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Adolescent Sleep, School Start Times, and Teen Motor Vehicle Crashes

2008; American Academy of Sleep Medicine; Volume: 04; Issue: 06 Linguagem: Inglês

10.5664/jcsm.27345

1550-9397

Fred Danner, Barbara Phillips,

Urban Transport and Accessibility

Free AccessSchool Start TimesAdolescent Sleep, School Start Times, and Teen Motor Vehicle Crashes Fred Danner, Ph.D., Barbara Phillips, M.D., M.S.P.H. Fred Danner, Ph.D. Department of Educational and Counseling Psychology , Barbara Phillips, M.D., M.S.P.H. Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, University of Kentucky, Lexington, KY Published Online:December 15, 2008https://doi.org/10.5664/jcsm.27345Cited by:139SectionsAbstractPDF ShareShare onFacebookTwitterLinkedInRedditEmail ToolsAdd to favoritesDownload CitationsTrack Citations AboutABSTRACTStudy objectives:To assess the effects of delayed high-school start times on sleep and motor vehicle crashes.Methods:The sleep habits and motor vehicle crash rates of adolescents from a single, large, county-wide, school district were assessed by questionnaire before and after a 1-hour delay in school start times.Results:Average hours of nightly sleep increased and catch-up sleep on weekends decreased. Average crash rates for teen drivers in the study county in the 2 years after the change in school start time dropped 16.5%, compared with the 2 years prior to the change, whereas teen crash rates for the rest of the state increased 7.8% over the same time period.Conclusions:Later school start times may both increase the sleep of adolescents and decrease their risk of motor vehicle crashes.Citation:Danner F; Phillips B. Adolescent sleep, school start times, and teen motor vehicle crashes. J Clin Sleep Med 2008;4(6):533–535.INTRODUCTIONThere is considerable evidence that a majority of adolescents do not get enough sleep for optimal functioning during the day.1–3 It is also clear that driving while drowsy is a serious traffic safety problem, especially among young drivers.4–6 Both social and biologic pressures appear to cause a shift in sleep patterns during the transition to adolescence, with the result that adolescents stay up progressively later as they progress through high school.7–9 Therefore, early school start times for adolescents decrease their sleep, which increases their daytime sleepiness,8 which may, in turn, increase their odds of crashing their vehicles while driving.Although concern is growing among sleep researchers about the detrimental effects of early school start times on adolescents, school scheduling is complex and emotionally laden.10 Any change in school start times affects the entire community, as it disrupts established child-care arrangements, extracurricular activities, work schedules, and family life. These logistical problems were evident in a recent national survey of secondary schools that reported that only 17% of high schools had even considered opting for later school start times in the preceding 3 years.11 Moreover, it is sometimes argued that starting high schools later will simply result in adolescents staying up even later, with no net gain in sleep, even though this did not appear to be the case in 3 recent studies.12–14To assess the effects of delayed high school start times on sleep and motor vehicle crashes, a survey of the sleep habits of the students from an entire county-wide school district was administered before and after a change in school start times. There was only 1 school district in this county, and students from the entire district participated. State-collected measures of collision statistics by age and residence of driver were used to compute crash rates per 1000 licensed drivers for teen drivers