Lewin Daniel S, Wang Guanghai, Chen Yao I, Skora Elizabeth, Hoehn Jessica, Baylor Allison, Wang Jichuan
Pulmonary and Sleep Medicine, Children's National Health System, Washington, DC.
Department of Developmental and Behavioral Pediatrics, Institute, Shanghai Children's Medical Center, Shanghai, China; School of Psychology and Cognitive Science, East China Normal University, Shanghai, China.
J Adolesc Health. 2017 Aug;61(2):205-211. doi: 10.1016/j.jadohealth.2017.02.017. Epub 2017 May 3.
Improving sleep health among adolescents is a national health priority and implementing healthy school start times (SSTs) is an important strategy to achieve these goals. This study leveraged the differences in middle school SST in a large district to evaluate associations between SST, sleep health, and academic performance.
This cross-sectional study draws data from a county-wide surveillance survey. Participants were three cohorts of eighth graders (n = 26,440). The school district is unique because SST ranged from 7:20 a.m. to 8:10 a.m. Path analysis and probit regression were used to analyze associations between SST and self-report measures of weekday sleep duration, grades, and homework controlling for demographic variables (sex, race, and socioeconomic status). The independent contributions of SST and sleep duration to academic performance were also analyzed.
Earlier SST was associated with decreased sleep duration (χ = 173, p < .0001) and deficient sleep (≤7 hours) among 45% of students. Students with SST before 7:45 a.m. were at increased risk of decreased sleep duration, academic performance, and academic effort. Path analysis models demonstrated the independent contributions of sleep duration, SST, and variable effects for demographic variables.
This is the first study to evaluate the independent contributions of SST and sleep to academic performance in a large sample of middle school students. Deficient sleep was prevalent, and the earliest SST was associated with decrements in sleep and academics. These findings support the prioritization of policy initiatives to implement healthy SST for younger adolescents and highlight the importance of sleep health education disparities among race and gender groups.
改善青少年的睡眠健康是一项国家卫生重点工作，实施健康的学校上课时间是实现这些目标的一项重要策略。本研究利用一个大辖区内中学上课时间的差异，评估上课时间、睡眠健康和学业成绩之间的关联。
这项横断面研究的数据来自一项全县范围的监测调查。参与者为三个八年级学生队列（n = 26440）。该学区很独特，因为上课时间从上午7:20到上午8:10不等。采用路径分析和概率回归分析上课时间与工作日睡眠时间、成绩和家庭作业的自我报告测量值之间的关联，并对人口统计学变量（性别、种族和社会经济地位）进行控制。还分析了上课时间和睡眠时间对学业成绩的独立贡献。
上课时间越早，睡眠时间越短（χ = 173，p < .0001），45%的学生存在睡眠不足（≤7小时）的情况。上课时间在上午7:45之前的学生，睡眠时间缩短、学业成绩下降和学习努力程度降低的风险增加。路径分析模型显示了睡眠时间、上课时间的独立贡献以及人口统计学变量的可变效应。
这是第一项在大量中学生样本中评估上课时间和睡眠对学业成绩的独立贡献的研究。睡眠不足很普遍，最早的上课时间与睡眠和学业成绩下降有关。这些发现支持将实施健康上课时间的政策举措作为优先事项，以惠及青少年，并凸显了种族和性别群体之间睡眠健康教育差异的重要性。
