Sleep Quality Among University Students: Evaluating the Impact of Smoking, Social Media Use, and Energy Drink Consumption on Sleep Quality and Anxiety

By Omar Afandi Et. Al.
2013, Vol. 5 No. 06 | pg. 1/3 |


Objectives: Identify the factors affecting quality of sleep, and assess the impact of low quality sleep on the daily activities of students.

Materials and Methods: A descriptive, cross-sectional survey was done, using self-administered questionnaires. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Data was collected, sleep quality was determined, and then data was analyzed using SPSS v.17 software.

Results: This study included 290 university students of different majors aged 17-29 years. Analysis of sleep perception revealed that 67.2% of students suffered from poor sleep. Non-smokers showed a better sleeping quality (25%) than smokers (75%). Of the students who never missed any class 62% had a good sleep pattern. Non-users of social networking, such as Facebook, MSN, and Twitter, had a better sleep quality than users. Poor sleep quality was strongly associated with higher anxiety level (p<0.001), and more morning classes missed (p<0.014).

Conclusion: Most university students suffer from poor sleep quality which is directly influencing behavior and anxiety levels.

University life is accompanied by many new stressful challenges, with increased freedom, self-responsibility, disorganized lifestyle, variable schedules, repeated deadlines, dormitory living, and social and academic obligations. In order to be able to cope with these challenges, students voluntarily alter their sleeping habits.

It accounts for one of the basic twenty four hours (circadian) rhythms, and can be seen in all species, including mammals, reptiles (Ropper, 2009). Sleep is the period in which the basic metabolic rate decreases, soft tissue and muscles are relaxed and revitalized, and the brain is able to process things that have been learned during the day (Clifford, 2007).

Harvard Women’s Health Watch states there aresix reasons for getting enough sleep, namelyfor improved learning and memory, maintenance ofmetabolism and weight,increased safety, enhanced mood, cardiovascular health and boosting up the immune system (Nicholoson, 2006). Prolonged periods of time with deprivation of sleep can lead to negative changes such as hallucinations, poor mental clarity, and often provoked disease, or even death. Many studies have directly correlated the majority of car accidents with lack of sleep (Clifford, 2007).

Students’ poor sleep habits and consequent poor sleep quality can have many mental, as well as physiological consequences. Students who spend their night getting one to two hours of less sleep have a tendency to accumulate a “sleep debt” which leads to excessive daytime sleepiness (Voelker, 2004; Teter, 2006). Deprivation of sleep to less than six to seven hours per day can lead to serious impairment of cognitive and psychomotor function(reduces concentration, memory and thinking strategies), daytime dysfunction, increased incidence of sleep related accidents (Teter, 2006; Banks, 2007; Brown, 2002), and diminished academic performance, often resulting in poor grades (Teter, 2006; Smith, 2005; Tsai, 2004).

It was noticed that students experiencing sleep deprivation try to avoid more difficult tasks (Trockel, 2009). Also, they often are not aware that the difficulties they are have academicallycan be directly relatedto their poor sleep quality (Engle-Friedman, 2003) and might get depressed about someone with a lower cognitive ability scoring better on a test than them, due to the fact that the latter had a better night’s sleep. This would explain the commonly heard comment, “I can’t understand why I did so badly, I spent all the previous day studying” (Engle-Friedman, 2003; Pilcher, 1997).

The poor academic performance in students having poor sleep qualitycould be connected to loss of REM sleep. Students who sleep less than eight hours per night miss some of the last two hours of REM sleep. Those two hours of REM sleep tend to be the most important for further processing of newly learned material (Buboltz, 2001; Smith, 2001; Smith, 1991). Therefore, if students experience sleep deprivation (with decreased REM sleep), irregular sleep schedules, or poor sleep quality, the rate at which they learn new material will be reduced (Buboltz, 2001). However, even if students sleep eight hours per night, if they shift their sleep/wake cycle by two hours, they may experience difficulty concentrating (Smith, 2004). Students meeting the criteria for delayed sleep phase disorder have been shown to have significantly lower grades, greater feelings of drowsiness, and more irritability compared to students without this sleeping disorder (Smith, 2004). Chronic shifting of the sleep/wake cycle has also been associated with feelings of depression, reduced affability, and increased irritability. Students who report excessive daytime sleepiness also disclose more frequent use of marijuana and alcohol and may potentially have a greater tendency to abuse caffeine and nicotine (Voelker, 2004; Smith, 2004).

Sleep deprivation can have serious side effects on different processes in our body, including endocrine, immunologic, metabolic and cardiovascular.The extents of these effects depend on how severe the sleep deprivation is (Teter, 2006; Buboltz, 2002).

When sleep is restricted to four hours per night in healthy young adults, abnormal endocrine responses (increased evening cortisol levels, increased sympathetic activation, decreased thyrotropin activity, and decreased glucose tolerance) and altered secretory patterns of appetite-regulating hormones (decreased leptin and increased ghrelin secretion) are observed. The latter effect is likely to increase appetite, which may promote weight gain and obesity (Banks, 2007).

Chronic sleep deprivation has also been associated with alteration of immune system function, the potential consequences being increased susceptibility to illness due to impaired host defenses (Smith, 1991) and activation of systemic inflammatory immune responses involved in the pathogenesis of insulin resistance and cardiovascular disease (Banks, 2007).

With respect to the latter, epidemiological studies have shown an increase in cardiovascular events in subjects averaging ≤5 or ≤7 hours of sleep per night (Smith, 1991). Other studies on the effects of insomnia have also shown that it can be an affective predictor of hypertension in adult males (Smith, 2004), and CAD mortality in middle-aged individuals (Suka, 2003). A high incidence of diabetes has also been observed in middle-aged males with sleep complaints or short-duration sleep (Mallon, 2002).

In addition, further studies of the effect of insomnia have established a link between poor sleep and risk for the development of mood changes, anxiety, suicidal tendencies, and substance abuse in young adults (Mallon, 2005; Ford, 1989; Breslau, 1996).

It is well known that sleep quality has neurobehavioral and physiological consequences that might affect students’ health, well-being, and academic functioningpositively or negatively. Therefore, the aim of the present study is to assess the different factors which affect the quality of sleep in students and correlate the effect of poor sleep quality with the performances and behaviors of related to students.

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