Don’t Hit Snooze:
The science behind sleep should be a wake-up call for colleges and universities
Foundational to learning well is a campus ecosystem that encourages healthy behaviors. Making healthy food accessible, offering opportunities for movement and exercise, and preventing substance use are key to a healthy campus, though all of this is easier said than done. On top of these challenges, it is commonly recognized—and research confirms—that students are not getting enough high-quality sleep. Less than half (46%) report getting seven or more hours of sleep per night1 and only 35% meet standard criteria for getting good quality sleep.2 Similar to substance use, some college students, parents, and even administrators, might see lack of sleep in college as something that is to be expected. However, sleep could just be the key to unlocking successful prevention efforts—it can support, or hinder, all the aforementioned healthy habits.
For many young adults, sleep habits are established prior to coming to college, and therefore these behaviors might be difficult to shift. In recent years, there has been much discussion about homework, extracurriculars, and school start times and how they impact sleep during high school. These concerns are well founded; short sleep duration among high school students in the US increased between 2009 and 2019,3 with 78% getting less than the recommended eight hours of sleep per night.
Navigating a new college environment is difficult, especially for students who have moved away from the structured environment of a family home. Students not only have to negotiate differences in routines and sleep habits with new roommates, but they are also pressured to socialize late into the night.4 There are plenty of opportunities to stay up later and messages about “pulling all-nighters” are pervasive. Shifts toward later bedtimes are common among undergraduates.2 Therefore, sleep problems that began in high school can worsen during college. With all that colleges have to offer, if a student is chronically tired, these opportunities might be lost. However, the science of sleep is complicated. Quantity is important, but quality of sleep is key and impacted by many different factors. Further, establishing good sleep habits during college is not only essential for the college years, but can carry forward into adulthood. So, what can colleges do to encourage healthy sleep patterns?
First, what do we mean by “good sleep” and which conditions make it possible?
“Good sleep” is restorative in nature. It is ideally for the right length of time, with few disturbances or awakenings throughout the night. Experts recommend that young adults sleep just under eight and a half (8.4) hours per night.5 Importantly, sleep schedules should be consistent. Although napping during the day might seem like a good idea, it is not a substitute for nighttime sleep.6 Making up for lost sleep on weekends should also be avoided because it interferes with the regularity of sleep cycles. Sleep hygiene, which health promotion professionals refer to as the habits that surround getting good sleep, depends on both personal and environmental factors. Personal factors include sticking to consistent bedtimes, reducing nighttime anxiety, limiting screen time close to bedtime, not relying on late nights to catch up on work, and avoiding excessive drinking, caffeine use, and other forms of substance use.
Academic behaviors can indirectly influence sleep. Attending class regularly, being attentive during class, and asking for help with the material as one progresses through a course, can reduce the pressure to catch up and “cram” to learn the material. Positive environmental factors that a student might be able to control include creating a quiet room with low light and noise levels, creating a comfortable sleep space, and communicating with roommates about sleep preferences. Environmental factors that are mostly under the control of the university and faculty include setting sensible course policies and schedules and timing campus events so that they promote healthy sleep patterns. We discuss these factors in more detail below.
Why is sleep important?
Regularly getting high-quality sleep is essential for several reasons, three of which are especially critical for college students. First, sleep affects both physical and mental health. During sleep, the human body repairs tissues and fights off disease-causing pathogens.7 Although it is commonly recognized that having mental health issues can affect your sleep,8 the reverse appears to be true as well. Individuals who do not get enough sleep are more at risk for experiencing depressive symptoms.9 A recent review of several research studies concluded that insomnia is a predictor for the future onset of depression, anxiety, and alcohol abuse.10
Second, sleep quality is linked to cognitive functioning and academic performance. One of the primary reasons why we sleep is to consolidate memories of things that happened and information that we learned during the day. It is well-documented in the research that sleep affects academic performance, which is reliant on the ability to recall and process new information.Even after accounting for several other predictors of academic success, getting fewer than the recommended number of hours of sleep during the first year of college is uniquely associated with lower GPAs.11
Hartmann and Prichard12 analyzed data from the American College Health Association’s annual survey of more than 55,000 students and found significant associations between the frequency of sleep problems during the past week, GPA, and the likelihood of withdrawing from a course. Each additional day per week that a student experienced sleep problems raised the chance of dropping a course by 10%, and decreased GPA by 0.02 points. Multiply that throughout a semester, and we have a serious problem. The authors concluded that "sleep education represents an underutilized opportunity for universities to maximize retention rates and academic success.”
