Despite Flo Medina's constant nudges, the tiny bundle stayed curled under a bed sheet, holding on to sleep. At 6:40 a.m., the Pearl City mom's morning challenges had only just begun.

"Lauren, honey? Good morning, baby," Medina whispered to her 4-year-old preschooler.

"I'm tired!" whimpered a weak little voice.

"I know you're tired, but you have to go to school."

After several failed attempts to wake her daughter, Medina began to dress her anyway, removing her pink Cinderella pajamas and replacing them with lavender Roxy shorts and a sweater. Minutes later, Lauren sat up half-conscious and dazed, as Medina did her hair into pigtails.

After tending to Lauren, Medina — whose children are in preschool, elementary, middle and high schools — made her way to the kitchen, where her struggles continued in a scene of organized chaos: "Mom, the glue didn't dry. I need tape!" "Can I have mac and cheese?" "I want the pink vitamin!"

Flo Medina is among hundreds of parents who are all too familiar with the madness associated with school mornings — from waking up long before sunrise and getting ready to scarfing breakfast and rushing out the door to beat traffic.

It's more than an annoyance. An early, hectic morning can lead to problems such as family stress, anxiety among children, lack of concentration in school among children who are too tired, and personal safety issues if a child is at a bus stop or on campus too early, experts say.

"Stress is the biggest problem stemming from a chaotic morning," said Patty Grenda, a Tinley Park, Ill., parent and creator of "The Family Planner," an organizational tool for families. "A child's ability to concentrate at school can be negatively affected by their increased level of anxiety."

Children and parents alike need to start the day with as little tension as possible, Grenda said. "Being in a frazzled state of mind can only compound throughout the day," she said. "A calm morning will hopefully set the tone for the day, making it a pleasant and productive one."

'HECTIC' SCHEDULES

With children ages 7, 4, 2 and 4 months, Denna-Lei Plunkett knows the perils of morning madness firsthand.

"I go crazy," said the full-time mom, 33, of Hau'ula. "It's very stressful."

The Plunketts' weekdays have to begin extra early — 4:30 a.m. for mom and 5 a.m. for the kids — since the family has to make a nearly 40-mile, hour-and-a-half drive from their home in Hau'ula to town, where her two older children attend private schools.

That means leaving by 6 to get to school in time by 7:30, Plunkett said.

While Plunkett constantly hopes for a strain-free morning, problems inevitably pop up while her two daughters get ready, she said, especially with her 7-year-old.

"Even though she wears a school uniform, she'll find a dilemma, whether it be the hair or whatever it is," Plunkett said. "Like today the ponytail wasn't good enough. It was made 10 times and it still wasn't good enough."

At times like that, Plunkett tries to make an extra effort to stay calm.

"I understand that to us it's not a big thing, but to them it's just here and now and they need the attention," she said. "It's like the biggest problem; their world is falling apart and it's very hard."

So if they end up running late, then they're late, Plunkett said.

"I try not to stress," she said. "I'd rather have the teachers being on my case and my daughters walking in (class) a little late, than have them walking in in tears because I flipped out or just started to scream in the car."

Carlin Ujimori-Kaeo, 40, of Kapolei says she also has to keep in mind her children's emotional well-being in the midst of the madness. In their household, prepping for school can often get "hectic," she said.

Ujimori-Kaeo, a quality management analyst, drives her three children — ages 7, 6 and 5 — into town to school each morning. The family gets up at 5 and leaves by 6 to get to school by 7:30.

"I don't like to be late, so when I see traffic (on the television) or I hear my kids fussing, I start going, 'Come on! Get ready! We're late!,' " Ujimori-Kaeo said. "I start pushing them, rushing them."

When Ujimori-Kaeo finds herself getting frantic like that, she'll take a minute to get ahold of her emotions.

"Then I feel sorry for them, so I have to catch myself, like, take it easy," she said.

MORNING DILEMMAS

Having to get up too early to ease the morning routine rush can lead to other troubles for students, such as sleep deprivation and lack of concentration in school, studies have shown.

A National Sleep Foundation study found that while pre-adolescents and adolescents require 8.5 to 9.25 hours each night, they're getting less than eight hours; only 15 percent of adolescents reported sleeping 8.5 or more hours on school nights.

"The majority of teens are probably getting seven hours or less of sleep each night," said Dr. David Paperny, an adolescent specialist at Kaiser Permanente.

Insufficient sleep in teens is a problem that leads to low grades and poor school performance, among other things, Paperny said.

"They really can't focus in school that well if they don't get enough sleep," he said.

Paperny recommends teens learn how to manage their time wisely, do relaxing activities before bed (turn off the computer or television and take a warm shower) and establish a regular bedtime.

Ujimori-Kaeo's children are still young, but she is strict about enforcing her children's bedtimes, which is usually by 7:30 p.m.

"It's not a big thing for them to get up early as long as you get them to sleep early," she said. "They do fine."

An early start in the day can pose other problems for families.

Kapolei mom Grace Pregana, who drives her 7- and 5-year-old children to school by 7:30 a.m., said she knows of other parents who have to bring their kids to bus stops or to school even when it's dark, because of early bus and work schedules.

"It's absolutely a safety issue," said Pregana, 37, a project manager. "Just the thought makes me scared."

At Maryknoll School, a private school in Honolulu, a staff member supervises the grade school's schoolyard starting at 6:45 a.m., and teachers monitor the driveway drop-off areas to help children out of cars beginning at 7:15, said Paul O'Brien, principal of the grade school division. The school doesn't encourage students to arrive earlier, but campus lights are turned on so that early arrivals don't step on campus in darkness.

If parents must leave their children at a bus stop or at school early in the morning, O'Brien offers these safety tips: