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Du C, Adjepong M, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Keaver L, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Amoah-Agyei F, de Kanter E, Wang W, Tucker RM. Gender Differences in the Relationships between Perceived Stress, Eating Behaviors, Sleep, Dietary Risk, and Body Mass Index. Nutrients 2022; 14:nu14051045. [PMID: 35268020 PMCID: PMC8912409 DOI: 10.3390/nu14051045] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/22/2022] [Accepted: 02/26/2022] [Indexed: 02/01/2023] Open
Abstract
Background: Obesity is a growing epidemic among university students, and the high levels of stress reported by this population could contribute to this issue. Singular relationships between perceived stress; engagement in restrained, uncontrolled, and emotional eating; sleep; dietary risk; and body mass index (BMI) have been reported in the current body of literature; however, these constructs interact with each other, and the complex relationships among them are infrequently examined. Therefore, the aim of the present study was to explore the complex relationships between these constructs using mediation and moderation analyses stratified by gender. Methods: A cross-sectional study, enrolling university students from the United States (U.S.), the Netherlands, South Korea, Malaysia, Ireland, Ghana, and China, was conducted between October 2020 and January 2021 during the COVID-19 pandemic. Perceived stress; maladaptive eating behaviors including restrained, uncontrolled, and emotional eating; sleep duration and quality; dietary risk; and BMI were assessed using validated questionnaires, which were distributed through an online platform. Results: A total of 1392 students completed the online survey (379 male, 973 female, and 40 who self-identified as “other”). Uncontrolled and emotional eating mediated the relationship between perceived stress and dietary risk for both males and females; higher sleep quality weakened this relationship among female students but not males. Emotional eating mediated the relationship between perceived stress and BMI for both males and females, but higher sleep quality weakened this relationship only among females. Conclusions: Our findings suggest that students in higher education are likely to benefit from interventions to reduce uncontrolled and emotional eating. Programs that improve sleep quality, especially during highly stressful periods, may be helpful.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
| | - Mary Adjepong
- Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; (M.A.); (F.A.-A.)
| | - Megan Chong Hueh Zan
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Min Jung Cho
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.); (E.d.K.)
| | - Jenifer I. Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland;
| | - Heesoon Lee
- Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Mary-Jon Ludy
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Wan Shen
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Jyothi Thrivikraman
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.); (E.d.K.)
| | - Felicity Amoah-Agyei
- Department of Biochemistry, Kwame Nkrumah University of Science and Technology, Kumasi 00233, Ghana; (M.A.); (F.A.-A.)
| | - Emilie de Kanter
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.); (E.d.K.)
| | - Wenyan Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (W.W.)
- Correspondence: ; Tel.: +1-517-353-3408
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Gonsalvez I, Li JJ, Stevens C, Chen JA, Liu CH. Preexisting Depression and Daytime Sleepiness in Women and Men. Behav Sleep Med 2022; 20:380-392. [PMID: 34003712 PMCID: PMC8599528 DOI: 10.1080/15402002.2021.1924720] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Sleep problems can persist following the treatment of depression and remission of symptoms. The extent to which having a previous history of depression may be associated with current daytime sleepiness is largely unknown. METHODS Data were obtained from the spring 2017 American College Health Association-National College Health Assessment (ACHA-NCHA) survey (92 institutions) which assessed self-reported health in U.S. college students (n = 41,670). Among the sample, 93.5% were 18-24 year of age, and 69.6% women. Logistic regression estimated the association between reported prior lifetime diagnosis of depression and daytime sleepiness from the past 7 days, while adjusting for depressive symptoms and antidepressant use from the past year. Unadjusted and adjusted logistic regression models stratified by gender were performed. RESULTS Among those who reported problems with sleepiness, 31.6% women and 19.4% men had a preexisting depression diagnosis. Individuals with preexisting depression were more likely than those without this diagnosis to report sleepiness problems (women: OR = 1.4, CI = 1.3-1.6, p < .001; men: OR = 1.2, CI = 1.0-1.4, p < .01). However, this association differed significantly by gender, with women with a preexisting depression diagnosis having a 13.0% greater likelihood of sleepiness compared to men. CONCLUSIONS Those with a preexisting depression diagnosis, and specifically women, may be at risk for daytime sleepiness even in the absence of current depressive mood-related symptoms. Given that many individuals are at risk for daytime sleepiness, mental health initiatives, including those on college campuses, should incorporate sleep hygiene within their programming.
