Review article
The Delivery of Behavioral Sleep Medicine to College Students

https://doi.org/10.1016/j.jadohealth.2010.09.023Get rights and content

Abstract

College students are vulnerable to a variety of sleep disorders, which can result in sleep deprivation and a variety of other consequences. The delivery of behavioral sleep medicine is particularly relevant for the college student population, as the early intervention on their sleep problems might prevent lifelong consequences. This article critically reviews the efficacy of relevant behavioral sleep medicine interventions and discusses special considerations for using them with college students who have unique sleep patterns and lifestyles. Recommendations are also given regarding ways to disseminate these empirically supported treatments into this environment. Finally, recommendations regarding future research directions are discussed in the present study.

Section snippets

Inadequate Sleep Hygiene

The ICSD defines ISH as a form of insomnia that has been present for at least 1 month, where at least one of the following behaviors is present and considered to cause the insomnia (see Table 1 for diagnostic criteria and behavioral examples). ISH results in self-imposed sleep deprivation and is a common problem in college students [20], [21], [22]. Over half of university students who were surveyed reported ISH [22], which was considerably higher than that reported by the high school students

Delayed Sleep Phase Disorder

Delayed Sleep Phase Disorder is a circadian rhythm sleep disorder marked by significant delays in sleep–wake cycles (e.g., bedtime after 1 a.m., wake time after 10 a.m.), relative to societal norms [27], [28]. It results in significant insomnia, sleep deprivation, and difficulties with daytime functioning. Symptoms of DSPD typically begin to appear as early as adolescence [29], [30], [31], [32], [33], with a biological phase preference for later bedtimes as children develop into adolescents.

Insomnia

Insomnia is characterized by complaints of difficulty in initiating sleep, maintaining sleep, or nonrestorative sleep, with at least one daytime impairment (e.g., fatigue/malaise, attention problems) attributable to the insomnia [28], [45], [46]. Insomnia is conceptualized as primary when the sleep disturbance is believed to be the fundamental problem for the individual or comorbid when insomnia coexists with another psychiatric, medical, or other sleep disorder [47]. In the general adult

Dissemination of Traditional and Developing BSM Approaches to College Students

College students might encounter several obstacles in receiving and using empirically based behavioral sleep medicine regimens. For instance, college students have limited access to sleep specialists, limited time, and limited financial resources to obtain treatment. They also may not yet be educated about sleep disturbance and its negative consequences or may minimize or de-prioritize its importance. Thus, the question of how to give access to and resources for behavioral sleep medicine

Future Considerations

For some students, sleep disorders have already emerged; for others college tenure may be the ideal “window of opportunity” to educate and prevent future sleep disorders from developing. Despite their vulnerabilities to sleep disruption, college students are an ideal population to target. They are accustomed to homework (consistent with CBT-I approaches), are in an environment that fosters learning and wellness, and, although busy, tend to have flexible schedules. Parallel to the many

Acknowledgments

The authors sincerely appreciate the work of Lacy Fenn at the University of North Texas who designed and contributed the phase response curve figures.

References (77)

  • A.G. Harvey et al.

    Cognitive approaches to insomnia

    Clin Psychol Rev

    (2005)
  • A.G. Harvey et al.

    An open trial of cognitive therapy for chronic insomnia

    Behav Res Ther

    (2007)
  • C.A. Espie

    Cognitive behavior therapy as the treatment of choice for primary insomnia

    Sleep Med Rev

    (1999)
  • R.A. Hicks et al.

    Self-reported sleep durations of college students: Normative data for 1978–79, 1988–89 and 2000–01

    Percept Mot Skills

    (2001)
  • W.C. Buboltz et al.

    Treatment approaches for sleep difficulties in college students

    Couns Psychol Q

    (2002)
  • C.M. Yang et al.

    Coping with sleep disturbances among young adults: A survey of first-year college students in Taiwan

    Behav Med

    (2003)
  • J. Pilcher et al.

    How sleep deprivation affects psychological variables related to college students' cognitive performance

    J Am Coll Health

    (1997)
  • W.E. Kelly et al.

    The relationship between sleep length and grade-point average among college students

    Coll Stud J

    (2001)
  • A.D. Medeiros et al.

    The relationships between sleep-wake cycle and academic performance in medical students

    Biol Rhythm Res

    (2001)
  • D.E. Rusovici

    Neuroendocrine and health aspects of partial sleep loss

    Diss Abstr Int: Sci Eng

    (2001)
  • W.C. Buboltz et al.

    Sleep habits and patterns of college students

    J Am Coll Health

    (2001)
  • F.C. Brown et al.

    Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students

    Behav Med

    (2002)
  • J.C. Sierra et al.

    Quality of sleep in university students: The importance of sleep hygiene

    Salud Ment

    (2002)
  • P.V. Thacher

    University students and “the all-nighter”: Correlates and patterns of students' engagement in a single night of total sleep deprivation

    Behav Sleep Med

    (2008)
  • T. Roehrs et al.

    Sleepiness and ethanol effects on simulated driving

    Alcohol Clin Exp Res

    (1994)
  • D. Dawson et al.

    Fatigue, alcohol and performance impairment

    Nature

    (1997)
  • M.A. Carskadon et al.

    Regulation of sleepiness in adolescents: Update, insights, and speculation

    Sleep

    (2002)
  • D.R. Jensen

    Understanding sleep disorders in a college student population

    J Coll Couns

    (2003)
  • J.H. Kang et al.

    Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan

    BMC Public House

    (2009)
  • L.K.P. Suen et al.

    Association between sleep behavior and sleep-related factors among university students in Hong Kong

    Chronobiol Int

    (2008)
  • R. Manni et al.

    Poor sleep in adolescents: A study of 869 17 year old Italian secondary school students

    J Sleep Res

    (1997)
  • T. Morgenthaler et al.

    Practice parameters for the psychological and behavioral treatment of insomnia: An updateAn American Academy of Sleep Medicine report

    Sleep

    (2006)
  • C.M. Morin et al.

    Psychological and behavioral treatment of insomnia: Update of the recent evidence (1998–2004)

    Sleep

    (2006)
  • F.C. Brown et al.

    Development and evaluation of the Sleep Treatment and Education Program for Students (STEPS)

    J Am Coll Health

    (2006)
  • International Classification of Sleep Disorders

    Diagnostic and Coding Manual

    (2005)
  • Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR

    (2000)
  • M.A. Carskadon et al.

    Association between puberty and delayed phase preference

    Sleep

    (1993)
  • R. Sack et al.

    Circadian rhythm sleep disorders: Part II, advanced sleep phase disorder, delayed sleep phase disorder, free-running disorder, and irregular sleep-wake rhythm

    Sleep

    (2007)
  • Cited by (0)

    View full text