before and after the change in school start times in both the county in which the start times changed and in the rest of the state, where start times remained unchanged.METHODSIn April of Year 1 (1998), a total of 9,966 students from grades 6 to 12, who obtained parental permission, filled out questionnaires concerning their sleep habits on school and nonschool nights and various aspects of their daytime functioning. Specifically, the students were asked when they typically went to bed and arose on weekdays and on each day of the weekend, how many naps they took, how much difficulty they had staying awake in various situations (Epworth Sleepiness Scale), and how they spent their time before and after school. These Year 1 participants comprised 66.9% of the total population of middle- and high-school students enrolled in the county. In April of Year 2 (1999), 10,656 students (72.8% of the total middle- and high-school population) filled out the same questionnaire. Unfortunately, participant ID codes assigned by the school system were changed in 1999, so it was not possible to link individual students' responses over time. Therefore, analyses of change reported here are based on system-wide aggregate data. School start times during Year 1 were 07:30 and 08:00 for high schools and middle schools, respectively. In Year 2, high schools and middle schools started 1 hour later (08:30 and 09:00, respectively).The data reported here focus on the sleep habits of high school students before and after the change in school start times, as well as on the rates of motor vehicle crashes of those students aged 17 to 18 years. Separate crash rates were computed for the county that changed high school start times and for the state as a whole (with the county data excluded). Crash rates were computed for the 5 years for which they were available—the 2 years prior to the school-start change (1996 and 1997) through 2 years following the school-start change (1999 and 2000). Results exclude 16-year-old drivers because Kentucky instituted a graduated drivers' license program in 1996 that severely restricts 16-year-olds' driving privileges. For their first 6 months, 16-year-olds may not drive after midnight and must have a licensed adult in the car with them at all times. These restrictions have resulted in a considerable decrease in crashes in the state among 16-year-olds but have not influenced crash rates for older teen drivers.15RESULTSAverage hours of sleep per night during Year 1 and Year 2 are presented in Figure 1. These data reflect group average comparisons rather than individual students tracked over time. Students in Year 2 averaged from 12 minutes (Grade 9) to 30 minutes (Grade 12) more self-reported sleep, compared with students in Year 1. T-tests on these changes in average amount of sleep at each grade level indicate that these Year 1 to Year 2 gains were significant at all 4 grades (all p values < .001). The percentage of students who got at least 8 hours of sleep per weeknight increased significantly from 35.7% to 50.0% (p < .01), and the percentage who got at least 9 hours of sleep increased significantly from 6.3% to 10.8% (p < .01). The average amount of additional sleep on Friday nights, compared with school nights, served as a crude proxy for sleep deprivation, as catch-up sleep on the weekends is a logical response to the build-up of a sleep debt during the week.8 The average amount of this additional weekend sleep significantly decreased from 1.9 hours to 1.1 hours (p < .001), and this drop in extra catch-up sleep by grade level is illustrated in Figure 2. Consistent with this indication of a reduced sleep debt, average scores on the Epworth Sleepiness Scale decreased from 8.9 to 8.2 (p < .001) from