Sleep duration, subjective sleep disturbances and associated factors among university students in Korea

Frequency and Factors of Sleep Paralysis Among Medical Students of Karachi

INTRODUCTION

Sleep paralysis is a prevalent phenomenon characterized by suffocation, immobility, and hallucinations. Its causes remain unknown, although the neurotransmitter imbalance is suggested as a potential factor. This condition is closely associated with hallucinations and a sense of intrusion, often observed in patients with narcolepsy, hypertension, and seizures.

METHODS

A cross-sectional study was conducted in various medical colleges in Karachi, involving 297 participants aged 18 to 30 years. The participants were divided into groups based on gender and year of study. They were surveyed about the frequency of sleep paralysis episodes, their beliefs about the phenomenon, sleep routines, and academic impacts.

RESULTS

Among the respondents, a significant number of females (n=209, 70.3%) reported experiencing sleep paralysis. The overall mean age was 20±2.0 years. Correlation analysis revealed an insignificant relationship between depression and mental anxiety (p=0.147). Similarly, no significant association was found when comparing the occurrence of sleep paralysis (p=0.16). However, a notable finding was the significant link between sleep paralysis and its impact on academics (p=0.043).

CONCLUSION

This study highlighted the frequency of sleep paralysis among medical students, particularly among females. Furthermore, it emphasizes the diverse beliefs held by individuals regarding these frightening episodes. To address this neglected issue, it is essential to conduct awareness sessions aimed at understanding and alleviating sleep paralysis in individuals' lives.

Developing and validating a university needs instrument to measure the psychosocial needs of university students

BACKGROUND

University students are four times more likely to experience elevated levels of psychological distress compared to their peers. The psychosocial needs of university students are associated with high psychological distress, stressful life events, and academic performance. Our study focuses on developing a measure to help universities identify these psychosocial needs.

AIMS

The study aimed to develop and validate the factor structure of the University Needs Instrument and identify the relationship between psychosocial needs, psychological distress and academic performance among university students.

SAMPLE

Undergraduate university students (N = 511) currently studying at university.

METHOD

Participants completed demographic questions, the University Needs Instrument and the Kessler-10 Psychological Distress scale. The University Needs Instrument comprises 30 items within six psychosocial factors (academic support, financial support, support from family, support from friends, practical support and emotional support), each consisting of five items.

RESULTS

Confirmatory factor analysis showed that all items significantly loaded on the six hypothesized factors. The hypothesized model was supported by the data displaying excellent model fit and psychometric properties. Our analysis determined that the UNI has strong internal consistency. The results also confirmed that university students' high levels of psychological distress and their academic performance may be affected by their psychosocial needs.

CONCLUSIONS

Our findings have provided an initial validation of the UNI to help screen and identify the psychosocial needs of university students. This scale can be used to identify the appropriate psychosocial support that can be offered to students and in turn could help reduce their psychological distress, improve their psychosocial well-being and increase academic performance.

Variability in energy expenditure is much greater in males than females

In mammals, trait variation is often reported to be greater among males than females. However, to date, mainly only morphological traits have been studied. Energy expenditure represents the metabolic costs of multiple physical, physiological, and behavioral traits. Energy expenditure could exhibit particularly high greater male variation through a cumulative effect if those traits mostly exhibit greater male variation, or a lack of greater male variation if many of them do not. Sex differences in energy expenditure variation have been little explored. We analyzed a large database on energy expenditure in adult humans (1494 males and 3108 females) to investigate whether humans have evolved sex differences in the degree of interindividual variation in energy expenditure. We found that, even when statistically comparing males and females of the same age, height, and body composition, there is much more variation in total, activity, and basal energy expenditure among males. However, with aging, variation in total energy expenditure decreases, and because this happens more rapidly in males, the magnitude of greater male variation, though still large, is attenuated in older age groups. Considerably greater male variation in both total and activity energy expenditure could be explained by greater male variation in levels of daily activity. The considerably greater male variation in basal energy expenditure is remarkable and may be explained, at least in part, by greater male variation in the size of energy-demanding organs. If energy expenditure is a trait that is of indirect interest to females when choosing a sexual partner, this would suggest that energy expenditure is under sexual selection. However, we present a novel energetics model demonstrating that it is also possible that females have been under stabilizing selection pressure for an intermediate basal energy expenditure to maximize energy available for reproduction.

The Effects of Anthropomorphism, Message Framing, and Voice Type on Unhealthy Sleep Behavior in Young Users: The Mediating Role of Risk Perception

Insufficient sleep is a severe social public health problem that can adversely affect the physical and mental health of young people. This study examined risk perceptions for unhealthy sleep behaviors and intentions for healthy sleep behaviors under different combinations of anthropomorphism, message framing, and voice type in cartoons. We used a three-factor between-subject experiment of two (anthropomorphism: anthropomorphic vs. non-anthropomorphic) × two (message framing: positive frame vs. negative frame) × two (voice type: cartoon child voice vs. adult female voice) design. We examined the effects of different audiovisual combinations of cartoon attitude, risk perception, and behavioral intention and the mediating role of risk perception. The research results show that (1) the integration of anthropomorphic design elements can positively impact users’ attitudes toward cartoons; (2) when the interface information is presented in a negative frame, anthropomorphism can more positively influence users’ attitudes toward cartoons than non-anthropomorphism; and (3) anthropomorphism, message framing, and voice type in cartoons significantly interact with risk perception. In addition, risk perception mediates the influence of anthropomorphism, message framing, and voice type on behavioral intention.