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Affiliation(s)
- Irene Gonsalvez
- Department of Psychiatry, St. Elizabeth’s Medical Center, Brighton, MA, USA,Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
| | | | | | - Justin A. Chen
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cindy H. Liu
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Harvard Medical School, Boston, MA, USA,Department of Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA,Corresponding Author: Cindy H. Liu, PhD, Tel: 617-525-4131
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Goel NJ, Sadeh-Sharvit S, Trockel M, Flatt RE, Fitzsimmons-Craft EE, Balantekin KN, Monterubio GE, Firebaugh ML, Wilfley DE, Taylor CB. Depression and anxiety mediate the relationship between insomnia and eating disorders in college women. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:976-981. [PMID: 31971482 PMCID: PMC7375933 DOI: 10.1080/07448481.2019.1710152] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/27/2019] [Accepted: 12/22/2019] [Indexed: 05/20/2023]
Abstract
Objective: This study examined the associations between insomnia, anxiety, and depression in college women with eating disorders (EDs). Participants: Six hundred and ninety women from 28 US colleges who screened positive for an ED were assessed for psychiatric comorbidities. Women were, on average, 22.12 years old, mostly White (60.1%) and undergraduates (74.3%). Methods: Two mediation models were tested to determine if depression and/or anxiety mediated the relationship between insomnia and ED symptomatology. Results: One-fifth of the sample (21.7%) reported clinically moderate and severe levels of insomnia. Both depression (B = .13, p <. 001) and anxiety (B = .13, p <. 001) significantly mediated the relationship between insomnia and ED psychopathology. Conclusions: Insomnia is relatively common in college-age women with EDs. Findings suggest that this association between ED and sleep disturbances can be explained, in part, by changes in depression and anxiety. Clinicians should consider incorporating mental health assessments for insomnia, depression, and anxiety into current ED prevention, intervention, and screening efforts on college campuses.
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Affiliation(s)
- Neha J Goel
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
- Institute for Inclusion, Inquiry and Innovation (iCubed), Virginia Commonwealth University, Richmond, VA, USA
| | - Shiri Sadeh-Sharvit
- Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for m2Health, Palo Alto University, Palo Alto, CA, USA
| | - Mickey Trockel
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Rachael E Flatt
- Department of Psychology and Neurosciences, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Grace E Monterubio
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Marie-Laure Firebaugh
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Denise E Wilfley
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - C Barr Taylor
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
- Center for m2Health, Palo Alto University, Palo Alto, CA, USA
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Du C, Wang W, Hsiao PY, Ludy MJ, Tucker RM. Insufficient Sleep and Poor Sleep Quality Completely Mediate the Relationship between Financial Stress and Dietary Risk among Higher Education Students. Behav Sci (Basel) 2021; 11:bs11050069. [PMID: 34063082 PMCID: PMC8147970 DOI: 10.3390/bs11050069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 11/16/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic worsened financial stress for higher education students in the U.S. Financial stress is associated with poor dietary behaviors; however, factors that might influence this relationship are not well characterized. The present cross-sectional study investigated the associations between financial stress and dietary intake and dietary risk scores among higher education students (undergraduate and graduate students) in the U.S. and examined whether poor sleep quality and short sleep duration mediated the relationship between financial stress and dietary risk score. Validated tools were used to assess financial stress, sleep quality, sleep duration, dietary intake, and dietary risk. A total of 1280 students from three large U.S. universities completed the study. Results indicated that higher financial stress was associated with lower vegetable, fruit, fiber, and calcium intake, higher added sugar intake from sugar sweetened beverages, and higher dietary risk score. Further, the positive relationship between financial stress and dietary risk score was completely mediated by poor sleep quality among students who reported poor sleep quality and by short sleep duration among students who slept less than 7 h per night. These findings suggest that students might benefit from both financial management training and sleep education services to reduce undesirable dietary behaviors.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (W.W.)
| | - Wenyan Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (W.W.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Mary-Jon Ludy
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (W.W.)