Year 1 to Year 2, and the proportion of teens who scored 10 or higher dropped from 43.3% to 37% (p < .001).Figure 1 Hours of sleep per night by grade level and year.Download FigureFigure 2 Hours of extra sleep on weekend nights by grade level and year.Download FigureThere was little evidence of change from Year 1 to Year 2 on any other measure collected from the adolescents' self-reports. There was a slight increase in the percentage who reported working 10 hours or more per week (28% vs 31%), but there were no significant differences in hours spent on homework, school sports, organized community sports, music activities, volunteer work, or hanging out with friends.Auto crash data per 1000 licensed drivers for those aged 17 and 18 are presented in Figures 3 and 4. Figure 3 presents all 5 years of available crash data and Figure 4 compares average crash rates for the 2 years prior to the change in school start times to those for the 2 years after the change. The year 1998 was dropped from Figure 4, as this was a transitional year during which the school district and the adolescents had to rearrange transportation to and from school. The county crash rates were considerably higher than the rest of the state prior to the change in school start times. This may have been because the study county is in the center of a rapidly expanding metropolitan area, with all of its attendant traffic congestion. Despite rapid population growth, the rate of crashes in the county dropped after the change in school start time. The average crash rates in the 2 years after the change in school start times, as shown in Figure 4, reflect a significant decrease of 16.5% in the study county (p < .01), whereas there was a significant increase of 7.8% across the same time period in the rest of the state (p < .01).Figure 3 Number of motor vehicle crashes per 1000 drivers aged 17 or 18 years in the study county and state.Download FigureFigure 4 Number of motor vehicle crashes per 1000 drivers aged 17 or 18 years during the 2 years before and 2 years after a change in school start times.Download FigureDISCUSSIONMoving the school start time 1 hour later for all of the adolescents in 1 large county school district (the only county to do so during the period of this study) resulted in meaningful increases in sleep time, an increase in the percentage of students who got an adequate amount of sleep, and a decrease in catch-up sleep on weekends. It was also associated with a significant drop in auto collision rates for high school-aged drivers in that county, whereas crash rates increased in the rest of the state during the same time period. These findings are not necessarily causal, since they are not the result of a direct assessment of the sleep habits and miles driven of drivers who did and did not have crashes.However, these data are consistent with the idea that allowing adolescents to sleep more on school nights by delaying the start of school not only results in them sleeping more, but also may have a measurable positive effect on their driving safety.DISCLOSURE STATEMENTThis was not an industry supported study. The authors have indicated no financial conflicts of interest.REFERENCES1 Danner FAdolescent sleep and daytime functioning: a national studySleep200023A199200 Google Scholar2 Frederiksen K, Rhodes J, Reddy R, Way NSleepless in Chicago: tracking the effects of adolescent loss during the middle school yearsChild Dev2004758495, 15015676 CrossrefGoogle Scholar3 Wolfson A, Carskadon , M Sleep schedules and daytime functioning in adolescentsChild Dev19986987587, 9768476 CrossrefGoogle Scholar4 McCartt A, Ribbner S, Pack A, Hammer MThe scope and nature of the drowsy driving problem in New York StateAccid Anal Prev1996285117, 8870778 