Self-report surveys of student sleep and well-being: a review of use in the context of school start times

A large body of literature supports the need to delay high school starting times to improve student health and well-being by allowing students an opportunity to get sufficient and appropriately timed sleep. However, a dearth of uniform and standardized tools has hampered efforts to collect data on adolescent sleep and related health behaviors that might be used to establish a need for, or to evaluate outcomes of, bell time delays. To assess validated tools available to schools and contrast them with tools that schools have actually used, we identified and reviewed published, validated self-report surveys of adolescent sleep and well-being, as well as unpublished surveys, used to assess student sleep and related health measures in US high schools considering later high school start times. Only three of the surveys reviewed had adequate psychometric properties and covered an appropriately wide range of health and academic questions to allow for discernment of outcomes in pre-post educational settings. The surveys exhibited marked variability in numerous areas, including focus, terminology, calculation of sleep duration, mode of administration, context of administration, and follow-up procedures. Our findings provide sleep researchers and school administrators with an overview of surveys that school districts have used, along with a deeper understanding of the challenges of choosing, designing, and administering self-report surveys in the context of changing school schedules. They also highlight the opportunities presented by these instruments to assess outcomes of delaying bell times, compare communities meaningfully, and establish the need for later school start times in individual school districts.