Sleep quality and its correlates among undergraduate medical students in Nepal: A cross-sectional study

Poor sleep quality has been found to affect students' learning abilities, academic performance, and interpersonal relationships. However, little is known about this issue in Nepal. This study aimed to identify the factors associated with poor sleep quality among undergraduate medical students in Nepal. A web-based survey was conducted in March 2021 among 212 undergraduate medical students at the Institute of Medicine, Kathmandu, Nepal. Sleep quality was measured using a 19-item Pittsburgh Sleep Quality Index (PSQI). Multivariable logistic regression analysis was done to assess the factors associated with sleep quality. In the study participants, 38.2% of the students were identified as poor sleepers. Factors like being depressed (AOR = 4.5, 95% CI; 1.2-5.4), current alcohol use (AOR = 2.5, 95% CI; 1.8-10.8), poor academic achievement (AOR = 3.4, 95% CI; 1.1-10.9), and being a fourth-year student (AOR = 3.6, 95% CI; 1.1-11.8) were significantly associated with poor sleep quality. Poor sleep quality was common among undergraduate medical students. Routine screening of sleep quality and depressive symptoms is necessary to mitigate their impact among medical students. Medical students of the fourth year, current alcohol users, and those who did not have good academic achievement had poor sleep quality. Special attention on these population subgroups is thus needed to enhance sleep quality.

Asociación entre alteraciones en el sueño y problemas de salud mental en los estudiantes de Medicina durante la pandemia de la COVID-19

Introduction

Medical students are a population vulnerable to poor sleep quality and sleep deprivation; these problems were accentuated during the COVID-19 pandemic. The objective was to evaluate the association between sleep disturbances and the presence of depression and anxiety in medical students during the pandemic.

Materials and methods

Cross-sectional, analytical study in medical students of a private university in Peru. Data were collected from May 22 to June 14, 2020, after 3 months of mandatory social isolation. The Patient Health Questionnaire (PHQ-9; ≥ 10), the Generalized Anxiety Disorder (GAD-7; ≥ 10) scale and the Insomnia Severity Index (ISI; ≥ 8) were used to assess depression, anxiety and insomnia, respectively. Poisson regressions with robust variance were used to calculate prevalence ratios.

Results

The prevalence of depression, anxiety and insomnia was 28.5%, 29.5% and 60.1% respectively. It was found that those who had short sleep (RPa: 1.40, CI: 1.05-1.87, p: 0.024), who slept after 2:00 hours (RPa: 2.24, CI: 1.31-3.83, p: 0.003) and who presented insomnia (RPa: 7.12, CI: 3.70-13.73, p: < 0.001) had a higher prevalence of anxiety. Likewise, those who slept after 2:00 hours (RPa: 2.13, CI: 1.24-3.64, p: 0.006) and those who presented insomnia (RP: 8.82, CI: 4.17-18.68, p: < 0.001) had a higher prevalence of depression.

Conclusions

Short sleep, bedtime and insomnia are factors associated with the prevalence of depression and anxiety.

Sex differences in the factors associated with sleep duration in university students: A cross-sectional study

BACKGROUND

Insufficient sleep duration among university students was commonly associated with many detrimental effects. University students experience substantial environmental and psychological changes. Female and male university students may differ in many spheres. However, most research on sleep duration of university students is based on an aggregate sample rather than digging the sex-specific profiles. The objective of this study is to examine potential sex differences in the correlates of sleep duration and explore the underlying mechanism of correlations.

METHODS

This is a large-scale university-based mental health survey, which was conducted in university students in Qinghai Province in Northwest China in December 2019. A multi-stage logistic regression was separately fitted by sex to examine the factors associated with short sleep duration in university students.

RESULTS

A total of 5,552 university students with an average sleep duration of 6.88 h (SD = 1.04) were included, among which 35.0% of the participants may currently be sleeping less than the optimal duration. Female students (6.84 h, SD = 1.00) slept shorter than males (6.94 h, SD = 1.09). The only parallel between sexes was that both female and male students with 3-5 times weekly breakfast were less likely to have short sleep duration. Adjusting for depressive symptoms in the following step eliminated the association between anxiety symptoms and short sleep duration in the model for female students. Female-specific associated factors with short sleep duration were age, grade, academic pressure, weekly physical exercise, depressive symptoms. Male-specific characteristics were current smoking tobacco cigarette, self-perceived health, duration of daily Internet use.

CONCLUSION

Characteristic profiles of sleep duration differed between female and male university students; only a few male-specific factors were identified. Psychological guidance and education courses as well as other interventions to improve university students' sleep and related health should be designed and implemented based on sex differences.

