Abstract
Objectives
Sleep is a major lifestyle factor that may change dramatically when students begin
college. Sleep duration has been shown to influence cardiometabolic health. We investigated
the feasibility of sleep extension in college students to increase actigraphically
measured sleep duration and the association of sleep extension with daytime sleepiness
and blood pressure.
Design
This was a within-participant experimental study.
Setting
The study setting was 14-day at-home study and 3 in-lab visits.
Participants
The participants included in this study were healthy undergraduate students (n=53;
mean age 20.5 ± 1.1 years; 70% female).
Intervention
Participants maintained a habitual sleep schedule during week 1 and then were instructed
to extend their sleep duration by at least 1 hour per night for week 2.
Measurements
Sleep measures included wrist actigraphy and daytime sleepiness assessed by the Epworth
Sleepiness Scale (ESS) and by daily diary. Cardiovascular measures included blood
pressure (BP) and heart rate (HR). ESS, BP and HR were measured during lab visits
on days 7 and 14. Multilevel modeling was used to test the effects of extension on
sleep duration, daytime sleepiness, BP and HR.
Results
Participants increased sleep duration during week 2 by 43.0 ± 6.2 standard error minutes
per night, compared with week 1 (p<.001). Furthermore, 41 of 53 participants (77%)
increased their sleep duration by >15 minutes per night (p<.001). Participants reported
less daytime sleepiness on weekly ESS (p<.05) and daily log ratings (p<.001) after
sleep extension; and systolic BP was significantly reduced by 7.0 ± 3.0 mmHg (p<.05).
Conclusion
This study demonstrates that substantive sleep extension is feasible in college students
and can positively impact their sleep and cardiovascular health.
Abbreviations:
ESS (Epworth Sleepiness Scale), BP (Blood Pressure), HR (Heart Rate), CVD (Cardiovascular Disease)Keywords
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References
- Chronic insomnia and stress system.Sleep Med Clin. 2007; 2: 279-291
- Effectiveness of interventions targeting physical activity, nutrition and healthy weight for university and college students: A systematic review and meta-analysis.Int J Behav Nutr Phys Act. 2015; 12: 45
- Insufficient sleep in adolescents and young adults: An update on causes and consequences.Pediatrics. 2014; 134: e921-e932
- Causes and consequences of sleepiness among college students.Nat Sci Sleep. 2014; 6: 73-84
- Sleep patterns and predictors of disturbed sleep in a large population of college students.J Adolesc Health. 2010; 46: 124-132
- Recommended amount of sleep for a healthy adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society.J Clin Sleep Med. 2015; 11: 591-592
- A two-week sleep extension in sleepy normals.Sleep. 1996; 19: 576-582
- National Sleep Foundation’s sleep time duration recommendations: Methodology and results summary.Sleep Health. 2015; 1: 40-43
- Elevated plasma oxytocin levels in children with Prader-Willi syndrome compared with healthy unrelated siblings.Am J Med Genet A. 2016; 170: 594-601
- The Prevalence of Sleep Disorders in College Students: Impact on Academic Performance.J Am Coll Health. 2010; 59: 91-97
- Calculating the contribution of sleep problems to undergraduates' academic success.Sleep Health. 2018; 4: 463-471
- Fatigue and mood correlates of sleep length in three age-social groups: School children, students, and employees.Chronobiol Int. 2006; 23: 1317-1328
- Sleep behaviors in traditional-age college students: A state of the science review with implications for practice.J Am Associ Nurse Pract. 2017; 29: 695-703
- Stress and sleep disturbances in female college students.Am J Health Behav. 2013; 37: 851-858
- Credit card debt, stress and key health risk behaviors among college students.Am J Health Promot. 2008; 22: 400-407
- Development of Young Adults Eating and Active for Health (YEAH) internet-based intervention via a community-based participatory research model.J Nutr Educ Behav. 2014; 46: S10-S25
- Sleep problems in university students - An intervention.Neuropsychiatr Dis Treat. 2017; 13: 1989-2001
- Beneficial impact of sleep extension on fasting insulin sensitivity in adults with habitual sleep restriction.Sleep. 2015; 38: 707-715