CrossrefGoogle Scholar5 National Sleep FoundationSleep in America Poll2002Washington, DCWB&A Market Research Google Scholar6 Pack A, Rodgman E, Cucchiara , A , Dinges , D , Schwab , C Characteristics of crashes attributed to the driver having fallen asleepAccid Anal Prev19952776975, 8749280 CrossrefGoogle Scholar7 Carskadon M, Acebo CRegulation of sleepiness in adolescents: update, insights, and speculationSleep20022560614, 12224839 CrossrefGoogle Scholar8 Carskadon M, Wolfson A, Acebo C, Tzischinsky O, Siefer RAdolescent sleep patterns, circadian timing, and sleepiness at a transition to early school daysSleep19982187181, 9871949 CrossrefGoogle Scholar9 Wolfson A, Carskadon MUnderstanding adolescents' sleep patterns and school performance: a critical appraisalSleep Med Rev20037491506, 15018092 CrossrefGoogle Scholar10 Wahlstrom KThe prickly politics of school starting timesPhi Delta Kappan1999803457 Google Scholar11 Wolfson A, Carskadon , M A survey of factors influencing high school start timesNASSP Bull2005894766 CrossrefGoogle Scholar12 Dexter D, Bijwadia J, Schilling D, Applebaugh GSleep, sleepiness and school start times: a preliminary studyWMJ: Official Publication of the State Medical Society of Wisconsin2003102446 Google Scholar13 Wahlstrom KLater high-school start times still workingEducation Digest2003684954 Google Scholar14 Wolfson AMiddle school start times: the importance of a good night's sleep for young adolescentsBehav Sleep Med20075194209, 17680731 CrossrefGoogle Scholar15 Agent K, Pigman J, Steenbergen L, Pollack S, Kidd P, McCoy CEvaluation of the Kentucky Graduated Driver Licensing SystemResearch Report KTC-01-28/NHTSA1-98-1F2001Lexington, KYKentucky Injury Prevention and Research Center Google Scholar Previous article Next article FiguresReferencesRelatedDetailsCited by Associations of mode and distance of commuting to school with cardiorespiratory fitness in Slovenian schoolchildren: a nationwide cross-sectional studyJurak G, Soric M, Sember V, Djuric S, Starc G, Kovac M and Leskosek B BMC Public Health, 10.1186/s12889-021-10326-6, Vol. 21, No. 1, Online publication date: 1-Dec-2021. Assessing the potential impact of age and inhalant use on sleep in adolescentsMalhotra C, Gunge D, Advani I, Boddu S, Nilaad S and Crotty Alexander L Journal of Clinical Sleep Medicine, Vol. 17, No. 11, (2233-2239), Online publication date: 1-Nov-2021.Child and teen sleep and pandemic-era schoolYuen K, Strang A, Flynn-Evans E, Barrantes Perez J, Berneking M, Bhui R, Cheng J, Dombrowsky J, Ganguly G, Rishi M, Rosen C, Upender R and Sullivan S Journal of Clinical Sleep Medicine, Vol. 17, No. 4, (613-615), Online publication date: 1-Apr-2021. Normal Sleep in Children and AdolescenceAgostini A and Centofanti S Child and Adolescent Psychiatric Clinics of North America, 10.1016/j.chc.2020.08.011, Vol. 30, No. 1, (1-14), Online publication date: 1-Jan-2021. Barrett R and Francescutti L Why Do We Ignore Sleep? Hardwired: How Our Instincts to Be Healthy are Making Us Sick, 10.1007/978-3-030-51729-8_5, (89-113), . School start time: a public health crisisSheldon S and Pelayo R Journal of Clinical Sleep Medicine, Vol. 16, No. S1, (11-12), Online publication date: 17-Dec-2020. Pediatric InsomniaHimelfarb M and Shatkin J Child and Adolescent Psychiatric Clinics of North America, 10.1016/j.chc.2020.08.004, , Online publication date: 1-Oct-2020. Delayed school start times and motor vehicle accidents: a need for further inquiryBarlaan D, Sinor K and Cromer L Journal of Clinical Sleep Medicine, Vol. 16, No. 9, (1627-1627), Online publication date: 15-Sep-2020. Delaying School Start Times to Improve Population HealthCheng E and Carroll A JAMA Pediatrics, 10.1001/jamapediatrics.2020.0351, Vol. 174, No. 7, (641), Online