Sleep expert looks at Va. Beach's early school days

Sleep expert Robert Vorona had an intriguing research subject right in his own home:

A drowsy 16-year-old daughter.

The Eastern Virginia Medical School doctor noted that his daughter's high school in Virginia Beach started at 7:25 a.m. while students in neighboring Chesapeake began at a much more civilized 8:40 a.m.

He knew that teens' natural sleep cycles make them more alert if they rise later in the day, so he decided to look at teen auto accident rates in the two cities.

He found the 2008 rate to be 41 percent higher in Virginia Beach than in Chesapeake.

He's quick to note that the research abstract is one of association only, not cause-and-effect, and that there could be many other factors involved, such as road congestion and time spent on the road.

But he thinks the findings, which he's presenting at a national sleep conference in Texas today, are worth exploring further.

"An association doesn't mean there is a causal factor, but I think the data is provocative," Vorona said. "It's difficult for teens to get adequate amounts of sleep. Anything we can do to optimize things for them is a good thing."

His is not the first study to center on teens' unique sleep needs. Others have shown that teens need more sleep than adults - about 9-1/4 hours a night - to function optimally. Part of the reason is that biological sleep patterns naturally shift toward later times during the teen years.

"They're not just being obnoxious," said Vorona, an EVMS associate professor of internal medicine and founder of the Virginia Academy of Sleep Medicine. "Physiologically, they want to go to bed later and sleep later."

At least 15 percent don't get enough sleep, according to the National Sleep Foundation.

Add the realities of teen life to their circadian cycles and it's easy to see why. Homework, extracurricular activities and jobs keep them running into the evening. And electronic devices such as cell phones and laptops can keep them wired late into the night with text messaging and Internet browsing.

"The likelihood that they would go to bed by 9 p.m. is almost nil," Vorona said, "They're fighting basic neurology."

Sleep deprivation puts teens at higher risk of poor academic performance and behavioral problems, and it's also a safety concern.

Drowsiness or fatigue has been tagged as the principal cause in at least 100,000 police-reported automobile crashes each year, killing more than 1,500 Americans and injuring 71,000, according to the National Highway Traffic Safety Administration.

Drivers 25 or younger are involved in more than half of "fall-asleep" crashes.

Some school districts across the country are trying later start times for high school students.

A study released in 2008 by the Journal of Clinical Sleep Medicine examined a change made in a Kentucky county in 1999.

The study found that delaying school start times by one hour led to an increase in teen sleep on week nights and decreased "catch-up sleep" on the weekends. The study also found that teens were involved in fewer auto accidents.

Vorona's research abstract examined 2008 records of the Virginia Department of Motor Vehicles.

There were about 65 crashes for every 1,000 drivers ages 16 to 18 in Virginia Beach, and 46 for every 1,000 Chesapeake teen drivers.

As lead author of the study, Vorona is presenting the data at the annual meeting of the Associated Professional Sleep Societies in San Antonio.

Vorona notes that other variables, including heavy traffic and the distance teens have to drive to school, could play a role. When he looked at accident rates of the general population, he said, Virginia Beach had higher rates than Chesapeake, but the contrast was not as pronounced as among teens:

"If you have more congested roadways and you add a sleepy teenager to it, then you are really asking for trouble."

Norfolk, Suffolk and Portsmouth high schools also start early, between 7:25 and 7:40 a.m. Vorona focused on Virginia Beach and Chesapeake because they are the most similar demographically and are next to each other geographically.

Afternoon crash rates were higher than morning rates.

In Virginia Beach, where school ends around 2 p.m., the afternoon teen crash rate peaked from 2 to 6 p.m. In Chesapeake, where school is dismissed at about 3:40 p.m., teen crash rates peaked from 4 to 5 p.m.

The research, which was supported by the EVMS Division of Sleep Medicine, has not yet been peer-reviewed.

Nancy Soscia, public relations coordinator for Virginia Beach schools, said Vorona has not yet shared the data with the district, so officials have not had a chance to review the study.

However, she said that the current schedule allows an earlier start time for athletic and other extracurricular activities in the afternoon, giving high school students more time to do homework in the evenings.

She said parents also sometimes depend on high school students to come home first to baby-sit younger siblings. Many high school students also have after-school jobs.

Transportation, operational cost and Standards of Accreditation needs also are factors in the district's start times.

"Naturally, if a decision was made to start high school at a later time, we would solicit input from staff, parents, students, and the community as the established daily schedules of each of these groups would be impacted," Soscia wrote in an e-mail response.

Tom Cupitt, spokesman at Chesapeake public schools, said high schools in that city switched to later start times in the mid-1970s. At the time, the main issue was safety for young children of working parents. An early start time for them meant many of their parents could see them off to school before they went to work, and only needed child care after school rather than before and after.

So the younger students began earlier than high school students, to meet transportation needs.

The next step for Vorona is to get the data he collected published and reviewed, and secure funding for a more detailed study.

In the meantime, teens out there whose parents think they sleep too much can turn to Vorona as an ally:

"Anything we can do to allow these kids more sleep is a good thing."

Read the report at www.aasmnet.org/Articles.aspx?id=1685.

Elizabeth Simpson, (757) 446-2635, elizabeth.simpson@pilotonline.com