Relationship of sleep quality and attention deficit hyperactivity disorder symptoms with quality of life in college students

Abstract

Objective: Attention deficit hyperactivity disorder (ADHD) negatively influences various aspects of life such as social relations, adaptive skills, and occupation. In addition, many university students experience sleep problems, academic failure, and low quality of life (QOL). We investigated the relationship among ADHD symptoms, sleep quality, and QOL of college students, and identified the factors related to their QOL. Participants and Methods: Using a survey questionnaire, data were collected from 195 students from March–May 2017. Results: QOL of students was related to ADHD symptoms and sleep quality. Factors significantly associated with better QOL were fewer ADHD symptoms, good sleep quality, male sex, high academic performance, and high economic status. The explanatory power of these variables on QOL was 32.0%. Conclusion: To improve the QOL of college students, a multifaceted approach that includes assessment of ADHD symptoms and sleep quality is needed.     

ADHD,depression, and substance abuse risk among beginning college students

Abstract

Objective: This study examined differences in substance use, depression, and academic functioning among ADHD and non-ADHD college students. Participants: Included 1,748 students (ages 18–25; women 68.4%; Caucasian 71.3%) with and without history of ADHD. Methods: We assessed the relationship of ADHD to substance use variables, controlling for depressive symptoms and examined relationships with GPA. Results: ADHD students were more likely to have engaged in frequent alcohol use, binge drinking, regular marijuana use and to have used other drugs in the last year. They reported higher depression symptoms than non-ADHD students, although substance abuse risk remained high even when controlling for depressive symptoms. ADHD students had lower overall GPA than those without ADHD. However, this difference was no longer significant when controlling for depression and marijuana use. Conclusions: College campuses should consider programing aimed at identifying ADHD students at risk for developing substance abuse problems and emotional difficulties.     

Multilevel analysis exploring the links between stress,depression, and sleep problems among two-year college students

Objective: This study explored the association of stress and depression with a multidimensional sleep problems construct in a sample of 2-year college students. Participants: The sample consisted of 440 students enrolled in 2-year study from Fall 2011 to Fall 2013. Methods: Participants in an obesity prevention study completed surveys assessing sleep, stress, and depression at baseline, 4, 12, and 24 months. Multilevel models predicting sleep problems were conducted to distinguish episodic from chronic reports of stress and depression. Results: Participants were primarily women (68%), white (73%), young adults (M age = 22.8), with an average of 8.4 hours of sleep per night. Neither stress nor depression was predictive of sleep quantity; however, they were predictive of sleep quality. Conclusions: Results show that sleep quality rather than sleep quantity may be the greater health concern for young adults, suggesting that intervention programs targeting depression, stress management, and healthy sleep patterns are warranted.     

Anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD): Cross-informant,sex, and subtype differences

Objective: This study examined symptoms of anxiety and depression among college students with attention-deficit/hyperactivity disorder (ADHD). Participants: Data were collected between March 2011 and March 2016 from 150 college students with ADHD and 150 college students without ADHD. Method: Participants with ADHD were compared to a sex- and ethnicity-matched control group. For the ADHD group, parent and self-report of anxiety and depression were also compared. Results: College students with ADHD self-reported significantly higher anxiety and depressive symptoms than did students without ADHD. Scores on parent-report measures of anxiety and depressive symptoms were significantly higher than scores on self-report measures. Significant sex differences were found for participants with ADHD, with females showing higher depressive and anxiety symptoms than males. Parent-reported anxiety symptoms were higher for those with inattentive type ADHD compared to combined type ADHD. Conclusion: The current study highlights the importance of multi-informant assessment in ADHD evaluations for college-aged adults.     

A person-centered analysis of sleep and emotion dysregulation: Short- and long-term links with depression and alcohol use

Objective: Our objective was to examine the co-occurrence of sleep problems and emotion dysregulation and its short- and long-term links to depressive symptoms and alcohol use in a sample of university students. Method: Participants included 1132 first-year university students from Southern Ontario (70.5% women). Time 1 data were collected in February/March, 2010, and Time 2 data (n?=?746) were collected in February/March, 2014. Participants were surveyed about sleep problems and emotion dysregulation (Time 1), and depressive symptoms and alcohol use (Times 1 and 2). Results: A latent class analysis revealed four groups: (1) Low Co-Occurrence, (2) Sleep Problems Only, (3) Emotion Dysregulation Only, and (4) High Co-occurrence. Group 4 had more depressive symptoms than all other groups in both the short- and long-term. Conclusions: First year university students with high co-occurrence of sleep problems and emotion dysregulation may be a target group for programs focused on reducing adjustment difficulties.     

