Sleep

Are you getting enough?

The average college student needs about 8 hours of sleep, but 60-70% of students get fewer than this. That means that a full two-thirds of college students are considered poor-quality sleepers! Lack of enough good sleep can take a huge toll on your mental, emotional and physical health, and we'd like to help you correct that problem. Browse through the information below to find out why college students have so much trouble with sleep and to find information and resources that just might help you sleep better.

Many adults have trouble sleeping, but college has a few extra things making the problem even worse. Some of these include:

  • New environment, priorities, and relationships
  • Academic demands they may not have had in high school
  • Inconsistent schedules
  • Difficulty scheduling and prioritizing between school, work, and social activities
  • Smaller living space, usually with roommates
  • Poor sleep behaviors

The new-found freedom of college life leads some students to experiment with drugs and alcohol. 

Reasons why alcohol can worsen sleep problems:

  • You may fall asleep faster, but alcohol decreases the quality of sleep.
  • Alcohol decreases rapid eye movement (REM) sleep, which is considered the most restorative type of sleep.
  • It can increase the number of times you have to get up to the bathroom at night.
  • Staying up late on weekends to go to parties leads to an inconsistent sleep schedule, which can cause sleep problems.

The use of non-prescribed stimulants is common among college students – most commonly Adderall or Ritalin – in order to stay awake and improve school or work performance. This can lead to a cycle of taking stimulants to stay awake, and sleeping pills to relax.

Health impacts of stimulants:

  • Highly addictive
  • Increased blood pressure
  • Irregular heart rate
  • High body temperature
  • Chronic insomnia
  • Depression
  • Seizures
  • Paranoia
  • Aggression
  • Psychosis 

Medical conditions can also cause sleep problems. Examples include obstructive sleep apnea (OSA), gastroesophageal reflux disease (GERD), thyroid problems, diabetes, asthma, and chronic pain. If you think there may be more to your sleep problems, please make an appointment with a provider at Student Health Service to explore possible health conditions.

 

Insomnia is difficulty falling asleep or staying asleep. Acute insomnia is brief and usually due to specific life circumstances. Acute insomnia usually resolves on its own once the situation ends. Chronic insomnia is when your sleep is disrupted at least three nights per week for at least three months. People with chronic insomnia can often benefit from treatment to improve their sleep.

Symptoms of insomnia:

  • Difficulty falling asleep
  • Waking up during the night
  • Waking up too early
  • Not feeling well-rested in the morning
  • Daytime sleepiness
  • Irritability
  • Depression
  • Anxiety
  • Difficulty concentrating
  • Making errors you usually wouldn't make
  • Worrying about sleep
  • Slow reaction time

Insomnia leads to sleep deprivation, which can have major effects on your life. Some of these include:

  • Anxiety and depression
  • Headaches
  • Weakened immune system
  • Specifically, higher risk of developing respiratory tract infections 
  • Long-term risk of chronic illnesses including high blood pressure, heart disease, diabetes, and kidney disease
  • Poor concentration, reduced problem-solving skills, and memory issues
  • Trouble learning new material
  • People with less sleep tend to do worse on exams

Below is a link to three tools to help you learn more about your sleep. You can download and complete them using Adobe Reader. Save or print when you're done to keep track of your results. You can also bring your results to Student Health Service to discuss your sleep with a health care provider.

The Pittsburgh Sleep Quality Index (PSQI) is a self-administered tool to look at your sleep in the last month. Scores range from 0-21; the higher your score, the worse your sleep quality. A total score of 5 or greater indicates poor sleep quality. Some people may not realize how poor their sleep really is. This tool can help put the problem into perspective.  Click here to take the PSQI

The Sleep Hygiene Index (SHI) is a self-administered tool to identify sleep hygiene behaviors. This tool is meant to help recognize behaviors that may be decreasing the quality of your sleep and identify areas for improvement. Higher scores indicate worse sleep hygiene, although there is no specific cutoff point for "good" and "bad" sleep hygiene. Scores range from 0-52 on this 13-point scale.  Click here to take the SHI

As with making any sort of change, you must first be motivated to do so. A form is included for you to list the pros and cons of changing your sleep behaviors to help you decide if you are ready to make the changes necessary that may improve your sleep.  Click here to look at your motivation level

Sleep Better

There are various techniques that can help you sleep better. Some are more appropriate in specific situations than others. However, good sleep hygiene behaviors are important for everyone. Explore the topics below to learn about things you can do to improve your sleep.

Sleep hygiene includes the behaviors and environmental factors needed for healthy sleep. Good sleep hygiene includes:

  • Go to sleep and get up at the same time every day, even on weekends
  • Eliminate or reduce caffeine and alcohol intake, especially in the hours before bed
  • The peak level of caffeine is within 30-60 minutes
  • The effects from caffeine can last between 8-14 HOURS!
  • Exercise daily, but not right before bed
  • Check out some of the activities available at Recreation and Sports Facilities
  • Spend time outside every day
  • If you nap, limit it to 30 minutes and avoid them in the late afternoon
  • Only use the bedroom for sleep and sex
  • Turn down bright lights in the evening
  • Don't eat before bed
  • Turn off all screens 30-40 minutes before bed
  • This includes cell phone, TV, and laptop! The lights and sounds stimulate your brain to stay awake.
  • Get a comfortable bed when possible
  • Don't sit and worry about your day
  • Make the room as comfortable as possible
  • Consider blackout curtains, eye shades, ear plugs, a white noise machine, or a fan

Soothing music facilitates relaxation by decreasing sympathetic arousal, decreasing the stress response, and providing a distraction from your thoughts. Listening for even 20-50 minutes before bed can improve sleep. It can be done alone or along with other relaxation techniques.

