Teachers' preference for later school start times.

Early morning school start times conflict with biologically determined sleep phase preference and thus contribute to common sleep deficits. This conflict is most pronounced in adolescents, and numerous studies have confirmed that later school start times are beneficial for their sleep and health. However, the conflict continues to exist beyond adolescence and, accordingly, also teachers might benefit from later school start times, but this has gained little attention so far. Importantly, teachers' resistance to delay school start time is one of the key barriers for a successful implementation and, therefore, teachers' school start time preferences and influencing factors are important to consider. To this end, we conducted an online survey. Teachers (n = 694, 56.1% female) from 17 high schools in Zurich, Switzerland, participated in the study. They indicated their school start time preference. In addition, four predictor blocks were assessed: sociodemographic, school-/work-related, and sleep characteristics, as well as teachers' perception of students in the first morning lesson. Mixed models were applied to predict the preference. The majority (51%) endorsed later school start times (median preferred delay 25.2 min). School start time, sleep characteristics and perception of students in the first morning lesson were significant predictors for the preference. Thus, teachers with more misaligned sleep and higher awareness for students' issues in the early morning were more likely to report a preference. This suggests psychoeducation about sleep biology throughout life span to be an effective measure to increase teachers' support to delay school start time, especially because also they themselves are likely to benefit from later school start times.

Adolescents' preference for later school start times.

As the chronotype delays progressively throughout puberty, early morning school start times (SSTs) contradict the sleep biology of adolescents. Various studies have demonstrated beneficial effects of later SSTs on sleep and health; however, adolescents' preferences for SSTs have to date never been investigated in detail. The present online survey study aimed to fill this gap and explored influencing factors. A total of 17 high schools in the Canton of Zurich, Switzerland, circulated the survey among their students. Participants were included if they reported their sex, age, and school (n = 5,308). Students indicated whether they preferred later SSTs. Additionally, five predictor blocks were assessed: sociodemographic, school-related, sleep, leisure-time, and health-related characteristics. We applied multivariate logistic regression models with fixed and random effects to predict the preference. The mean (SD) age of the students was 16.09 (1.76) years (65.1% female). The majority (63.2%) endorsed later SSTs with a preferred delay of 55 min (interquartile range 25-75 min). In the multilevel analysis (n = 2,627), sex, mother tongue, sleep characteristics, mobile device use at bedtime, caffeine consumption, and health-related quality of life were significant predictors for the preference. Hence, the majority of adolescents preferred later SSTs, and especially those with sleep or health-related problems. These characteristics have been consistently shown to improve after delaying SSTs. Thus, also from adolescents' view, later SSTs should be considered to improve the adolescents' health.

Sleep and Health-Related Characteristics among Adolescents during COVID-19: An Update.

Two opposing effects on adolescents' health during COVID-19 lockdown have been described: A beneficial one due to longer sleep times during school closures and a detrimental one of psychological distress. This study investigated how sleep and health changed in the course of the pandemic when schools were open again. Overall, 12,238 adolescents in Switzerland participated in three cross-sectional online surveys: In 2017 under regular conditions (control group), during pandemic school closures in 2020 (closure group), and in 2021 still under pandemic conditions, but schools were open again (postclosure group). Sleep behavior and health-related characteristics (health-related quality of life; caffeine, alcohol, and nicotine use) in all three groups and depressive symptoms in the closure and postclosure groups were assessed. The sleep period on school days was longer in the closure group (median 9.00 h, interquartile range 8.25-9.75) and similar in the postclosure (7.92, 7.00-8.50) compared to the control group (7.75, 7.08-8.33). Health-related characteristics were better during school closures and similar to worse in the postclosure compared to the control group. Depressive symptom levels were higher in the postclosure than in the closure group. Therefore, beneficial effects were specific to school closures and adolescents' psychological distress increased over the course of the pandemic.

Association Between Homeschooling and Adolescent Sleep Duration and Health During COVID-19 Pandemic High School Closures.

Importance: Although negative associations of COVID-19 pandemic high school closures with adolescents' health have been demonstrated repeatedly, some research has reported a beneficial association of these closures with adolescents' sleep. The present study was, to our knowledge, the first to combine both perspectives. Objective: To investigate associations between adolescents' sleep and health-related characteristics during COVID-19 pandemic school closures in Switzerland. Design, Setting, and Participants: This survey study used cross-sectional online surveys circulated among the students of 21 public high schools in Zurich, Switzerland. The control sample completed the survey under regular, prepandemic conditions (May to July 2017) and the lockdown sample during school closures (May to June 2020). Survey respondents were included in the study if they provided their sex, age, and school. Exposures: High school closures during the first COVID-19 pandemic wave in Switzerland (March 13 to June 6, 2020). Main Outcomes and Measures: Sleep-wake patterns, health-related quality of life (HRQoL, assessed by the KIDSCREEN-10 questionnaire), substance use (caffeine, alcohol, and nicotine), and depressive symptoms (lockdown sample only; assessed using the withdrawn/depressed scale from the Youth Self Report). Multilevel regression models were used to assess sample differences and associations of health-related characteristics with sleep duration and depressive symptoms. Results: The total sample consisted of 8972 students, including 5308 (59.2%) in the control sample (3454 [65.1%] female) and 3664 (40.8%) in the lockdown sample (2429 [66.3%] female); the median age in both samples was 16 years (IQR, 15-17 years). During school closures, the sleep period on scheduled days was 75 minutes longer (semipartial R2 statistic [R2ß*], 0.238; 95% CI, 0.222-0.254; P < .001) and the students had better HRQoL (R2ß*, 0.007; 95% CI, 0.004-0.012; P < .001) and less consumption of caffeine (R2ß*, 0.010; 95% CI, 0.006-0.015; P < .001) and alcohol (R2ß*, 0.014; 95% CI, 0.008-0.022; P < .001). Longer sleep duration was associated with better HRQoL (R2ß*, 0.027; 95% CI, 0.020-0.034; P < .001) and less caffeine consumption (R2ß*, 0.013; 95% CI, 0.009-0.019; P < .001). In the lockdown sample, an inverse association was found between depressive symptoms and HRQoL (R2ß*, 0.285; 95% CI, 0.260-.0311; P < .001) and a positive association was found with caffeine consumption (R2ß*, 0.003; 95% CI, 0.000-0.008; P = .01). Conclusions and Relevance: In this survey study, 2 opposing associations between school closures and adolescents' health were identified: a negative association with psychological distress and a beneficial association with increased sleep duration. These findings should be considered when evaluating and implementing school closures. Furthermore, the findings provide support for delaying school start times for adolescents.