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Sleep Patterns and Predictors of Disturbed Sleep in a Large Population of College Students

      Abstract

      Purpose

      To characterize sleep patterns and predictors of poor sleep quality in a large population of college students. This study extends the 2006 National Sleep Foundation examination of sleep in early adolescence by examining sleep in older adolescents.

      Method

      One thousand one hundred twenty-five students aged 17 to 24 years from an urban Midwestern university completed a cross-sectional online survey about sleep habits that included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale, the Horne-Ostberg Morningness–Eveningness Scale, the Profile of Mood States, the Subjective Units of Distress Scale, and questions about academic performance, physical health, and psychoactive drug use.

      Results

      Students reported disturbed sleep; over 60% were categorized as poor-quality sleepers by the PSQI, bedtimes and risetimes were delayed during weekends, and students reported frequently taking prescription, over the counter, and recreational psychoactive drugs to alter sleep/wakefulness. Students classified as poor-quality sleepers reported significantly more problems with physical and psychological health than did good-quality sleepers. Students overwhelmingly stated that emotional and academic stress negatively impacted sleep. Multiple regression analyses revealed that tension and stress accounted for 24% of the variance in the PSQI score, whereas exercise, alcohol and caffeine consumption, and consistency of sleep schedule were not significant predictors of sleep quality.

      Conclusions

      These results demonstrate that insufficient sleep and irregular sleep–wake patterns, which have been extensively documented in younger adolescents, are also present at alarming levels in the college student population. Given the close relationships between sleep quality and physical and mental health, intervention programs for sleep disturbance in this population should be considered.

      Keywords

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      References

        • Léger D.
        • Massuel M.A.
        • Metlaine A.
        • SISYPHE Study Group
        Professional correlates of insomnia.
        Sleep. 2006; 29: 171-178
        • Léger D.
        • Scheuermaier K.
        • Phillip P.
        • et al.
        SF-36: Evaluation of quality of life in severe and mild insomniacs compared with good sleepers.
        Psychosom Med. 2001; 63: 49-55
        • Katz D.A.
        • McHorney C.A.
        The relationship between insomnia and health-related quality of life in patients with chronic illness.
        J Fam Pract. 2002; 51: 229-235
        • Roth T.
        • Jaeger S.
        • Jin R.
        • et al.
        Sleep problems, comorbid mental disorders, and role functioning in the national comorbidity survey replication.
        Biol Psychiatry. 2006; 60: 1364-1371
        • Wolfson A.R.
        • Carskadon M.A.
        Understanding adolescents' sleep patterns and school performance: a critical appraisal.
        Sleep Med Rev. 2003; 7: 491-506
        • Taylor D.J.
        • Jenni O.G.
        • Acebo C.
        • et al.
        Sleep tendency during extended wakefulness: insights into adolescent sleep regulation and behavior.
        J Sleep Res. 2005; 14: 239-244
        • Crowley S.J.
        • Acebo C.
        • Carskadon M.A.
        Sleep, circadian rhythms, and delayed phase in adolescence.
        Sleep Med. 2007; 8: 602-612
        • Van den Bulck J.
        Television viewing, computer game playing, and Internet use and self-reported time to bed and time out of bed in secondary-school children.
        Sleep. 2004; 27: 101-104
      1. National Sleep Foundation: Sleep in America Poll, 2006 [Online]. Available at: http://www.sleepfoundation.org. Accessed July 15, 2008.