Music should be:

  • Something that you consider relaxing
  • A consistent volume throughout the song
  • Played quieter than your usual volume

Mind-body relaxation techniques can help to slow the body, ease the mind, and get ready for sleep. Pilates and yoga focus on concentration, control, breathing, and flow. They can improve mood, promote self-efficacy, and improve sleep. The combination of mediation, deep breathing, and the postures used are likely what lead to sleep improvement. Meditation helps to stabilize your emotions. Deep breathing helps to cue the body to relax. The flow of postures increases the mind-body connection.

Lavender is the most common essential oil used for sleep because of its calming and relaxing effects. Lavender oil can be used to improve mild insomnia, improve mood, and decrease anxiety. Nighttime lavender aromatherapy can decrease the difficulty of falling asleep and morning sleepiness. Other essential oils are also often used to improve sleep;however lavender is the only one with much research behind it so far. Other essential oils thought to help with sleep include roman chamomile, bergamot, clary sage, and ylang ylang.

Melatonin is a naturally secreted hormone that amplified day-night differences. People with primary insomnia tend to have lower nocturnal melatonin levels. Taking melatonin is especially helpful if your sleep-wake cycle has been disrupted, such as when working late evenings or nights, or to counteract "jet lag."

Bright light therapy can also be used when the sleep-wake cycle has been disrupted such as by working evening or night shifts, routinely staying up late, and jet lag. The shift in cycle leads to poor sleep and decreased alertness. The light-dark cycle is an environmental cue for the circadian rhythm. Bright light can help to shift the circadian clock and increase alertness. The light must be at least 7,000-10,000 lux and should be used for at least 20-30 minutes to be effective. These lights can be purchased online and at many stores including Walmart, Walgreens, and Bed Bath & Beyond.

The best timing for the bright light therapy depends on the sleep problem.

  • Wake up too early and can't fall back asleep? Evening bright light therapy can be effective to delay the sleep-wake cycle.
  • Wake up in the morning still feeling tired? Morning bright light therapy can help increase alertness.

There are various types of sleep aid medications. Some are over-the-counter (OTC) and others require a prescription. OTC sleep aids can be helpful on a short-term basis but are not meant for long-term use. Prescription sleep aids should only be used under the care of a healthcare provider.

Most OTC sleep aid medications contain antihistamines. Examples include diphenhydramine and doxylamine. Below are some of the pros and cons of taking OTC sleep aids.

Pros of OTC sleep aid medications:

  • Often fast and effective
  • Help break a pattern of insomnia

Cons of OTC sleep aid medications:

  • Don't treat the underlying cause of insomnia
  • The quality of sleep is often not the same
  • Can cause morning hangovers and daytime drowsiness in some people
  • Other possible side effects include dry mouth, dizziness, nausea, loss of appetite, drowsiness, headache, weakness, and constipation
  • Extended use can make you develop a tolerance, making them less effective over time
  • Can have negative interactions with other medications and alcohol, including other sedatives, anxiety medications, anti-seizure medications, muscle relaxants, allergy medications, monoamine oxidase inhibitors (MAOIs), and prescription pain medications.

If you need to use OTC sleep aids for more than a short period of time or think you might need a prescription medication, please make an appointment at Student Health Service to speak with a healthcare provider about your problems sleeping.

CBT-I is the 1st line treatment for insomnia. It focuses on stimulus control, sleep restriction, relaxation, and anxiety about sleep. CBT-I can be done as an individual in-person therapy, group therapy, telephone-delivered therapy, and online-based therapy. This is a short-term therapy that gives you the tools to change your sleep beliefs and behaviors. Most programs are 4-8 weeks long.

If you think this might be for you, check out the links in the Apps and Resources section below, or make an appointment at Student Health Services or Counseling Services to see if they offer something that is right for you.

If you would like to talk with a healthcare provider about your sleep, please make an appointment at Student Health Service.

Smartphone apps to help you sleep better

  • SleepyTime - Bedtime Calculator: Helps you decide what time you should go to bed to get enough sleep.
  • Sleep Genius: Helps you find your ideal bedtime, provides a relaxation program and has a progressive alarm that slowly wakes you up. 
  • Calm - Meditate, Sleep, Relax: Teaches meditation, breathing exercises, and provides nature sounds and scenes.
  • Relax Melodies - Sleep Sounds: Has 52 sleep sounds and white noise

Cognitive Behavioral Therapy for Insomnia (CBT-I)

  • Online programs
    • SHUTi: 6-week online program with weekly CBT-I strategy and learning sessions personalized to you. Each session takes 25-45 minutes to complete.
    • CBT for Insomnia: 5-week online program with weekly sessions with personalized feedback.
  • App available for smartphone
    • CBTI Coach: Free on iOS and android. This app helps you learn about sleep, develop positive sleep routines, and improve sleep environments.

Helpful websites about sleep

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