Sleep Deprivation and Its Associated Factors Among Undergraduate Students in Malaysia

This cross-sectional study examines the prevalence of sleep deprivation and its associated factors among 1017 undergraduate students in Malaysia. Sociodemographic and lifestyle factors such as smoking, alcohol, dietary habits, Internet/smartphone use, physical activity, and sedentary behavior were assessed. Sleep deprivation was defined as sleeping less than 7 hours in a day. There were almost equal proportions of females (51.0%) and males (49.0%), and the average age was 20.71 ± 1.47 years. Prevalence of sleep deprivation was 58.1% and its associated factors were students in Year 3 (adjusted odds ratio [AOR] = 0.52, 95% confidence interval [CI] = 0.35-0.77) and Year 4 (AOR = 0.65, 95% CI = 0.45-0.95), Chinese ethnicity (AOR = 0.44, 95% CI = 0.34-0.59), Indian ethnicity (AOR = 0.49, 95% CI = 0.25-0.96), and consuming fast food more than once a week (AOR = 0.69, 95% CI = 0.51-0.93). Understanding the associated lifestyle factors with sleep deprivation among young generation will be beneficial to develop public health policies and programs to tackle the issue.

Smoking and risk of sleep-related issues: a systematic review and meta-analysis of prospective studies

OBJECTIVES

Smoking has many deleterious consequences on health, one of which can be sleep-related issues. Therefore, a meta-analysis was performed with the aim of pooling results from studies on the relationship between smoking and sleep-related issues.

METHODS

The present study follows PRISMA guidelines. Databases were searched by both researchers to find the articles. The review was done up to December 2018. In order to analyze the results of the screened articles, statistical indexes were converted to logarithms and the studies were combined with each other. Finally, several analyses were conducted with respect to various subgroups. In the subgroup analysis, the pool index of the studies was determined and the degree of heterogeneity in each subgroup was presented. Meta-regression was also used.

RESULTS

Smoking is associated with a risk of developing sleep-related issues. Risk ratio (1.47; 1.20-1.79) for smokers was higher than for non-smokers. Egger's test and Begg's test indicated publication bias.

CONCLUSIONS

Smoking is associated with sleep-related issues. Informing smokers about the effects of smoking on sleep issues can be effective in reducing and preventing its consequences.

Perception and simplified question for assessing problems sleeping among university students at a primary care unit

Introduction:

Students entering university undergo various lifestyle changes, many of which may affect their sleeping habits. This study aimed to evaluate 1) individual perception of the problems sleeping, 2) “actual“ problems sleeping as detected using a simplified questionnaire, 3) the relationship between individual perceptions and actual problems sleeping, and 4) the factors affecting the problems sleeping.

Methods and Material:

This was a descriptive study of 240 university students who attended the “123 Primary Care Unit“ for no sleep-related problems between March and June 2019. The tool was a self-response questionnaire that assessed the respondent's demographic data and sleep patterns over the past year. All parameters and problems sleeping were analyzed for their association.

Results:

Most of the students (51.3%) perceived themselves as having problems sleeping. Actual problems sleeping was found in 174 (72.5%) students. Individual perception was significantly related to the presence of all four of the problems sleeping assessed, which included difficulty in initiating sleep, waking up at night and being unable fall back to sleep, the need for daytime napping, and the feeling that one is sleep deprived (P < 0.05).

Conclusions:

This study provides a simplified method for assessing problems sleeping among university students at a primary care facility. Most of the students had problems sleeping and accurate perceptions of those problems sleeping, but the problems sleeping were often ignored. Further improvements to the system for screening and treating problems sleeping are required.

Poor sleep quality and associated factors among prisoners of the Diredawa correctional facility in eastern Ethiopia

BACKGROUND

Impaired sleep quality affects judgment, psychomotor skills, memory, decision-making, concentration, and attention. It might also contribute to the development of new physical health problems, as well as exacerbating already existing physical problems. Despite this, there is a scarcity of research done in Africa including Ethiopia that addressed this issue. So this study assessed the quality of sleep and related factors among prisoners of the Diredawa correctional facility, Diredawa, eastern Ethiopia.

METHODS

A cross-sectional study was done using a simple random sampling technique to recruit 421 participants from May 21 to June 21; 2017. A semi-structured questionnaire, Pittsburgh Sleeps Quality Index (PSFIG), Patient Health Questionnaire-9 (PQ-9), and Sleep Hygiene Index (SHI) were used to assess participants' socio-demographic data, sleep quality, depression, and sleep hygiene, respectively. The collected data were entered into EPA-data 3.1 and analyzed by using SPAS-20. Descriptive and analytical statistics were used. Bivariate and multivariable logistic regression with odds ratio and 95% CI were employed. The statistical significance was declared at p value < 0.05.

RESULTS

A total of 421 out of 423 prisoners were interviewed, resulting in a response rate of 99.5%. The prevalence of poor sleep quality was 227 (53.9%) with 95% CI (49.2, 58.7). Having co-morbidity of depression (adjusted odds ratio; OAR = 3.47, 95% CI 1.38,8.76), lifetime use of cigarette (OAR = 2.16, 95% CI 1.21,5.58), marijuana and hashish (OAR = 5.02, 95% CI 1.63,15.46), current use of coffee (OAR = 2.75, CI 1.37, 7.05), poor sleep hygiene (OAR = 3.19, CI 1.32,7.69), committing assault crime (OAR = 4.12, CI 1.29,10.63) and crime of rape (OAR = 5.57, CI (1.45, 13.89) were the associated factors for poor sleep quality in this study.

