title: Setting Adolescents Up for Success: Promoting a Policy to Delay High School Start Times.
abstract: A unique biological shift in sleep cycles occurs during adolescence causing later sleep and wake times. This shift is not matched by a concurrent modification in school start times, resulting in sleep curtailment for a large majority of adolescents. Chronic inadequate sleep is associated with poor academic performance including executive function impairments, mood, and behavioral issues, as well as adverse health outcomes such as an increased risk of obesity, hypertension, and cardiovascular disease. In order to address sleep deficits and the potential negative outcomes associated with chronic sleep deprivation, the American Academy of Pediatrics (AAP) and US Centers for Disease Control and Prevention (CDC) support delaying school start times for middle and high school students.
  
  
  
  We summarize current evidence, explicate the need for policy change, and urge school districts to put adolescent students' health as top priority and implement school start times consistent with their developmental needs.
  
  
  
  Whereas substantial evidence illustrating adverse consequences of inadequate sleep on psychological and physical health, and recommendations exist to adapt daytime school schedules to match sleep needs have been released, actual implementation of these recommendations have been limited.
  
  
  
  This is a call to action for the implementation of AAP/CDC recommendations across the state and nation.
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233. mbarnes@peds.uab.edu.
authors.forename: Margaux
authors.initials: M
authors.lastname: Barnes
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233. kmdavis@peds.uab.edu.
authors.forename: Krista
authors.initials: K
authors.lastname: Davis
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233. mmancini@peds.uab.edu.
authors.forename: Mackenzie
authors.initials: M
authors.lastname: Mancini
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233. jriffin@peds.uab.edu.
authors.forename: Jasmine
authors.initials: J
authors.lastname: Ruffin
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233. tsimpson@peds.uab.edu.
authors.forename: Tina
authors.initials: T
authors.lastname: Simpson
authors.affiliation: Department of Pediatrics, Division of General Pediatrics and Adolescent Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL 35233. kcasazza@peds.uab.edu.
authors.forename: Krista
authors.initials: K
authors.lastname: Casazza
mesh_terms: D000124:Achievement; D000293:Adolescent; D000294:Adolescent Behavior; D005260:Female; D006801:Humans; D008297:Male; D057766:Policy; D012574:Schools / Q000458:organization & administration*; D012890:Sleep / Q000502:physiology*; D012892:Sleep Deprivation / Q000150:complications* / Q000453:epidemiology; D013334:Students / Q000523:psychology*; D013997:Time Factors
keywords: adolescence; development; school health policy; school start times; sleep; sleep deprivation