The changing sleep habits of university students: an update

The freshman sleep and health (FRoSH) study: Examining sleep and weight gain in incoming college freshmen

OBJECTIVE

Examine how changes in sleep duration, objectively measured by activity trackers, impact weight gain in incoming college freshman. Participants: Incoming college freshmen, age ≥ 18. Methods: We measured weight and daily sleep duration before college entry and through the 1st college quarter. Additionally, we examined changes in sleep variability, activity levels and smartphone screen time use as possible predictors of weight gain. Results: 75 participants completed the study. Total sleep duration decreased from 437.9 ± SD 57.3 minutes at baseline to 416.5 ± SD 68.6 minutes by the end of the first quarter (p = 6.6 × 10-3). (BMI) did not change significantly in this cohort. Higher sleep variability at baseline and an increase in sleep variability were associated with increases in BMI. Smartphone screen use was note to be high (235.2 ± SD 110.3 minutes/day) at the end of the first quarter. Conclusions: College weight gain may be affected by factors other than sleep duration, including sleep variability.

Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2032720.

Time Management Behavior Structural Equation Model Predicts Global Sleep Quality in Traditional Entry University Students

Background

Poor sleep is commonplace among traditional entry university students. Lifestyle modifications, such as time management behaviors, may improve sleep quality by allocating sufficient time for sleep and mitigating stress-associated sleep latency inefficiencies.

Purpose

The purpose of our study was to evaluate time management behaviors as predictors of sleep quality in traditional entry university students. We hypothesized time management behaviors would predict perceived control of time, which in turn, would predict global sleep quality.

Methods

A cross-sectional convenience sample of university students (n=302) completed a 73-item instrument comprised of the Pittsburgh Sleep Quality Index and the Time Management Behavior scale. Model building procedures included exploratory factor analysis, confirmatory factor analysis, and structural equation modeling.

Results

Our specified model identified significant paths between setting goals and priorities (β= .261; p=.012), mechanics of time management (β=.210; p=.043) and preference for organization (β=.532; p<.001) for perceived control of time (R2=.300 p<.001). We further identified a significant path between perceived control of time and global sleep quality (R2=.196, p=.022).

Discussion

Our study suggests time management behaviors are associated with global sleep quality.

Translation to Health Education Practice

Health education interventions addressing sleep quality of traditional entry university students should consider incorporating time management behaviors.

Magnitude of Poor Sleep Hygiene Practice and Associated Factors among Medical Students in Ethiopia: A Cross-Sectional Study

Background

Good sleep hygiene plays an important role in human health. Medical students are notorious for insufficient and irregular sleep habits which are linked with students' learning abilities, poor academic performance, and poor interpersonal relationship which predispose them to mental illnesses. However, it has not been studied among medical students in Ethiopia.

Method

This institution-based cross-sectional study was conducted among 576 undergraduate medical students selected by using a stratified sampling technique. Sleep hygiene (SHI) was assessed by a 13-item sleep hygiene questionnaire. Binary logistic regression was used to identify the potential determinants of poor sleep hygiene among undergraduate medical students. Variables with p values less than 0.05 were considered statistically significant, and the strength of the association was presented by adjusted odds ratio with 95% C.I.

Result

The prevalence of poor sleep hygiene practice among undergraduate medical students was 48.1% (95% 43.7, 52.1). After adjusting for the possible confounders, being female (AOR = 1.53, 95% CI 1.03, 2.26), having depressive symptoms (AOR = 3.55, 95% CI 2.26, 5.59), with stress symptoms (AOR = 2.41, 95% CI 1.61, 3.60), and having anxiety symptoms (AOR = 2.2, 95% CI 1.42, 3.31) were associated with poor sleep hygiene practice at p value < 0.05.

Conclusion

Almost half of the medical students had poor sleep hygiene practice. Routine screening of depressive and stress symptoms and education about sleep hygiene are warranted among medical students.

Exploring Relationships of Sleep Duration with Eating and Physical Activity Behaviors among Canadian University Students

BACKGROUND

Students pursuing postsecondary education are a population described as vulnerable for sleep problems, poor dietary habits, weight gain, and reduced physical activity. The primary goal of this study was to examine relationships of sleep behaviors with eating and physical activity behaviors in a sample of undergraduate health sciences students.

