Q: How big an issue is sleep for college students? Fall 2012 - PDF document

10/22/2014 Q: How big an issue is sleep for college students?  Fall 2012 National College Health Assessment of A Campus ‐ Wide Intervention to Change the 28,237 undergraduates… Sleeping Habits of College Students  24 9% reported difficulty handling sleeping  24.9% reported difficulty handling sleeping issues Presented by Suzanne Bornschein, M.D., and Caroline Doyle, B.A.  19.7% reported sleep as a factor that affected their academic performance in some way A special thanks to Kathy Kelleher, RN, Tricia Leahey, Ph.D., Joseph Fava, Ph.D., and Kathryn Middleton, Ph.D.  73.4% reported that their college/university did not provide them with any information on sleeping difficulties (American College Health Association, 2012). “Health ‐ Related Variables and Academic Performance Among First ‐ Year College Students: Health Impediments to Academic Performance Implications for Sleep and Other Behaviors” Mickey T. Trockel, et al. Reduce the proportion of students who report JACH; Volume 49, Issue 3, 2000 that their academic performance was adversely affected by sleep difficulties in the past 12 y p p months. Baseline: 20.0 percent of students reported that sleep difficulties adversely affected their academic performance in the past 12 months in spring 2010 Target: 18.0 percent “Sleep and Academic Performance” “The Prevalence of Sleep Disorders in College 103 studies reviewed by Curcio, Ferrera and Gennaro Sleep Med Rev. 2006 Students: Impact on Academic Performance” JACA, Oct;10(5):323 ‐ 37. Jane F. Gaultney Volume 59, Issue 2, 2010 • Sleep loss/learning capacity/academic performance ‐ Elem.ed ‐ university • EDS= excessive daytime sleepiness • Older adolescents with adolescent physiology Older adolescents with adolescent physiology Sleep loss negatively correlated with academic • performance Many college students are at risk for sleep • disorders Sleep loss led to daytime sleepiness which also • • At risk for academic failure correlated with academic performance 1

10/22/2014 “The Relationship between Sleep Length and Grade Risk for a sleep disorder predicted • Point Average Among College Students” GPA (Kelly et al 2001) 147 college students GPA predicts student’s persistence in • 3 groups: college college • <6 hours/night • <6 hours/night • 7 ‐ 8/night • >9hrs/night • Identifying and successfully resolving sleep problems at the college level could Mean GPA of short sleepers = 0.5 points lower increase retention and graduation rates than long sleepers “Symptoms of sleep disorders and objective The State of Sleep Among College Students at a Large academic performance” Public University (Bizari and de Carvalho et al, 2013) (Orzech, et al, 2011) With/without symptoms of sleep disorders Poor sleep interacted with academics and mental • 5400 questionnaires to elementary schools in São Paulo, Brazil age 7 10 Brazil age 7 ‐ 10 health health academic grades in 2384 children • Education campaign positively affected student sleep breathing sleep disorders = increased risk for poor academic performance • Sleep may be gateway topic for health care professionals to address sensitive health issues such as depression Poorer sleep quality is “ The interplay between sleep and mood in predicting academic functioning, physical health and psychological associated with lower health: a longitudinal study.” (Lau , Wan, Cheung, Hui, Mok, 2013) emotion –regulation Sleep duration and quality have direct and • indirect (via mood) effects on college students‘: ( ) g ability • academic function physical • • and psychological health. • Findings underscore the importance of healthy sleep patterns for better adjustment in college Iris Mauss, Allison Troy years Cognition and Emotion, 2013 2

