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

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          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=11:21 pm, ESC=11:11 pm), but LSC students woke up later (7:23 am) than ESC students (6:55 am; F 1,48=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.

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          Most cited references38

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          The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

          Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.
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            About sleep's role in memory.

            Over more than a century of research has established the fact that sleep benefits the retention of memory. In this review we aim to comprehensively cover the field of "sleep and memory" research by providing a historical perspective on concepts and a discussion of more recent key findings. Whereas initial theories posed a passive role for sleep enhancing memories by protecting them from interfering stimuli, current theories highlight an active role for sleep in which memories undergo a process of system consolidation during sleep. Whereas older research concentrated on the role of rapid-eye-movement (REM) sleep, recent work has revealed the importance of slow-wave sleep (SWS) for memory consolidation and also enlightened some of the underlying electrophysiological, neurochemical, and genetic mechanisms, as well as developmental aspects in these processes. Specifically, newer findings characterize sleep as a brain state optimizing memory consolidation, in opposition to the waking brain being optimized for encoding of memories. Consolidation originates from reactivation of recently encoded neuronal memory representations, which occur during SWS and transform respective representations for integration into long-term memory. Ensuing REM sleep may stabilize transformed memories. While elaborated with respect to hippocampus-dependent memories, the concept of an active redistribution of memory representations from networks serving as temporary store into long-term stores might hold also for non-hippocampus-dependent memory, and even for nonneuronal, i.e., immunological memories, giving rise to the idea that the offline consolidation of memory during sleep represents a principle of long-term memory formation established in quite different physiological systems.
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              Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine.

              Sleep is essential for optimal health in children and adolescents. Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. The recommendations are summarized here. A manuscript detailing the conference proceedings and the evidence supporting these recommendations will be published in the Journal of Clinical Sleep Medicine.
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                Author and article information

                Journal
                Nat Sci Sleep
                Nat Sci Sleep
                nss
                nss
                Nature and Science of Sleep
                Dove
                1179-1608
                10 December 2020
                2020
                : 12
                : 1161-1172
                Affiliations
                [1 ]Department of Psychology, “Sapienza” University of Rome , Rome, Italy
                [2 ]I.R.C.C.S. Fondazione Santa Lucia , Rome, Italy
                [3 ]I.I.S.S. “Ettore Majorana” , Brindisi, Italy
                [4 ]Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila , L’Aquila, Italy
                Author notes
                Correspondence: Luigi De Gennaro “Sapienza” University of Rome , Via Dei Marsi, 78, Rome00185, ItalyTel (+39) 06-49917647Fax (+39) 06-49917711 Email luigi.degennaro@uniroma1.it
                Author information
                http://orcid.org/0000-0002-9929-0399
                http://orcid.org/0000-0003-3298-8052
                http://orcid.org/0000-0002-9260-7111
                http://orcid.org/0000-0003-3650-0683
                http://orcid.org/0000-0002-9196-7078
                http://orcid.org/0000-0003-2304-7576
                http://orcid.org/0000-0003-3613-6631
                Article
                273875
                10.2147/NSS.S273875
                7735793
                33328774
                f7fad3db-a0d9-4f1c-b192-d6225759439e
                © 2020 Alfonsi et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 25 July 2020
                : 14 November 2020
                Page count
                Figures: 5, Tables: 4, References: 38, Pages: 12
                Categories
                Original Research

                sleep,school start time,attention,school health,sleep loss,adolescence

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