METHODS

Using a cross-sectional design, undergraduate health sciences students in a small Canadian university were recruited to complete an on-line questionnaire about their sleep, eating, and physical activity behaviors using valid and reliable instruments. Key sociodemographic characteristics and self-reported height and weight data were also captured.

RESULTS

The participants (n = 245) were on average 23 years of age, female (86%), and the majority were full-time students (92%). The mean BMI was within a healthy range (mean 24.58 SD 5.55) with the majority reporting low physical activity levels (65%). Despite self-reports of very or fairly good (65%) sleep quality in the past month, the mean global sleep scores (scores > 5, mean 7.4, SD 3.3) indicated poor overall sleep quality. Poorer sleep quality was associated with higher BMIs (r = 0.265, p < 0.001).

CONCLUSIONS

The findings highlight the need to expand the scope of on-campus wellness programs to promote healthy sleep habits in a vulnerable university population.

Sleep hygiene awareness: Its relation to sleep quality among medical students in King Saud University, Riyadh, Saudi Arabia

Background/Objective:

Sleep hygiene (SH) is considered to be an effective method to treat sleep disturbances, especially among adolescents and young adults. This study aimed to find out the relationship of SH awareness and its importance in overall sleep quality among medical students and to assess the prevalence of sleep disturbance among them.

Methodology:

This was a cross-sectional study conducted in the College of Medicine, King Saud University during the period between April and July 2016. A total of 225 students participated in this study and were recruited by a convenience sampling method. Two validated questionnaires were used, Pittsburg Sleep Quality Index (PSQI) to assess sleep quality and the Sleep Beliefs Scale (SBS) to assess the awareness of students about SH. Data were entered into, and analyzed by SPSS Version 20.

Results:

Overall, more than half of the participants, 113 (56.5%), had a poor sleep quality. Sixty one (30.5%) students got excellent score in SH awareness and the rest of the participants (n = 139; 69.5%) scored poor/intermediate. Thirty-five (57.4%) poor sleepers and 42.6% of good sleepers scored excellent in SH awareness.

Conclusion:

This study showed a higher prevalence of sleep disturbance among medical students and no significant correlation between SH awareness and good sleep quality, which means that SH awareness may not necessarily ensure a good sleep quality.

Sleep Duration and Sleep Patterns in Chinese University Students: A Comprehensive Meta-Analysis

STUDY OBJECTIVES

This meta-analysis aimed to determine duration and patterns of sleep in Chinese university students.

METHODS

English (PubMed, PsycINFO, Embase) and Chinese (SinoMed, Wan Fang Database, and Chinese National Knowledge Infrastructure) databases were systematically and independently searched from their inception until August 16, 2016. Data on sleep duration and sleep patterns of tertiary student population in eligible studies were extracted and pooled using random-effects models.

RESULTS

A total of 57 studies with 82,055 university students were included in the meta-analysis. Pooled mean sleep duration was 7.08 h/d (95% confidence interval [CI]: 6.84 to 7.32 h/d). The percentage of students with sleep duration shorter than 6 h/d and 7 h/d (short sleep) was 8.4% (95% CI: 5.7% to 12.3%) and 43.9% (95% CI: 36.9% to 51.1%), respectively. In contrast, the percentage of students with sleep duration longer than 8 hours and 9 hours (long sleep) was 18.3% and 5.7%, respectively. The pooled mean bedtime was at 12:51 am. The percentage of university students who fall asleep after midnight was 23.8%. The percentage of students with sleep latency more than 30 minutes was 25.5%. The pooled mean wake-up time was at 8:04 am on weekdays and on weekends.

CONCLUSIONS

Short sleep duration and unhealthy sleep patterns were found to be common among Chinese university students.