publication date: 1-Jul-2020. Association of Delaying School Start Time With Sleep Duration, Timing, and Quality Among AdolescentsWidome R, Berger A, Iber C, Wahlstrom K, Laska M, Kilian G, Redline S and Erickson D JAMA Pediatrics, 10.1001/jamapediatrics.2020.0344, Vol. 174, No. 7, (697), Online publication date: 1-Jul-2020. High school start times and student achievement: Looking beyond test scoresLenard M, Morrill M and Westall J Economics of Education Review, 10.1016/j.econedurev.2020.101975, Vol. 76, , (101975), Online publication date: 1-Jun-2020. Later School Start Time: The Impact of Sleep on Academic Performance and Health in the Adolescent PopulationAlfonsi V, Scarpelli S, D'Atri A, Stella G and De Gennaro L International Journal of Environmental Research and Public Health, 10.3390/ijerph17072574, Vol. 17, No. 7, (2574) Estimating Representative Group Intrinsic Circadian Period from Illuminance-Response Curve DataStack N, Zeitzer J, Czeisler C and Diniz Behn C Journal of Biological Rhythms, 10.1177/0748730419886992, Vol. 35, No. 2, (195-206), Online publication date: 1-Apr-2020. Neural activity moderates the association between sleep and risky driving behaviors in adolescenceBaker A, Tashjian S, Goldenberg D and Galván A Developmental Cognitive Neuroscience, 10.1016/j.dcn.2020.100790, , (100790), Online publication date: 1-Apr-2020. School start time change and motor vehicle crashes in adolescent driversBin-Hasan S, Kapur K, Rakesh K and Owens J Journal of Clinical Sleep Medicine, Vol. 16, No. 3, (371-376), Online publication date: 15-Mar-2020. The Association of Sport Specialization, Overuse Injury, and Travel With Daytime Sleepiness in Youth AthletesPost E, Trigsted S, Schaefer D, Cadmus-Bertram L, Watson A, McGuine T, Brooks M and Bell D Athletic Training & Sports Health Care, 10.3928/19425864-20190219-01, Vol. 12, No. 2, (59-66), Online publication date: 1-Mar-2020. School Start Times, Delinquency, and Substance Use: A Criminological PerspectiveSemenza D, Meldrum R, Jackson D, Vaughn M and Piquero A Crime & Delinquency, 10.1177/0011128719845147, Vol. 66, No. 2, (163-193), Online publication date: 1-Feb-2020. Bus Routing Optimization Helps Boston Public Schools Design Better PoliciesBertsimas D, Delarue A, Eger W, Hanlon J and Martin S INFORMS Journal on Applied Analytics, 10.1287/inte.2019.1015, Vol. 50, No. 1, (37-49), Online publication date: 1-Jan-2020. Role of Sleep Duration in the Association Between Socioecological Protective Factors and Health Risk Behaviors in AdolescentsOrdway M, Wang G, Jeon S and Owens J Journal of Developmental & Behavioral Pediatrics, 10.1097/DBP.0000000000000721, Vol. 41, No. 2, (117-127), . Impact of sleep opportunity on asthma outcomes in adolescentsMeltzer L, Beebe D, Jump S, Flewelling K, Sundström D, White M, Zeitlin P and Strand M Sleep Medicine, 10.1016/j.sleep.2019.07.014, Vol. 65, , (134-141), Online publication date: 1-Jan-2020. Shimura A Chronotype and Performance in Students Neurological Modulation of Sleep, 10.1016/B978-0-12-816658-1.00002-8, (19-23), . References Risky Decision Making in Psychological Disorders, 10.1016/B978-0-12-815002-3.00020-6, (245-390), . Wahlstrom K Circadian Rhythms and School Start Times: The Indivisible Link Between Medicine and Education Circadian Rhythm Sleep-Wake Disorders, 10.1007/978-3-030-43803-6_7, (91-108), . Carter G and Auger R Delayed Sleep-Wake Phase Disorder Circadian Rhythm Sleep-Wake Disorders, 10.1007/978-3-030-43803-6_6, (67-90), . Topical Review: A Biopsychosocial Framework for Pediatric Narcolepsy and Idiopathic HypersomniaGraef D, Byars K, Simakajornboon N and Dye T Journal of Pediatric Psychology, 10.1093/jpepsy/jsz085, Adolescent-Sleep-Intervention Research: Current State and Future DirectionsBlake