June 18, 2019
There is a dose-response relationship between insufficient sleep and mental health symptoms in college students, including student-athletes, a new study suggests.
"It was really surprising to see how strongly insufficient sleep was associated with a wide variety of mental health symptoms among college students," Thea Ramsey, an undergraduate student at the University of Arizona in Tucson, who led the study, said in a statement.
"Also, it was intriguing that while student-athletes experienced on average fewer nights of insufficient sleep and better mental health, the relationship between insufficient sleep and mental health was as strong or stronger in athletes compared to nonathletes," said Ramsey.
The study was presented here at SLEEP 2019: 33rd Annual Meeting of the Associated Professional Sleep Societies.
Depression, Hopelessness, Anger
The researchers pooled data from the 2011–2014 waves of the National College Health Assessment. The analysis included data on 110,496 college students, including 8462 varsity athletes.
Insufficient sleep was assessed as the number of nights students did not get enough sleep to feel rested when they woke up. Mental health symptoms were defined as the presence of symptoms in the prior month.
Adjusted models controlled for age, sex, race/ethnicity, and survey year. Additional models included controls for insomnia and depressed mood.
In adjusted models, insufficient sleep was associated with all mental health variables. Findings showed a dose-response relationship; with each additional night of insufficient sleep, the risk for mental health symptoms increased on average by more than 20%.
The risk for depressed mood was increased 21%; for hopelessness and anger, 24%; for anxiety and desire to self-harm, 25%; for functional problems, 28%; and for thoughts of suicide, 28%.
"The fact that sleep health was so strongly related to mental health is important, since the majority of college students don't get the recommended amount of sleep needed for optimal health and functioning," said senior investigator Michael Grander, PhD, director of the Behavioral Sleep Medicine Clinic at the University of Arizona.
"So, these young adults aren't sleeping enough, and not only does that increase their likelihood for things like worse academic performance and health, but it also takes a toll on their mental health as well," he added.
Commenting on the results for Medscape Medical News, American Academy of Sleep Medicine spokesperson Nitun Verma, MD, said the study's strength lies in its large sample size of more than 100,000 students.
"It's intuitive that insufficient sleep increases the risk for mood or anxiety disorders, and the percentages in this study are quite high. We should not ignore the lack of sleep that college students get, not just for their mental health but also for their academic and physical performance, because if they sleep better, they will actually perform better too," said Verma, a sleep physician at AC Wellness, San Francisco, California.
Research has shown that keeping a regular sleep schedule during the college years is just as important as getting enough sleep.
In a study of 204 college students, researchers found that week-long irregular sleep schedules were significantly associated with lower self-reported morning and evening happiness, healthiness, and calmness during the week after controlling for weekly average sleep duration, as reported by Medscape Medical News.
The study was supported by a National Collegiate Athletic Association innovations grant. Ramsey, Grandner, and Verma have disclosed no relevant financial relationships.