COVID-19 instructional approaches (in-person, online, hybrid), school start times, and sleep in over 5,000 US adolescents

Study Objectives: To examine associations among instructional approaches, school start times, and sleep during the COVID-19 pandemic in a large, nationwide sample of U.S. adolescents. Methods: Cross-sectional, anonymous self-report surrey study of a community-dwelling sample of adolescents (grades 6-12), recruited through social media outlets in October/November 2020. Participants reported on instructional approach (in-person, online/synchronous, online/asynchronous) for each weekday (past week), school start times (in-person or online/synchronous days), and bedtimes (BT) and wake times (WT) for each identified school type and weekends/no school days. Sleep opportunity was calculated as BT-to-WT interval. Night-to-night sleep variability was calculated with mean square successive differences. Results: Responders included 5,245 racially and geographically diverse students (similar to 50% female). BT and WT were earliest for in-person instruction; followed by online/synchronous days. Sleep opportunity was longer on individual nights students did not have scheduled instruction (>1.5 h longer for online/asynchronous than in-person). More students obtained sufficient sleep with later school start times. However, even with the same start times, more students with online/synchronous instruction obtained sufficient sleep than in-person instruction. Significantly greater night-to-night variability in sleep-wake patterns was observed for students with in-person hybrid schedules versus students with online/synchronous + asynchronous schedules. Conclusions: These findings provide important insights regarding the association between instructional approach and school start times on the timing, amount, and variability of sleep in U.S. adolescents. Given the public health consequences of short and variable sleep in adolescents, results may be useful for education and health policy decision-making for post-pandemic secondary schools.

Automated summary

This study examined the impact of instructional approaches and school start times on the timing, amount, and variability of sleep in U.S. adolescents during the COVID-19 pandemic. Results showed that later school start times were associated with more students obtaining sufficient sleep. Students with online/synchronous instruction were more likely to get sufficient sleep compared to those with in-person instruction at the same start times.