CONCLUSION

More than half of the participants (53.9%) have poor sleep quality. Depression, lifetime use of cigarettes, using cannabis and hashish, current use of coffee, poor sleep hygiene, and crime types were the associated factors that should be taken into consideration and evaluated early to minimize poor sleep quality.

Sex-specific associations between sleep and mental health in university students: a large cross-sectional study

Objective: To examine the associations between sleep problems and mental health dimensions in university students, and the effect of sex on these associations. Participants: Self-reported survey data from 3,483 students aged 18-30 years was drawn from a larger web-based study (i-Share) conducted in France in the years 2013-2017. Methods: We performed logistic regression analyses stratified by sex using insufficient sleep duration, poor sleep quality, difficulty initiating sleep and excessive daytime sleepiness, in relation with stress, self-esteem, depression and anxiety. Results: All sleep problems were strongly associated with all mental health dimensions, particularly anxiety, in female students. Sleep and mental health problems were also associated in male students, with the exception of low self-esteem, but odds ratios were lower than for female students. Conclusions: Present findings warrant attention to propose early interventions targeting sleep and mental health in the university setting taking sex into account.

Predictors of behaviour change for unhealthy sleep patterns among Indian dental students

OBJECTIVE

The present study aimed at determining predictors of sleep behaviour change among dental students using the multi-theory model (MTM) of health behaviour change in India.

METHODS

This study was conducted among 535 students of a dental college in India. Predictors of sleep behaviour change were assessed using a validated 30-item questionnaire. Theoretical predictors of sleep behaviour were modelled using multiple linear regression.

RESULTS

The response rate was 95.10%. A total of 449 of 535 students filled in the form, out of which 127 (28.30%) were inadequate sleepers. Inadequate sleep behaviour showed a strong preponderance within the male population (81.9%). The percentage of inadequate sleepers was highest in second year undergraduates and those obtaining between 60 and 69.9% marks in previous exams. For the initiation model, the standardised regression coefficients (β) for the three constructs - participatory dialogue, behavioural confidence and change in physical environment were 0.050 [p = 0.579, 95% (confidence interval)CI: -0.039 to 0.070], 0.213 (p = 0.019, 95% CI: 0.029-0.320) and 0.062 (p = 0.496, 95% CI: -0.073 to 0.149), respectively. For the sustenance model, β for emotional transformation, practice for change and changes in social environment was 0.192 (p = 0.047, 95% CI: 0.002-0.250), 0.175 (p = 0.091, 95% CI: -0.024 to 0.318) and 0.046 (p = 0.623, 95% CI: -0.094 to 0.157), respectively.

CONCLUSION

Improving behavioural confidence and bringing about emotional transformation were significant predictors for a reduction in inadequate sleep behaviour in dental students. Working on these predictors may improve sleep behaviours in dental students.

[Sleep quality and its parameters in schoolchildren]

AIM

Sleep disorders are very common among teenagers. One of possible reasons is a discrepancy between social and biological activity of children. It is known that adolescents with a late chronotype (e.g., a later midpoint of sleep) have a lowered academic achievement. The aim of our study was to evaluate sleep quality and other sleep-wake characteristics in relation to academic scores self-reported by teenagers living in urban and rural areas of Republic of Karelia.

MATERIAL AND METHODS

Five hundred respondents, aged 10-17 years, participated in a questionnaire survey of chronotype and sleep quality. The Munich chronotype questionnaire (MCTQ) and the Pittsburgh Sleep Quality Index (PSQI) were used. Sleep duration during week and weekend, sleep quality and hygiene were assessed.

RESULTS AND CONCLUSION

A decrease in sleep duration in adolescents, aged 10-18 years, was observed. A larger social jetlag was significantly higher in girls compared to boys. Gender had a significant impact on sleep quality. More than 10% of the total variation in academic achievement of Karelian teenagers can be explained by the difference in their gender and average sleep duration.

Eveningness is associated with skipping breakfast and poor nutritional intake in Brazilian undergraduate students

Some studies have proposed that self-reported eveningness, which reflects the preference of performing activities in the evening, may harm nutritional health and influence the eating behavior and nutritional status of individuals. However, the relationship between these variables (eveningness and nutritional status) and the consumption of breakfast, which is currently considered a marker of health, has been insufficiently explored by studies. The aim of this study was to investigate, in undergraduate students, the association between diurnal preference, being overweight, and food consumption (with special focus on breakfast). The study included 721 undergraduate students from a Brazilian public university. Dietary intake was assessed by 24-hour food recall, and the usual time for breakfast was identified. Body weight, height, and waist circumference were measured by trained researchers. Diurnal preference was determined by the Horne and Ostberg questionnaire validated for the Brazilian population, and the participants were classified into three categories: evening (coefficient: 16-41), intermediate type (coefficient: 42-58) or morning type (coefficient: 59-86). The prevalence of skipping breakfast was higher among the evening types (p = 0.02), when compared with morning and intermediate types. A negative association between the diurnal preference coefficient and total caloric (coefficient -0.25, p = 0.007, r² adjusted = 0.12), carbohydrate (coefficient -0.19, p = -0.04, r² adjusted = 0.04) and lipid intake (coefficient -0.18, p = 0.04, r² adjusted = 0.05) was also found in the breakfast skippers but not in breakfast eaters. In other words, breakfast skippers with diurnal preference values indicative of eveningness consumed more calories, carbohydrates and fats. Evening types presented significant odds of skipping breakfast (OR = 1.7, CI = 1.1-2.9, p = 0.02) when compared with morning and intermediate chronotypes. We conclude that eveningness is associated with skipping breakfast and a higher consumption of calories, carbohydrates and fats in breakfast skippers. These eating behaviors may predispose these individuals to being overweight.

