Evidence map›Paper›PMID 38847813›Full record

ArticleSocial psychiatry and psychiatric epidemiology2024

Delaying high school start times impacts depressed mood among students: evidence from a natural experiment.

Ekaterina Sadikova, Rachel Widome, Elise Robinson, Izzuddin M Aris, Henning Tiemeier

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Social psychiatry and psychiatric epidemiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Delayed school start times to improve sleep duration and mitigate depression in adolescents: a systematic review and meta-analysis.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
    Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Ekaterina SadikovaDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA. sadikova@hcp.med.harvard.edu.
Rachel WidomeDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
Elise RobinsonStanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
Izzuddin M ArisDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School, Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Henning TiemeierDepartment of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.

Funding

Training Program in Psychiatric Genetics and Translational ResearchT32MH017119 · NIMH · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI KARESTAN C KOENEN, Jukka-Pekka Onnela · 1985 to 2026
$8.9M
Minnesota Population Center Science and Technical CoreP2CHD041023 · NICHD · UNIVERSITY OF MINNESOTA · PI THERESA LOUISE OSYPUK · 2016 to 2026
$4.3M
Impacts of Later High School Start Times on Adolescent Weight and Weight-Related BehaviorR01HD088176 · NICHD · UNIVERSITY OF MINNESOTA · PI WIDOME, RACHEL · 2016 to 2019
$1.7M
The Influence of School Start Time on Sleep, Academic Achievement, and Behavioral Outcomes in AdolescentsR21HL156218 · NHLBI · UNIVERSITY OF MINNESOTA · PI WIDOME, RACHEL · 2021 to 2022
$232k
NHLBI NIH HHS R21 HL156218NICHD NIH HHS P2C HD041023NICHD NIH HHS R01 HD088176NIMH NIH HHS T32 MH017119NIMH NIH HHS T32 MH 17119-36
6 · The paper itself

Abstract

purposeDelaying high school start times prolongs weekday sleep. However, it is not clear if longer sleep reduces depression symptoms and if the impact of such policy change is the same across groups of adolescents.

methodsWe examined how gains in weekday sleep impact depression symptoms in 2,134 high school students (mean age 15.16 ± 0.35 years) from the Minneapolis metropolitan area. Leveraging a natural experiment design, we used the policy change to delay school start times as an instrument to estimate the effect of a sustained gain in weekday sleep on repeatedly measured Kandel-Davies depression symptoms. We also evaluated whether allocating the policy change to subgroups with expected benefit could improve the impact of the policy.

resultsOver 2 years, a sustained half-hour gain in weekday sleep expected as a result of the policy change to delay start times decreased depression symptoms by 0.78 points, 95%CI (-1.32,-0.28), or 15.6% of a standard deviation. The benefit was driven by a decrease in fatigue and sleep-related symptoms. While symptoms of low mood, hopelessness, and worry were not affected by the policy on average, older students with greater daily screen use and higher BMI experienced greater improvements in mood symptoms than would be expected on average, signaling heterogeneity. Nevertheless, universal implementation outperformed prescriptive strategies.

conclusionHigh school start time delays are likely to universally decrease fatigue and overall depression symptoms in adolescents. Students who benefit most with respect to mood are older, spend more time on screens and have higher BMI.

Indexed as

DepressionSchoolsSleepStudentsAdolescentFatigueFemaleHumansMaleScreen TimeTime FactorsAdolescent depressionCausal inferenceHeterogeneity of treatment effectInstrumental variableSchool start time delays

Identifiers

PMID38847813
PMCPMC11846681

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.