M, Latham M, Blake L and Allen N Current Directions in Psychological Science, 10.1177/0963721419850169, Vol. 28, No. 5, (475-482), Online publication date: 1-Oct-2019. School start times and teenage driver motor vehicle crashesFoss R, Smith R and O'Brien N Accident Analysis & Prevention, 10.1016/j.aap.2018.03.031, Vol. 126, , (54-63), Online publication date: 1-May-2019. Interventions for Transitioning Adolescents with ADHD to Emerging Adulthood: Developmental Context and Empirically-Supported Treatment PrinciplesLaCount P, Hartung C, Canu W and Knouse L Evidence-Based Practice in Child and Adolescent Mental Health, 10.1080/23794925.2018.1518120, Vol. 4, No. 2, (170-186), Online publication date: 3-Apr-2019. School start time changes in the COMPASS study: associations with youth sleep duration, physical activity, and screen timePatte K, Qian W, Cole A, Faulkner G, Chaput J, Carson V and Leatherdale S Sleep Medicine, 10.1016/j.sleep.2018.09.020, Vol. 56, , (16-22), Online publication date: 1-Apr-2019. Optimizing schools' start time and bus routesBertsimas D, Delarue A and Martin S Proceedings of the National Academy of Sciences, 10.1073/pnas.1811462116, Vol. 116, No. 13, (5943-5948), Online publication date: 26-Mar-2019. Altering Adolescents' Pre-Bedtime Phone Use to Achieve Better Sleep HealthBartel K, Scheeren R and Gradisar M Health Communication, 10.1080/10410236.2017.1422099, Vol. 34, No. 4, (456-462), Online publication date: 21-Mar-2019. Objective data contribute to the school start time debateAgostini A Sleep, 10.1093/sleep/zsz021, Vol. 42, No. 2, Online publication date: 1-Feb-2019. Later high school start times associated with longer actigraphic sleep duration in adolescentsNahmod N, Lee S, Master L, Chang A, Hale L and Buxton O Sleep, 10.1093/sleep/zsy212, Vol. 42, No. 2, Online publication date: 1-Feb-2019. Disturbed sleep and excessive daytime sleepiness in a Saudi population-based sampleAlAhmari M and Alshehri K Saudi Journal for Health Sciences, 10.4103/sjhs.sjhs_162_19, Vol. 8, No. 3, (141), . Longitudinal associations of childhood bedtime and sleep routines with adolescent body mass indexLee S, Hale L, Chang A, Nahmod N, Master L, Berger L and Buxton O Sleep, 10.1093/sleep/zsy202, Vol. 42, No. 1, Online publication date: 1-Jan-2019. Berger A, Widome R and Troxel W Delayed school start times and adolescent health Sleep and Health, 10.1016/B978-0-12-815373-4.00033-2, (447-454), . SAVED BY THE MORNING BELL: SCHOOL START TIME AND TEEN CAR ACCIDENTSBostwick V Contemporary Economic Policy, 10.1111/coep.12277, Vol. 36, No. 4, (591-606), Online publication date: 1-Oct-2018. It Takes a Village: Multidisciplinary Approach to Screening and Prevention of Pediatric Sleep IssuesSevecke J and Meadows T Medical Sciences, 10.3390/medsci6030077, Vol. 6, No. 3, (77) Physical Exercise Interventions for Emerging Adults with Attention-Deficit/Hyperactivity Disorder (ADHD)LaCount P and Hartung C The ADHD Report, 10.1521/adhd.2018.26.5.1, Vol. 26, No. 5, (1-11), Online publication date: 1-Aug-2018. All the Clocks Are Ticking: Sleep Health and MetabolismLewin D Journal of Adolescent Health, 10.1016/j.jadohealth.2018.05.002, Vol. 63, No. 1, (3-4), Online publication date: 1-Jul-2018. Level of alpha amylase activity in human saliva as a non-invasive biochemical marker of sleep deprivationPradhan R and Sinha N Sleep and Biological Rhythms, 10.1007/s41105-018-0165-7, Vol. 16, No. 3, (357-364), Online publication date: 1-Jul-2018. Current scholarship and future questions on delayed school start times for adolescents' sleep and well-beingWolfson A Sleep, 10.1093/sleep/zsy107, Vol. 41, No. 6, Online publication date: 1-Jun-2018. Later Start, Longer Sleep: Implications of Middle School Start TimesTemkin D, Princiotta