Subscribe to RSS
DOI: 10.1055/s-0044-1788288
Exploring Sleep Patterns in 3,475 College Students: A Comparative Study of Geographical Location, Gender, and Age
Abstract
Objective Sleep is a fundamental physiological process essential for maintaining overall health and optimal functioning across various cognitive, emotional, and physical domains. To cross-sectionally investigate the sleep pattern among college students according to geographical location, gender, and age.
Materials and Methods A total of 3,475 valid responses, 3,366 from 4 continents (Africa – n = 1,095; America – n = 182; Asia – n = 1,562; Europe – n = 527); 2,075 from female students and 1,369 from male students (n = 3,444), were analyzed. Sleep quality, insomnia, and daytime sleepiness were assessed using validated questionnaires (Pittsburgh Sleep Quality Index [PSQI], Insomnia Severity Index [ISI], and Epworth Sleepiness Scale [ESS], respectively).
Results Students from all continents had poor sleep quality, and there were inter-countries differences in sleep quality. The frequency of poor sleep quality and subclinical-to-clinical insomnia were higher among Asian (AsiS) and African students (AfS) compared with American (AmS) and European students (EuS) (p < 0.05). Asian students had a greater frequency of excessive daytime sleepiness (EDS) compared with those from other continents (p < 0.05). Females showed higher mean ISI scores (p < 0.001) as well as a greater frequency of poor sleep quality (p < 0.05), subclinical-to-clinical insomnia (p < 0.05), and EDS (p < 0.05) compared with males. Insufficient sleep duration was more frequent in older-aged groups (i.e., 26–30, 31–35, and > 36 years) compared with the ≤ 20 years age group (p < 0.05). Excessive daytime sleepiness was more frequent in younger age groups (i.e., ≤ 20 and 21–25 years) versus the > 36 years (p < 0.05) group. There were no significant differences in the frequency of various degrees of insomnia across age groups.
Conclusion Our results suggest the need for tailored interventions for addressing sleep disturbances among college students of all age groups, with a specific focus on AsiS and AfS, as well as female students.
Ethics Approval and Informed Consent
The study's protocol (web-based, cross-sectional survey administered in three languages: Arabic, English, and French) (i) received approval from the Ethics Committee of Qatar University (QU-IRB 1510-EA/21), (ii) adheres to the ethical standards of the Declaration of Helsinki (2013 and its subsequent amendments), and (iii) ensures anonymity according to the guidelines of the General Data Protection Regulation (gdpr-info.eu). Participation in the study was voluntary, and participants had the right to withdraw from the study at any time without facing any penalties or consequences. Before commencing the survey, participants provided online informed consent for their involvement.
Publication History
Received: 08 March 2024
Accepted: 12 June 2024
Article published online:
23 July 2024
© 2024. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Gao C, Guo J, Gong TT. et al. Sleep Duration/Quality With Health Outcomes: An Umbrella Review of Meta-Analyses of Prospective Studies. Front Med (Lausanne) 2022; 8: 813943 DOI: 10.3389/FMED.2021.813943/BIBTEX.
- 2 Zisapel N. Sleep and sleep disturbances: biological basis and clinical implications. Cell Mol Life Sci 2007; 64 (10) 1174-1186 DOI: 10.1007/S00018-007-6529-9/METRICS.
- 3 Vargas PA, Flores M, Robles E. Sleep quality and body mass index in college students: the role of sleep disturbances. J Am Coll Health 2014; 62 (08) 534-541 DOI: 10.1080/07448481.2014.933344.
- 4 Romdhani M, Hammouda O, Chaabouni Y. et al. Sleep deprivation affects post-lunch dip performances, biomarkers of muscle damage and antioxidant status. Biol Sport 2019; 36 (01) 55-65 DOI: 10.5114/biolsport.2018.78907.
- 5 Lee S, Mu CX, Wallace ML. et al. Sleep health composites are associated with the risk of heart disease across sex and race. Sci Rep 2022; 12 (01) 2023 DOI: 10.1038/s41598-022-05203-0.