- Correspondence: ; Tel.: +1-517-353-3408
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Estevan I, Sardi R, Tejera AC, Silva A, Tassino B. Should I study or should I go (to sleep)? The influence of test schedule on the sleep behavior of undergraduates and its association with performance. PLoS One 2021; 16:e0247104. [PMID: 33690625 PMCID: PMC7946303 DOI: 10.1371/journal.pone.0247104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 02/01/2021] [Indexed: 01/01/2023] Open
Abstract
Sleep is crucial for college students' well-being. Although recommended sleep duration is between 7-9 hours per day, many students do not sleep that much. Scholar demands are among the causes of observed sleep deprivation in youth. We explored the influence of having a school test on previous night sleep in first-year students and the association of sleep duration and test performance. We ran two surveys in freshman students of the Universidad de la República, Montevideo, Uruguay: 1) 97 students of the School of Sciences who took the test at the same time; and 2) 252 School of Psychology students who took the test in four successive shifts. More than 1/2 of the participants (survey #1) and almost 1/3 (survey #2) reported short regular sleep duration (< 7h). In both samples, the sleep duration of the night before the test was reduced with respect to regular nights (survey #1: 2.1 ± 0.2 h, p < 0.001; survey #2: between 1.7 ± 0.4 h and 3.6 ± 0.3 h, all p < 0.001), with more than 10% of the students who did not sleep at all. In survey 2, sleep duration increased in later shifts (F (3,248) = 4.6, p = 0.004). Using logit regressions, we confirmed that sleep duration was positively related to test scores in both samples (survey #1: exp B = 1.15, p < 0.001; pseudo-R2 = 0.38; survey #2: exp B = 1.03, p < 0.001; pseudo-R2 = 0.25). Delaying test start time may prevent the reduction in sleep duration, which may also improve school performance. In addition, educational policies should include information for students about the impact of sleep on learning and of the consequences of reduced sleep duration.
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Affiliation(s)
- Ignacio Estevan
- Programa de Neuropsicología y Neurobiología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
- * E-mail:
| | - Romina Sardi
- Programa de Neuropsicología y Neurobiología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Ana Clara Tejera
- Programa de Neuropsicología y Neurobiología, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
| | - Ana Silva
- Laboratorio de Neurociencias, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
| | - Bettina Tassino
- Sección Etología, Facultad de Ciencias, Universidad de la República, Montevideo, Uruguay
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Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai CC, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Tseng KW, Tseng WC, Doak S, Folk SYL, Tucker RM. The Effects of Sleep Quality and Resilience on Perceived Stress, Dietary Behaviors, and Alcohol Misuse: A Mediation-Moderation Analysis of Higher Education Students from Asia, Europe, and North America during the COVID-19 Pandemic. Nutrients 2021; 13:442. [PMID: 33572863 PMCID: PMC7911351 DOI: 10.3390/nu13020442] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/22/2021] [Accepted: 01/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has increased the already high levels of stress that higher education students experience. Stress influences health behaviors, including those related to dietary behaviors, alcohol, and sleep; yet the effects of stress can be mitigated by resilience. To date, past research studying the connections between dietary behaviors, alcohol misuse, sleep, and resilience commonly investigated singular relationships between two of the constructs. The aim of the current study was to explore the relationships between these constructs in a more holistic manner using mediation and moderation analyses. METHODS Higher education students from China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands, and the United States were enrolled in a cross-sectional study from April to May 2020, which was during the beginning of the COVID-19 pandemic for most participants. An online survey, using validated tools, was distributed to assess perceived stress, dietary behaviors, alcohol misuse, sleep quality and duration, and resilience. RESULTS 2254 students completed the study. Results indicated that sleep quality mediated the relationship between perceived stress and dietary behaviors as well as the relationship between perceived stress and alcohol misuse. Further, increased resilience reduced the strength of the relationship between perceived stress and dietary behaviors but not alcohol misuse. CONCLUSION Based on these results, higher education students are likely to benefit from sleep education and resilience training, especially during stressful events.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (S.Y.L.F.)
| | - Megan Chong Hueh Zan
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Min Jung Cho
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Jenifer I. Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (S.Y.L.F.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Richard Hsiao
- Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (L.K.); (S.D.)
| | - Chang-Chi Lai
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - HeeSoon Lee
- Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Mary-Jon Ludy
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Wan Shen
- Department of Public and Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Jyothi Thrivikraman
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Kuo-Wei Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Wei-Chin Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Stephen Doak
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland; (L.K.); (S.D.)
| | - Sara Yi Ling Folk
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (S.Y.L.F.)