Sleep Quality and Alcohol Risk in College Students: Examining the Moderating Effects of Drinking Motives

Abstract

Objective: Sleep problems and alcohol misuse are common issues experienced by college students that can have detrimental effects on overall health. Previous work indicates a strong relationship between poor sleep quality and alcohol risk in this population. This study explored the moderating effect of drinking motives in the relationship between global sleep quality and experience of alcohol-related negative consequences. Participants: College students (N = 1,878) who reported past-month drinking. Methods: Participants completed online surveys assessing sleep and alcohol-related behaviors. Results: Poorer sleep quality and higher drinking motives (coping, conformity, and enhancement) predicted greater alcohol-related consequences, controlling for drinking. Further, coping motives moderated the relationship between sleep quality and consequences such that participants reporting poor sleep and high coping motives experienced heightened levels of consequences. Conclusions: These findings advance the understanding of the relationship between sleep problems and alcohol-related risk and provide implications for targeted campus-based health promotion interventions.     

Mindfulness and health behaviors in college students: The moderating role of sleep

Abstract

Objective: To examine the moderating effects of subjective sleep quality (SSQ) and sleep duration on the relationships between mindfulness and health behaviors (i.e. nutrition and exercise) among undergraduate students. The unique influence of the five facets (i.e. factors) of mindfulness (i.e. observing, describing, acting with awareness, nonreactivity to inner experience and nonjudging of inner experience) on students’ health behaviors was also explored. Participants: Three hundred fifty seven undergraduate students enrolled in U.S. colleges. Methods: Students completed an online survey. Hierarchical multiple regression analyses were conducted to determine whether SSQ moderated the relationship between mindfulness and nutrition behavior. Results: SSQ moderated the relationship between mindfulness and nutrition behavior. The observe facet of mindfulness was the most predictive of nutrition behavior, whereas the observe and describe facets were the most predictive of exercise behavior. Conclusions: Interventions that target mindfulness and sleep quality may help promote healthy eating and increased exercise engagement in college students.     

Attention-deficit hyperactivity disorder symptomatology,binge eating disorder symptomatology,and body mass index among college students

Abstract

Objective: To explore the relationship between symptoms of attention-deficit hyperactivity disorder (ADHD), symptoms of binge eating disorder, and body mass index (BMI) among students at a southern university. Participants: Two hundred seventy-seven college students. Methods: Between January 31, 2013 and March 27, 2013, participants completed the Adult ADHD Self-Report Scale (ASRS) Screener and the Binge Eating Scale (BES) in addition to permitting researchers to measure their height and weight. Results: Higher ASRS scores, higher BMIs, and lower BES scores were observed among men. Among both men and women, BES scores were positively correlated with BMI and ASRS scores; however, the correlation between ASRS and BMI was not significant. Conclusion: Binge eating disorder symptomatology was associated with increased ADHD symptomatology and a higher BMI among both men and women. Among students presenting with obesity or ADHD, screening for binge eating may assist with the identification of problematic eating behaviors.     

A multivariate analysis of adverse childhood experiences and health behaviors and outcomes among college students

Objective: This study investigated associations between adverse childhood experiences (ACE) prior to age 18 years and multiple health behaviors (eg, cigarette and other substance use) and outcomes (eg, obesity, depression) for a large college sample. Participants: 2,969 college students from seven universities in the state of Georgia were included in the analysis. Methods: Web-based surveys were completed by students (45–60 minutes) during the spring semester, 2015. Results: Findings indicate that more ACEs are associated with higher levels of depressive symptoms, ADHD symptoms, cigarette use, alcohol use, marijuana use, and BMI, in addition to lower levels of fruit and vegetable intake, and sleep. Conclusion: ACEs may carry forward in the lifespan to influence a range of unhealthy outcomes among college students. College intervention programs may benefit by recognizing the pervasiveness of ACEs and their associations with health behaviors and outcomes, and include interventions across more than one health behavior.     

Evaluating the consistency of scales used in adult attention deficit hyperactivity disorder assessment of college-aged adults

Objective: Neurocognitive evaluations are commonly integrated with clinical assessment to evaluate adult Attention Deficit Hyperactivity Disorder (ADHD). Study goal is to identify measures most strongly related to ADHD diagnosis and to determine their utility in screening processes. Participants: 230 students who were evaluated at the Vanderbilt University Psychological and Counseling Center between July 2013 and October 2015. Methods: We retrospectively examined charts, including clinical diagnosis, family history, childhood parental reported and current self-reported ADHD symptoms, psychiatric comorbidities, and continuous performance test (CPT). Result: Positive report of childhood and current ADHD symptoms, and lack of comorbid psychiatric symptoms were strongly associated with clinical diagnosis. CPT results were not associated with an ADHD diagnosis. The absence of reported childhood and current ADHD symptoms may serve as a contradictory marker for ADHD diagnosis. Conclusion: Clinical assessment of ADHD symptoms and ADHD childhood history, but not CPT, contributes to an accurate diagnosis of ADHD in college-aged adults.     