- 6 Stranges S, Tigbe W, Gómez-Olivé FX, Thorogood M, Kandala NB. Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia. Sleep 2012; 35 (08) 1173-1181 DOI: 10.5665/SLEEP.2012.
- 7 Jiang XL, Zheng XY, Yang J. et al. A systematic review of studies on the prevalence of insomnia in university students. Public Health 2015; 129 (12) 1579-1584 DOI: 10.1016/J.PUHE.2015.07.030.
- 8 Tsai LL, Li SP. Sleep patterns in college students: gender and grade differences. J Psychosom Res 2004; 56 (02) 231-237 DOI: 10.1016/S0022-3999(03)00507-5.
- 9 Hershner SD, Chervin RD. Causes and consequences of sleepiness among college students. Nat Sci Sleep 2014; 6: 73-84 DOI: 10.2147/NSS.S62907.
- 10 Nsengimana A, Mugabo E, Niyonsenga J. et al. Sleep quality among undergraduate medical students in Rwanda: a comparative study. Sci Rep 2023; 13 (01) 265 DOI: 10.1038/s41598-023-27573-9.
- 11 Zhang T, Lu L, Ren YM. et al. Sleep disturbance and quality of life among university freshmen in Qinghai-Tibet Plateau of China. Front Psychiatry 2022; 13: 996996 DOI: 10.3389/FPSYT.2022.996996/BIBTEX.
- 12 Gaultney JF. The prevalence of sleep disorders in college students: impact on academic performance. J Am Coll Health 2010; 59 (02) 91-97 DOI: 10.1080/07448481.2010.483708.
- 13 Galvin J, Evans MS, Nelson K. et al. Technostress, Coping, and Anxious and Depressive Symptomatology in University Students During the COVID-19 Pandemic. Eur J Psychol 2022; 18 (03) 302-318 DOI: 10.5964/EJOP.4725.
- 14 Peltzer K, Pengpid S. Sleep duration and health correlates among university students in 26 countries. Psychol Health Med 2016; 21 (02) 208-220 DOI: 10.1080/13548506.2014.998687.
- 15 Lund HG, Reider BD, Whiting AB, Prichard JR. Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health 2010; 46 (02) 124-132 DOI: 10.1016/J.JADOHEALTH.2009.06.016.
- 16 Brown FC, Buboltz Jr WC, Soper B. Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behav Med 2002; 28 (01) 33-38 DOI: 10.1080/08964280209596396.
- 17 Becker SP, Jarrett MA, Luebbe AM, Garner AA, Burns GL, Kofler MJ. Sleep in a large, multi-university sample of college students: sleep problem prevalence, sex differences, and mental health correlates. Sleep Health 2018; 4 (02) 174-181 DOI: 10.1016/J.SLEH.2018.01.001.
- 18 Wang G, Goebel JR, Li C, Hallman HG, Gilford TM, Li W. Therapeutic effects of CPAP on cognitive impairments associated with OSA. J Neurol 2020; 267 (10) 2823-2828 DOI: 10.1007/S00415-019-09381-2/TABLES/2.
- 19 Mehrtash M, Bakker JP, Ayas N. Predictors of Continuous Positive Airway Pressure Adherence in Patients with Obstructive Sleep Apnea. Lung 2019; 197 (02) 115-121 DOI: 10.1007/S00408-018-00193-1/TABLES/1.
- 20 Maniaci A, Riela PM, Iannella G. et al. Machine Learning Identification of Obstructive Sleep Apnea Severity through the Patient Clinical Features: A Retrospective Study. Life (Basel) 2023; 13 (03) 702 DOI: 10.3390/LIFE13030702/S1.
- 21 Faris MAE, Salem ML, Jahrami HA, Madkour MI, BaHammam AS. Ramadan intermittent fasting and immunity: An important topic in the era of COVID-19. Ann Thorac Med 2020; 15 (03) 125-133 DOI: 10.4103/ATM.ATM_151_20.
