ABSTRACT
INTRODUCTION Following the U.S. baby boom in the 1960s, schools not only increased in number but educators also began to experiment with staggered class schedules to accommodate the influx of new students. As other social, economic, and politico-legal pressures converged, school start times, particularly for the older high school students, gradually migrated to earlier hours (1). By 1975 most U.S. high schools started as early as 8:00 a.m. and school systems throughout the Western world, under similar pressures, eventually followed suit (2). Consequently, increasing societal demands promoted by a 24/7 culture over the past three decades have contributed to even earlier school start times for both middle and high school students (3); (Fig. 1).
