The interplay between sleep and mood in predicting academic functioning, physical health and psychological health: A longitudinal study
Introduction
College students face multiple challenges, such as intellectual demands and identity formation. Furthermore, their sleep behaviors have been characterized by sleep deprivation, poor sleep quality and excessive daytime sleepiness [1]. Growing evidence suggests poor sleep patterns are related to impaired academic performance [2], physical health [3] and psychological well‐being [4]. Yet, the temporal relationships among sleep and these functional outcomes are unclear.
The relationship between sleep, mood and other psychological functions has lately become a rapidly developing research area. While negative mood, such as depression and anxiety, has long been identified as harming nighttime sleep, recent findings show that the relationship between sleep and mood is bi-directional [5]. Neuropsychological evidences suggest that both quality and quantity of sleep are vital to the optimal functioning of brain activity in regulating our emotions [5]. Fredriksen and coworkers [4] provided longitudinal data to show that among adolescents, sleep loss was a significant predictor of increased depressive feeling and self-esteem. In fact, Walker and Harvey [6] argued that while sleep and mood are unquestionably linked, future studies should assess how exactly they are related and the outcomes of such interaction/relation.
Sleep and mood also affect school performance. Kelly, Kelly and Clanton [7] found a positive correlation between hours of sleep and school grades. Students with ≥ 8 h of sleep reported an average grade-point-average (GPA) of 3.24 compared to an average GPA of 2.74 for those with < 7 h of sleep. Psycho-physiological research indicated that sleep is crucial for the consolidation and reactivation of memory [8]. Sleep-deprived participants have greater difficulty than healthy controls in recalling learned materials [9]. Good sleep quality was also associated with higher learning motivation and school performance. Gomes, Tavares and de Azevedo [10] recently demonstrated that both sleep duration and quality are significant predictors of school grades among undergraduates. While other evidence suggests that mood is related to school grades and motivation [11], how mood mediates the relationship between sleep behaviors and academic functioning remains to be determined.
A healthy sleep pattern has been shown to relate to desirable health conditions. Sleep duration and quality are suggested to closely relate to daytime sleepiness which reflects one's inability to sustain attention [1]. Daytime sleepiness has been used as an indicator of the health status in both patient and healthy population. For instance, excessive daytime sleepiness is seen as a cardinal symptom in sleep apnea and it is correlated with increasing medical problems in an otherwise healthy population [12]. Apart from daytime sleepiness, sufficient sleep is also demonstrated to predict health conditions, such as blood pressure [13] and body mass index (BMI) [3]. Chang and coworkers [14] found that among cancer patients' caregivers, poor self-reported sleep quality predicted dissatisfaction with physical health. While sleep behaviors appear to correlate with physical health, limited studies compared the relative contribution of different sleep behaviors in predicting health conditions.
Although increasing evidence suggests that sleep behaviors are closely linked with mood and functional outcomes (including academic functioning, physical and psychological health), causal relationships cannot be established without longitudinal or experimental evidence [2]. The current study aims primarily to explore the temporal relationships from sleep behaviors to the aforementioned functional outcomes. We also intend to explore if sleep affects daytime functions through inducing negative mood. In other words, we plan to test the mediating role of mood between sleep behaviors and daytime functions. While some sleep behaviors were shown to have differential roles in predicting daytime functions in previous cross-sectional studies, we aim to compare the relative contribution of interdependent sleep behaviors in predicting the outcome measures with a longitudinal structural equation modeling (SEM) approach. With the use of SEM, all regression pathways can be tested at once and comparisons of strengths of pathways can be made accordingly.
Section snippets
Participants
Chinese undergraduates, aged 18–25 from 16 universities and colleges in Hong Kong and Macau were recruited through campus flyers, emails and online platforms. Of the 1195 participants who completed the measurements in Time 1, 1006 (84.2%) continued in Time 2 and 930 (77.8% of Time 1) in Time 3.
Procedures
The current investigation was a sub-study of a large-scale longitudinal research program on the formation and transformation of beliefs, lifestyle, and well‐being in Chinese. Ethics approval was obtained
Results
Details of the demographic information are summarized in Table 2. The final sample, with mean age of 21.7 (SD = 2.22), was composed of second-year students (45.2%), with 10.3% and 44.5% in their first- and third-year or above, respectively. There were 307 males and 619 females. Table 3 summarized the correlational data and showed that there were less than 5% data missing among all measured variables. The Little's MCAR test suggested that the data missing were completely at random, χ2(1584) =
Discussion
The current study primarily aimed to investigate the directional relationships between different sleep behaviors, mood and daytime functions, including physical health (daytime sleepiness and physical well‐being), psychological health (mood and self-esteem) and academic functioning (school grades and study effort). Our findings showed that not all, but some specific sleep behaviors may directly or indirectly (through inducing negative mood) predict the aforementioned daytime functions
Conclusion
Taken together, the current study strengthens the claim that specific domains of sleep behaviors can directly or indirectly (through mood) predict physical and psychological health and academic functioning. The current findings call attention to the need for colleges to raise students' awareness of the relationships between their sleep, mood, and academic performance and to provide sleep hygiene education. Besides testing the predictive/mediating roles of different sleep behaviors in affecting
Conflict of interest statement
This is not an industry‐supported study. The authors have indicated no financial conflicts of interest.
Acknowledgments
We thank Ms. Jasmine Lam for her assistance in data collection.
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These authors contributed equally to this work.