- 22 Buysse DJ, Reynolds III CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989; 28 (02) 193-213 DOI: 10.1016/0165-1781(89)90047-4.
- 23 Johns MW. A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 1991; 14 (06) 540-545 DOI: 10.1016/j.sleep.2007.08.004.
- 24 Bastien CH, Vallières A, Morin CM. Validation of the Insomnia Severity Index as an outcome measure for insomnia research. Sleep Med 2001; 2 (04) 297-307 DOI: 10.1016/S1389-9457(00)00065-4.
- 25 Suleiman KH, Yates BC, Berger AM, Pozehl B, Meza J. Translating the pittsburgh sleep quality index into arabic. West J Nurs Res 2010; 32 (02) 250-268 DOI: 10.1177/0193945909348230.
- 26 Blais FC, Gendron L, Mimeault V, Morin CM. [Evaluation of insomnia: validity of 3 questionnaires]. Encephale 1997; 23 (06) 447-453
- 27 Ahmed AE, Fatani A, Al-Harbi A. et al. Validation of the Arabic version of the Epworth sleepiness scale. J Epidemiol Glob Health 2014; 4 (04) 297-302 DOI: 10.1016/J.JEGH.2014.04.004.
- 28 Kaminska M, Jobin V, Mayer P, Amyot R, Perraton-Brillon M, Bellemare F. The Epworth Sleepiness Scale: self-administration versus administration by the physician, and validation of a French version. Can Respir J 2010; 17 (02) e27-e34 DOI: 10.1155/2010/438676.
- 29 Morin CM, Belleville G, Bélanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep 2011; 34 (05) 601-608 DOI: 10.1093/SLEEP/34.5.601.
- 30 Chahoud M, Chahine R, Salameh P, Sauleau EA. Reliability, factor analysis and internal consistency calculation of the Insomnia Severity Index (ISI) in French and in English among Lebanese adolescents. eNeurologicalSci 2017; 7: 9-14 DOI: 10.1016/J.ENSCI.2017.03.003.
- 31 Romdhani M, Rae DE, Nédélec M. et al. COVID-19 Lockdowns: A Worldwide Survey of Circadian Rhythms and Sleep Quality in 3911 Athletes from 49 Countries, with Data-Driven Recommendations. Sports Med 2022; 52 (06) 1433-1448 DOI: 10.1007/s40279-021-01601-y.
- 32 Cohen J. A power primer. Psychol Bull 1992; 112 (01) 155-159 DOI: 10.1037/0033-2909.112.1.155.
- 33 Jahrami H, AlKaabi J, Trabelsi K. et al. The worldwide prevalence of self-reported psychological and behavioral symptoms in medical students: An umbrella review and meta-analysis of meta-analyses. J Psychosom Res 2023; 173: 111479 DOI: 10.1016/J.JPSYCHORES.2023.111479.
- 34 Patrick ME, Griffin J, Huntley ED, Maggs JL. Energy Drinks and Binge Drinking Predict College Students' Sleep Quantity, Quality, and Tiredness. Behav Sleep Med 2018; 16 (01) 92-105 DOI: 10.1080/15402002.2016.1173554.
- 35 Wang F, Bíró É. Determinants of sleep quality in college students: A literature review. Explore (NY) 2021; 17 (02) 170-177 DOI: 10.1016/J.EXPLORE.2020.11.003.
- 36 Basak P, Abir T, Al Mamun A. et al. A Global Study on the Correlates of Gross Domestic Product (GDP) and COVID-19 Vaccine Distribution. Vaccines (Basel) 2022; 10 (02) 266 DOI: 10.3390/VACCINES10020266.
- 37 Babicki M, Piotrowski P, Mastalerz-Migas A. Insomnia, Daytime Sleepiness, and Quality of Life among 20,139 College Students in 60 Countries around the World-A 2016-2021 Study. J Clin Med 2023; 12 (02) 692 DOI: 10.3390/JCM12020692/S1.
