Multilevel analysis exploring the links between stress,depression, and sleep problems among two-year college students

Objective: This study explored the association of stress and depression with a multidimensional sleep problems construct in a sample of 2-year college students. Participants: The sample consisted of 440 students enrolled in 2-year study from Fall 2011 to Fall 2013. Methods: Participants in an obesity prevention study completed surveys assessing sleep, stress, and depression at baseline, 4, 12, and 24 months. Multilevel models predicting sleep problems were conducted to distinguish episodic from chronic reports of stress and depression. Results: Participants were primarily women (68%), white (73%), young adults (M age = 22.8), with an average of 8.4 hours of sleep per night. Neither stress nor depression was predictive of sleep quantity; however, they were predictive of sleep quality. Conclusions: Results show that sleep quality rather than sleep quantity may be the greater health concern for young adults, suggesting that intervention programs targeting depression, stress management, and healthy sleep patterns are warranted.     

Impact of a sleep course on sleep,mood and anxiety symptoms in college students: A pilot study

Objective: To examine the impact of a sleep course on sleep-related behaviors, mood, and anxiety in college students. Participants: Participants were 145 students enrolled in either the sleep course (n = 70) or a psychology course (n = 75); data were collected in September 2014, November 2014, and February 2015. Methods: Sleep characteristics and symptoms of depression and anxiety were assessed using validated questionnaires and sleep logs. Linear, logistic and proportional odds regression models were used to test course effects. Results: In November, sleep course students reported significant differences in sleep hygiene (SHI; p < .001), perceived sleep latency (PSQI; p < .05), and circadian sleep phase (MEQ; p < .05), compared to controls. In February, the sleep course students maintained most of the aforementioned gains and reported fewer symptoms of depression (CES-D; p = .05) and anxiety (BAI; p < .05). Conclusions: These positive preliminary results indicate that focused education has the potential to improve sleep among college students.     

Mindfulness and health behaviors in college students: The moderating role of sleep

Abstract

Objective: To examine the moderating effects of subjective sleep quality (SSQ) and sleep duration on the relationships between mindfulness and health behaviors (i.e. nutrition and exercise) among undergraduate students. The unique influence of the five facets (i.e. factors) of mindfulness (i.e. observing, describing, acting with awareness, nonreactivity to inner experience and nonjudging of inner experience) on students’ health behaviors was also explored. Participants: Three hundred fifty seven undergraduate students enrolled in U.S. colleges. Methods: Students completed an online survey. Hierarchical multiple regression analyses were conducted to determine whether SSQ moderated the relationship between mindfulness and nutrition behavior. Results: SSQ moderated the relationship between mindfulness and nutrition behavior. The observe facet of mindfulness was the most predictive of nutrition behavior, whereas the observe and describe facets were the most predictive of exercise behavior. Conclusions: Interventions that target mindfulness and sleep quality may help promote healthy eating and increased exercise engagement in college students.     

The relationship between sleep and autonomic health

Abstract

Objective: To examine the relationship between sleep and resting autonomic nervous system (ANS) functioning in college students. Participants: Participants were 141 undergraduate students (52 males) recruited from a large southeastern university during September–October 2017. Methods: Participants completed self-report inventories (demographic and sleep characteristics). Resting state skin conductance (SC) and heart rate variability (HRV) were measured in a laboratory setting for ANS functioning. Results: SC was positively associated with sleep quality (p?=?0.027), sleep latency (p?=?0.040), and use of sleep medication (p?<?0.001). Analyses yielded a negative association between the standard deviation of the normal-normal interval of heart beats (SDNN) and the self-reported amount of time to fall asleep each night (p?=?0.041). Sleep efficiency was negatively correlated with low frequency HRV (p?=?0.002). Conclusions: Sleep components are associated with resting ANS activity, and targeted interventions focused on improved ANS functioning may benefit sleep quality in college students.     

Daytime Sleepiness,Poor Sleep Quality,Eveningness Chronotype,and Common Mental Disorders Among Chilean College Students

Abstract

Objectives: To evaluate whether daytime sleepiness, poor sleep quality, and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. Methods: A total of 963 college students completed self-administered questionnaires that collected information about sociodemographic characteristics, sleep quality characteristics, CMDs, and other lifestyle behaviors. Results: The prevalence of CMDs was 24.3% (95% confidence interval [CI] [21.5%, 27.1%]) among all students. Prevalence estimates of both excessive daytime sleepiness and poor sleep quality were higher among females (35.4% and 54.4%) than males (22.0% and 45.8%). Cigarette smoking was statistically significantly and positively associated with having CMDs (p = .034). Excessive daytime sleepiness (odds ratio [OR] = 3.65; 95% CI [2.56, 4.91]) and poor sleep quality (OR = 4.76; 95% CI [3.11, 7.29]) were associated with increased odds of CMDs. Conclusion: Given the adverse health consequences associated with both sleep disorders and CMDs, improving sleep hygiene among college students is imperative to public health.     

