Sleep Behavior Among College Students

Mackenzie Morgan

HLTH 2400

Section 1

HEALTH BEHAVIOR

The word “healthy” means different things to different people. According to WHO, and

for the sake of this paper, “health” is defined as “a state of complete physical, mental and social

well-being and not merely the absence of disease or infirmity” (World Health Organization,

2003). This definition takes a very holistic approach, noting not just the physical wellbeing of a

person, as many people would define health, but also social and mental aspects. In fact, social

interactions and good mental health lend themselves to a good physical health. One health

behavior in particular plays a key role in the maintenance of physical health, and that is sleep.

The recommended hours of sleep for children between fourteen and eighteen years are between

nine to eleven hours. For adults, the recommended hours of sleep lessens to seven to eight hours,

however, insufficient sleep is now considered a public health epidemic (CDC, 2014). Sufficient

sleep is notable for aiding in learning and memory, weight loss, cardiovascular health, and

warding off disease (Harvard, 2006). People that get a healthy amount of sleep every night are, in

turn, likely to participate in other healthy behaviors. People who report a lack of sleep on a

nightly basis often also self-report unintentional sleeping habits, such as falling asleep at the

wheel or during school.

STATISTICS

Figure 1 reports statistics on what percentage of each age group reported falling asleep

while driving in the past month. According to Figure 1, the adults age 25-35 reported the highest

percentage of falling asleep at the wheel, which those age 35-45 coming in second and those age

18-25 coming in third. In addition, other non-Hispanic races had the highest percentage of falling

asleep at the wheel, and males reported falling asleep at the wheel more than females.

Figure 1. Sleep Behaviors

Figure 2 shows that adults over that age of 20 reported that they had difficulty

concentrating on things 23.3% of the time, remembering things 18.2% of the time, driving 11.3%

of the time, and performing work 8.6% of the time.

Figure 2. Sleep-related Difficulties

Even though only 26% of the population reported nodding off while driving in 2009,

54% of people reported driving while drowsy in 2009 (National Sleep Foundation, 2009). That

means that almost half of those that are drowsy actually fall asleep at the wheel. In 2009, 1.9

million reported having a car accident or a close call due to falling asleep at the wheel (National

Sleep Foundation, 2009). That is almost 2 million accidents that could have been prevented by

having enough sleep the night before. Long-term side effects of sleep deprivation include high

blood pressure, heart failure, obesity, Attention Deficit Disorder, and depression (Breus, 2006).

HEALTHY PEOPLE 2020

With 25% of adults in the U.S. reporting insufficient sleep at least half of every month,

Healthy People 2020, a program that sets national objectives for health improvement of

Americans, set three objectives: 1) “Increase the proportion of students in grades 9-12 who get

sufficient sleep” 2) “Increase the proportion of adults who get sufficient sleep” and 3) “Reduce

the rate of vehicular crashes per 100 million miles traveled that are due to drowsy driving”

(Healthy People, 2013).

The aim of this paper is to look at the sleeping habits of high school and college students,

determine reasons in which students lack good sleeping habits, and look at the risks associated

with poor sleeping habits.

BELIEFS, VALUES, ATTITUDES, KNOWLEDGE

People often don’t get enough sleep because they simply underestimate the importance of

sleep. According to a study published in the Journal of School Health in 2009, students know

what should be done and how to do it in regards to obtaining the right amount of sleep; however,

they still practice risky behaviors. In the study, 82% of participants believed that exercising

regularly throughout the week would aid sleep, but only 68.4% reported actually exercising

regularly (Dake, Noland, Price, & Telljohann, 2009). Similarly, 70% of participants stated that

taking naps throughout the day would help them catch up on sleep, but only 38.6% reported

taking naps (Dake et al., 2009). This data tells us that the issue with sleep deprivation is not that

students don’t know how to combat it, but that students don’t want to combat it. In other terms,

students don’t care enough about the problem to correct the problem. This indicates that, in order

to decrease the percentage of sleep deprivation among students, students’ attitudes and beliefs

about sleep must change.

