Dream team

In his senior in high school, one of James Underwood’s friends left a Friday night party around 12:30 a.m. and nodded off at the wheel in a remote stretch of rural Arkansas. Exhausted after a long week, including early-morning commutes to school, he veered off the road and struck a tree about a mile from home.

“It was kind of a shock to everyone,” says Underwood, now a sophomore at Stanford University. Fortunately, his friend suffered no major injuries, but Underwood realized the consequences could have been catastrophic. The experience motivated him to volunteer in Stanford’s Sleep Ambassadors program, designed to teach high school students about the importance of sleep — and the dangers that lurk when they don’t.

Through the program, which has won awards from the California School Boards Association and the National Sleep Foundation, Stanford students and faculty in the undergraduate-level Sleep and Dreams class reach out to every freshman at the nearby Menlo-Atherton High School to give them a primer on the value of sleep. The college students also pair up with juniors from the high school, who continue to spread the gospel among their peers as part of an ongoing educational campaign.

It’s a unique program among high schools nationwide, where sleep is rarely part of the curriculum, says Stanford sleep expert William Dement, MD, PhD, who helped start the project. “It’s still true that sleep is not addressed in the educational system,” he says. “It’s terrible. All over the country it’s a huge problem.” In the winter of 2016, the program will be expanded to Palo Alto’s two high schools — Gunn High School and Palo Alto High School — where student stress has been an issue of concern, says Rafael Pelayo, MD, a pediatric sleep specialist at the Stanford Sleep Disorders Clinic and one of the professors in the program. Pelayo also has made presentations to parents, teachers and students at the schools to encourage healthy sleep habits among the teens.

The program was spearheaded in 2006 by a passionate group of parents who had connections to Dement and to Mark Rosekind, PhD, now the administrator of the National Highway Safety Traffic Safety Administration and an expert on human fatigue. Dement says he had served as an expert witness in far too many tragic car accidents and was primarily concerned with drowsy driving among the teens.

“I had learned that drowsy driving was the No. 1 cause of traffic fatalities. High school is when most students are learning to drive,” he says. Some two-thirds of all sleepiness-related crashes involve adolescents and young adults, who don’t always perceive that they are fatigued and may be prone to risk-taking, studies show.

“A lot of people have the mindset, ‘I’ll be fine. I can make myself stay awake. I’m invincible.’ But that’s not really true,” Underwood says. “If you’re not surrounded by a stimulus, you can crash very suddenly. … So it can be incredibly problematic.” In addition to lessons on drowsy driving, the program teaches students about the basics of teen sleep and the many ways in which sleep deprivation can affect their lives, affecting memory, attention, learning and mood, among other things.

“We try to give them what they need to know going into high school at a time when sleep deprivation is so common,” says Marleyna Mohler, a Stanford sophomore and one of the teaching assistants for this year’s class. “Sleep is seen as a kind of joke and not a serious topic. … There’s definitely a stigma that people who sleep a lot aren’t having fun. Pulling an all-nighter is like a badge of honor, a diehard commitment.”

Around the time the program was introduced at Menlo-Atherton, a group of parents pressured the school board to change the bell schedule as part of the campaign to improve students’ sleep habits. The high school’s 7:45 a.m. start time was pushed back to 8:45 a.m., with classes starting twice a week at 9:30 a.m. That gives students a midweek respite to catch up on sleep, rather than rely on the weekend to recover from their accumulated sleep debt, says outgoing principal Matthew Zito.

Zito thinks those changes and other innovations, such as a ban on AP summer classes and a homework-free winter break, have helped improve student well-being.

“Student behavior is greatly improved. The number of disciplinary actions of a serious nature is dramatically reduced. This isn’t all related to student sleep. The campus has improved its facilities and made other changes. But I think sleep is a factor in having a healthier academic and socioemotional climate on the campus,” he says.