Predictors of well-being among college students

ABSTRACT

Objectives: Identification of health-related risk behaviors associated with well-being in college students is essential to guide the development of health promotion strategies for this population. The purposes were to evaluate well-being among undergraduate students and to identify health-related risk behaviors that predict well-being in this population. Methods: A cross-sectional Web-based survey of undergraduate students was conducted at a metropolitan university in the Southeast United States. A total of 568 students responded (response rate 14.2%). Data were collected on health-related risk behaviors using the National College Health Assessment II. Results: Controlling demographic characteristics, the best predictive model included physical activity, current tobacco user, depression, ever received mental health services, and sleep quality, which was the strongest predictor (β = .45, p < .001). This model explained 35% of the variance in well-being. Conclusions: Interventions that promote sleep quality among college students may be most beneficial in improving well-being.     

Mobile MyPlate: A Pilot Study Using Text Messaging to Provide Nutrition Education and Promote Better Dietary Choices in College Students

Abstract

Objective: To evaluate the acceptance and effectiveness of repetitive nutrition-related text messages on college students’ nutrition knowledge and fruit and vegetable consumption. Participants: One hundred fifty undergraduate (18–24 years old) non–health major students with a texting mobile phone. Methods: The intervention group received biweekly text messages of the MyPlate icon and the United States Department of Agriculture's Dietary Guidelines (DGs) for 7 weeks. The control group received the same information in a mailed brochure. A pre and post online survey assessed the students’ knowledge and behavior. Results: The intervention resulted in greater MyPlate food group recognition (p <.05) compared with control and a trend toward improved knowledge of the DGs. In the intervention group, fruit consumption was elevated (p <.05) and a trend toward elevated vegetable consumption was determined. No gender differences in intervention effectiveness exist. Conclusion: Texting repeated messages appears to be an acceptable and effective way to increase nutrition knowledge and promote positive diet-related behaviors in college students.     

Charlotte Attitudes Towards Sleep (CATS) Scale: A validated measurement tool for college students

Objective: Using a 4-phase study design, the present study developed and tested the Charlotte Attitudes Towards Sleep (CATS) Scale, a measurement tool for assessing sleep attitudes in college students. Participants: Participants were 706 undergraduate students recruited at a southeastern university and on a national recruitment Web site between October 2013 and April 2015. Methods: All participants completed the CATS Scale. Participants then completed either a measure of social desirability, faulty sleep beliefs, or measures of sleep and sleep hygiene. Phase 3 participants (N = 168) completed the CATS Scale 2 weeks later to examine test-retest reliability. Results: Analyses indicated that the scale was content valid, internally consistent, and independent of social desirability, yielded acceptable temporal stability, and demonstrated concurrent validity in relation to sleep behaviors and outcomes. Conclusions: The CATS Scale is a theoretically driven instrument with promising psychometric properties that may prove beneficial for future research and application efforts among college students.     

Sleep Quality and Alcohol Risk in College Students: Examining the Moderating Effects of Drinking Motives

Abstract

Objective: Sleep problems and alcohol misuse are common issues experienced by college students that can have detrimental effects on overall health. Previous work indicates a strong relationship between poor sleep quality and alcohol risk in this population. This study explored the moderating effect of drinking motives in the relationship between global sleep quality and experience of alcohol-related negative consequences. Participants: College students (N = 1,878) who reported past-month drinking. Methods: Participants completed online surveys assessing sleep and alcohol-related behaviors. Results: Poorer sleep quality and higher drinking motives (coping, conformity, and enhancement) predicted greater alcohol-related consequences, controlling for drinking. Further, coping motives moderated the relationship between sleep quality and consequences such that participants reporting poor sleep and high coping motives experienced heightened levels of consequences. Conclusions: These findings advance the understanding of the relationship between sleep problems and alcohol-related risk and provide implications for targeted campus-based health promotion interventions.     

Differences in Sleep Quality and Health-Related Quality of Life in Young Adults With Allergies and Asthma and Their Healthy Peers

Abstract

Objective: The current study examined the relationship between sleep quality and health-related quality of life (HRQOL). Participants: Participants were 501 undergraduate students with allergies (167), asthma + allergies (167), or with no history of a chronic illness (167) completed study measures from August 2011 to April 2012. Methods: The undergraduate students completed questionnaires online as part of a larger study of psychosocial adjustment of young adults. Results: Young adults with allergies and asthma + allergies reported significantly worse sleep quality and HRQOL than healthy peers. Additionally, those with allergies and asthma + allergies had significantly more sleep disturbances and used sleeping medication significantly more often in the previous month than healthy peers. Conclusions: These results highlight concerns regarding quality of life and sleep problems in an often-overlooked population. Importantly, sleep difficulties can result in difficulties in daily living and impairment in academic functioning.     