        • Carskadon M.A.
        • Wolfson A.R.
        • Acebo C.
        • et al.
        Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days.
        Sleep. 1998; 21: 871-881
        • Hansen M.
        • Janssen I.
        • Schiff A.
        • et al.
        The impact of school daily schedule on adolescent sleep.
        Pediatrics. 2005; 115: 1555-1561
        • Wolfson A.R.
        • Spaulding N.L.
        • Dandrow C.
        • et al.
        Middle school start times: the importance of a good night's sleep for young adolescents.
        Behav Sleep Med. 2007; 5: 194-209
        • Campbell I.G.
        • Higgins L.M.
        • Trinidad J.M.
        • et al.
        The increase in longitudinally measured sleepiness across adolescence is related to the maturational decline in low-frequency EEG power.
        Sleep. 2007; 30: 1677-1687
        • Carskadon M.A.
        • Harvey K.
        • Duke P.
        • et al.
        Pubertal changes in daytime sleepiness.
        Sleep. 1980; 2: 453-460
        • Roberts R.E.
        • Roberts C.R.
        • Chen I.G.
        Functioning of adolescents with symptoms of disturbed sleep.
        J Youth Adolesc. 2001; 30: 1-18
        • Fredricksen K.
        • Rhodes J.
        • Reddy R.
        • et al.
        Sleepless in Chicago: tracking the effects of adolescent sleep loss during the middle school years.
        Child Dev. 2004; 75: 84-95
        • Oginska H.
        • Pokorski J.
        Fatigue and mood correlates of sleep length in three age-social groups: school children, students, and employees.
        Chronobiol Int. 2006; 23: 1317-1328
        • Chung K.F.
        • Cheung M.M.
        Sleep–wake patterns and sleep disturbance among Hong Kong Chinese adolescents.
        Sleep. 2008; 31: 185-194
        • O'Brien E.M.
        • Mindell J.A.
        Sleep and risk-taking behavior in adolescents.
        Behav Sleep Med. 2005; 3 (133–33)
        • Roberts R.E.
        • Roberts C.R.
        • Duong H.T.
        Chronic insomnia and its negative consequences for health and functioning of adolescents: a 12-month prospective study.
        J Adolesc Health. 2008; 42: 294-302
        • Medeiros A.L.D.
        • Mendes D.B.F.
        • Lima P.F.
        • et al.
        The relationships between sleep–wake cycle and academic performance in medical students.
        Bio Rhythm Res. 2001; 32: 263-270
        • Tsai L.L.
        • Li S.P.
        Sleep patterns in college students: gender and grade differences.
        J Psychosom Res. 2004; 56: 231-237
        • Buysse D.J.
        • Reynolds 3rd, C.F.
        • Monk T.H.
        • et al.
        The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research.
        Psychiatry Res. 1989; 28: 193-213
        • Johns M.W.
        Reliability and factor analysis of the Epworth Sleepiness Scale.
        Sleep. 1992; 15: 376-381
        • Horne J.A.
        • Otsberg O.
        A self-assessment questionnaire to determine morningness–eveningness in human circadian rhythms.
        Int J Chronobiol. 1976; 4: 97-110
        • Wolpe J.
        The Practice of Behavioral Therapy.
        3rd ed. Pergamon Press, New York1982
        • McNair D.M.
        • Lorr M.
        • Droppleman L.F.
        Profile of mood states. EdITS Manual for the Profile of Mood States.
        EdITS/Educational and Industrial Testing Service, San Diego, CA1992
        • Roehrs T.
        • Shore E.
        • Papineau K.
        • et al.
        A two-week sleep extension in sleepy normals.
        Sleep. 1996; 19: 576-582
        • Lund H.G.
        • Whiting A.B.
        • Prichard J.R.
        The relationship between sleep quality, mood, and stress in college Women.
        Sleep Abstr. 2006; : 29
        • Ohayon M.M.
        • Roth T.
        Place of chronic insomnia in the course of depressive and anxiety disorders.
        J Psychiatr Res. 2003; 37: 9-15
        • Breslau N.
        • Roth T.
        • Rosenthal L.
        • Andreski P.
        Sleep disturbances and psychiatric isorders: a longitudinal epidemiological study of young adults.
        Biol Psychiatry. 1996; 39: 411-418
        • Chang P.P.
        • Ford D.E.
        • Mead L.A.
        • et al.
        Insomnia in young men and subsequent depression. The Johns Hopkins Precursors Study.
        Am J Epidemiol. 1997; 146: 105-114
        • Forbes E.E.
        • Williamson D.E.
        • Ryan N.D.
        • et al.
        Peri-sleep-onset cortisol levels in children and adolescents with affective disorders.
        Biol Psychiatry. 2006; 59: 24-30
        • Drake C.
        • Richardson G.
        • Roehrs T.
        • et al.
        Vulnerability to stress-related sleep disturbance and hyperarousal.
        Sleep. 2004; 27: 285-291
        • Jose P.E.
        • Ratcliffe V.
        Stressor frequency and perceived intensity as predictors of internalizing symptoms: gender and age differences in adolescence.
        N Z J Psychol. 2004; 33: 145-154
        • Stasio M.J.
        • Curry K.
        • Sutton-Skinner K.M.
        • et al.
        Over-the-counter medication and herbal or dietary supplement use in college: dose frequency and relationship to self-reported distress.
        J Am Coll Health. 2008; 56: 535-547
        • Brower K.J.
        • Aldrich M.S.
        • Robinson E.A.
        • et al.
        Insomnia, self-medication, and relapse to alcoholism.
        Am J Psychiatry. 2001; 158: 399-404
        • Bootzin R.R.
        • Stevens S.J.
        Adolescents, substance abuse, and the treatment of insomnia and daytime sleepiness.
        Clin Psychol Rev. 2005; 25: 629-644
        • Neckelmann D.
        • Mykletun A.
        • Dahl A.A.
        Chronic insomnia as a risk factor for developing anxiety and depression.
        Sleep. 2007; 30: 873-880
        • Roane B.M.
        • Taylor D.J.
        Adolescent insomnia as a risk factor for early adult depression and substance abuse.
        Sleep. 2008; 31: 1351-1356

      Linked Article

      • Adolescents and Emerging Adults' Sleep Patterns: New Developments
        Journal of Adolescent HealthVol. 46Issue 2
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          Over the last three decades, researchers have established an increasingly more nuanced understanding of adolescents' sleep demands, circadian timing, underlying bioregulatory processes, and environmental constraints [1–5]. Studies have also documented the clear consequences of insufficient and inconsistent sleep for developing adolescents, such as poor academic performance and school absenteeism, drowsy-driving accidents, substance abuse, and emotion regulation difficulties [6–10]. This critical area of adolescent health research has also started to inform policy from school start times to drivers' education programs [11–15].
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