According to the National Center on Sleep Disorders Research, there are many

misconceptions about sleep that could lead a person to not receive enough sleep. One common

misconceptions is that receiving one less hour of sleep every night wont have an affect on

daytime performance (National Institutes of Health, 2003). This is an incorrect way of thinking,

because a “sleep debt” will form. Over time, even losing one hour of sleep per night can cause a

steady decrease in task performance. Another popular misconception is that a person’s body will

adjust to their sleep schedule (National Institutes of Health, 2003). One way the body prepares to

sleep is by releasing melatonin. Melatonin is a hormone secreted from the pineal gland when

there are low light levels. That is why melatonin is naturally secreted at night. When a person

tries to perform activities during the brain’s time of rest, cognition and motor skills will be

affected (National Institutes of Health, 2003).

DEMOGRAPHICS AND SOCIOECONOMIC STANDARDS

There is statistical evidence that sleeping habits vary between races and ethnicities, as

well as different social classes. In a lecture by Michael Grandner, a professor at the University of

Pennsylvania and member of the Center for Sleep and Circadian Neurobiology, makes a case that

race and income level effect sleep outcome. As seen in Figure 3, compared to whites, blacks,

Mexican-Americans, and other Hispanics all had higher probabilities of poor sleep. Black were

more likely to partake in longer sleeps rather than shorter sleeps, as well as Mexican-Americans.

Other Hispanic and other non-Hispanic races were more likely to partake in short sleep rather

than long sleep (Grandner).

Figure 3. Sleep Duration in relation to race/ethnicity

Source: Grandner

As seen in Figure 4, whites living in poverty had the highest probability of poor sleep

compared to any other race living in poverty, while whites not living in poverty had the lowest

probability of poor sleep compared to any other races not living in poverty (Grandner).

Figure 4. Poverty among different race/ethnicities and sleep

Source: Grandner

Grandner also pointed out that at almost every income level, women had a higher

probability of sleep disturbance compared to men at the same level. Figure 5 shows that, in

regards to education, females had higher probabilities of sleep disturbance then males at every

education level. The education levels include less than high school, high school graduate, and

some college (Grandner). Location of residence also proved to be an indicator sleep, with inner-

cities being associated with a 24% increased risk for poor sleep (Grandner).

Figure 5. Education and Probability of Sleep Disturbances

Source: Grandner

PSYCHOLOGICAL OR PERSONALITY CHARACTERISTICS

At any given moment, approximately 25% of adolescents are experiencing some sort of

psychological distress (Glozier, Martiniuk, Patton, Ivers, Qiang, Hickie, Senserrick, Woodward,

Norton, Stevenson, 2010). This increase in psychological distress has been a rising trend over the

past couple of decades (Glozier et al., 2010). Adolescents typically at risk for having

psychological distress are usually the ones who report sleep disturbance or insufficient sleep

(Glozier et al. 2010). According to the Sleep Journal, the students most likely to sleep

deprivation are extroverts (Balkin, Killgore, Rupp, 2010). According to the study, those exposed

to 12 or more hours of social interaction were more likely to show signs of sleep deprivation than

those who had not been exposed to social interaction for the same amount of time (Balkin et al,

2010). The explanation behind this is that those found in social situations are fatiguing their brain

of sleep by using up the attention and alertness areas of the brain (Balkin et al, 2010).

SOCIAL SUPPORT

Studies show that the ties a young adult has to his or her family, friends, and coworkers

have an effect on his or her health behaviors (Umberson, Crosnoe, and Reczek, 2010). According

to scientists, the human brain evolved where protection against predators was aided by strong

social ties, which allowed for a sense of security that allowed for sleep (Trockel, Barnes, and

Egget, 2000). Research suggests that arguments with others can lead insufficient and disruptive

sleep, while strong social ties with others tend to allow for better quality sleep (Dahl, 2002).

