, transport to school is fast, but in the Highlands and Islands many teenagers may need even later times. Scotland showed commitment to public health by banning smoking in the workplace, and commitment to young people by granting them the right to vote. It can give a commitment to let its teenagers have the sleep they need by starting secondary schools later. It’s only a matter of time.
Dr Paul Kelley is honorary associate in Sleep, Circadian and Memory Neuroscience at The Open University.