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Sports Injuries and School Start Times - Doing the Math

If early school start times are associated with chronic sleep deprivation, and if chronic sleep deprivation is associated with 68% more sports injuries, it doesn't take long to do the math.

My teen started his wrestling season with an injury that required sutures and ended the season with an injury that took him out of the running for 3rd in the PTC.  He is only one of many teens to incur injuries in every sport, every season - and thankfully his were relatively minor.  Worries about more serious things like fractures and concussions keep many parents and coaches awake at night, which is ironic considering that sleep deprivation may play a significant role in injuries among student athletes.

At the American Academy of Pediatrics national conference in October, Dr. Mathew Milewksi reported that teens who are chronically sleep-deprived experience 68% more sports injuries than their teammates who obtain more sleep, a correlation not expected by his research team. "We were surprised to find that sleep played such an important role in athletic injury," Dr. Milewski is quoted in a Reuters interview.  "We thought that having a private coach and doing sports outside of school and doing sports more often would increase the rates of injury, not the lack of sleep."

Many sleep experts, however, are not surprised by that study.  They know that  sleep plays a vital role for humans – particularly among still-growing youth.  We utilize sleep to reorganize and fine-tune cognitive functioning (neuronal ‘plasticity’ has recently been examined in relation to sleep), and during sleep we release growth hormones and engage in tissue repair.  If you want to function like a well-oiled machine and bounce back like a fresh new rubber band you need your sleep.  Athletes (and non-athletes) who obtain good sleep are more coordinated, faster, stronger, and heal better.  They also have better impulse control and engage in better decision-making due to increased metabolic activity in the pre-frontal region of the brain.  


So is the answer to put my teen to bed earlier? Unfortunately it’s not that simple.  In the last two decades researchers discovered that during puberty our  adolescents experience a temporary later shift in their circadian rhythm.  Because of this ‘phase-delay’ my son tosses and turns until around 11pm.  There’s no TV in his room, no cell phone, he doesn’t pound a Red Bull or eat a bag of candy at 6pm, and we don’t have him jog around the block at 8pm.  I even shine a $270.00 therapy light on him while he’s eating his breakfast to try to fool his pineal gland into a non-pubertal pattern.  Like most American households the problem isn’t bad sleep hygiene or being a bad mother, it’s battling Mother Nature. 

I do the math nearly every night: I know that adolescents require 8.5 to 9.25 hours of sleep for optimum health.  I know that my son’s school starts before 7:30am.  I know the bus comes at 6:35.  I know that when I wake him up at 6am he has gotten only 7 hours of sleep.  I know that 91.8% of teens with school start times before 8:30 am are chronically sleep deprived and average 6.75 hours of
sleep on school nights.  I know that teens who sleep more than 2 hours later than usual on the weekend experience ‘jet lag’ effects and have higher rates of grade failure – so I know that weekend catch-up is not the answer.

I do know, however, that moving middle and high school start times to one hour later could increase that average to 7.75 hours.  Despite assumptions that later start times would result in kids going to bed later at night, study after study after study shows that when schools adopt healthier start times the kids get more sleep. 

And a 68% reduction in sports injuries is worth any change our schools can make. 

People often oppose changing school start times due to the possible negative effect on athletics – particularly practice schedules.  To get the straight scoop I e-mailed Athletics Directors from schools around the country that adopted later start times to ask them how much it impacted sports, and I was pleasantly surprised by the comments that ranged from ‘it worked out better than we anticipated’ to ‘our teams are among the best in the state’.  In Fayette County, Kentucky, where high schools moved from 7:30 am to 8:30 am and in the two years afterwards the county noted a reduction in teen auto accidents, the AD told me the time change ‘has never been an issue’.  In St. George’s school, which hosts 48 teams in 22 sports and most students are required to participate in 2 sports per season, the AD told me the change was ‘one of the best things our school has ever done’ – a sentiment echoed by administration and teachers given the documented improvement in attention and grades. 

People are surprised and sometimes skeptical that improving sleep can do so much.  But when we consider the fact that we spend 1/3 of our life in this state it must be important – and researchers are proving that importance with more and more studies every month.

A Northeast Ohio petition at SignOn.org is asking our schools to talk about the math:  http://signon.org/sign/start-portage-county.fb23?source=s.icn.fb&r_by=6059954.  The petition simply asks our schools to form committees to discuss the research - similar to what has been done in Duxbury, Parma and Hudson.

For more information on the research: 
http://startschoollater.pbworks.com/w/page/58217472/Start%20School%20Later%20Reference%20List

Milewksi interview: http://www.modernmedicine.com/news/chronic-lack-sleep-makes-teens-prone-sports-injuries

This post is contributed by a community member. The views expressed in this blog are those of the author and do not necessarily reflect those of Patch Media Corporation. Everyone is welcome to submit a post to Patch. If you'd like to post a blog, go here to get started.