Even though we aren’t predators today, our brain still functions in similar manor. Today, strong

and health ties with the community, our families, and our friends lend to better, less disruptive

sleeping habits.

SOCIAL INTERACTIONS

The social support a person receives comes from the social interactions they have, and

they do this through a number of ways. Social interactions can include relationships with family

members, friends, and the community. One, positive social interactions can make a person feel

cared and loved for. This positive interaction can even have and affect on a person’s physical

health, like lowering stress levels and heart rates. Studies show that high stress and heart rate can

cause disruptive sleep, so having positive social interactions is one way to lower that chance.

Conversely, if a social interaction is negative and causes stress to a person, that person may be

more inclined to have disruptive sleep due to that feeling of conflict and stress. (Umberson and

Montez, 2010). The most important social interaction is the one between a child and his or her

parent. While most college students have fewer interactions with their parents while they are at

college compared to when they are home, the effect is still the same. Children of divorced

parents are more likely to take on the family’s stress as their own, and as previously mentioned,

stress can lead to disruptive sleep (Maume, 2013). Kids of divorced parents can also become

stressed when a parent remarries. Also, if there is a financial burden in the family and a student

has to work or take our student loans to pay for schooling, then the student is more likely to

experience stress and disruptive sleep (Maume, 2013). Up until recently, sleep was not

considered a health behavior; therefore, more research must be done to fully evaluate how social

interactions affect sleep (Maume, 2013)

ORGANIZATIONS, SOCIAL INSTITUTIONS

There are two main organizations on the national level that deal with sleep. One is the

National Sleep Foundation, and another is the American Sleep Association. The National Sleep

Foundation was founded in 1990 in Washington D.C. The mission of the National Sleep

Foundation is to “improve health and well-being through sleep education and advocacy”

(Missions, n.d.). The National Sleep Foundation has set the goals to ensure that: 1) sleep is used

as a vital sign by the health care system, 2) the sleep/wake cycle becomes common knowledge, 3)

schools and workplaces are sleep-friendly, and 4) the science of sleep is used in product making

(Missions, n.d.). To carry out these goals, the National Sleep Foundation has a variety of

programs. For example, the Foundation puts on the National Sleep Awareness Week. This week

is hosted in March, and is designed to educate the public on the importance of sleep. The

Foundation has Sleep Care Center members that put on events in their local communities. The

National Sleep Foundation also supports sleep research and practices reaching out to health care

providers to help with the understanding of sleep-related health problems. In an effort to

collaborate well with professional, governmental, voluntary, and other organizations, the National

Sleep Foundation started the National Sleep Awareness Roundtable (About NSART, n.d.). The

National Sleep Awareness Roundtable coordinates communication between federal agencies,

professional organizations, and the public. The second major organization regarding sleep health

is the American Sleep Association, which was founded in 2002 (National Sleep Foundation,

Phys.Org, n.d.). The American Sleep Association, like the National Sleep Foundation, aims to

bring physicians, health care workers, scientists, and the public to educate all on the importance

of sleep and sleep disorders (About ASA, n.d.)

RELATIONSHIPS BETWEEN ORGANIZATIONS AND COMMUNITIES

Both the National Sleep Foundation and the American Sleep Association work with the

public to help combat unhealthy sleep behaviors. As mentioned before, the National Sleep

Foundation created the National Sleep Awareness Roundtable. One main goal of the National

Sleep Awareness Roundtable is to increase and improve “collaboration among local, state, and

federal agencies; professional organizations; and the public” (About NSF, n.d.). The American

Sleep Association also have links to handouts, message boards, chat rooms, video lectures, and

many more features on their website, making it easy for the public to get involved.

Social Media has also made it easier than ever to connect with the public. The National

Sleep Foundation’s Facebook page regularly shares news articles and information bits on sleep

health. Currently, the National Sleep Foundation is uploading photos to Facebook and Twitter

based on the 2014 Sleep in America Poll® as a part of National Sleep Awareness Week. One

example can be seen in Figure 6.