The relationship between sleep and academic performance is not a simple one. A student’s level of interest in a course, having a disruptive living situation, being involved in athletics, having a job, or being a parent can all complicate the relationship between sleep and academic performance. Assessing how these variables affect one’s sleep, and making modifications, if possible, is important.
Third, several studies have shown that getting poor sleep might increase cravings for alcohol and cannabis13 as well as lead to a greater likelihood of binge drinking and cannabis use.14 Though not entirely clear, some speculate that poor sleep might contribute to elevated stress levels and/or irritability and anxiety where substances might be used to alleviate a negative mood state.
Regardless of the directions of all of these associations, it is clear that establishing consistent sleep routines will result in significant payoffs for student well-being.
What interferes with sleep and how?
For college students, the most obvious contributor to disrupted sleep patterns are the multiple demands on their schedules. Juggling responsibilities for class, work, and extracurricular activities with social and family obligations can create a situation where sleep becomes an afterthought. Ironically, getting enough sleep helps us use time more efficiently and productively during the day. Unfortunately, the overwhelming feeling of not being able to keep up with everything can create a vicious cycle where sleep becomes even more impaired.
Excessive caffeine use, especially later in the day, can impair the ability to fall asleep. Much research has been conducted on the negative health effects of highly-caffeinated energy drinks and how they can lead to disrupted sleep patterns.15
From a practical standpoint, staying up late to party and drinking alcohol impairs natural sleep cycles by delaying bedtimes and oversleeping in the morning. Biologically, alcohol use suppresses REM sleep time, which occurs in the second half of the night. Many studies confirm the negative impact of alcohol consumption on sleep duration and quality.16,17
Drazdowski et al.18 studied 354 college students who used cannabis and found that 44% reported using cannabis to help them sleep. However, contrary to most students’ beliefs, greater use of cannabis for sleep predicted worse sleep, a longer time to fall asleep, and more problematic cannabis use. Research shows that chronic cannabis use can also interfere with sleep.17,19 When individuals try to cut down or stop cannabis use, common withdrawal symptoms include restless sleep and strange dreams. Reinstating cannabis use will relieve these withdrawal symptoms, leading to a catch-22 situation where the student believes that cannabis is the key to better sleep.
An added challenge that this generation’s college students are experiencing like never before is the impact of technology on sleep. “Blue light” emitted from electronic devices acts as a stimulant to your brain by suppressing production of melatonin, the hormone that your body naturally produces to help you fall asleep in response to darkness. Exposure to screens, including cellphone use at bedtime, can prolong the time it takes for us to fall asleep and can lead to waking up too early.20
A regular exercise routine comes with many benefits, including improved sleep quality. Experts suggest avoiding intense exercise at nighttime, which can raise cortisol levels and make it hard to fall asleep. For student-athletes, who easily get enough exercise, sleep routines might still be interrupted because of the multiple demands on their schedules. In a review of scientific findings on how sleep deprivation adversely affects athletic performance, Vitale et al.21 states “Optimizing all three pillars (i.e., diet, exercise, and sleep) is critically important to overall health and recovery and is a better strategy than resorting to supplements and energy drinks that athletes (and the general population) may turn to when fatigued and lacking adequate sleep.”
What can campuses do to promote good sleep habits among students?