- 38 Rizk R, Haddad C, Sacre H. et al. Assessing the relationship between food insecurity and lifestyle behaviors among university students: a comparative study between Lebanon and Germany. BMC Public Health 2023; 23 (01) 807 DOI: 10.1186/S12889-023-15694-9/TABLES/6.
- 39 Hirshkowitz M, Whiton K, Albert SM. et al. National Sleep Foundation's sleep time duration recommendations: methodology and results summary. Sleep Health 2015; 1 (01) 40-43 DOI: 10.1016/J.SLEH.2014.12.010.
- 40 Ghrouz AK, Noohu MM, Dilshad Manzar M, Warren Spence D, BaHammam AS, Pandi-Perumal SR. Physical activity and sleep quality in relation to mental health among college students. Sleep Breath 2019; 23 (02) 627-634 DOI: 10.1007/S11325-019-01780-Z/TABLES/2.
- 41 Pagel JF. Excessive daytime sleepiness. Am Fam Physician 2009; 79 (05) 391-396 https://www.aafp.org/pubs/afp/issues/2009/0301/p391.html Accessed September302023
- 42 Sanchez SE, Martinez C, Oriol RA. et al. Sleep Quality, Sleep Patterns and Consumption of Energy Drinks and Other Caffeinated Beverages among Peruvian College Students. Health (Irvine Calif) 2013; 5 (8B): 26-35 DOI: 10.4236/HEALTH.2013.58A2005.
- 43 Surani AA, Zahid S, Surani A, Ali S, Mubeen M, Khan RH. Sleep quality among medical students of Karachi, Pakistan. J Pak Med Assoc 2015; 65 (04) 380-382
- 44 Yazdi Z, Loukzadeh Z, Moghaddam P, Jalilolghadr S. Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences. J Caring Sci 2016; 5 (02) 153-160 DOI: 10.15171/JCS.2016.016.
- 45 Siddiqui AF, Al-Musa H, Al-Amri H, Al-Qahtani A, Al-Shahrani M, Al-Qahtani M. Sleep Patterns and Predictors of Poor Sleep Quality among Medical Students in King Khalid University, Saudi Arabia. Malays J Med Sci 2016; 23 (06) 94-102 DOI: 10.21315/MJMS2016.23.6.10.
- 46 Zhang B, Wing YK. Sex differences in insomnia: a meta-analysis. Sleep 2006; 29 (01) 85-93 DOI: 10.1093/SLEEP/29.1.85.
- 47 Frange C, Banzoli CV, Colombo AE. et al. Women's Sleep Disorders: Integrative Care. Sleep Sci 2017; 10 (04) 174-180 DOI: 10.5935/1984-0063.20170030.
- 48 Maslowsky J, Ozer EJ. Developmental trends in sleep duration in adolescence and young adulthood: evidence from a national United States sample. J Adolesc Health 2014; 54 (06) 691-697 DOI: 10.1016/J.JADOHEALTH.2013.10.201.
- 49 Schlarb AA, Claßen M, Grünwald J, Vögele C. Sleep disturbances and mental strain in university students: results from an online survey in Luxembourg and Germany. Int J Ment Health Syst 2017; 11 (01) 24 DOI: 10.1186/S13033-017-0131-9/TABLES/9.
- 50 Levenson JC, Shensa A, Sidani JE, Colditz JB, Primack BA. The association between social media use and sleep disturbance among young adults. Prev Med 2016; 85: 36-41 DOI: 10.1016/j.ypmed.2016.01.001.
- 51 Orzech KM, Salafsky DB, Hamilton LA. The state of sleep among college students at a large public university. J Am Coll Health 2011; 59 (07) 612-619 DOI: 10.1080/07448481.2010.520051.
- 52 Johns MW. Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the epworth sleepiness scale: failure of the MSLT as a gold standard. J Sleep Res 2000; 9 (01) 5-11 DOI: 10.1046/J.1365-2869.2000.00177.X.