Association of Stress, General Health, and Alcohol Use with Poor Sleep Quality among U.S. College Students

Teresa D. Valerio, Myoung Jin Kim, and Kathy Sexton-Radek

Sleep quality is foundational to cognitive, psychomotor, and emotional functioning. Because these abilities are critical for college students to succeed, it is particularly alarming that 20% to 60% of college students report poor quality sleep. College students are especially vulnerable to sleep problems due to their social maturity level and to self-imposed stress stemming from their increased educational and social demands. Despite a few promising interventions, sleep quality has not improved over the last decade. Instead, sleep problems are increasing among college students, and the consequences of poor sleep are mounting to serious proportions. Unfortunately, health educators, administrators, and other key personnel on college campuses seeking to improve both students’ health and their academic performance have little guidance about how these are affected by sleep quality. In this article, we outline the research literature on poor sleep among students and its associated problems, analyze data revealing both the national scope of the problems and specific factors associated with poor sleep, and recommend focusing campus health interventions on sleep quality issues.

The 2011 Sleep in America Poll survey documented that young adult sleepers (age 19 to 29 years) frequently reported sleep disturbances and were identified as one of the cohorts at risk for developing sleep disorders.5 Sleep disorders in young adults have reached an epidemic level in the United States, creating a significant public health problem. For example, in a public poll of 293 Generation Y-ers (aged 19–29 years), 23% said that they get an inadequate amount of sleep, 51% do not get good sleep, 67% often feel unrefreshed from their sleep, and 66% admitted they have driven when drowsy. Symptoms of poor sleep quality and/or quantity, such as excessive daytime sleepiness and tiredness, occur more than 2 days a week in 25% to 50% of U.S. college students. Beyond the United States, poor sleep quality in college students is also found in many countries. Furthermore, college students with poor sleep quality experience significant function and chronic disease– related problems. Sleep problems have been consistently identified for over 10 years as a top issue affecting academic performance. Reduced sleep quality has been associated with increased stress, use of marijuana and alcohol, and motor vehicle crashes. Wilner found that college students with poor sleep quality had higher levels of anxiety, depression, hostility, interpersonal sensitivity, obsessive–compulsive behaviors, phobic anxiety somatization, and psychoticism disorders per clinician rating. The negative correlation between poor sleep and emotional health, physical health, academic achievement and retention, and quality of life is clear, and it may last a lifetime.

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