The Omnipotent Sponge - Soak it up! February 19, 2013 at 10:43 PM
Take a nap. If you can't sleep in like you want to, suck it up and take a nap when you get home. The world doesn't bow down to you just because you're tired. Try pulling that BS in the real world when you're an adult and you'll be out a job.
Jean Williams February 19, 2013 at 11:35 PM
wow 68-32 percent what was the test subject size 20 ?????? out of 20 kids tested 12 were injured more and 8 were injured less !!! to me it sounds like bad luck
Garry Kanter February 20, 2013 at 01:26 AM
If it was 20, all results would end in 0 or 5. 25 looks like the smallest sample size that would return 68% and 32%.
Garry Kanter February 20, 2013 at 01:27 AM
But I don't think that's how they came up with the 68%.
The Omnipotent Sponge - Soak it up! February 20, 2013 at 01:55 PM
And mommy can't help you get your job back, either.
Kristen LePrevost February 20, 2013 at 09:35 PM
Some districts in other states have adjusted to a later start time for school because of studies coming out showing that a little more sleep made a huge difference in the teen's school performance..makes sense to include how it effects sports and injuries...interesting topic...
Heather Macintosh February 20, 2013 at 10:26 PM
Excellent article. Thank you!
Teresa K. February 21, 2013 at 02:13 PM
Are sports still considered EXTRA curiculum? I dont think sports injuries should be thown in the mix with the start time for school as they are not really part of school. What else do you have? Where are the stats on grades going up? Less violence among the kids? Less drugs activity cuz the kids got more sleep? The best way to get everyone on board is to show STUDIES where the grades changed for the better. (yes, I went to the link and looked at all the other schools that changed their start times)
Stacy Simera February 21, 2013 at 06:21 PM
Teresa, you may like an editorial written by Dr. Toni Salvatore, director of pediatrics of Greenwich Hospital in Connecticut, who basically said the same thing regarding athletics. She sums up with: "Children are in school to learn first, play later. Who is making these unhealthy decisions for our children? Certainly, we as parents would not." There have been literally hundreds of studies that show things like decreased obesity, healthier insulin resistance, improved grades, improved test scores, fewer nurse visits, fewer counseling referrals, reduced detentions, decreased auto accidents, decreased risk-taking, etc with better sleep. I should have pointed out that my link at the end of the article leads to a compilation of the research regarding all of the benefits - not just athletic - compiled by the national group Start School Later. Despite the research schools often cite athletics as a reason not to adopt changes - when it should be the opposite. Smart coaches and Athletics Directors know that safer and better athletes would be the icing on the cake when schools change start times to improve academics. Dr. Salvatore: http://www.lohud.com/article/20130202/OPINION03/302020067/Early-school-start-robs-teens-sleep
Teresa K. February 21, 2013 at 07:00 PM
Stacy: ty for the link, I went and read it. It's an opinion, like mine, not gonna change the world. Could you point me to studies that have shown GRADES will improve with the later start time? I' m only concerned with the grades part of it. School is school. Sports are sports. If all the documented studies are true, they will be true for ALL students, athletes and non-athletes-- improved grades, less obesity, less counseling !, less risk taking, better blood sugar numbers and fewer car accidents. An hour more of sleep is like a miracle drug for teens it would appear. Who wouldnt sign on for those kind of results? (besides me, that is)
Stacy Simera February 21, 2013 at 07:39 PM
Here's a sampling: Middle school - Wolfson, A., Spaulding, N., Dandrow, C., & Baroni, E. (2007). Middle School Start Times: The Importance of a Good Night's Sleep for Young Adolescents. Behavioral Sleep Medicine, 5(3), 194-209. http://www.ncbi.nlm.nih.gov/pubmed/17680731 High School - CAREI: Center for Applied Research and Educational Improvement, University of Minnesota, College of Education, School Start Time Study (1998-2001), available at: www.education.umn.edu/CAREI/Reports 1st year of college (Air Force Academy - since cadets are still going through the pubertal shift) - Carrell et al (2011) A’s from Zzz’s, American Economic Journal: Economic Policy 3: 62–81 http://www.econ.ucdavis.edu/faculty/scarrell/sleep.pdf More: http://startschoollater.pbworks.com/w/page/60412535/Sleep%20Loss%20and%20Academic%20Achievement
cheryl till March 24, 2013 at 12:40 AM
It sounds like you did not get some compassion needs met and therefore you have no compassion. You clearly are not educated on the shift in circadian rythyms that teens experience due to the growth they are experiencing......they are not fully grown adults and should not be expected to behave like one. Every stage of life has its developmentally appropriate responses to the "real world" and teens should not be expected to behave like adults. You are the one that needs a reality check!!
Stacy Simera March 24, 2013 at 01:14 AM
Teresa, I provided a sampling of studies that look just at grades in the post below this, but I realized I didn't clarify what they are, sorry - it's the post dated Feb 21. I tried to find studies that you can easily see online (the journals and articles are usually only available through library accounts - university or public).

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