- Engage students in discussions about the importance of sleep. The vast majority of undergraduates (73%) report never receiving any information about sleep from their university,12 despite two-thirds reporting interest. In addition to offering actionable suggestions for improving sleep hygiene, students could also strategize in small groups about how to handle situations involving a disruptive roommate or work together with housemates to agree on nighttime routines that are conducive to better sleep.
- Implement evidence-based strategies to reduce excessive drinking and cannabis use. A comprehensive plan to address college student substance use will promote the health, safety, and success of college students.22 Because of the strong associations between these behaviors and sleep hygiene, reducing substance use will help students maintain healthy sleep patterns.
- Refrain from promotion of highly-caffeinated energy drinks in dining halls and convenience stores on campus.
- Train residence life staff to discuss expectations early on that part of being a respectful roommate is respecting the sleep needs of the other person. They can encourage roommate conversations on needs and preferences for rest and sleep. Also, students who appear to be up extremely late at night or always appear tired and groggy might need an extra check-in or a referral to resources to address either a mental health or a substance use issue.
- Train health and counseling center staff to discuss how sleep trouble can be an indicator of other concerns. Given that sleep can exacerbate mental health problems, holistic screenings (assessing both sleep and mental health issues) in health and counseling centers might serve as a springboard for having meaningful conversations that illuminate a bigger picture of what might be impacting a student’s sleep.
- Offer sleep workshops for students to educate them about strategies to minimize sleep disruptions. For example, using the Grayscale setting on a cellphone can decrease the stimulating nature of colors, posts, etc. on social media. One study showed that individuals who used the Grayscale setting significantly decreased their screen time, and few reported “annoyance” to using this strategy.23 In general, students need practical tips related to using their time efficiently and decreasing procrastination, both of which can lead to nighttime anxiety and detract from getting a good night’s sleep.
- Discuss what faculty can do, such as adjusting assignment deadlines. Many experts4, including Dr. Sarah Lipson, a principal investigator of the Healthy Minds Network, advise schools to revisit policies around deadlines and extensions. Faculty should consider multiple, shorter assignments and quizzes rather than relying on very few big exams, which likely exacerbate procrastination and cramming. Rather than traditional midnight and 9AM deadlines that might perpetuate the behavior of working through the night to finish an assignment, it might be prudent to set a more reasonable submission deadline, such as 5PM. Colleges should consider messaging about healthier ways to manage time and that staying up all night to study might not produce the best outcomes.
- Infuse information about sleep hygiene in classes through guest lectures or health center staff presentations. These can be good opportunities to correct misperceptions on the effectiveness of all-nighters, stimulants, and other “quick fixes” that can become habitual.
- Reconsider how final exam programming is structured. Holding de-stress events at 11PM in the student center, while well-intentioned, is mixed messaging. Administrators should think about whether having study spaces open 24/7 is best for students. Putting a positive spin on health messaging by encouraging students to engage in healthy behaviors (e.g., get enough rest, eat nourishing food, and exercise regularly), rather than focusing on telling them what not to do might be more effective.
This generation’s knowledge of and fondness for better health and well-being is a facilitator of sleep conversations that campuses can use. Tapping into what matters to students already—good mental health, academic performance, and physical well-being—can go a long way. We can take the adage of “meeting students where they are” a step further by connecting their challenges to practical resources and solutions. Getting good rest is a worthwhile lesson that all of us can learn.
A commonly used tool to measure sleep quality is the Pittsburgh Sleep Quality Index (PSQI). The PSQI can serve as an efficient screening tool for sleep problems and takes about 5-10 minutes to administer.24
Amelia M. Arria, Ph.D. is currently the Director of the Center on Young Adult Health and Development at the University of Maryland School of Public Health and a Professor in the Department of Behavioral and Community Health.
Kelsey O’Hara is the Training and Technical Assistance Coordinator for The Maryland Collaborative at the Center on Young Adult Health and Development at the University of Maryland School of Public Health.
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