Relationship of sleep quality and attention deficit hyperactivity disorder symptoms with quality of life in college students

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) negatively influences various aspects of life such as social relations, adaptive skills, and occupation. In addition, many university students experience sleep problems, academic failure, and low quality of life (QOL). We investigated the relationship among ADHD symptoms, sleep quality, and QOL of college students, and identified the factors related to their QOL. Participants and Methods: Using a survey questionnaire, data were collected from 195 students from March–May 2017. Results: QOL of students was related to ADHD symptoms and sleep quality. Factors significantly associated with better QOL were fewer ADHD symptoms, good sleep quality, male sex, high academic performance, and high economic status. The explanatory power of these variables on QOL was 32.0%. Conclusion: To improve the QOL of college students, a multifaceted approach that includes assessment of ADHD symptoms and sleep quality is needed.     

The impact of a health education intervention on health behaviors and mental health among Chinese college students

Abstract

Objective: This study aimed to assess the impact of a health education intervention on health behaviors, self-efficacy, and well-being among college students. Participants: Between March and October 2016, a total of 532 undergraduates participated. Methods: A theory-based intervention was conducted at Wuhan University, China. Participants were assigned to a control or intervention group (IG). The IG attended a 7-week health education class on knowledge, attitude, and practice of health behaviors. Results: Participants in the IG, compared with those in the control group (CG), reported significantly increased prevalence of high physical activity and regular breakfast, as well as lower screen time, sugar beverage intake, and Internet addiction tendency. Furthermore, intervention students improved in health behavior scores (p?=?0.040), compared with the CG, while the changes in subjective well-being and self-efficacy remained similar between the two groups. Conclusions: Health education may promote health behaviors among Chinese college students.     

A person-centered analysis of sleep and emotion dysregulation: Short- and long-term links with depression and alcohol use

Objective: Our objective was to examine the co-occurrence of sleep problems and emotion dysregulation and its short- and long-term links to depressive symptoms and alcohol use in a sample of university students. Method: Participants included 1132 first-year university students from Southern Ontario (70.5% women). Time 1 data were collected in February/March, 2010, and Time 2 data (n?=?746) were collected in February/March, 2014. Participants were surveyed about sleep problems and emotion dysregulation (Time 1), and depressive symptoms and alcohol use (Times 1 and 2). Results: A latent class analysis revealed four groups: (1) Low Co-Occurrence, (2) Sleep Problems Only, (3) Emotion Dysregulation Only, and (4) High Co-occurrence. Group 4 had more depressive symptoms than all other groups in both the short- and long-term. Conclusions: First year university students with high co-occurrence of sleep problems and emotion dysregulation may be a target group for programs focused on reducing adjustment difficulties.     

Sleep Quality and Body Mass Index in College Students: The Role of Sleep Disturbances

Abstract

Objective: Obesity and its comorbidities have emerged as a leading public health concern. The aim of this study was to explore the relationship between body mass index (BMI) and sleep patterns, including duration and disturbances. Methods: A convenience sample of 515 college students completed an online survey consisting of the Pittsburgh Sleep Quality Index (PSQI), and self-reported height and weight to calculate BMI. Univariate and multivariate logistic regression analyses were performed using components of the PSQI as predictors of overweight (BMI ≥ 25). Results: One-third of the participants had BMI ≥ 25, and 51% were poor-quality sleepers (PSQI > 5). Controlling for age and sex, only sleep disturbances were associated with overweight (odds ratio = 1.66, 95% confidence interval [1.08, 2.57]). Conclusions: Sleep disturbances, rather than sleep duration, predicted overweight among young adults; this is consistent with the most recent evidence in the literature. These findings support expanding the scope of wellness programs to promote healthy sleep among students.     

Sleep Patterns of College Students at a Public University

Objective: The authors' purpose in this study was to determine the sleep patterns of college students to identify problem areas and potential solutions. Participants: A total of 313 students returned completed surveys. Methods: A sleep survey was e-mailed to a random sample of students at a North Central university. Questions included individual sleep patterns, problems, and possible influencing factors. Results: Most students reported later bedtimes and rise times on weekends than they did on weekdays. More than 33% of the students took longer than 30 minutes to fall asleep, and 43% woke more than once nightly. More than 33% reported being tired during the day. The authors found no differences between freshmen, sophomores, juniors, seniors, and graduate students for time to fall asleep, number of night wakings, or total time slept each night. Conclusions: Many students have sleep problems that may interfere with daily performance, such as driving and academics. Circadian rhythm management, sleep hygiene, and white noise could ameliorate sleep difficulties.     