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.

Relationships of Sleep Duration With Weight-Related Behaviors of U.S. College Students

This study describes sleep behaviors of U.S. college students (N = 1,252; 18-24 years old; 59% female) and examines associations of sleep duration with weight-related behaviors. More than one quarter of participants slept < 7 hr/night and had mean Pittsburgh Sleep Quality Index (PSQI) scores indicating poor sleep quality. There were significant differences for all PSQI scales among sleep duration categories, < 7 hr (n = 344), 7-8 hr (n = 449), ≥ 8 hr (n = 459) sleep/night. Compared to those who slept ≥ 8 hr, those who slept < 8 hr had significantly more negative eating attitudes (2% higher), poorer internal regulation of food (4% lower), and greater binge eating (4% higher) scores. Findings advocate for health care professionals to evaluate sleep behaviors of college students during office visits and promote good sleep behaviors.

Sleep in university students across years of university education and gender influences

Purpose: Assessment of the influence of gender and increasing years at university on sleep health of students.

Methods: Four hundred and eighteen students from different streams across years of undergraduate to postgraduate courses participated. Descriptive statistics, test of differences, and correlation were used. The sleep health data comprised of subjective evaluation using a questionnaire and personal interviews.

Results: Overall, 43.1% had sleep problems, females were more affected (51.67% vs. 48.33% in males) but were early bed goers. The prevalence of circadian rhythm sleep disorder (11.6% vs. 9.5%) and delayed sleep phase syndrome (4.5% vs. 2.7%) was slightly higher in males. The daytime dysfunction and hypnotic use significantly differed in students of the same class among gender. Bedtime got significantly delayed along years [H(2)=29.769, p<0.001], and hypnotic use [H(2)=8.807, p=0.012] differed significantly among them. The moderate-very strong correlational statistics among sleep health elements was very similar across gender and years of university education. However, more pronounced influence of years of university education than gender was seen in the significant differences for correlated correlation among sleep health parameters.

Conclusion: Gender and years of university education influence sleep among university students both separately and concomitantly.

Correlates of self-reported sleep duration in middle-aged and elderly Koreans: from the Health Examinees Study

Though various factors related to fluctuations in sleep duration have been identified, information remains limited regarding the correlates of short and long sleep duration among the Korean population. Thus, we investigated characteristics that could be associated with short and/or long sleep duration among middle-aged and elderly Koreans. A total of 84,094 subjects (27,717 men and 56,377 women) who participated in the Health Examinees Study were analyzed by using multinomial logistic regression models. To evaluate whether sociodemographic factors, lifestyle factors, psychological conditions, anthropometry results, and health conditions were associated with short and/or long sleep duration, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated with sleep duration of 6-7 hours as the reference group, accounting for putative covariates. Regardless of sexual differences, we found that adverse behaviors and lifestyle factors including low educational attainment, unemployment, being unmarried, current smoking status, lack of exercise, having irregular meals, poor psychosocial well-being, frequent stress events, and poor self-rated health were significantly associated with abnormal sleep duration. Similarly, diabetes mellitus and depression showed positive associations with abnormal sleep duration in both men and women. Our findings suggest that low sociodemographic characteristics, adverse lifestyle factors, poor psychological conditions, and certain disease morbidities could be associated with abnormal sleep duration in middle-aged and elderly Koreans.

Sleep disturbances among medical students: a global perspective

Medical students carry a large academic load which could potentially contribute to poor sleep quality above and beyond that already experienced by modern society. In this global literature review of the medical students' sleep experience, we find that poor sleep is not only common among medical students, but its prevalence is also higher than in non-medical students and the general population. Several factors including medical students' attitudes, knowledge of sleep, and academic demands have been identified as causative factors, but other potential mechanisms are incompletely understood. A better understanding about the etiology of sleep problems in medical trainees is essential if we hope to improve the overall quality of medical students' lives, including their academic performance. Sleep self-awareness and general knowledge appear insufficient in many studied cohorts, so increasing education for students might be one beneficial intervention. We conclude that there is ample evidence for a high prevalence of the problem, and research in this area should now expand towards initiatives to improve general sleep education for medical students, identify students at risk, and target them with programs to improve sleep.

