From awareness to action: Tackling sleep issues in college students

Sleep disturbances are increasingly prevalent among college students, negatively affecting academic performance by impairing concentration and memory, contributing to mood disturbances, and diminishing overall well-being [1]. The burden of sleep disturbances among college students is higher than in the general population, as short sleep duration affects 70 % of college students, and poor sleep quality is reported by 60 % [2,3]. The transition to university life often brings heightened stress, irregular schedules, and increased social and academic demands, all of which can disrupt healthy sleep patterns [4]. Biological and environmental factors also impact sleep in young adults [5]. During adolescence and young adulthood, a natural shift in circadian rhythms leads to a delayed sleep phase, resulting in a preference for later bedtimes and wake times [6]. Combined with low levels of physical activity, unhealthy dietary habits, and mental health challenges such as anxiety and depression, these factors collectively influence sleep patterns. Consequently, young adults may be particularly susceptible to sleep disturbances during their college years.

College campuses serve as the hub of academic and social life for students during their four years of study, a period in which they transition from teens to young adults. As such, educators and administrators are in a unique position to promote healthy habits by raising awareness through coursework and programs, designing interventions to address poor sleep habits, and offering medical services to diagnose and treat sleep disorders. However, the college environment often fosters poor sleep habits, sometimes through activities and services provided by the college itself. During finals week, many campuses provide 24-h access to libraries and extend the hours of food services and coffee shops, making it easier for students to stay up late and further disrupt their sleep schedules. Several colleges maintain longstanding finals week traditions – midnight breakfasts, games, therapy dogs and late-night recreation activities – intended to support students during this stressful time [7]. However, these events can inadvertently disrupt healthy sleep patterns and impact sleep hygiene, potentially contributing to development of chronic sleep disorders including insomnia and delayed sleep phase syndrome.

Nonetheless, sleep health is increasingly recognized as essential for overall well-being, and many college health centers now offer sleep health education during orientation week, include sleep health modules in first-year wellness courses, and incorporate sleep hygiene guidance into their counseling services. Sleep health interventions are also offered through various formats including in-person workshops, digital, or online sleep education programs to promote healthy sleep among students [[8], [9], [10]]. The impact of these interventions have been mixed, with some studies showing an increased awareness of sleep hygiene and improved sleep practices leading to consistent bedtimes, longer sleep duration, and better sleep quality, while others found no benefit for sleep health [11,12]. The mixed findings have been attributed to differences in interventions types, approaches, formats, duration and intensity.

In this issue, Howlin et al. describe three undergraduate courses at New York University that promote sleep health through educational and behavioral interventions [13]. The authors found that participation in these courses was associated with better sleep duration, improved sleep quality, and enhanced sleep health and conclude that sleep education and targeted interventions could improve sleep health among college students, which in turn would lead to better mental health and an overall college experience. These sleep health initiatives are feasible and well-received by young adults, making them valuable options for consideration at other colleges and universities [13]. Importantly, these courses included an applied experiential learning component in addition to didactic training, allowing students to identify their own sleep challenges and deficiencies along with actionable ways to address them. While we find this work highly promising and inspiring, these course-based strategies could be further complemented by campus-wide strategies for addressing poor sleep among students. We believe that colleges could positively shift campus culture to promote sleep health among students by adopting a comprehensive strategy encompassing education and awareness, policy and environmental changes, and support services. Here, we recommend a range of interventions at the individual, institutional, and environmental levels that have the potential to improve not only the student experience, but also the experiences of instructors and campus staff, who frequently address student absences, illnesses, and poor academic performance related to sleep deprivation.

Sleep health education can be offered through first-year workshops and seminars, health and wellness classes, orientation events, and elective coursework on the science of sleep and sleep from a public health perspective. Academic advisors could regularly check in with students at the beginning of each semester to ensure that their course schedules and other commitments allow sufficient time for sleep. If necessary, advisors can help students adjust their schedules to prioritize healthy sleep habits. Social media campaigns could emphasize the importance of sleep, debunk myths, share practical sleep tips, discourage habitual consumption of energy drinks as a substitute for poor sleep, and destigmatize prioritizing sleep. Policy and environmental changes to alleviate poor sleep may include adjustment of academic, athletic and social schedules to allow for adequate sleep opportunities and take into account the natural evening preferences inherent to this age group (e.g., no classes before 9 a.m.). During finals week, colleges should reconsider traditional programs, such as midnight breakfasts or 24/7 culture by discouraging all-night studying and substituting late-night campus activities with daytime events. A dark and quiet dorm environment is key to promoting healthy sleep. Enforcing quiet hours and establishing designated quiet zones in residence halls and libraries can help support healthy sleep. For first year students, matching roommates that have similar circadian preferences and sleep schedules can also foster conducive sleep environments. Counseling and health services could train counselors and health care providers to screen for sleep disturbances and educate about sleep hygiene and provide welcome packages with sleep masks, earplugs, and relevant literature.

The rapidly growing rates of sleep disturbances among students demand immediate action from educators, healthcare providers, and campus leaders alike. Sleep health interventions should include education, guidance, and support for behavioral changes to address poor sleep and foster a healthier and more productive college experience.

CRediT authorship contribution statement

Galit Levi Dunietz: Writing – original draft. Erica C. Jansen: Writing – review & editing.

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.