Challenged by extremely irregular school schedules, Uruguayan adolescents only set their waking time

Early school start times adversely influence adolescents' sleep duration. Late school start times and remote learning are associated with longer sleep durations. We leveraged a highly variable school schedule adopted after the first SARS-CoV-2 wave in Uruguay to study the influence of a hybrid mode of instruction (in-person/remote) with irregular school start times on adolescents' sleep.

Objective sleep on school nights (120 observations) was determined using accelerometry recordings of 15 high-school students (3 males 15-17 years old). We used mixed-effects regressions to explore the influence of the mode of instruction (in-person/remote) and school start time on adolescents' sleep patterns (onset, end, and duration).

An irregular individual regime of 2-6 school days per week, either in-person or remote, and with irregular start times (range: 07:30-12:00) were observed during the studied period. Remote learning delayed sleep end by 48 ± 9 min and increased sleep duration by 36 ± 12 min. In addition, 1 h delay in school start time delayed sleep end in 36 ± 4 min and increased sleep duration in 34 ± 5 min.

A strong linear association of the mode of instruction and the school start time with participants' sleep was observed: Only waking time was associated with both school start time and mode of instruction, and sleep duration increased when students were taught remotely and when school started later. These results add evidence to the effectiveness of delaying school start time to improve adolescents' sleep. However, these efforts may not overcome the influence of a very late circadian orientation, as observed in Uruguayan adolescents.