Figure 6. National Sleep Foundation’s Sleep Awareness Week Campaign Photo

Source: National Sleep Foundation Facebook

Social media has been very important in connecting these large-scale organizations with

the everyday person by brining the issue right to the public in their own homes and work places.

PHYSICAL ENVIRONMENT

Many factors go into the quality and amount of sleep received each night. For example,

room temperature, noise, and light can all affect the quality of sleep. Having cell phone,

computer, or television light later at night have been proven to cause people to go to sleep later

and have more disruptive sleep (Environmental, n.d.). Having loud noise, whether from traffic or

home, can also cause more disruptive sleep and even the release of stress hormones

(Environmental, n.d.). One study found that intermittent sounds, like something falling or a

honking car, could be more harmful to sleep quality than a continuous noise (Environmental,

n.d.). This led to the conclusion that people living in urban areas have a higher probability of

sleep deprivation (Environmental, n.d.).

There are some simple tips that people can follow to aid in healthy sleeping, such as

making a bedroom comfortable and inviting, turning out lights, turning off electronics, and

adjusting the thermostat (Environmental, n.d.)

PUBLIC POLICY, LAW, REGULATION

There are not public policies or laws regarding sleep, because of the nature of this health

behavior.

PREDISPOSING, ENABLING, REINFORCING FACTORS

Predisposing, enabling, and reinforcing factors all influence a person’s behavior, and

therefore, his or her health. Predisposing factors are considered the components that come before

a behavior is done, such as attitudes, knowledge, beliefs, values, and confidence (Williams,

2013). Predisposing factors for sleep behavior of college students would be knowledge about

adverse side effects of sleep deprivation, beliefs about how important healthy sleeping habits are,

and attitudes about getting enough sleep daily. Enabling factors are components that come before

the behavior, but they actually facilitate the behavior, such as teaching skills and physical

limitations (Williams, 2013). An example of an enabling factor is community resources that

educate students on the importance of sleep. Reinforcing factors provide feedback for a behavior

from interactions with family and friends or health professionals (Williams, 2013). Reinforcing

factors are outside of the person but have a social support feel to them, while enabling factors are

outside of the person, but are based more on physical limitations (Williams, 2013). Examples of

reinforcing factors would be how supportive friends and family are towards having enough sleep

daily, how accepting friends and roommates would be of getting enough sleep on weekends

instead of staying out late.

DETERMINANTS INTERACTING TO INFLUENCE BEHAVIOR

Predisposing, reinforcing, and enabling factors are all interwoven to allow for a behavior

to occur. Predisposing factors in regards to sleeping habits among college students include a

college student’s knowledge about the problems associated with sleep deprivation, his or her

attitudes and beliefs towards healthy sleeping habits, as well as his or her motivation to have

healthy sleeping habits. Enabling factors are factors that facilitate a behavior, so in the case of

college students’ sleeping habits, some enabling factors include whether or not services are

provided for increasing awareness of the consequences of sleep deprivation and other unhealthy

sleeping habits. Enabling factors really deal with ways to overcome physical barriers and

limitations, so other examples would be the resources available to learn how to have healthy

sleeping habits. Reinforcing factors are considered intrapersonal and interpersonal, so

interactions with friends, family, and health care professionals that provide feedback are

examples. These interactions provide feedback in the form of rewards or punishments.

Applications of this would be how encouraging a college student’s friends and family were of

trying to have healthy sleeping behaviors.

SOCIAL ECOLOGICAL MODEL DIAGRAM

THEORY OF PLANNED BEHAVIOR

In a study published by the Psychology and Health Journal in 2011, the theory of planned

behavior was applied to the sleeping habit behaviors of college students. A sample of 273 first

year undergraduate psychology students from Australia was given an initial questionnaire online.