Investigating the mediational role of negative urgency in the anxiety sensitivity pathway to cannabis problems and dependence symptoms among postsecondary students

Objectives: Anxiety sensitivity (AS) is associated with cannabis use. People high in AS may use cannabis to cope with elevated anxiety. This association is consistently supported in the literature. However, we have much to learn about the mechanisms of the AS pathway to cannabis use. We aimed to examine negative urgency—the tendency to act impulsively when distressed—as a mediator of the association of AS with cannabis problems and cannabis dependence symptoms. We hypothesized that negative urgency would uniquely mediate the association of AS with cannabis outcomes after controlling for other facets of impulsivity. Participants and Methods: Postsecondary students (N = 91; Fall 2012) completed online self-reports. To participate, students needed to be ≥18 years old, enrolled in postsecondary studies, and needed to report current cannabis use. Results: Negative urgency uniquely mediated associations between AS and cannabis problems and dependence symptoms. Conclusions: Our findings suggest a mechanistic role of negative urgency in the AS pathway to cannabis misuse.     

Correlates of AUDIT Risk Status for Male and Female College Students

Abstract

Objective: The current study identified gender-specific correlates of hazardous drinker status as defined by the AUDIT. Participants: A total of 462 college student volunteers completed the study in 2006. The sample was predominantly Caucasian (75%) and female (55%). Methods: Participants completed a survey assessing demographics, alcohol use patterns, and health indices. Scores of 8 or more on the AUDIT defined the at-risk subsample. Logistic regression models determined which variables predicted AUDIT risk status for men and women. Results: The at-risk participants reported higher alcohol use and related problems, elevated sleep problems and lower health ratings. High typical blood alcohol concentration (BAC), lifetime drug use, and psychosocial problems predicted risk status for males. Binge frequency and psychosocial problems predicted risk status for females. Conclusions: Different behavioral profiles emerged for men and women identified as hazardous drinkers on the AUDIT. The efficacy of brief alcohol interventions could be enhanced by addressing these behavioral correlates.     

Daytime Sleepiness,Poor Sleep Quality,Eveningness Chronotype,and Common Mental Disorders Among Chilean College Students

Abstract

Objectives: To evaluate whether daytime sleepiness, poor sleep quality, and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. Methods: A total of 963 college students completed self-administered questionnaires that collected information about sociodemographic characteristics, sleep quality characteristics, CMDs, and other lifestyle behaviors. Results: The prevalence of CMDs was 24.3% (95% confidence interval [CI] [21.5%, 27.1%]) among all students. Prevalence estimates of both excessive daytime sleepiness and poor sleep quality were higher among females (35.4% and 54.4%) than males (22.0% and 45.8%). Cigarette smoking was statistically significantly and positively associated with having CMDs (p = .034). Excessive daytime sleepiness (odds ratio [OR] = 3.65; 95% CI [2.56, 4.91]) and poor sleep quality (OR = 4.76; 95% CI [3.11, 7.29]) were associated with increased odds of CMDs. Conclusion: Given the adverse health consequences associated with both sleep disorders and CMDs, improving sleep hygiene among college students is imperative to public health.     

Depression,anxiety, and tobacco use: Overlapping impediments to sleep in a national sample of college students

ABSTRACT

Objectives: To examine how tobacco use and depression/anxiety disorders are related to disturbed sleep in college students. Participants: 85,138 undergraduate respondents (66.3% female, 74.5% white, non-Hispanic, ages 18–25) from the Spring 2011 American College Health Association–National College Health Assessment II database. Methods: Multivariate analyses of tobacco use (none, intermediate, daily) and mental health (diagnosed and/or symptomatic depression or anxiety) were used to predict sleep disturbance. Results: Daily tobacco use was associated with more sleep problems than binge drinking, illegal drug use, obesity, gender, and working >20 hours/week. Students with depression or anxiety reported more sleep disturbances than individuals without either disorder, and tobacco use in this population was associated with the most sleep problems. Conclusions: Tobacco use and depression/anxiety disorders are both independently associated with more sleep problems in college students. Students with depression and/or anxiety are more likely to be daily tobacco users, which likely exacerbates their sleep problems.     

