Impact of sleep problems on daytime function in school life: a cross-sectional study involving Japanese university...

The aims of this study were 1) to clarify the prevalence of sleep problems (insomnia, insufficient sleep, and delayed sleep-wake phase) among Japanese university students; 2) to examine sociodemographic characteristics, lifestyle, and sleep-related symptoms in each sleep problem; and 3) to evaluate the association between the above-mentioned sleep problems and daytime dysfunction in school life.

Self-report questionnaire surveys were conducted at eight universities in Japan, and we received 1034 valid answers (78% female). The questionnaire consisted of socio-demographic characteristics, information on lifestyle, sleep pattern, sleep-related symptoms, and daytime dysfunction in school life. Groups with insomnia, behaviorally induced insufficient sleep syndrome (BIISS), delayed sleep-wake phase (DSWP), and BIISS + DSWP were defined. To identify the association between sleep problems and daytime dysfunction in school life, the generalized linear mixed effect model was conducted.

Sleep duration on weekdays was 5.9 ± 1.2 h, and 38.2% of the students had a sleep duration < 6.0 h. About 16% of the students were categorized as evening-type individuals. More than half of the students (56.1%) had excessive daytime sleepiness. Insomnia was associated with tardiness (aOR: 0.8, 95%CI: 0.7-0.9) and falling asleep during class (aOR: 1.6: 95%CI: 1.4-2.0). BIISS was associated with tardiness (aOR: 1.5, 95%CI: 1.1-2.2) and interference with academic achievement (aOR: 1.9, 95%CI: 1.3-2.6). DSWP and BIISS + DSWP were associated with absence (aOR: 3.4, 95%CI: 2.2-5.1 / aOR: 4.2, 95%CI: 3.2-5.6), tardiness (aOR: 2.7, 95%CI: 1.8-4.1 / aOR: 2.2, 95%CI: 1.6-2.8), falling asleep during class (aOR: 2.6, 95%CI: 1.4-4.8 / aOR: 7.6, 95%CI: 3.3-17.2), and interference with academic achievement (aOR: 2.6, 95%CI: 1.7-3.9 / aOR: 2.1, 95%CI: 1.6-2.8).

Students with DSWP and BIISS + DSWP were significantly associated with daytime dysfunction in school life, i.e. absence, tardiness, falling asleep during class and interference with academic achievement. Students displaying BIISS + DSWP were considered to have a relatively more serious condition compared with those with only insomnia, DSWP, or BIISS. It is therefore of utmost importance that university students aim to prevent DSWP and BIISS which were associated with daytime function in school life.