1. INTRODUCTION
Sleep is essential for survival. Higher quality sleep is associated with increased well-being, mood,
decision-making, and perception. College students report significantly worse sleep quality than the
general population. Poor sleep habits in college students can lead to the following daytime
consequences:
(Brown, 2006)
After measuring several variables including exercise, eating, mood, stress, time management, and
work hours, researchers found that sleep habits had the largest effect on GPA.
Being sleep deprived also makes students more likely to fall asleep at the wheel or have car accidents.
Many students also use substances, either to maintain alertness (e.g. caffeine, stimulants) or to
facilitate sleep initiation (e.g. alcohol, over-the-counter sleeping aids) which may perpetuate the
vicious cycle of poor sleep.
(Trockel, 2000; Taylor and Bramoweth, 2010)
CONSCIOUSNESS ABOUT CONSCIOUSNESS: SLEEP INTERVENTIONS FOR COLLEGE STUDENTS
Rebecca Kiefer
Argelinda Baroni, MD
Christina Di Bartolo, LMSW
PREDICTED OUTCOMES
There have been many adaptations to the original intervention performed. The biggest modification
is that REST will be a stand-alone intervention rather than being embedded in the While You Were
Sleeping class. In order to refine the intervention, we delivered a REST workshop to high school
students in May-June 2016. We were able to acquire qualitative results indicating that the
workshops can positively influence sleep. However, the long-term goal is to administer REST to
college students and to obtain quantitative actigraphy data, along with questionnaires. We expect
that, compared to controls, students exposed to REST will present with improved sleep, mood, and
anxiety.
SLEEP HYGIENE
HOW DO WE GET COLLEGE STUDENTS TO SLEEP BETTER?
Researchers have demonstrated that improving sleep hygiene practices and knowledge is a component
of effective treatment for insomnia. For this reason, sleep hygiene practice and education may convey
a valuable benefit to a non-clinical population with poor sleep hygiene and a high prevalence of
insomnia, like college students.
(Brown, 2002)
To test this hypothesis we developed Rapid Education in Sleep Training (REST), a sleep intervention for
college students. This intervention was given as a part of the NYU CAMS course While You Were
Sleeping in 2014. In addition to questionnaires and sleep logs, the students’ sleep activity was
measured through FitBit sleep trackers. While the students’ sleep improved according to subjective
measures, FitBit sleep trackers failed to record the sleep activity accurately. As such, the current study
will utilize actigraphy to obtain objective sleep data. The actigraph is an FDA-approved device used to
monitor activity and sleep.
(Baroni et al, in preparation)
What is Sleep Hygiene?
Sleep hygiene is a set of habits and practices
that are conducive to sleeping well on a
regular basis.
More Car
Accidents
Lower
GPA
Decreased
Mood Weight
Gain
“Freshman
15”
Environmental Distractions:
Environmental distractions are a major reason
college students are widely recognized as having
poor sleep habits. In particular, the environmental
distractions in college that make regular sleep
difficult include:
ACTIGRAPHY
Sample Data
What To Do? How To Do It?
Avoid light or
noise during sleep
• Use a sleep mask or dark
curtains
• Use earplugs
Avoid Stimulants
or substances
which disrupt
sleep
• Avoid caffeine after
noon
• Avoid alcohol or
marijuana before bed
Maintain a regular
sleep schedule
• Wake up each day at
approximately the same
time
• Keep a sleep log
Substance
Use
CIRCADIAN RHYTHM STABILIZATION
(“What is the Circadian Rhythm?”, 2016)
SLEEP-CONDUCIVE BEHAVIORAL STRATEGIES
There is growing evidence that daily activities influenced by social rhythms (e.g. getting in or out of
bed, eating, or adhering to a work schedule) have important implications for sleep. The following are
social behaviors associated with good and poor sleep, respectively:
(Carney, 2006)
My Sleep Activity
Summary Statistics
• Average Bed Time: 12:49am
• Average Wake Time: 10:14am
• Average Hours in Bed: 9:24 hours
• Average Time Sleeping: 7:29 hours
• Sleep Efficiency: 79.00 %
• Standard Deviation of total sleep
time: 4.80 hours
WEARABLE SLEEP TRACKERS
Apps like Sleep Cycle, SleepBot, and Sunriser permit the user to input information and are popular
methods for monitoring sleep. However, they are not as efficient as wearable sleep platforms.
Wearable devices track a person’s body movements or biometric information without requiring any
input from the user. They are also more accurate since they derive their data directly from the wearer’s
movements.
(Ko, 2015)
Three of the most popular wearable trackers are:
CONSUMER REPORTS
FitBit has a variety of models
that automatically detect
activity and track sleep.
Long-term sleep trends can
also be viewed online.
(Montogomery, 2012)
JAWBONEup devices track
sleep and activity. This
tracker can wake the
sleeper with a vibration. The
product can also supposedly
detect “light” from “deep”
sleep, but this claim is
unsubstantiated.
(from Jawbone website)
Actigraphy is the only FDA-
approved activity monitoring.
Actigraphy uses an algorithm
to determine circadian
rhythms, sleep cycles, and
sleep quality over an extended
period of time. Actigraphy is a
reliable method for tracking
sleep.
(Choe, 2010)
Fitbit JAWBONEup Actigraph
To the right is a sample of a week of
my sleep activity recorded using
Actigraphy. As the updated
intervention will track college
students’ sleep using Actigraph
devices, this represents what the
baseline data may look like when
collected.
What is Circadian Rhythm Stabilization?
The circadian rhythm is often referred to as the “body clock”. It is a cycle
that tells our bodies when to sleep, rise, eat—it regulates many
physiological processes. When one’s circadian rhythm is disrupted, sleep
schedules can run amok.
The most powerful component of circadian rhythm stabilization is correct
light exposure and regularity of sleep schedule
Conducive sleep behaviors
• Regular sleep and wake times
• Early first beverage
• Healthy social interaction
Non-conducive sleep behaviors
• Irregular sleep and wake times
• Sporadic and irregular meal times and
activities
INTERVENTION CONTENT
In the upcoming study, REST will be administered as a stand-alone workshop delivered in two sessions
for a total of four hours. During these sessions, students will analyze their sleep and learn practical
information. They will then attempt to improve their sleep by applying the information from the
workshop. Content of the workshop includes:
Intervention outcomes will be assessed with questionnaires, sleep logs, and actigraphy.
Circadian Rhythm Stabilization
Sleep Hygiene
Sleep-Conducive Behavioral Strategies
social
temptations
academic
obligations
roommates