Sleep and Health

Adequate sleep contributes to a student’s overall health and well-being. Students should get the proper amount of sleep at night to help stay focused, improve concentration, and improve academic performance.

Children and adolescents who do not get enough sleep have a higher risk for many health problems, including obesity, type 2 diabetes, poor mental health, and injuries.^1-4 They are also more likely to have attention and behavior problems, which can contribute to poor academic performance in school.^1,2

How Much Sleep Do Students Need?

How much sleep someone needs depends on their age. The American Academy of Sleep Medicine has made the following recommendations for children and adolescents¹:

Recommended Hours of Sleep Per Day by Age Group
Age Group	Recommended Hours of Sleep Per Day
6–12 years	9 to 12 hours per 24 hours
13–18 years	8 to 10 hours per 24 hours

Recommended Hours of Sleep Per Day. Most students need more sleep..

Insufficient Sleep Among Students

The data from the 2015 national and state Youth Risk Behavior Surveys, a CDC study, shows that a majority of middle school and high school students reported getting less than the recommended amount of sleep for their age.⁵

Middle school students (grades 6–8)

Students in 9 states were included in the study.
About 6 out of 10 students (57.8%) did not get enough sleep on school nights.

High school students (grades 9–12)

National sample.
About 7 out of 10 students (72.7%) did not get enough sleep on school nights.

In 2014, American Academy of Pediatrics recommended that middle schools and high schools start no earlier than 8:30 a.m. to allow adolescents to get the sleep they need.¹²

The American Medical Association,¹³ the American Academy of Sleep Medicine,¹⁴ and other medical associations have since expressed support of delaying school start times for adolescents.

Good sleep hygiene in combination with later school times will enable adolescents to be healthier and better academic achievers.

Provide Sleep Education

Schools can add sleep education to the K–12 curriculum to help children and adolescents learn why sleep is important to maintain a healthy lifestyle. Lessons in sleep patterns and sleep disorders, snoring, drowsy driving, and insomnia are among topics teachers can cover in the classroom to help students develop healthy sleep habits.

Sleep education programs in school may result in significantly longer weekday and weekend total sleep time and improved sleep hygiene (habits that support good sleep) after completion.⁶However, more research is needed to determine how best to maintain these improvements long term. One possible strategy is to incorporate refresher sessions for students.

Review School Start Times

The combination of late bedtimes and early school start times results in most adolescents not getting enough sleep. In recent years, evidence has accumulated that later school start times for adolescents result in more students getting enough sleep.^10,11

School officials can learn more about the research connecting sleep and school start times. School districts can support adequate sleep among students by implementing delayed school start times as recommended by the American Academy of Pediatrics (AAP), the American Medical Association, and the American Academy of Sleep Medicine.

A mother and daughter discussing a health issue

Model and encourage habits that help promote good sleep. Setting a regular bedtime and rise time, including on weekends, is recommended for everyone—children, adolescents, and adults alike. Adolescents with parent-set bedtimes usually get more sleep than those whose parents do not set bedtimes.
Dim lighting. Adolescents who are exposed to more light (such as room lighting or from electronics) in the evening are less likely to get enough sleep.
Implement a media curfew. Technology use (computers, video gaming, or mobile phones) may also contribute to late bedtimes. Parents should consider banning technology use after a certain time or removing these technologies from the bedroom.

Educate adolescent patients and their parents about the importance of adequate sleep and factors that contribute to insufficient sleep among adolescents.

Sleep Education

School Start Times

CDC Feature—Schools Start Too Early.
Start School Later—Learn More.
Reports
- Owens J, Drobnich D, Baylor A, Lewin D. School start time change: an in-depth examination of school districts in the United States. Mind Brain Educ. 2014;8:182–213.
- Wheaton AG, Chapman DP, Croft JB. School start times, sleep, behavioral, health, and academic outcomes: a review of the literature. J Sch Health. 2016;86(5):363–381.
- Morgenthaler TI, Hashmi S, Croft JB, et al. High school start times and the impact on high school students: what we know, and what we hope to learn. J Clin Sleep Med. 2016;12:1681–1689.

Paruthi S, Brooks LJ, D’Ambrosio C, et al. Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: methodology and discussion. J Clin Sleep Med. 2016;12:1549–1561.
Owens J; Adolescent Sleep Working Group; Committee on Adolescence. Insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics. 2014;134:e921–e932.
Lowry R, Eaton DK, Foti K, McKnight-Eily L, Perry G, Galuska DA. Association of sleep duration with obesity among US high school students. J Obes. 2012;2012:476914.
Fitzgerald CT, Messias E, Buysse DJ. Teen sleep and suicidality: results from the Youth Risk Behavior Surveys of 2007 and 2009. J Clin Sleep Med. 2011;7:351–356.
Wheaton AG, Everett Jones S, Cooper AC, Croft JB. Short sleep duration among middle school and high school students — United States, 2015. MMWR Morb Mortal Wkly Rep. 2018;67:85–90.
Chung K-F, Chan M-S, Lam Y-Y, Lai CS-Y, Yeung W-F. School-based sleep education programs for short sleep duration in adolescents: a systematic review and meta-analysis. J Sch Health. 2017;87:401–408.
Crowley SJ, Acebo C, Carskadon MA. Sleep, circadian rhythms, and delayed phase in adolescence. Sleep Med. 2007;8:602–612.
Bartel KA, Gradisar M, Williamson P. Protective and risk factors for adolescent sleep: a meta-analytic review. Sleep Med Rev. 2014;21:72–85.
Knutson KL, Lauderdale DS. Sociodemographic and behavioral predictors of bed time and wake time among US adolescents aged 15 to 17 years. J Pediatr. 2009;154:426–430. e1.
Wheaton AG, Chapman DP, Croft JB. School start times, sleep, behavioral, health, and academic outcomes: a review of the literature. J Sch Health. 2016;86(5):363–381.
Morgenthaler TI, Hashmi S, Croft JB, et al. High school start times and the impact on high school students: what we know, and what we hope to learn. J Clin Sleep Med. 2016;12:1681–1689.
Adolescent Sleep Working Group, Committee on Adolescence, Council on School Health. Policy statement: school start times for adolescents. Pediatrics. 2014;134:642–649.
American Medical Association. AMA Supports Delayed School Start Times to Improve Adolescent Wellness website. Retrieved from https://www.ama-assn.org/ama-supports-delayed-school-start-times-improve-adolescent-wellness.
Watson NF, Martin JL, Wise MS, et al. 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.