A Profile of Sleeping Habits among College Students-A Cross-sectional Study

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1 International Journal of Advances in Health Sciences (IJHS) ISSN Vol2, Issue3, 2015, pp Original Article A Profile of Sleeping Habits among College Students-A Cross-sectional Study ABSTRACT: Rehan Safee* and S.T.A. Bilgrami PSM,Department, Z.V.M.Unani Medical College, Pune, India *Corresponding Author: rehansafee@ymail.com [Received-1/06/2015, Accepted-12/06/2015] Since the inception of mankind, sleep has been regarded as one of the most vital necessity for the human body needed for rejuvenation after a tiresome day s work. Social activities, stressful relationships and academic commitments often end up in sleep deprivation during college life. The objective of this study was to determine the prevalent sleeping habits among college student community. This cross sectional study was carried in an educational campus of the city using a questionnaire based on Pittsburgh Sleep Quality Index (PSQI). 1 Among the sample size of 1000 respondents majority of students had late bed timingsand early wake ups with the mean sleep duration of 7 hours.on sleep latency,42.9% of the participants reportedly took minutes to fall asleep and54.7% reported waking up in the middle of the night. Most of the students thus had problems in falling asleep and maintaining a sound and uninterrupted sleep. The study concludes thatfaulty perception of sleep among student community may lead to more difficulties in later life, which if not heeded to now, may develop into social, physical, and mental health problems. Keywords: Student community, Sleep perception&latency, Sleep duration, physical and mental health problems. INTRODUCTION: According to the principles of Unani System of Medicine (a traditional system of medicine practiced mostly in India, Pakistan Bangladesh among others), the maintenance of health and continuation of life depends on six essential factors (causes) known as Asbab-e- SittaZarooriya. Sleep along with wakefulness has been described as a part of these factors.they are seen characteristically similar to relaxation and activity. 2,3,4,5 Unani philosophers and scholars have highlighted the significance of sleep and its repercussions on health. They were of the opinion that moderate and sufficient sleep is helpful in digestion and assimilation of food and also the elimination of wastes. Hence if a person is not getting sufficient sleep, he/she may become vulnerable to digestive and excretory disorders. Ahmad Jurjani, another unani physician, while describing the signs of dominance of a particular humor, has discussed the sleeping attitude and dreams in context with the respective humor e.g. parasomnia with dominance of phlegmatic humor and disturbed sleep with bilous humor. 6,7 While sleep has been considered as a vital component of a healthy life, unfortunately most of the people in this achievement oriented life tend to neglect sleep considering it to be unproductive activity. Most of the studies related to sleep and some of

