Abstract
STUDY OBJECTIVES: This narrative review aims to synthesize peer-reviewed and gray literature research that associates middle school start times to adolescent sleep, health, and academic performance. METHODS: A systematic search of publications in PubMed, Scopus, ERIC, APA PsycInfo, CINAHL, ProceedingsFirst, and ProQuest Dissertations and Theses from 2002-2020 was conducted. Studies with middle school students that had either an empirical evaluation of the implementation of a change in school start time or a comparison of schools with different school start times, and which also reported outcomes related to sleep and health and quantitative academic measures were included. School characteristics, student demographics, study design, start times, and outcomes were extracted from the full-text review. RESULTS: The review identified 1,136 articles; after removing duplicates, 845 were screened. Following title and abstract review, 18 articles were eligible for full-text review. Nine studies did not meet inclusion criteria. Half of the reviewed 10 studies used cross-sectional designs, 8 evaluated sleep, 6 evaluated behavioral health, and 3 evaluated academic performance. CONCLUSIONS: Late middle school start times can improve adolescents' sleep and reduce daytime sleepiness by increasing total sleep time and delaying waketime. The current studies provide promising evidence that late-start times can improve tardiness, executive function, negative affect and mood, grade-point average, and standardized test scores. Methodologically robust research on delayed middle school start times can inform public policy and promote change. CITATION: Barlaan DR, Pangelinan BA, Johns A, Schweikhard A, Cromer LD. Middle school start times and young adolescent sleep, behavioral health, and academic performance outcomes: a narrative review. J Clin Sleep Med. 2022;18(11):2681-2694.