One week after the initial questionnaire, the same students were given a follow up questionnaire.

The follow up questionnaire measured the frequency of healthy sleep behaviors. The sample

consisted mostly of students living at home and female students.

Figure 7. Theory of Reasoned Action and Planned Behavior Constructs

The 4 main constructs in the Theory of Reasoned Action and Planned Behavior are

attitude towards the behavior, subjective norms, perceived behavioral control, and behavioral

intention. In this particular study, attitude, subjective norm, perceived behavioral control, and

intention were all measured. Attitudes were measured using a 7-point semantic differential scale.

Subjective norms were measured using a scale of 7-point Likert scale, “1” for very unlikely and

“7” for very likely. Perceived behavioral control was measured for self-efficacy, controllability,

and confidence to partake in healthy sleep behaviors on a 7-point scale, from strongly disagree to

strongly agree. Intention was also measured on a 7-point scale from strongly disagree to strongly

agree. Another variable that was measured was response inhibition, which can be defined as the

ability to inhibit a desired action in favor of less prominent action. Response inhibition was

measured using a Go/No Go computer test. During this test, if a participant hit “go”, when he or

she was supposed to hit “no go” or vice versa, it was counted as an error. It is similar to self-

control. Behavior was measured after one week, and past behavior was assessed at the beginning

using a single item for each behavior (Kor and Mullan, 2011).

Of the 273 that started the survey, only 257 completed the entire survey. The results of

the study indicated that subjective norms and perceived behavioral control were significant

predictors of intention, while attitude was not; it was negatively weighted with intentions.

Intention itself predicted a small amount of variance in behavior. Once intention was controlled

for, perceived behavioral control added more variance to behavior (Kor and Mullan, 2011).

Subjective norms was said to be the strongest predictor of intentions, and response inhibition was

the strongest predictor of behavior (Kor and Mullan, 2011). This means that the sleep behaviors

of a college student are very likely to depend on the demands and reinforcement of friends and

family. With these results in mind, the ability to self control and self regulate should be the target

of interventions (Kor and Mullan, 2011).

INTEGRATIVE MODEL OF BEHAVIOR

The Integrative Model of Behavior follows the Theory of Reasoned Action and Planned

Behavior in the fact that both have attitudes, subjective norms, perceived behavioral control, and

behavioral intentions as major constructs. The Integrative Model of Behavior adds two more

constructs: behavioral skills and environmental constraints. These two new constructs are

considered moderators, meaning that they have an effect on behavior but doesn’t lie in the

pathway of other variables. This can been seen in Figure 8.

Figure 8. Integrative Model of Behavior Diagram (Robbins and Niederdeppe, 2014)

In a study published by Health Communication Journal, a small group of college

undergraduates were given a questionnaire about their attitudes, subjective norms, and perceived

behavioral control regarding sleep. These answers were used to generate a survey that was then

given to a larger group of college undergraduate students. For this particular study, attitudes,

perceived norms, perceived behavioral control, and behavioral intention were all measured, while

descriptive norm beliefs, injunctive norm beliefs, and beliefs about enablers and barriers to

behavioral control were all assessed.

Attitudes are defined as the beliefs about an expected outcome of participating in a

behavior (Robbins and Niederdeppe, 2014). This expectation can be positive or negative, and

that can influence intention to perform a behavior. Perceived norms are the social influences that

affect intention, such as how society approves or disapproves of a certain behavior (Robbins and

Niederdeppe, 2014). Perceived behavioral control is how in control a person feels over

performing a behavior, which in turn influences intention (Robbins and Niederdeppe, 2014).

Intention can be said to be a mediating variable, because it relates the constructs to the behavior.

In this study, attitudes were measured using 7-point semantic differential pairs.