Prevalence and risk factors of poor sleep quality among Inner Mongolia Medical University students: A cross-sectional survey

Medical students face new challenges at the beginning of college life, such as being responsible for oneself, an unfamiliar environment, social obligations, and academic stress, all of which influence or even heavily change their sleep quality and life, leading to sleep-related problems to some degree. This study investigated the relationship between sleep quality and behavior among students at the Inner Mongolia Medical University in China. Self-administered questionnaires were used to collect information on sociodemographic characteristics and lifestyle habits. The Pittsburgh Sleep Quality Index was also used. A total of 6044 and 6085 students completed the questionnaires in 2011 and 2013. According to the index, 27.8% (1694) of students had poor sleep quality with major risk factors being poor academic performance and interpersonal relationships in 2013. Among others, regular exercise less than three times a week, skipping breakfast, and studying in higher grades were associated with poor sleep quality. These results will help university administrators understand the risk factors of poor sleep quality among students, which can be improved through individual efforts, and provide adequate counseling and systematic education to improve their behavior and lifestyle.

Sleep hygiene awareness: its relation to sleep quality and diurnal preference

Background

Sleep hygiene is a core component for psychological treatments of insomnia and essential for maintaining a satisfactory sleep. Our study aimed to measure the sleep hygiene awareness and the self-reported quality of sleep among three age groups (young adults, adults and middle-aged adults) and to determine their relation. We also measured their relation with diurnal preference.

Methods

Using an online questionnaire, we surveyed six hundred fifty two participants, recruited nationwide from the community and from the students in three main cities in Romania.

Results

Sleep hygiene awareness was moderate on the whole and significantly worse in young adults (compared to the other age groups) and in those complaining of poor sleep (compared to those with good sleep). Sleep quality was average and linked positively with diurnal preference (the more evening oriented, the poorer the sleep). Diurnal preference was not found to play a role regarding sleep hygiene awareness.

Conclusions

Our results suggest that better sleep hygiene awareness does not necessarily guarantee better sleep quality and that it may actually be an indicator of dissatisfaction with the obtained sleep.

Electronic supplementary material

The online version of this article (doi:10.1186/s40303-015-0008-2) contains supplementary material, which is available to authorized users.

The relationship between self-reported sleep quality and reading comprehension skills

Inadequate sleep undermines many cognitive functions, including memory, concentration, and attention, which are vital in everyday activities. We hypothesized that poor quality or shorter sleep length may impair reading-related skills, resources, and outcomes, specifically verbal working memory span, verbal efficiency, and reading comprehension. Contrary to the hypotheses, neither short sleep length nor self-reported sleep quality were related to reading skills performance. However, longer sleep times were significantly related to lower verbal efficiency, and participants with the poorest sleep quality fared significantly better on the reading comprehension task than participants with moderate sleep quality. Given the paucity of research examining sleep and reading specifically, as well as these surprising data, more research in this area is warranted.

The role of implied motion in engaging audiences for health promotion: encouraging naps on a college campus

OBJECTIVE

Lack of sleep among college students negatively impacts health and academic outcomes. Building on research that implied motion imagery increases brain activity, this project tested visual design strategies to increase viewers' engagement with a health communication campaign promoting napping to improve sleep habits.

PARTICIPANTS

PARTICIPANTS (N = 194) were recruited from a large southwestern university in October 2012.

METHODS

Utilizing an experimental design, participants were assigned to 1 of 3 conditions: an implied motion superhero spokes-character, a static superhero spokes-character, and a control group.

RESULTS

The use of implied motion did not achieve the hypothesized effect on message elaboration, but superheroes are a promising persuasive tool for health promotion campaigns for college audiences.

CONCLUSIONS

Implications for sleep health promotion campaigns and the role of implied motion in message design strategies are discussed, as well as future directions for research on the depiction of implied motion as it relates to theoretical development.

Association between sleep behavior and sleep-related factors among university students in Hong Kong

Sleep problems among university students are common; however, the association between many sleep-related factors and sleep behaviors is still unclear. The purpose of this study is to examine different sleep behaviors and sleep-related factors influencing such behaviors in university students. A descriptive survey was conducted on 400 university students in Hong Kong. The instruments for data collection consisted of the Pittsburgh Sleep Quality Index (PSQI), a sleep hygiene practice questionnaire, demographic data, and other sleep-related factors. The results reveal that 57.5% of the 400 university students are poor sleepers. Sex, year of study, sleep hygiene practice, and perceived adequate sleep in the past month all demonstrate significant associations with poor sleepers. A high prevalence of sleep-related problems among college students is confirmed and associated factors are identified. Students should be encouraged to follow sleep hygiene practice, adequate time management for academic and social activities, and suitable stress-relieving measures.