D, Ryberg R and Lewin D Journal of School Health, 10.1111/josh.12622, Vol. 88, No. 5, (370-378), Online publication date: 1-May-2018. Association between Erythrocyte Membrane Phospholipid Fatty Acids and Sleep Disturbance in Chinese Children and AdolescentsTang J, Yan Y, Zheng J, Mi J and Li D Nutrients, 10.3390/nu10030344, Vol. 10, No. 3, (344) The associations of self-reported physical fitness and physical activity with sleep quality in young adults: A population-based studyŠtefan L, Krističević T and Sporiš G Mental Health and Physical Activity, 10.1016/j.mhpa.2018.04.002, Vol. 14, , (131-135), Online publication date: 1-Mar-2018. Racial/ethnic sleep disparities in US school-aged children and adolescents: a review of the literatureGuglielmo D, Gazmararian J, Chung J, Rogers A and Hale L Sleep Health, 10.1016/j.sleh.2017.09.005, Vol. 4, No. 1, (68-80), Online publication date: 1-Feb-2018. Meltzer L, Thomas J and Williamson A Sleep Disturbances Encyclopedia of Adolescence, 10.1007/978-3-319-33228-4_98, (3607-3618), . Meadows T, Hoffses K and Sevecke J Sleep Disorders Handbook of Pediatric Behavioral Healthcare, 10.1007/978-3-030-00791-1_18, (243-257), . Is 8:30 a.m. Still Too Early to Start School? A 10:00 a.m. School Start Time Improves Health and Performance of Students Aged 13–16Kelley P, Lockley S, Kelley J and Evans M Frontiers in Human Neuroscience, 10.3389/fnhum.2017.00588, Vol. 11, High school start times after 8:30 am are associated with later wake times and longer time in bed among teens in a national urban cohort studyNahmod N, Lee S, Buxton O, Chang A and Hale L Sleep Health, 10.1016/j.sleh.2017.09.004, Vol. 3, No. 6, (444-450), Online publication date: 1-Dec-2017. Law-based arguments and messages to advocate for later school start time policies in the United StatesLee C, Nolan D, Lockley S and Pattison B Sleep Health, 10.1016/j.sleh.2017.09.003, Vol. 3, No. 6, (486-497), Online publication date: 1-Dec-2017. Self-report surveys of student sleep and well-being: a review of use in the context of school start timesZiporyn T, Malow B, Oakes K and Wahlstrom K Sleep Health, 10.1016/j.sleh.2017.09.002, Vol. 3, No. 6, (498-507), Online publication date: 1-Dec-2017. A quasi-experimental study of the impact of school start time changes on adolescent sleepOwens J, Dearth-Wesley T, Herman A, Oakes J and Whitaker R Sleep Health, 10.1016/j.sleh.2017.09.001, Vol. 3, No. 6, (437-443), Online publication date: 1-Dec-2017. The economic implications of later school start times in the United StatesHafner M, Stepanek M and Troxel W Sleep Health, 10.1016/j.sleh.2017.08.007, Vol. 3, No. 6, (451-457), Online publication date: 1-Dec-2017. Engaging the community in the process of changing school start times: experience of the Cherry Creek School DistrictMeltzer L, McNally J, Plog A and Siegfried S Sleep Health, 10.1016/j.sleh.2017.08.005, Vol. 3, No. 6, (472-478), Online publication date: 1-Dec-2017. Effects of school start time on students' sleep duration, daytime sleepiness, and attendance: a meta-analysisBowers J and Moyer A Sleep Health, 10.1016/j.sleh.2017.08.004, Vol. 3, No. 6, (423-431), Online publication date: 1-Dec-2017. Adolescent Sleepiness: Causes and ConsequencesHansen S, Capener D and Daly C Pediatric Annals, 10.3928/19382359-20170816-01, Vol. 46, No. 9, Online publication date: 1-Sep-2017. Pediatric Sleep MedicineCarbone T Pediatric Annals, 10.3928/19382359-20170815-04, Vol. 46, No. 9, Online publication date: 1-Sep-2017. School transportation mode, by distance between home and school, United States, ConsumerStyles 2012Beck L and Nguyen D Journal of Safety Research, 10.1016/j.jsr.2017.04.001, Vol. 62, , (245-251), Online publication date: 1-Sep-2017. Sleepiness in AdolescentsMerdad R, Akil H and Wali S