Perceived norms were measured using a 7-point Likert scale from strongly disagree to strongly

agree, and Perceived behavioral control was measured using a 7-point semantic differential from

easy to hard on one question and a 7-point scale from strongly disagree to strongly agree for two

questions (Robbins and Niederdeppe, 2014). Between this study and the study previously

mentioned that applied the Theory of Planned Behavior to the sleeping habits of college students,

the way that attitude, perceived behavioral control, and perceived norms were measured was

almost identical. The difference between experiential attitude and instrumental attitude was not

measured, and

Self-efficacy was not differentiated from perceived control under perceived behavioral control.

Skill knowledge and environmental constraints were not measured, for unknown reasons.

The results of this study conclude that attitudes and perceived behavioral control were the

strongest predictors of intentions (Robbins and Niederdeppe, 2014). Indirect measures, such as

descriptive norm beliefs, injunctive norm beliefs, and beliefs about enablers and barriers to

behavioral control, were stronger predictors of intention than direct measures, such as attitude,

perceived norms, and perceived behavioral control (Robbins and Niederdeppe, 2014).

RECOMMENDATIONS FOR INTERVENTION

After looking at these two studies that apply different health behavior models to sleep

behavior of college students, it would seem as if knowledge about the benefits of healthy sleeping

behaviors. In both cases, the strongest predictor of intention was subjective and perceived norms.

This means that students are basing their behavior off of what society accepts, rather than what is

best of their health. Therefore, awareness of the benefits of having healthy sleeping habits in

regards to school and health in general, needs to be increased. A recommendation given by

Robbins and Niederdeppe (2014) was to have a “message-based intervention.” This means that

the importance of sleep and our misconceptions about how sleep affects our ability to perform

tasks can be address by simply informing students about the benefits of sleep (Robbins and

Niederdeppe, 2014). The same “message-based intervention” can be said for beliefs that time

management and less stress allow for healthy sleeping habits. While these two beliefs are

correlated with intention, not many students hold fast to them. This leaves rom for intervention.

In all, the promotion of healthy sleeping behaviors can be achieved through “strategic

communication” (Robbins and Niederdeppe, 2014). With very effective strategic

communication, messages that encourage healthy sleeping habits in college will hopefully

discourage behaviors and beliefs that discourage healthy sleeping habits. Robbins and

Niederdeppe (2014) also recommended that further research be conducted to study how

descriptive norms are formed and how the sleeping habits of others have so much affect on the

sleeping habits of one person.

INTERVENTION

In order to change the sleeping behavior of college students, the intrapersonal and

interpersonal levels of the social ecological model must be targeted. There are several ways in

which the intrapersonal level of communication from the social ecological model can be

addressed, and they include:

1) Increased knowledge about how to get better sleep

2) Increased knowledge about the negative consequences associated with poor sleeping

habits.

3) Increased skills in how to achieve healthy sleeping habits

Ways to address the interpersonal level of communication include:

1) Increased support from friends and family about healthy sleeping habits

2) Increased support from a job and/or school

In addressing the intrapersonal and interpersonal levels of the social ecological model, several

constructs of the theory of planned behavior and reasoned action are also addressed, such as

attitude towards healthy sleeping habits, perceived behavioral control to have healthy sleeping

habits, and how others view healthy sleeping habits. Increasing knowledge about how to get

better sleeping habits and increasing the support from friends, family, and community affect

behavioral intention, and intention ultimately affects whether or not a behavior is formed.

Another way to look at the sleep behavior of college students would be to look at

predisposing, enabling, and reinforcing factors associated with said behavior. Predisposing

factors, in this case, are very similar to the intrapersonal level of the social ecological model,

mainly being comprised of knowledge, attitudes, beliefs, and values of towards healthy sleeping

behaviors. Enabling factors are antecedents that facilitate a behavior, such as skills, and

resources, and policies; enabling factors are a mixture of the community and organizational levels

of the social ecological model. Reinforcing factors elicit feedback for behavior from interactions

with friends and family and would lead more toward the interpersonal level of the social

ecological model.