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (S.Y.L.F.)
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Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai CC, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Tseng KW, Tseng WC, Almotwa J, Feldpausch CE, Folk SYL, Gadd S, Wang L, Wang W, Zhang X, Tucker RM. Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk. Clocks Sleep 2021; 3:12-30. [PMID: 33467418 PMCID: PMC7838912 DOI: 10.3390/clockssleep3010002] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/11/2022] Open
Abstract
Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Megan Chong Hueh Zan
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Min Jung Cho
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Jenifer I. Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Richard Hsiao
- Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland;
| | - Chang-Chi Lai
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - HeeSoon Lee
- Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Mary-Jon Ludy
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Wan Shen
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Jyothi Thrivikraman
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Kuo-Wei Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Wei-Chin Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei 11153, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Juman Almotwa
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Clare E. Feldpausch
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Sara Yi Ling Folk
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Suzannah Gadd
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Linyutong Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Wenyan Wang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Xinyi Zhang
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
| | - Robin M. Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.); (J.A.); (C.E.F.); (S.Y.L.F.); (S.G.); (L.W.); (W.W.); (X.Z.)
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Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai CC, Lee H, Ludy MJ, Shen W, Swee WCS, Thrivikraman J, Tseng KW, Tseng WC, Tucker RM. Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries. Clocks Sleep 2020; 2:334-353. [PMID: 33089208 PMCID: PMC7573806 DOI: 10.3390/clockssleep2030025] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 08/05/2020] [Indexed: 12/12/2022] Open
Abstract
High levels of perceived stress and anxiety among university students are a global concern and are known to negatively influence sleep. However, few studies have explored how stress response styles, like psychological resilience and rumination, might alter these relationships. Using validated tools, perceived stress, anxiety, stress response styles, and sleep behaviors of undergraduate and graduate students from seven countries during the height of the COVID-19 pandemic were characterized in order to examine the relationships between these factors using mediation and moderation analyses. Students enrolled in universities in China, Ireland, Malaysia, Taiwan, South Korea, the Netherlands, and the United States were recruited in May 2020. A total of 2254 students completed this cross-sectional study. Perceived stress and anxiety were negatively associated with sleep quality through the mediation of rumination. Increased psychological resilience weakened the relationships between perceived stress and anxiety on sleep quality. The majority of students reported that COVID-19 negatively influenced their mental health and sleep quality but not sleep duration. Based on these results, university students would likely benefit from sleep education and mental health promotion programs that include trainings to increase psychological resilience and reduce rumination, particularly during times of increased stress.
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Affiliation(s)
- Chen Du
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.)
| | - Megan Chong Hueh Zan
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Min Jung Cho
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Jenifer I Fenton
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.)
| | - Pao Ying Hsiao
- Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Richard Hsiao
- Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA;
| | - Laura Keaver
- Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland;
| | - Chang-Chi Lai
- Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - HeeSoon Lee
- Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA;
| | - Mary-Jon Ludy
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Wan Shen
- Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA; (M.-J.L.); (W.S.)
| | - Winnie Chee Siew Swee
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia; (M.C.H.Z.); (W.C.S.S.)
| | - Jyothi Thrivikraman
- Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands; (M.J.C.); (J.T.)
| | - Kuo-Wei Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Wei-Chin Tseng
- Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan; (C.-C.L.); (K.-W.T.); (W.-C.T.)
| | - Robin M Tucker
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA; (C.D.); (J.I.F.)
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Prichard JR. Sleep Predicts Collegiate Academic Performance: Implications for Equity in Student Retention and Success. Sleep Med Clin 2019; 15:59-69. [PMID: 32005350 DOI: 10.1016/j.jsmc.2019.10.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
College students show high levels of insufficient sleep, excessive daytime sleepiness, sleep schedule irregularity, poor sleep quality, and inadequate sleep hygiene. This article describes the evidence linking poor sleep with impaired academic performance; discusses mediating environmental, behavioral, and demographic factors that correlate with sleep; and highlights examples of successful health promotion initiatives on college campuses. Given that students who are traditionally minoritized on college campuses tend to have worse sleep, improving sleep health emerges as an important issue for retention, equity, and inclusion.
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Affiliation(s)
- J Roxanne Prichard
- University of St. Thomas, 2115 Summit Avenue, JRC LL56, St Paul, MN 55105, USA.
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