Sleep Medicine Clinics, 10.1016/j.jsmc.2017.03.014, Vol. 12, No. 3, (415-428), Online publication date: 1-Sep-2017. Response to Troxel commentary: further evidence that school start times are associated with behavioral problems in elementary schoolsKeller P, Gilbert L, Haak E, Bi S and Smith O Sleep Health, 10.1016/j.sleh.2017.05.002, Vol. 3, No. 4, (228-230), Online publication date: 1-Aug-2017. Variable School Start Times and Middle School Student's Sleep Health and Academic PerformanceLewin D, Wang G, Chen Y, Skora E, Hoehn J, Baylor A and Wang J Journal of Adolescent Health, 10.1016/j.jadohealth.2017.02.017, Vol. 61, No. 2, (205-211), Online publication date: 1-Aug-2017. Complete List of References The Neuroscience of Adolescence, 10.1017/9781316106143.011, (256-306) Glossary of Key Terms The Neuroscience of Adolescence, 10.1017/9781316106143.010, (251-255) Brain Plasticity The Neuroscience of Adolescence, 10.1017/9781316106143.005, (85-115) Preface The Neuroscience of Adolescence, 10.1017/9781316106143.001, (xvii-xviii) Galván A The Neuroscience of Adolescence Later school start times for supporting the education, health, and well-being of high school studentsMarx R, Tanner-Smith E, Davison C, Ufholz L, Freeman J, Shankar R, Newton L, Brown R, Parpia A, Cozma I and Hendrikx S Cochrane Database of Systematic Reviews, 10.1002/14651858.CD009467.pub2 Level of Alpha Amylase Activity in Human Saliva as Noninvasive Biochemical Marker of Sleep DeprivationPradhan R and Sinha N Indian Journal of Sleep Medicine, 10.5005/jp-journals-10069-0001, Vol. 12, No. 2, (1-6), Online publication date: 1-Jun-2017. Delaying Middle School and High School Start Times Promotes Student Health and Performance: An American Academy of Sleep Medicine Position StatementWatson N, Martin J, Wise M, Carden K, Kirsch D, Kristo D, Malhotra R, Olson E, Ramar K, Rosen I, Rowley J, Weaver T and Chervin R Journal of Clinical Sleep Medicine, Vol. 13, No. 04, (623-625), Online publication date: 15-Apr-2017. School start time and sleep in Canadian adolescentsGariépy G, Janssen I, Sentenac M and Elgar F Journal of Sleep Research, 10.1111/jsr.12475, Vol. 26, No. 2, (195-201), Online publication date: 1-Apr-2017. Delayed high school start times later than 8:30am and impact on graduation rates and attendance ratesMcKeever P and Clark L Sleep Health, 10.1016/j.sleh.2017.01.002, Vol. 3, No. 2, (119-125), Online publication date: 1-Apr-2017. Impact of a modest delay in school start time in Hong Kong school adolescentsChan N, Zhang J, Yu M, Lam S, Li S, Kong A, Li A and Wing Y Sleep Medicine, 10.1016/j.sleep.2016.09.018, Vol. 30, , (164-170), Online publication date: 1-Feb-2017. Impacts of standardizing school start time on children and household workers – An examination with NHTS dataDeka D Journal of Transport Geography, 10.1016/j.jtrangeo.2017.01.005, Vol. 59, , (40-48), Online publication date: 1-Feb-2017. Later school start times for supporting the education, health, and well‐being of high school students: a systematic reviewMarx R, Tanner‐Smith E, Davison C, Ufholz L, Freeman J, Shankar R, Newton L, Brown R, Parpia A, Cozma I and Hendrikx S Campbell Systematic Reviews, 10.4073/csr.2017.15, Vol. 13, No. 1, (1-99), Online publication date: 1-Jan-2017. Relationships Between Smoking and Sleep Problems in Black and White AdolescentsBellatorre A, Choi K, Lewin D, Haynie D and Simons-Morton B Sleep, 10.1093/sleep/zsw031, Vol. 40, No. 1, Online publication date: 1-Jan-2017. High School Start Times and the Impact on High School Students: What We Know, and What We Hope to LearnMorgenthaler T, Hashmi S, Croft J, Dort L, Heald J and Mullington J Journal of Clinical Sleep Medicine, Vol. 12, No. 12, (1681-1689), Online publication date: 15-Dec-2016. Impleme