2 its aspects have been conducted in the western countries. Researches have suggested that poor sleep quality among students is linked to increased tension, irritability, depression and lower life satisfaction. 8,9 Lack of sleep in college student s life not only hampers the health of the students but also affects their psychological condition in several ways. Surveys conducted in American colleges concluded that nearly 75% of college students reported sleep problems such as difficulty in falling asleep, sleep disturbances, delayed sleep phase syndrome and excessive daytime sleepiness. The National Institute of Health, United States, has recognized adolescents and emerging adults as a population at high risk for problem sleepiness based on evidence that the prevalence of problem sleepiness is high and increasing with particularly serious consequences. 10,11 Current review of literature indicated that there are very few published data from India on this important yet ignored field. Thus, this study was carried out with the objective of assessing the sleep habits in the college student community. METHODOLOGY: This cross-sectional study was carried out over a period of one-year in an educational campus of Pune city, which caters to different fields of education. The primary sleep measure was the questionnaire based on Pittsburgh Sleep Quality Index (PSQI) 1, designed to measure sleep quality and disturbance during the past one month.those who consented were explained about the study and written informed consent was taken. Apparently healthy subjects were requested to participate.the pilot study was carried out to assess the feasibility and applicability of the questionnaire in 50 individuals and estimated problems in response. Initially 1053 students were approached but 53 subjects were excluded from the study on the ground of providing incomplete information or after they reported having cognitive behavioral therapy or use of any medications with known or suspected effects on sleep within the previous one month. The overall response rate was about 95% and subjects were interviewed using the pre-tested and validated proforma. Data containing information pertaining to demographic variables (age, gender and education), sleep environment, bedtime routine and habits, sleep schedule and effects experienced due to sleeping patterns of subjects were collected. No laboratory investigations were undertaken during the present study.observations were made in context of various aspects of sleep. The data was entered into an Excel datasheet and SPSS (Version 20.0) was used for statistical analysis. Appropriate statistical data was applied to analyze the result which was presented in the form of tables and graphs.all the subjects were counseled about the benefits of sleep, sleep hygiene, tips to better sleep and those having problems with sleep and their consequences were asked to consult sleep experts.results:the first purpose was to describe various sleep patterns of students which included their bed time, wake up time, sleeping duration etc.the result depicts the perception of sleep among the student community, their sleep habits and possible health effects of varying sleeping patterns on the respondents. This helped us to understand the possible relationship between sleep patterns and their consequences. Among the final sample size of 1000, the respondents comprised of 59% female and 41% male students with the mean age of years(sd= 1.79). Most of the male students belonged to 22 yrs of age group, while maximum numbers of females belonged to 19 yrs of age group.majority of students reported late bed timings. 82.2% of the students slept between 11p.m. and 12midnight. On sleep latency, 42.9% of the participants took minutes to fall asleep. While 44.3% female students and 38.3% male students took less than 15 minutes to sleep, a minority of students (0.7%) reportedly took more than 60 minutes to sleep. Fig. 1 shows number of minutes (NOM) taken by respondents to sleep. Results of sleep duration records showed that most of the students (69.8%) slept for more Rehan Safee and S.T.A. Bilgrami 380

3 than 7 hours. Sleep duration of 6-7 hours was reported by 27.1% male students and 24.6% female students. Only 3 female students reported sleeping for less than 5 hours. (Table1) The mean sleep duration among the student respondents was 7 hours which has been recommended for good health among this age group. 12 Wake up time varied among the respondents. Among the studied participants 40.7% students reportedly woke up by 6 am. Among these 40% male and 41.3% female students reported the wake up time of around 6 a.m. (Fig 2). Data of the last one month was also recorded for sleep disturbances reported by the respondents.of the total participants, 54.4% of the male and 54.9% of the female students reported waking up in the middle of the night. Among the participants 40.5% of the male and 38.5% of the female students reported dreams or nightmares as the reason while 29.5% of the male and 33.7% of the female students reported pain as the reasons for having trouble while sleeping. Nocturia was reported by 29% male students (n= 119) and 20.3% females (n= 120). Among the male students 11.9% admitted snoring problem while in the female students it was on lower side with 8.6%. Many students reported multiple problems. In spite of the problems faced by the students, 64.6% males and 59.7% females did not feel that they had any sleep disturbance. Only 3.1% respondents reported severely disturbed sleep. Majority of the students reported satisfactory sleep, with 54% males (n=221) and 55.7% females (n=329) satisfied with their sleep quality, while only 7.2 % of the total participants reported to having poor to very poor sleep. General perception ofsleep quality was found to be good among students. DISCUSSION: Various studies have demonstrated that disturbed sleep patterns could have detrimental effects on their daily performance leading to depressed mood, behavioral and other problems. This study demonstrates varied sleep patterns among the student community. Most of the students (82.2%) reported the sleeping time as between 11p.m. and 12 midnights. This might reflect the lifestyle prevalent among the student community. In a similar study Buboltz et al indicated pm as the average bed time among the students. 9 Similarly in a study conducted in Tehran University, majority of students slept between 10 pm and 12 midnight. 13 On sleep latency, most of the participants (42.9%) took minutes to sleep, while 15.3% reported inability to fall asleep within 30 minutes Lund et al in their study had reported 32% of the students were unable to sleep within 30 minutes. 14 Mean sleep duration for the students was 7 hours. This shows that though the students had late sleeping time, most of them had adequate sleep. In the area of sleep disturbances, this study found that 54.7% of the students reportedly woke up during the night. While 54.9% of the males (n=225) reported waking up in the middle of the night, 54.4% of females (n=321) reported the same.but surprisingly a majority of students, 64.6% males and 59.7% females didn t consider waking up during the night as a disturbance as only 38.3% participants reported sleep disturbances. This finding is in consistence with the findings of Panda et al where sleep disturbances were noted in 34.2% respondents. 15 On sleep perception, majority of the students (55%) reported satisfactory sleep, with 54% of the maleand 55.7% female students reportedly satisfied with their sleep quality, while only 7.2 % participants reported to having poor to very poor sleep and 37.8% students reported having a good sleep. The results can vary under different circumstances as Panda et al in their study have stated that overall subjective sleep quality was good in 93.8% respondents while Nojomi et al had stated that 44% of the respondents reported good sleep quality. The study concludes that varying life styles and commitments have brought about a change in sleep perception among the student community who does not consider late bed Rehan Safee and S.T.A. Bilgrami 381

