I am writing to share some thoughts in anticipation of the upcoming forum to discuss delaying school start times in East Greenwich. We are fortunate to have an international expert on adolescent sleep, Dr. Mary Carskadon from Brown University and E.P. Bradley Hospital, speaking at the forum, which will be held on Thursday, Feb. 26, at 7 p.m. in the Cole Middle School library.

In the weeks since the first forum, I have spoken to many people in East Greenwich about this issue, and would like to take the opportunity to share some ideas. First, I suggest that our community should be thinking about delaying school start times as an opportunity to address an important public health issue. There are volumes of research showing that today’s teens get less sleep than in previous generations and that on average most teens obtain an insufficient duration of sleep. I argue this is a public health issue because multiple studies show that insufficient sleep increases risks of poor physical and mental health outcomes, including increased risk of obesity and diabetes, depression, substance abuse, suicidal behavior, poor impulse control, and increased risks of accidents. The last two issues are particularly concerning among our teens who are new drivers. Furthermore, from an educational standpoint, insufficient sleep is associated with poor academic performance from elementary school through college.

In medicine, we talk about two concepts that are related to the school start time issue facing East Greenwich. The first is evidenced-based practice, and the second is modifiable risk factors. Evidence-based practice means that when new research is released showing that a new treatment is better than an old treatment or that an old treatment we thought worked isn’t as good as we thought, we change our medical practices to reflect that updated information. An example where this has occurred in our schools is the integration of new concussion protocols. The past decade has seen important progress in our understanding of sports related brain injuries, and has resulted in more and better helmet use and better treatment for youth who unfortunately experience a head trauma while engaging in athletics. Changing school start times should be viewed in the same way as these new concussion protocols. We now have excellent data showing that poor sleep is bad for teens and that delaying school start times helps mitigate this risk. It is time for communities like East Greenwich to integrate this new scientific data into practice.

The second concept, of modifiable risk factors, also relates to delaying school start times. An analogy is preventative measures for heart disease. Thus, although we may not be able to change our genetic predisposition for how our bodies metabolize cholesterol, we can choose to eat healthy diets and engage in regular physical activity to mitigate our cardiac risk – healthy eating habits and increased exercise are modifiable risk factors. Similarly, with regard to sleep deprivation in teens, we as a community cannot legislate the individual bedtimes of every student in our community. This is not a realistically modifiable risk factor. On the other hand, changing school start times to align with teens’ biological tendency to sleep later is a modifiable risk factor that has been shown to help teens get more sleep.

This brings me to some of the questions that parents in the community have raised. One argument against this change is that “changing the school start times isn’t going to make my child get more sleep.” This may be true, and how different families handle sleep times in their households obviously is up to them. However, numerous studies show that overall, teens get more sleep when school start times are delayed. Again, if we think of this as a public health issue, we should all be in favor of more of the teens in East Greenwich getting adequate sleep because we want to reduce risk for our whole town, not just the teens living in our homes. Indeed, we drive on the same roads, and our teens may even be passengers in the cars of sleepy teens, so improving outcomes for the whole town is a worthy pursuit with the potential to benefit our whole community.

Another concern I have heard is regarding the impact that changing school start times will have on extracurricular schedules. The breadth and excellence of our communities’ enrichment programs and sports are deserving of praise and admiration. However, these extracurriculars should not supersede students’ academic pursuits or their health. As with any change adopted by a community, adjustments will be necessary. If a delayed start time proposal is adopted, it may require juggling of peoples’ schedules. However, a change that is likely to benefit the majority of students must be prioritized, even if it initially poses logistical challenges for extracurricular activities and sports. Indeed, the data show that school start times improve outcomes the most for at-risk students, who may be struggling so much that they are unable to take advantage of extracurriculars in the present climate. Furthermore, imagine the enhanced performance we may observe if our most talented students obtain adequate sleep!

I hope we will have a great turnout for the School Start Time Forum. There will be experts on hand to answer questions. Delaying the school start times in East Greenwich would be a courageous act by our school committee and superintendent, and will require some adjustments for many families. But based on the principles of modifiable risk factors, public health, and evidence-based practice, it is the right thing in our town at this time.

– Katie Sharkey, MD, PhD, FAASM

The author is a 1987 graduate of East Greenwich High School and a board-certified Sleep Medicine Physician. She has two children in the East Greenwich Public Schools.