Failure to find executive function deficits following one night's total sleep deprivation in university students under naturalistic conditions

Young adult male students participated in a naturalistic, group-design experiment to ascertain the effects of one night's total sleep deprivation (TSD) on performance of diverse executive function tasks presented as an extended, multitask battery. On the majority of component tasks in this battery, performance has been reported to be impaired following one night's TSD when tasks are administered in isolation. However, participants sleep deprived 35 to 39 hr showed few performance deficits among tests in this battery when compared with non-sleep-deprived controls. Sleep-deprived participants showed only poorer recognition memory and overconfidence in incorrect temporal judgments. Behavioral and physiological adaptation to chronically sleep-restricting lifestyles may confer resistance to the cognitive effects of sleep deprivation in high-functioning young adults.

Evaluation of Depressive Symptoms and Sleep Alterations in College Students

BACKGROUND

Increasing evidence suggests that sleep alterations could favor subsequent depression development. In order to identify the simultaneous occurrence of these parameters in young people, in this work we evaluated the prevalence of depressive symptoms, sleep habits, and possible sleep disturbances in college students.

METHODS

Beck Depression Inventory (BDI), Epworth Sleepiness Scale (ESS), and a Sleep Habits Questionnaire were applied to students registered at the Autonomous University of Yucatan, Merida (mean age 20.2 +/- 2.6 years). The final sample was composed of 340 (53%) women and 298 (47%) men. Reliability of the BDI and ESS was assessed by Cronbach's alpha method.

RESULTS

Taking 10 as ESS cut-off point, it was found that 31.6% of the students had a high level of sleepiness. Students with depressive symptoms had a greater number of days with somnolence during class (p <0.05) and perceived that this affected their academic performance at a higher level (p <0.001) than the students without symptoms. In comparison to subjects without depressive symptoms, students with those symptoms rated their sleep quality as poor (p <0.001), perceived a greater latency to initiate sleep after going to bed (p <0.03), and experienced a greater number of awakenings (p <0.04).

CONCLUSIONS

We found diverse sleep alterations in a large proportion of the studied subjects, which were more severe in those who showed depressive symptoms. Educating students for appropriate sleep hygiene and encouraging them to seek professional advice to treat sleep disturbances may be useful to prevent depression.

Sleep education in college: a preliminary study

In this study we evaluated the effect of a two-credit (100 min./week) "Sleep Management" course on the sleep patterns of college students as the course progressed over an 18-wk. semester. Curricular activity included lectures, group discussions, and practice of self-evaluation of sleep. Instead of giving the students the whole list of sleep hygiene at the outset of the course, each concept of sleep hygiene was introduced and discussed under related lecture topics. A total of 241 students (131 men and 110 women) took the course and kept 7-day sleep logs three times. Concurrently, sleep-log data were collected from 65 students (32 men and 33 women) who were not taking the course. Both groups showed similar varieties of academic backgrounds and characteristics of sleep patterns at the beginning. Similarly, their sleep patterns, namely, rise time, nighttime awakenings, time asleep, time in bed, sleep efficiency, and rise time regularity, changed over the semester. Women in both groups had more nighttime awakenings. In contrast, sleep quality was progressively better for the group in the course but not for the control group. Only women in the course decreased their nap time in the second and third months. Thus, the course of "Sleep Management" only had a mild and limited effect on sleep patterns. The course content needs refinement to maximize influence on students' sleep patterns and habits, particularly, on reduction of insufficient sleep and daytime sleepiness which are the highest ranking sleep problems among college students.

Sleep quality, sleep propensity and academic performance

We examined associations between measures of sleep propensity on the Epworth Sleepiness Scale, sleep quality on the Pittsburgh Sleep Quality Index and academic performance by GPA and grades in introductory psychology for 414 students. In the total sample, neither sleep propensity nor sleep quality correlated with GPA or introductory psychology grades. However, among students carrying a full course load, those reporting poor sleep quality performed less well on academic measures than those reporting a better quality of sleep. Further research is needed to assess the moderating influence of overall demands of daytime functioning on the association between sleep quality and academic performance.