- The effects of sleep extension on the athletic performance of collegiate basketball players.Sleep. 2011; 34: 943-950
- The effects of sleep extension and sleep hygiene advice on sleep and depressive symptoms in adolescents: A randomized controlled trial.J Child Psychol Psychiatry. 2014; 55: 273-283
- Pilot Study of a sleep health promotion program for college students.Sleep Health. 2016; 2: 167-174
- The effects of extended bedtimes on sleep duration and food desire in overweight young adults: A home-based intervention.Appetite. 2014; 80: 220-224
- Sleep extension is a feasible lifestyle intervention in free-living adults who are habitually short sleepers: A potential strategy for decreasing intake of free sugars? A randomized controlled pilot study.AmJ Clin Nutr. 2018; 107: 43-53
- Impact of sleep extension and restriction on children’s emotional lability and impulsivity.Pediatrics. 2012;
- The impact of extended sleep on daytime alertness, vigilance, and mood.Sleep Med. 2004; 5: 441-448
- Sleep extension improves serving accuracy: A study with college varsity tennis players.Physiol Behav. 2015; 151: 541-544
- Differential and interacting effects of age and sleep restriction on daytime sleepiness and vigilance in adolescence: A longitudinal study.Sleep. 2018; 41
- 25 by 25: Achieving Global Reduction in Cardiovascular Mortality.Curr Cardiol Rep. 2016; 18: 10
- Association between sleep deficiency and cardiometabolic disease: Implications for health disparities.Sleep Med. 2016; 18: 19-35
- Sleep duration and 24-hour ambulatory blood pressure in adults not on antihypertensive medications.J Clin Hypertens. 2018; 20: 1712-1720
- A prospective study of the association between total sleep duration and incident hypertension.J Clin Hypertens. 2017; 19: 550-557
- Relationship between sleep duration and hypertension in Northeast China: A cross-sectional study.BMJ Open. 2019; 9: e023916
- Efficacy and safety of combined use of aliskiren and valsartan in patients with hypertension: A randomised, double-blind trial.Lancet. 2007; 370: 221-229
- Relationship between daytime sleepiness and blood pressure in healthy older adults.Am J Hypertens. 2004; 17: 787-792
- Increasing sleep duration to lower beat-to-beat blood pressure – A pilot study.J Sleep Res. 2013; 22: 295-304
- Assessment of daytime sleepiness and reliability test of Epworth sleepiness scale in young individuals.Tanta Medical Journal. 2014; 42: 79-82
- Measuring sleep: Accuracy, sensitivity, and specificity of wrist actigraphy compared to polysomnography.Sleep. 2013; 36: 1747-1755
- Later high school start times associated with longer actigraphic sleep duration in adolescents.Sleep. 2018; (zsy212-zsy212)
- 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults.J Am Coll Cardiol. 2018; 71: e127-e248
- Meeting the Healthy People 2020 Goals: Using the Health Information National Trends Survey to monitor progress on health communication objectives.J Health Commun. 2014; 19: 1497-1509
- Excessive daytime sleepiness and its pattern among Indian college students.Sleep Med. 2017; 29: 23-28
- Associations of caffeinated beverage consumption and screen time with excessive daytime sleepiness in Korean high school students.Clin Nutr Res. 2017; 6: 55-60
- Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013.Lancet. 2015; 385: 117-171
- Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies.Lancet. 2002; 360: 1903-1913
- The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report.JAMA. 2003; 289: 2560-2572
- Development of predictive models for long-term cardiovascular risk associated with systolic and diastolic blood pressure.Hypertension. 2002; 39: 105-110
- Blood pressure, systolic and diastolic, and cardiovascular risks. US population data.Arch Int Med. 1993; 153: 598-615
- What is the most important component of blood pressure: Systolic, diastolic or pulse pressure?.Curr Opin Nephrol Hypertens. 2003; 12: 293-297
- A review of evidence for the link between sleep duration and hypertension.Am J Hypertens. 2014; 27: 1235-1242
Article info
Publication history
Published online: November 18, 2019
Accepted:
October 4,
2019
Received in revised form:
September 12,
2019
Received:
May 10,
2018
Identification
Copyright
© 2019 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
