Minges Karl E, Redeker Nancy S
Yale University, USA.
Yale University, USA.
Sleep Med Rev. 2016 Aug;28:86-95. doi: 10.1016/j.smrv.2015.06.002. Epub 2015 Jun 29.
Many schools have instituted later morning start times to improve sleep, academic, and other outcomes in response to the mismatch between youth circadian rhythms and early morning start times. However, there has been no systematic synthesis of the evidence on the effects of this practice. To examine the impact of delayed school start time on students' sleep, health, and academic outcomes, electronic databases were systematically searched and data were extracted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Six studies satisfied selection criteria and used pre-post, no control (n = 3), randomized controlled trial (n = 2), and quasi-experimental (n = 1) designs. School start times were delayed 25-60 min, and correspondingly, total sleep time increased from 25 to 77 min per weeknight. Some studies revealed reduced daytime sleepiness, depression, caffeine use, tardiness to class, and trouble staying awake. Overall, the evidence supports recent non-experimental study findings and calls for policy that advocates for delayed school start time to improve sleep. This presents a potential long-term solution to chronic sleep restriction during adolescence. However, there is a need for rigorous randomized study designs and reporting of consistent outcomes, including objective sleep measures and consistent measures of health and academic performance.
许多学校已经制定了上午较晚的上课时间，以改善睡眠、学业成绩和其他方面的结果，以应对青少年昼夜节律与清晨上课时间之间的不匹配。然而，对于这种做法的效果，尚未有系统的证据综合。为了研究推迟上学时间对学生睡眠、健康和学业成绩的影响，我们系统地检索了电子数据库，并根据系统评价和荟萃分析的首选报告项目（PRISMA）指南提取了数据。六项研究符合选择标准，采用了前后对照、无对照组（n = 3）、随机对照试验（n = 2）和准实验（n = 1）设计。学校上课时间推迟了25至60分钟，相应地，每个工作日晚上的总睡眠时间每周增加了25至77分钟。一些研究表明，白天嗜睡、抑郁、咖啡因摄入、上课迟到和难以保持清醒的情况有所减少。总体而言，证据支持了最近的非实验性研究结果，并呼吁制定政策，倡导推迟上学时间以改善睡眠。这为解决青少年长期慢性睡眠限制问题提供了一个潜在的长期解决方案。然而，需要严格的随机研究设计和一致结果的报告，包括客观的睡眠测量以及健康和学业表现的一致测量方法。