4 timings, waking up in the middle of night, as a hindrance to quality sleep. LIMITATIONS: The results of the study may have been influenced by some limitations. The geographic and urban setting of the campus may lead to difficulty in generalizing the results to other regions. Secondly the PSQI has been set according to European norms, which may lead to bias in results and finally, the data recorded has been self reported by the students. They may not have reported their sleeping habits,nature or extent of difficulties experienced by them, accurately. REFERENCES: 1. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ: The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 1989, 28: Ibn-e-Sina, Al Qanoon fil Tib, Translated by HkmQantoori Syed, vol. 3, Ejaz Publishing, Nafisi,Burhanuddin, Kulliyat -e-nafisi, Translated by HkmKabeeruddin, Idarakitabul-Shifa, New Delhi, p231, Kabeeruddin, Kulliyat-e-Qanoon, IdaraKitabul-Shifa, New Delhi,2006, 1:1, p23 5. Hamdani,SyedKamaluddin, Usool-e-Tib, Uttar Pradesh Urdu Academy, Lucknow,1980, p Ahmad al Hasan Jurjani, ZakheeraKhwarzamShahi, Translated by Hkm.Hadi Hussain, IdaraKitab-ul-Shifa, New Delhi, 2010,Vol 2, p Malik, WamiqAmeen, QadeemIlmulAmraz, 3 rd Ed. Qaumi Council BaraiFarogh E-Urdu, New Delhi, 2002, p Pilcher JJ, Ginter DR, Sadowsky B. Sleep Quality versus sleep quantity: Relationships between sleep and measures of health, well being and sleepiness in college students. J Psychosom Res,1997; 42: Buboltz WC, Brown F, Soper B, Sleeping habits and patterns of college students, J American college Health, 2001; 50: 3, Wolfson, Amy R, Adolescents and Emerging Adults Sleep Patterns: New Developments, Journal of Adolescent Health 46 (2010) p Carskdon Mary, Roth Thomas, Adolescent Sleep Needs and Patterns, National Sleep Foundation, Hirshkowitz M, The National Sleep Foundation s sleep duration recommendations, Sleep Health, MarziehNojomi,Sleep Pattern in Medical Students and Residents, Arch Iran Med 2009; 12 (6): Lund HG, Reider BD, Sleep Patterns and Predictors of Disturbed Sleep in a Large Population of College Students, Journal of Adolescent Health 46 (2010) Panda S, Taly AB, Sleep related disorders among healthy population in south India, Neurol India 2012, 60:68 74 FIGURES AND TABLES Fig. 1Number of minutes (NOM) taken by respondents to sleep Rehan Safee and S.T.A. Bilgrami 382

5 Table 1.Sleep duration reported by respondents Duration Males Females No. % No. % >7 hours <7 and >6 hours <6 and >5 Hours <5 hours TOTAL Fig. 2 Wake up timings reported by the respondents Table 2 Perception of Sleep Quality among respondents Quality Males Females No. % No. % Good Satisfactory Poor Very poor TOTAL Rehan Safee and S.T.A. Bilgrami 383