Nocturnal sleep problems among university students from 26 countries

BACKGROUND

The aim of this study is to estimate the prevalence of nocturnal sleeping problems and its associated factors among university students in mainly low- and middle-income countries.

METHODS

A cross-sectional survey was conducted with 20,222 undergraduate university students (mean age, 20.8; SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas.

RESULTS

Overall, 10.4% reported severe or extreme nocturnal sleeping problems (male, 10.2%; female, 10.5%) in the past month. Noctural sleeping problems differed by country, from 32.9% in Indonesia to 3.0 % in Thailand among Asian countries, from 13.7% in Mauritius to 7.5% in South Africa, and from 11.8% in Jamaica to 6.1% in Columbia in the Americas. In multivariate logistic regression analysis, coming from a poor family background, staying off campus (on their own or with parents or guardians), stress (history of child sexual abuse), poor mental health (depression and PTSD symptoms), health risk behaviour (tobacco use, heavy internet use, gambling, skipping breakfast and having sustained an injury), lack of social support and poor academic performance were associated with nocturnal sleeping problems.

CONCLUSIONS

A significant prevalence of past-month nocturnal sleeping problems was found. Potential factors associated with the risk of reporting sleeping complaints were identified, which may assist in prevention strategies to promote a better quality of sleep.

[Correlation between anthropometric indicators and sleep quality among Brazilian university students]

The current study investigated the correlation between anthropometric indicators and sleep quality among Brazilian university students using the Pittsburgh Sleep Quality Index. A cross-sectional assessment with 702 university students was conducted between March 2010 and June 2011. Results showed that cases of obesity were more frequent among students who were good sleepers. On the other hand, overweight and high cervical and abdominal circumference was most prominent among poor sleepers. Thus, apart from the damage caused by sleep disorders alone, additional risks due to the association between poor sleep quality and being overweight, central obesity, and increased cervical perimeter are highlighted.

Association of sociodemografic factors and sleep quality in brazilian university students

The aim of this study was to analyze relationship between sociodemographic factors and poor sleep quality in Brazilian university students. Cross-sectional study, surveyed 701 students in Fortaleza, Ceará, Brazil. We applied a questionnairre with sociodemographic questions and Pittsburgh Sleep Quality Index. We did not identify associations and/or statistically significant linear trends between sleep quality and sociodemographic analyzed factors. However, the analysis found that the relative risk in college aged > 31 years, in those who lived alone and with relatives (other than parents) there is greater vulnerability to poor sleep quality.

A longitudinal examination of the bidirectional association between sleep problems and social ties at university: the mediating role of emotion regulation

Despite the growing body of research linking sleep problems and social ties, research investigating the direction of effects between these two constructs is lacking. Furthermore, there remains a dearth of research examining the mechanisms that may explain the association between sleep problems and social ties within a longitudinal design. The present 3-year longitudinal study addressed two research questions: (1) Is there a bidirectional association between sleep problems and social ties at university? and (2) Does emotion regulation mediate the association between sleep problems and social ties at university? Participants (N = 942, 71.5% female; M = 19.01 years at Time 1, SD = 0.90) were university students who completed annual assessments of sleep problems, social ties, and emotion regulation, for three consecutive years. Results of path analysis indicated that the bidirectional association between sleep problems and social ties was statistically significant (controlling for demographics, sleep-wake inconsistency, sleep duration, and alcohol). Analyses of indirect effects indicated that emotion regulation mediated this link, such that better sleep quality (i.e., less sleep problems) led to more effective emotion regulation, which, subsequently, led to more positive social ties. In addition, more positive social ties led to more effective emotion regulation, which, in turn, led to less sleep problems. The findings highlight the critical role that emotional regulation plays in the link between sleep problems and social ties, and emphasize the need for students as well as university administration to pay close attention to both the sleep and social environment of university students.

Avaliação da qualidade do sono de estudantes universitários de Fortaleza-CE

O objetivo desta pesquisa foi avaliar a qualidade do sono de estudantes universitários de Fortaleza, Ceará, Brasil. Estudo transversal foi realizado com 701 alunos da Universidade Federal do Ceará, entre março e junho de 2011. Foi aplicado o Índice de Qualidade do Sono de Pittsburgh. A maioria dos universitários tinha uma qualidade subjetiva do sono ruim (54%), latência e eficiência do sono inferior a 15 minutos (60, 1%) e a 65% (99%), respectivamente. A duração do sono da amostra foi de 6, 3 horas diárias (DP±1, 4 horas) (p<0.001). A análise dos dados evidenciou que parcela substancial dos universitários investigados (95, 3%) possui má qualidade do sono. É determinante operacionalizar ações de promoção da saúde nas universidades para que o próprio acadêmico atue na construção da sua qualidade de sono.

Secular changes in sleep duration among Australian adults, 1992-2006

OBJECTIVE

To determine whether sleep duration of Australian adults has declined over recent years.

DESIGN

Analysis of nationally representative data from repeated cross-sectional time-use surveys conducted in 1992, 1997 and 2006.

SETTING

Private households in Australia.

PARTICIPANTS

Respondents aged 15 years and over (N = 21 195) who completed time-use diaries over two consecutive days.

MAIN OUTCOME MEASURE

Change in sleep duration by sociodemographic group.