One organizational level intervention for a university could be having discussions put on

by student government or some authoritative campus organization, such as a psychology

department, that would be open to college students to allow them to understand why and how to

get better sleep. By having student government try to educate on the issue, more students will be

more likely to listen because student government is comprised of peers of the same age dealing

with the same issues. By having a certain department, such as psychology, put on a discussion,

students will be more likely to listen because a psychology department has authority over the

subject because they will have the most knowledge about the consequences on your body from

insufficient sleep. This intervention would target both interpersonal and intrapersonal levels of

the social ecological model by increasing knowledge, awareness, and skills for better sleeping

habits, as well as targeting the other students and friends to have healthy sleeping habits. This

intervention also addresses the predisposing factors and reinforcing factor, while the intervention

itself would be an enabling factor.

Other nonpharmaceutical interventions can include relaxation therapies, stimulus control

therapy, and sleep restriction therapy (Austin, 2007). Relaxation therapy is a way to calm the

mind before sleep (National Sleep Foundation). This can be accomplished through breathing

exercises, helpful visualizations, mediation, and muscle relaxation exercises (National Sleep

Foundation). Stimulus control therapy is aimed to rewire the brain so that lying in bed is

associated with sleep instead of being awake (National Sleep Foundation). By not napping

throughout the day and getting up at the same time each day, a person can reset his or her bedtime

cues (National Sleep Foundation). Finally, sleep restriction therapy is when a person is restricted

to being in bed for the amount of time he or she actually spends asleep, not how much he or she

wants to sleep (National Sleep Foundation). The goal of this is increase sleep efficiency. Then, a

small amount of time is added to the time in bed, to eventually reach the desired amount of sleep.

There are also pharmaceutical interventions, such as taking drugs that help you sleep

easier and deeper at night. These drugs, however, should only be taken for insomnia that has

been diagnosed by a doctor and has a genetic or biological etiology (National Sleep Foundation).

Even then, drugs that help treat insomnia should only be taken for short periods of time (National

Sleep Foundation).

Some limitations must also be addressed in regards to intervention success. The only

way that relaxation therapy, stimulus control therapy, and sleep restriction therapy will work is if

a student suffers from insomnia. If a student is fully capable of getting better sleep, but chooses

not to, then only the first intervention mentioned will work. However, if a student does not have

healthy sleeping habits because of insomnia or another sleep related disease, then educating him

or her on the importance of healthy sleeping behaviors will be no good, since he or she cannot

partake, even if he or she wishes to. Therefore, there are two categories that a student can be

placed into: 1) choosing not to have healthy sleeping habits and 2) not being able to have healthy

sleeping habits because of a sleep related disease. To get to the root of those who choose not to

have healthy sleeping habits, the attitude and knowledge about the importance of acting on a

certain behavior must be examined. This type of intervention was the first one mentioned about

having a campus discussion. To get to the root of those who cannot sleep well because of

insomnia, specific medical interventions, such as therapy or pharmaceutical drugs, must be used

to treat the disease.

CONCLUSION

Sleep deprivation among college students is a real health behavior epidemic that needs to

be addressed. Sleep is very important in maintaining physical health, aiding in learning and

memorization, increasing cardiovascular health, and warding off diseases (Harvard, 2006). For

college students, lack of sleep often leads to decreased quality of work. In order to combat this

epidemic, the attitudes and beliefs about the importance of sleep must be changed. This can be

done with several interventions that target changing social norms, such as discussions put on by

student government and fliers put up in dorms and residence halls. In the case that a student

doesn’t choose to not get enough sleep, but just can’t get enough sleep, meditation and relaxation

therapies have proven to help (National Sleep Foundation, Insomnia). Pharmaceutical

interventions have also proven effective when a student suffers from insomnia; however,

pharmaceuticals should not be taken for extended periods of time, for the risk of addition to them.

In all, the most change in the sleeping habits of college students will occur if social norms and

perceived behavioral control are changed (Kor and Mullan, 2011).

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