Adolescents in Baltimore don’t get enough sleep, and school schedules should be adjusted to support their health, say researchers who are examining the impacts of later school start times on wellness and performance.But Baltimore City went in the opposite direction at the start of the 2022-23 school year, moving the start time for many schools earlier. That decision shaved sleep time from teens, and contradicted well-established science and the experiences of other large districts.In the aftermath of the move, the Abell Foundation commissioned a comprehensive new report that reinforces the links between sleep and health, describes how adolescent sleep patterns are different, and recommends steps that Baltimore and Maryland officials should take to help kids thrive.Baltimore students face a unique set of challenges. There are no zoned high schools, so students and familes can select the school they want. But they rely on public transporation to get there — averaging 45 minutes, many with a bus transfer. And in many neighborhoods, noise, light pollution and unstructured time exacerbate disadvantages and disparities. Many parts of the city just aren’t conducive to a good night’s sleep.According to the CDC, more than 8 out of 10 high school students in Baltimore get less than 8 hours of sleep a night, below the recommended amount.And in the last school year, 81 percent of high schools started earlier than 8:30 a.m. , up from 51 percent the prior year.Baltimore Fishbowl spoke with a lead author of the study — Amy Wolfson, a Loyola professor who also teaches at the Johns Hopkins University Bloomberg School of Public Health — about the report and its findings.BFB: I feel like looking at this, the science is very clear on why adolescents need sleep, and what it means if they don’t get sleep. Is there any doubt right now about that?Amy Wolfson: There’s no doubt. And it’s not just a sleep need either, as we talk about in the report. We’re talking 30, if not 40, years of knowledge. I’ve been at this a long time, along with many of my colleagues, including the preeminent Mary Carskadon, who’s at Brown University. It’s the sleep need, but it’s also the biological circadian phase delay that, in combination with the sleep need, that creates this clear reason that we need later school start time so that adolescents can get the amount of sleep that they need.BFB: Can you explain the circadian issue for a lay person? AW: There’s really three clocks out there. There’s the clock of light and dark, our big external clock. There’s the clock that’s human-made — that we created, going back centuries, this 24 hour clock that we live on, with the schedules that we live by.And then all humans and all animals have a biological clock. In humans, we have a clock called the suprachiasmatic nucleus, referred to as the SCN, And our actual biological clock works a little longer than 24 hours. And there is research that shows that it is a biological marker for puberty for this clock to shift. In other words, the ideal time for an adolescent to fall asleep, that is to say, when the clock’s going to be ready to fall asleep, is later in the evening, and hence, later in the morning to wake up — compared to a peer who may be just pre adolescent and hasn’t entered puberty. There’s this shift, and we say in the report, the shift for some teenagers can be as much as two to three hours. So in other words, you’re not going to be ready to fall asleep. And so the problem that ensues as a result of this is there’s a mismatch between what the biological clock is telling the teenager and what the school schedule, or other schedules are telling you, and it creates what what colleagues of mine in the field have come to call ‘social jet lag.’We all understand jet lag with travel. Either we’ve read about or we’ve experienced it ourselves. For a teenager, it’s as if they’re traveling back from, say, California to Baltimore every day, and you’re being forced, basically, to get up when your body is telling you to still sleep, to be in school, to be ready to participate in the day. … That’s what makes these early school start times so so treacherous. And yes, we’ve understood this now for 30 years, at least.BFB: And it feels like a lot is pushing in the opposite direction of addressing this, between unstructured time, screen time and social media. Plus moving some schools earlier in 2022-23.AW: That’s sort of the point, and why Abell reached out to us, and I got a group together to do this report, is that we already knew the science. And yet a decision was made [in Baltimore] that really goes against everything we know about adolescence and sleep. It’s not to say there aren’t hurdles that have to be overcome, and there could be one-time costs, but it advantages everybody, if we think about this, which is not true for an individual intervention. This helps all boats rise equally if we pay attention to the starting time of school.BFB: The report has specific sections on disparities and social determinants of health and how lack of sleep and the school start time issue relates to that. Could you address those points?AW: Baltimore is complicated city with a lot of youth who are disadvantaged for a range of different reasons, historically disadvantaged and currently disadvantaged. And I felt that there had not been a report that really attended to the particular needs of a city like Baltimore.Both for children, adolescents and adults, there are sleep health disparities. In addition to the other health disparities we know that minority populations face and those living at or below the poverty line face, sleep is another one of these. We talk about the research in this report that adolescents, Black adolescents, minority adolescents, adolescents who are lacking financial resources or who live in perhaps crowded environments, environments with too much noise and light, get insufficient sleep as it is, or irregular sleep because of these other factors. And so we advantage them by minimally helping them have a school start time that fits with their biological clock, and so that’s the reason that we spend this time in the report setting the stage for understanding sleep health disparities, because it’s so relevant to what we’re concerned about here in our own city.BFB: Let’s get into the recommendations in the report, because really anybody as a researcher and an academic would get great satisfaction if the research gets turned into reality.Recommendation 1: A guardrail that suggests a 9:00 a.m. start timeAW: That’s what we’re all about. As you said at the beginning of our conversation, we know what the science tells us. The next step is really the implementation of changes and helping districts make these changes. So the first recommendation is to set guardrails. No middle school or high school should start before 8:30 in the morning. And the reason we came up with that time, it’s not rocket science. If adolescents need eight and a half to nine and a half hours of sleep, what time on average are adolescents most likely to fall asleep?Probably around 11 o’clock at night. How do we ensure that they get sufficient sleep? What we add in this report is that it is crucial to think about commute time, and that’s where we say there may be a reason in Baltimore City that the guardrail needs to be nine o’clock and not 8:30. In Baltimore City, students have school choice, but that also means that students in Baltimore are needing to rely on public transportation to get to and from school, and many students need to take two busses to get to school. And if you back that up and think about the average commute time, which ranges from 45 minutes to as much as 60 minutes, you really need to think about 9 o’clock, possibly as the guardrail, and not 8:30.Recommendation 2: Raising awarenessAW: The second recommendation has to do with education. We know from other school districts, and one example is Seattle, another large urban school district that has delayed school start times, that you have to educate the community. You need several years to help a community value sleep health, not just for these teenagers, but for everyone in the district. And so we recommend sleep health education for the city of Baltimore, specifically, adolescents, their parents, teachers, administrators, but really the community at large. Recommendation 3: Rethinking unsupervised timeAW: One of the writers of the report is my colleague, Dylan Jackson, who’s a criminologist and is at the Bloomberg School, and he and others in his field have have been arguing that unsupervised time leads challenges. Adolescents like to socialize, and they’re more likely to get involved in conduct problems when unsupervised. The earlier school gets out, we know you’re leaving more time for unsupervised time. And so we think that that is another key reason that later school start times are going to benefit the youth in Baltimore. Recommendation 4: A statewide standard through legislationWe strongly support legislation that’s already been written that is very similar to California’s legislation and Florida’s legislation, which are the only two states that have legislated school start times at no earlier than 8 for middle schools and 8:30 for high schools. I think Baltimore City has some other considerations to take into account, but we really want to encourage Maryland to follow California and Florida and pass legislation. Yes, there are individual situations with each school district, but we’d like to see kind of a mandate around what time school should start, and that sort of takes that question out of the formula, so to speak. So we’re hopeful that Maryland can can move forward and pass similar legislation.More than 80 percent of Baltimore high school students don’t get enough sleep. Credit: Abell FoundationWolfson and other top researchers will be speaking at the National Conference on Adolescent Sleep and School Start Times, to be held in Baltimore on Oct. 18-19.