RESULTS

Mean sleep duration was 8 h 20 min in 1992, 8 h 33 min in 1997, and 8 h 30 min in 2006 (SEM for all years, 1 min). After adjustment for sampling during weekends and different seasons, there was no significant change in sleep duration from 1992 to 2006 (adjusted difference, 2 min; 95% CI, -2 to 5 min; P = 0.33). The only significant decreases in sleep duration were observed in people aged 65 years and over (adjusted difference, 12 min; 95% CI, 4-19 min; P < 0.001), people with no income (adjusted difference, 17 min; 95% CI, 7-27 min; P = 0.001) and male carers (adjusted difference, 31 min; 95% CI, 9-53 min; P = 0.002), although people in these groups reported over 8 h sleep on average.

CONCLUSIONS

Most Australian adults were not sleeping less in 2006 than they did in 1992. Public health concerns over declining sleep duration do not appear to be warranted. Investigation of possible changes in quality of sleep is required.

Sleep characteristics, sleep problems, and associations of self-efficacy among German university students

BACKGROUND

Sleep problems, especially insomnia, are a common complaint among adults. International studies on university students have shown prevalence rates between 4.7% and 36.2% for sleep difficulties, and 13.1% and 28.1% for insomnia. Sleep problems are associated with lower social and academic performance and can have a severe impact on psychological and physical health.

OBJECTIVE

The goal of this study was to outline sleep characteristics, prevalence of sleep problems, insomnia, and associations with self-efficacy among German university students.

METHODS

A total of 2196 university students (70.9% women; mean age 24.16 years) participated in the study. Sleep characteristics, sleep problems, insomnia, and self-efficacy were assessed using a questionnaire.

RESULTS AND CONCLUSION

Analyses revealed that more than 16% of surveyed students needed more than 30 minutes to fall asleep. About 7.7% of the students suffered from insomnia. Short sleep was significantly associated with a considerably increased rate of insomnia (20%). Insomniacs showed lower self-efficacy than students without sleep problems.

Sleep habits and sleep problems among Palestinian students

AIM

The aim of this study was to describe sleep habits and sleep problems in a population of undergraduates in Palestine. Association between self-reported sleep quality and self-reported academic achievement was also investigated.

METHODS

Sleep habits and problems were investigated using a convenience sample of students from An-Najah National University, Palestine. The study was carried out during spring semester, 2009. A self-administered questionnaire developed based on The Diagnostic and Statistical Manual of Mental Disorders IV criteria and Pittsburgh Sleep Quality Index was used.

RESULTS

400 students with a mean age of 20.2 ± 1.3 were studied. Reported mean duration of night sleep in the study sample was 6.4 ± 1.1 hours. The majority (58.3%) of students went to bed before midnight and 18% of the total sample woke up before 6 am. Sleep latency of more than one hour was present in 19.3% of the students. Two thirds (64.8%) of the students reported having at least one nocturnal awakening per night. Nightmares were the most common parasomnia reported by students. Daytime naps were common and reported in 74.5% of the study sample. Sleep quality was reported as "poor" in only 9.8% and was significantly associated with sleep latency, frequency of nocturnal awakenings, time of going to bed, nightmares but not with academic achievement.

CONCLUSION

Sleep habits among Palestinian undergraduates were comparable to those reported in European studies. Sleep problems were common and there was no significant association between sleep quality and academic achievement.

Neuropsychological effects of sleep loss: implication for neuropsychologists

There is rapidly accumulating evidence of a close relationship between sleep loss and cognition. Neuropsychologists need to become aware of this body of knowledge as the effects of sleep loss on brain functions are significant. The current study (a) outlines the extent to which insufficient sleep affects performance on cognitive tasks in otherwise healthy people, (b) discusses the relationship between sleep and neurocognitive disorders, and (c) highlights key issues that merit consideration for neuropsychologists. This review shows that sleep loss has a measurable impact on performance through decreases in cognitive functions and effects on biological pathways that support cognitive performance. Sleep loss reliably produces reductions in speed of processing and attention. Higher order cognitive functions are affected to a lesser extent, and there is sparing on tasks of crystallized abilities. Deficits worsen with increasing time awake, but may be overturned after normal sleep is resumed. The review also shows that sleep disorders are a major feature of neuropsychological conditions contributing to the pattern of cognitive impairment. Overall, neuropsychologists must be alert to sleep problems in their clients, so that sleep interventions, or referrals, are put in place in the rehabilitation plan of individuals with cognitive dysfunctions. Recommendations also include routine screening of sleep as part of cognitive assessment.

Perceived connections between information and communication technology use and mental symptoms among young adults - a qualitative study

Background

Prospective associations have been found between high use of information and communication technology (ICT) and reported mental symptoms among young adult university students, but the causal mechanisms are unclear. Our aim was to explore possible explanations for associations between high ICT use and symptoms of depression, sleep disorders, and stress among young adults in order to propose a model of possible pathways to mental health effects that can be tested epidemiologically.