10/22/2014 Sleep Problems: Sleep deprivation =loss of sleep ‐ Deficits in attention ‐ Deficits in academic performance ‐ Drowsy driving ‐ Total sleep deprivation p p ‐ Risk taking behavior ‐ Partial sleep deprivation ‐ Depression ‐ Sleep fragmentation ‐ Impaired social relationships ‐ Poorer health “Social Jetlag Negatively Correlates with Sleep quality…. Academic Performance in Undergraduates” Chronobiology International: The Journal of Biological &Medical Rhythm Research. Jun 2014.  feeling rested on waking Socially enforced sleep times on  level of daytime sleepiness  level of daytime sleepiness weekends adversely affected k d d l ff t d  number of awakenings academic performance throughout the night (Harvey et al, 2008) Sleep and College Students Biological and social factors  Students wake up about 2 contribute to sleep deprivation: hours LATER on weekends, How to address? on average ( on average ( Lund et al, 2010 ) ) Simpler approach than Social jet lag ‐ The discrepancy convincing students to adopt between social and biological better sleep hygiene? time, between work and free days (Wittmann et al, 2006) 3

10/22/2014 “ Causes and Consequences of Sleepiness Among The Importance of Sleep College Students” Hershnerand Chewin Nature and Science of Sleep 2014:6 73 ‐ 84.  Sleep quality impacts physical and 50% college students reported daytime sleepiness mental health ( Tanaka, et al, 2002; Lund, et al, 2010) 70% reported insufficient sleep  Sleep deprivation increases likelihood of Interventions: developing diseases such as… • Sleep education classes  stroke, heart attack, hypertension, • Online programs depression, obesity and diabetes (Gupta et al, • Encouragement of naps 2002; Colten and Altevogt, 2006). • Adjustment of class time Working against our endogenous circadian clock: Breast Poor Sleep, Poor HF Outcomes: cancer and electric lighting in the modern world . Mutat Res. 2009 Routinely Test Sleep Quality? Nov-Dec;680(1-2):106-8. Breast cancer incidence increases rapidly as societies industrialize. Many changes occur during the industrialization Nighttime sleep that's process, one of which is a dramatic alteration in the lighted environment from a sun-based system to an electricity-based routinely poor quality was routinel poor qualit as system. Increasingly, the natural dark period at night is being t I i l th t l d k i d t i ht i b i seriously eroded for the bulk of humanity. Based on the fact that a significant predictor of light during the night can suppress melatonin, and also disrupt the circadian rhythm, it was proposed in 1987 that increasing use of electricity to light the night accounts in part for the rising risk of cardiac events Heart Failure Society of breast cancer globally. Predictions from the theory include: non- day shift work increases risk, blindness lowers risk, long sleep America (HFSA) 2014 Scientific Meeting duration lowers risk, and population level community nighttime light level co-distributes with breast cancer incidence . Worldwide prevalence of obesity has doubled since 1980. “Sleep and obesity” Beccutia and Pannaina, 2011 • In 2008, 1 in 10 adults was obese “…Epidemiological and laboratory evidence • Obesity epidemic has paralleled a trend of confirm an association between sleep loss and confirm an association between sleep loss and reduced sleep duration. i increased risk of obesity .” Poor sleep quality leads to overall sleep loss. Obesity could represent a Short sleep duration and poor sleep quality =risk ‘chronobiological disease ’ factors for the development of obesity. 4

10/22/2014 Impact: Behavioral sleep curtailment endemic in modern times -24/7 society • Later bedtimes -more evening and night-time work and leisure activities -sacrifice hours available for sleep sacrifice hours available for sleep. • Reduced total sleep time i major impact : -duration of dark exposure -disrupted organization of circadian rhythm • Opportunity to be active ….exposure to artificial light after sunset and often and ingest food during the before sunrise natural night Feeding represents a major Sleep is an important modulator of synchronizer of peripheral circadian neuroendocrine function and glucose clocks metabolism sleep loss results in metabolic and endocrine sleep loss results in metabolic and endocrine -found in virtually all tissues found in virtually all tissues alterations : -prolonged night-time wakefulness • decreased glucose tolerance • decreased insulin sensitivity leads to desynchrony between • increased evening concentrations of cortisol • increased levels of ghrelin/decreased levels of leptin central circadian and peripheral • increased hunger and appetite clocks Sleep regulates our The relationship between sleep and obesity appetite and fullness mediated by multiple pathways: • Orexin neurons +changes in appetite- regulating hormones - affects food intake • Ghrelin ( promotes hunger) increases with sleep restriction • Leptin (contributing to satiety) decreases 5