Depression,anxiety, and tobacco use: Overlapping impediments to sleep in a national sample of college students

ABSTRACT

Objectives: To examine how tobacco use and depression/anxiety disorders are related to disturbed sleep in college students. Participants: 85,138 undergraduate respondents (66.3% female, 74.5% white, non-Hispanic, ages 18–25) from the Spring 2011 American College Health Association–National College Health Assessment II database. Methods: Multivariate analyses of tobacco use (none, intermediate, daily) and mental health (diagnosed and/or symptomatic depression or anxiety) were used to predict sleep disturbance. Results: Daily tobacco use was associated with more sleep problems than binge drinking, illegal drug use, obesity, gender, and working >20 hours/week. Students with depression or anxiety reported more sleep disturbances than individuals without either disorder, and tobacco use in this population was associated with the most sleep problems. Conclusions: Tobacco use and depression/anxiety disorders are both independently associated with more sleep problems in college students. Students with depression and/or anxiety are more likely to be daily tobacco users, which likely exacerbates their sleep problems.     

Heart checks in college-aged students link poor sleep to cardiovascular risk

Objective: To describe the relationships between the cardiovascular health, lifestyle behaviors, and lifestyle beliefs among college-aged students.

Participants: Seven hundred and twenty-nine college-aged students participated between October 2016 and April 2017.

Methods: Heart checks, consisting of a cross-sectional survey and biometric screening, were conducted on a large Midwestern university campus.

Results: A small proportion of students (24.5%) engaged in the recommended 150+ minutes of physical activity per week and 7.9% consumed 5+ servings of fruit/vegetables daily. Half (49.6%) slept 7 hours or less per night. Biometric screenings found that 26.4% of the students had high stress, 31.9% were overweight or obese, and 17.3% had prehypertension or hypertension. Less sleep was significantly associated with higher risks of being stressed, being overweight/obese, and having elevated blood pressure.

Conclusions: Early detection, treatment, and education is critical to identify individuals at risk for cardiovascular disease and to promote healthy lifestyle changes before heart disease develops or progresses.     

Promoting healthy transition to college through mindfulness training with first-year college students: Pilot randomized controlled trial

Objective: Given the importance of developmental transitions on young adults' lives and the high rates of mental health issues among U.S. college students, first-year college students can be particularly vulnerable to stress and adversity. This pilot study evaluated the effectiveness and feasibility of mindfulness training aiming to promote first-year college students' health and wellbeing. Participants: 109 freshmen were recruited from residential halls (50% Caucasian, 66% female). Data collection was completed in November 2014. Methods: A randomized control trial was conducted utilizing the Learning to BREATHE (L2B) program, a universal mindfulness program adapted to match the developmental tasks of college transition. Results: Participation in the pilot intervention was associated with significant increase in students' life satisfaction, and significant decrease in depression and anxiety. Marginally significant decrease was found for sleep issues and alcohol consequences. Conclusions: Mindfulness-based programs may be an effective strategy to enhance a healthy transition into college.     

Therapeutic Effects of an Outdoor Activity Program on Nursing Home Residents with Dementia

Abstract

Objective: The purpose of this one-year pilot study was to obtain preliminary information on the effects of an outdoor activity program, in comparison to an indoor activity program, on sleep and behavior in nursing home residents with dementia. Structured activity programs have been shown to improve dementia-related behavior problems, and there are some indications that improved behavior is associated with improved sleep. Previous research has shown that sleep disturbance is common in nursing home residents, and that limited exposure to light bright enough to entrain circadian rhythms contributes to their sleep problems. Thus, we expected to see improvements in behavior in both the outdoor and indoor activity groups, but improvements in sleep in the outdoor activity group only.

Methodology: A two-group (outdoor program, indoor program) two phase (baseline, intervention) design was used. Subjects were randomized to the outdoor or indoor program groups. Sleep and behavior disturbance were assessed over a 10-day period at baseline (usual activity conditions, which were expected to include little or no time spent outdoors) and at intervention (daily structured activity program offered outdoors or indoors). Sleep was assessed with wrist actigraphs with photocells, which also allowed for monitoring of light exposure. Behavior disturbance was assessed with the Cohen-Mansfield Agitation Inventory. Both activity programs were offered Monday-Friday over a 2 week period, included similar content and were offered by research project staff. The analytical approach emphasized primary changes between baseline and intervention measures of sleep and behavioral symptoms in the two activity groups. Because this was a pilot study, the significance level was set a priori at p< 0.10.

Findings: The outdoor activity group experienced significant improvements in maximum sleep duration. Both groups showed significant improvements in total sleep minutes. There also was a significant improvement in verbal agitation in the outdoor activity group.