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29.04.2021 21:08:39
Copyright © 2010 Elsevier Inc. All rights reserved.
See full version: Sleep state switching
Copyright © 2010 Elsevier Inc. All rights reserved.
Figure 2. The REM-NREM sleep switch more
Figure 5. Summary of the cascading wake-sleep…
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Depression and sleep are interrelated. A cardinal feature of depression is disturbed sleep.76,77 Depression is common during the college years: 14.8% of students report a diagnosis of depression and an estimated 11% have suicidal ideation.78 Insufficient sleep can increase depressive symptoms. In a study of female college students, sleep debt of 2 hours per night and/or a bedtime after 2 am was associated with greater depressive symptoms.79 Irregular sleep schedules have been associated with greater depressive symptoms. Prolonged sleep latency was associated with loss of pleasure, punishment feelings, and self-dislike.80 Differences between sex were apparent, as women went to bed earlier, slept longer, had more nocturnal awakenings, and reported more depressive symptoms. However, when the sleep variable was removed by deleting the question, “Have you experienced changes in sleep?”, no significant difference in sex persisted, suggesting the greater incidence of depression in college-aged women may be due in part to the greater number of reported sleep difficulties.80,81 [links]
Many studies investigating the interaction of sleep, memory, and learning use scenarios of a specific memory task and then alter subjects’ sleep pattern or duration to determine the impact that sleep had on the subject’s performance. These scenarios often may not directly correlate with the memory and learning that college students are expected to perform or the alterations in their sleep schedule they experience. Despite these limitations, these studies illuminate the impact of sleep on students’ memory, learning, and potential academic performance. [links]
Energy drinks are becoming increasingly popular and 34% of 18–24-year-olds consume them regularly. In 2006, Americans spent more than $3.2 billion on energy drinks.41 The majority (67%) of users consumed energy drinks to help compensate for insufficient sleep.42 The contents of energy drinks are variable and depend on the individual product, but usually contain caffeine, herbal products, and sometimes vitamins and other supplements. Caffeine is the primary constituent responsible for the effect of increased energy. The amount of caffeine varies widely from 45–500 mg. Use of energy drinks is associated with higher use of alcohol and possibly other drugs, including stimulants.43
Driving after drinking is commonplace during college, as up to 34% of students reported driving after drinking within the last 30 days.75 The combination of sleep deprivation and drinking may be especially common at the end of the semester, when sleep-deprived students celebrate the end of exams with drinks before driving home for the holiday break. The dangerous combination of sleep loss and alcohol could impair driving performance even in students who are not legally intoxicated.
Use of either prescribed or nonprescribed stimulants is a growing problem in young adults. The most commonly reported reason is to “stay awake to study” or increase concentration.44 Students may utilize these drugs more than age-matched non-students.45 A survey at 119 colleges and universities across the US found a 6.9% lifetime prevalence for the use of stimulants.46 Other studies show prevalence as high as 14%.44,47 Men are more likely than women to use stimulants, as well as caffeine and energy drinks. Nonprescribed use of stimulants is associated with increased use of alcohol, cocaine, and marijuana.46 Not all stimulant use is illicit, as between 2%–8% of college students’ self-reported symptoms are consistent with attention deficit hyperactivity disorder (ADHD).48 However, when parents of college students were asked to report such symptoms in their children, the prevalence of ADHD decreased to around 1%. Stimulants increase sleep latency and suppress REM sleep; subjects who use stimulant medications report worse sleep quality.23,47
Students with sleep disorders probably do not achieve optimal academic performance, and up to 27% of students may be at risk for at least one sleep disorder.57 Students at risk for academic failure (GPA <2.0) were at a disproportionately high risk for sleep disorders. Among those who screened positive for obstructive sleep apnea, 30% were at risk for academic failure. Medical students classified as frequent snorers more frequently failed their Internal Medicine examination (47%) than did occasional snorers (22.2%) or non-snorers (12.8%). After adjustment for age, BMI, and sex, the relative risk for snorers to fail the examination was 1.26 (95% confidence interval: 1.01–1.57).65 Obstructive sleep apnea is suspected to have cognitive effects in both children and adults.66 A higher percentage of students at risk for academic failure screened positive for other sleep disorders including: periodic limb movement disorder/restless legs syndrome (21%),67 insomnia (22%), circadian rhythm sleep disorders (26%), and hypersomnia (21%).57 As nearly one in four students is at risk for a sleep disorder, screening for sleep disorders among students with poor academic performance may well be advisable.