Methods

We conducted a qualitative interview study with 16 women and 16 men (21-28 years), recruited from a cohort of university students on the basis of reporting high computer (n = 28) or mobile phone (n = 20) use at baseline and reporting mental symptoms at the one-year follow-up. Semi-structured interviews were performed, with open-ended questions about possible connections between the use of computers and mobile phones, and stress, depression, and sleep disturbances. The interview data were analyzed with qualitative content analysis and summarized in a model.

Results

Central factors appearing to explain high quantitative ICT use were personal dependency, and demands for achievement and availability originating from the domains of work, study, social life, and individual aspirations. Consequences included mental overload, neglect of other activities and personal needs, time pressure, role conflicts, guilt feelings, social isolation, physical symptoms, worry about electromagnetic radiation, and economic problems. Qualitative aspects (destructive communication and information) were also reported, with consequences including vulnerability, misunderstandings, altered values, and feelings of inadequacy. User problems were a source of frustration. Altered ICT use as an effect of mental symptoms was reported, as well as possible positive effects of ICT on mental health.

Conclusions

The concepts and ideas of the young adults with high ICT use and mental symptoms generated a model of possible paths for associations between ICT exposure and mental symptoms. Demands for achievement and availability as well as personal dependency were major causes of high ICT exposure but also direct sources of stress and mental symptoms. The proposed model shows that factors in different domains may have an impact and should be considered in epidemiological and intervention studies.

A study on the sleep patterns and problems of university business students in Hong Kong

OBJECTIVE

To investigate sleep patterns and problems of university business students.

PARTICIPANTS

Undergraduate Chinese business students in Hong Kong.

METHODS

Self-reported questionnaires were completed during class lectures and through online system.

RESULTS

Of the 620 participating students (mean age 19.9 years), sleep duration was significantly shorter during weekdays (6.9 hours) than weekends (8.6 hours). Two thirds of students reported sleep deprivation. The following factors were associated with being a "poor sleeper" (Pittsburgh Sleep Quality Index > 5): attending early morning lectures (odds ratio [OR] = 1.90), living on-campus (OR = 1.89), Sleep Sufficiency Index less than 0.8 (OR = 2.55), sleep debt (differences of total time-in-bed between weekday and weekend > or = 75 minutes) (OR = 1.58), and minor psychiatric disturbances (OR = 2.82).

CONCLUSIONS

Poor sleep quality and sleep deprivation were prevalent in university business students in Hong Kong, especially for those attending early morning lectures and living on-campus. Systemic education on the importance of sleep and stress and time management is needed for university students.

Perceived Sleep Quality and Sleepiness in South African University Students

Little is known about the sleep habits of South African students. The objectives in this study were to evaluate sleep habits and daytime behaviours of South African university students and to examine possible factors associated with their sleep quality and daytime sleepiness. Nine hundred and eighty-six undergraduate students completed a questionnaire about their sleep and lifestyle habits over the previous month, and their fatigue-related driving history. Sleep habits were similar for male and female students, although male students went to bed later and had fewer night-time awakenings. Black students went to bed significantly later than white and Asian students and woke earlier than white students during the week; consequently they were more likely to have a shorter time in bed than white students. Black students were more likely to nap than white students, possibly to supplement their overall sleep amount. Sleep quality and daytime sleepiness were not influenced by gender or ethnicity. Twenty percent of the students reported having ever fallen asleep while driving and 2% reported having had a fatigue-related accident; these findings have implications for road safety. Eighteen percent of the students reported poor sleep quality, although few students (4%) had consulted a doctor about a sleeping problem. Logistic multiple regression modeling revealed that poor sleep quality was associated with the following factors: long sleep onset latency; night-time awakenings; late bed times; use of sleep medication; not getting enough sleep; and low energy. Based on the Epworth Sleepiness Scale, 44% of the students had a high propensity for daytime sleepiness, which was associated with not getting enough sleep, consuming more caffeinated beverages, daytime napping, and having no/little energy. Daytime sleepiness and associated factors in South African students need to be investigated further and it is recommended that students be better informed about sleep problems and their consequences. First-line help-professionals such as psychologists, doctors, and healthcare workers should be better trained to support students with sleep problems.

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 patterns in college students: gender and grade differences

OBJECTIVE

Since gender effect is inconsistent and grade effect has not been addressed in previous studies, we investigated both effects on the daily sleep patterns in a group of young college students.

METHODS

The sample consisted of 237 students aged 18-24 years. Each subject completed a 7-day sleep log.

RESULTS

Gender differences were found in several sleep variables and those were mostly not dependent on weekday/weekend difference. The female students went to bed and rose earlier and had longer sleep latency, more awakenings, and poorer sleep quality than the male. Gender differences were also shown in the relationship between sleep quality and other sleep variables. The correlation between sleep quality and rise time, time in bed, and sleep efficiency was stronger in men than in women. In contrast, grade differences were mostly dependent on weekday/weekend difference. The freshmen rose earlier and had shorter sleep time than did the other students on weekdays only. Sleep latency was the longest in seniors on weekdays only.

CONCLUSION

This study showed that gender differences in sleep patterns and sleep difficulties were remarkable in the group of young college students. Alarmed by the high prevalence of sleep difficulties among general college students, it is recommended that the students should be informed of their sleep problems and the consequences.