Differences in Sleep Quality and Health-Related Quality of Life in Young Adults With Allergies and Asthma and Their Healthy Peers

Abstract

Objective: The current study examined the relationship between sleep quality and health-related quality of life (HRQOL). Participants: Participants were 501 undergraduate students with allergies (167), asthma + allergies (167), or with no history of a chronic illness (167) completed study measures from August 2011 to April 2012. Methods: The undergraduate students completed questionnaires online as part of a larger study of psychosocial adjustment of young adults. Results: Young adults with allergies and asthma + allergies reported significantly worse sleep quality and HRQOL than healthy peers. Additionally, those with allergies and asthma + allergies had significantly more sleep disturbances and used sleeping medication significantly more often in the previous month than healthy peers. Conclusions: These results highlight concerns regarding quality of life and sleep problems in an often-overlooked population. Importantly, sleep difficulties can result in difficulties in daily living and impairment in academic functioning.     

Sex-specific associations between sleep and mental health in university students: a large cross-sectional study

Abstract

Objective: To examine the associations between sleep problems and mental health dimensions in university students, and the effect of sex on these associations. Participants: Self-reported survey data from 3,483 students aged 18–30?years was drawn from a larger web-based study (i-Share) conducted in France in the years 2013–2017. Methods: We performed logistic regression analyses stratified by sex using insufficient sleep duration, poor sleep quality, difficulty initiating sleep and excessive daytime sleepiness, in relation with stress, self-esteem, depression and anxiety. Results: All sleep problems were strongly associated with all mental health dimensions, particularly anxiety, in female students. Sleep and mental health problems were also associated in male students, with the exception of low self-esteem, but odds ratios were lower than for female students. Conclusions: Present findings warrant attention to propose early interventions targeting sleep and mental health in the university setting taking sex into account.     

Sleep disturbance as a clinical sign for severe hypogonadism: efficacy of testosterone replacement therapy on sleep disturbance among hypogonadal men without obstructive sleep apnea

Objective: The present subanalysis of the EARTH study investigates the effects of one year testosterone replacement therapy (TRT) on sleep disturbance among hypogonadal men without obstructive sleep apnea.

Methods: Sleep disturbance was defined as three or more points in question 4 of the aging males symptoms (AMS) questionnaire. All participants completed the AMS scale, International Prostatic Symptoms Score (IPSS), Sexual Health Inventory for Men (SHIM) and Short Form 36 (SF-36) health survey at baseline and after 12?months. Sexual symptoms were also evaluated based on three AMS subscores (Q15, 16 and 17).

Results: We identified 100 patients with sleep disturbance, of whom 48 (24 each in the TRT and control groups) were ultimately included for analysis. All SF-36 categories , AMS scale, IPSS and SHIM score subdomains were significantly worse in patients with sleep disturbance than in those without disturbance. Statistically significant differences in sleep disturbance, erectile symptoms, sexual desire and some domains of the SF-36 were observed between the TRT and control groups after 12?months.

Conclusion: Sleep disturbance may be one of the clinical signs for severe hypogonadism. Moreover, TRT improved sleep conditions, sexual function and quality of life among hypogonadal men with sleep disturbance.     

Impact of a sleep course on sleep,mood and anxiety symptoms in college students: A pilot study

Objective: To examine the impact of a sleep course on sleep-related behaviors, mood, and anxiety in college students. Participants: Participants were 145 students enrolled in either the sleep course (n = 70) or a psychology course (n = 75); data were collected in September 2014, November 2014, and February 2015. Methods: Sleep characteristics and symptoms of depression and anxiety were assessed using validated questionnaires and sleep logs. Linear, logistic and proportional odds regression models were used to test course effects. Results: In November, sleep course students reported significant differences in sleep hygiene (SHI; p < .001), perceived sleep latency (PSQI; p < .05), and circadian sleep phase (MEQ; p < .05), compared to controls. In February, the sleep course students maintained most of the aforementioned gains and reported fewer symptoms of depression (CES-D; p = .05) and anxiety (BAI; p < .05). Conclusions: These positive preliminary results indicate that focused education has the potential to improve sleep among college students.     

Characteristics of university students who mix alcohol and energy drinks

Objective: Research has identified correlates (eg, drug use, risky sex, smoking) of using alcohol mixed with energy drinks (AMEDs). Few studies have investigated common mental health-related concerns (eg, depression, sleep). Participants: Alcohol-using college students (n = 380 never used AMEDs, n = 180 used AMEDs) were recruited in the study during the fall 2011 semester. Methods: The study examined demographics, substance use, depressive symptoms, and sleep problems in association with AMED use. Results: Multivariable logistic regression indicated that alcohol use severity (AOR = 1.24; 95% CI = 1.14+1.34), drug use severity (AOR = 1.20; 95% CI = 1.04–1.39), depressive symptoms (AOR = 1.06; 95% CI = 1.01–1.12), and smoking (AOR = 2.12; 95% CI = 1.22–3.68) were independently associated with AMED use; sleep problems were non-significant. Conclusions: Administrators may consider policies regarding energy drink availability on campus, and campus health personnel may increase screening and education surrounding AMED use to reduce risks among students.