Abstract
A number of students develop sleep problems when attending university due to a variety of reasons. Previous research used a quantitative approach which suggested bedtime schedules, gender differences and alcohol consumption had an effect on sleep quality. The aim of this study was to explore the causes of sleep deprivation in undergraduates, utilising a qualitative approach in a 1:1 semi-structured interview lasting 3-5 minutes. Purposeful sampling recruited 4 first-year students (2 male, 2 female) aged 18-20 who attended university in the North East of England and lived in halls of residence. Results of thematic analysis exposed 2 key themes: lifestyle and technology, which displayed the difficulties students found to find a set sleeping pattern when transitioning to university. Findings revealed varying lecture times, mobile phones, alcohol and naps contributed to sleep deprivation. These results should be researched further to identify how these causes can be managed to ensure students’ mental health and well-being which can be supported by universities through offering counselling sessions.
Introduction
When students attend university for the first time, there are many physical and emotional changes that occur, including sleep difficulties, which may be due to the increased need for sleep in adolescents than pre-pubertally as a result of circadian phase shifts (Carskadon, 1990). In 2015, the National Sleep Foundation issued new sleep recommendations of 7-9 hours per night for younger adults (aged 18-25). It is important to consider the changes in sleep patterns within undergraduates as findings have shown that students are oblivious to the negative consequences a lack of sleep has on their cognitive ability to complete tasks (Pilcher & Walters, 1997). The causes of sleep deprivation should be identified in order to offer support so students can function at a higher standard.
In Ethiopia, a cross-sectional survey using questionnaires such as Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality among 2551 randomly selected second and final-year students (Lemma et al. 2012). Findings showed 55.8% (1424 students) suffered from poor sleep quality and statistics were considerably higher in females, second-year and third-year students. The cross-sectional nature limits this research because it is difficult to assess whether adjustments in sleep quality is a result of negative moods or if mood, anxiety and stress are all a contribution to poor sleep; the differences may be between the different groups of participants sampled. The use of questionnaires also weakens the study, as it doesn’t allow participants to elaborate on their choices, whereas a qualitative approach allows the researcher to ask for further detailed answers.
Kang & Chen (2009) investigated the connection between irregular bedtime schedules, sleep quality, daytime sleepiness and fatigue amid 160 medical undergraduates in Taiwan. Semi-structured interviews were conducted in conjunction with a 4-part survey which also included PSQI. Data showed an increase in bedtime schedule irregularity was related to a diminishing amount of sleep per day, which was correlated with PSQI scores. This study failed to gain a representative sample as only medical students from Taiwan were examined which is also considered culturally bias and cannot be generalised to the further population. Additionally, the use of surveys (a form of quantitative research) addresses sleep and results rather than the cause of inadequate sleep schedules.
Daily sleep patterns in undergraduates were examined on the effects of gender and grade differences in Taiwan (Tsai et al., 2004). 237 students aged 18-24 completed a 7-day sleep log which established grade changes were mostly dependent on weekday and weekend differences in sleep variables, whereas, gender differences were not. For example, females took longer to get to sleep (which was disturbed frequently) and had poorer overall sleep quality. A positive of this study was the specific criteria of participants making the research concise therefore the current study used the same approach (purposeful sampling) when recruiting participants. However, the study only investigated the effects of gender and grade on sleep patterns showing a correlation but failed to show a causation of sleep deprivation.
Alcohol consumption, sleep and intellectual achievement were explored by Singleton & Wolfson (2009) by which 236 liberal arts undergraduates were randomly selected to take part in interview surveys. This measured a variety of different variables including alcohol expenditure, gender and daytime sleepiness. Results showed that alcohol consumption was a significant predictor of 4 different sleep patterns: the duration and timing of sleep, the difference between workday and weekend sleep hours and bedtime delay of the weekday and weekend. Alcohol was also found to have direct effects on sleepiness and grades due to the response on the sleep schedule. A strength of this study is the assessment of the impact of alcohol; consumption, which is the simplest way to measure the effect on sleep. The present study included this within the interview schedule by asking ‘If you go on nights out, how many units of alcohol do you drink?’ However, the study is culturally biased as students were from the US which lacks research in the UK.
It is important this study aims to investigate the causes of sleep deprivation because it produces reductions in brain activity and cognitive processes (Pilcher & Walters, 1997) which could have negative consequences on university work. The majority of studies researching sleep quality use PSQI, few studies adopt a qualitative approach exclusively to investigate the causes of sleep deprivation in first-year students within the UK. Therefore, the ongoing study aims to explore these causes by conducting 1:1 semi-structured interviews. The research question intends to gain in-depth information concerning ‘What are the causes of sleep deprivation in students?’
Method
Approach
A qualitative approach was utilized to ensure detailed information was acquired about the causes of sleep deprivation which was aided by thematic analysis. This was developed by Braun & Clarke (2006) in order to identify key themes within the data which was obtained by 1:1 semi-structured interviews.
Participants
A purposeful sample was used in which 4 undergraduates who attended university in the North-East of England and lived in halls of residence took part.
Participant A was an 18-year-old female and studied Dentistry.
Participant B was a 19-year-old male who studied Graphic Design.
Participant C was an 18-year-old male and studied Psychology.
Participant D was an 18-year-old female who studied Law.
Materials
An interview schedule (Appendix A) with a mix of 14 open and closed questions was developed in order to find the causes of sleep deprivation, for example, questions concerning whether being on their phone before bed, consuming alcohol or living in halls had big effects on their sleep pattern. Questions included ‘do you feel peer pressured to stay up longer?’ and ‘do you use your phone before you sleep?’ A voice recording device was also used within the semi-structured interviews in order to transcribe the data and find key themes.
Procedure
The study was granted ethical approval by Northumbria University Department of Health and Life Sciences. Participants were taken to Northumbria Library and were provided with an information sheet (Appendix B) which explained their contribution to the study and assured confidentiality. A consent form (Appendix C) was given to inform participants of a recording device, the right to withdraw from the study and reinstated anonymity which both the participant and researcher signed.
With the assistance of the interview schedule, the researcher asked a series of questions in a semi-structured setting lasting between 3-5 minutes. A debrief sheet (Appendix D) was presented afterward reminding participants of the right to withdraw.
Procedure for analysis
Braun & Clarke’s (2006) 6 phases of thematic analysis (Appendix E) was applied to the study by firstly transcribing the data from the voice recorded interviews (Appendix F- I) to better familiarise with the data. This then allowed common features to be identified across the entirety of the data set which created codes. These codes were then categorised into potential themes which were further analysed to ensure they encompassed the codes. This lead to a refined definition of each theme which was used for analysis within the results and discussion.
Results & Discussion
The lack of qualitative research studying first-year students in the UK, drove the objective of this study to find the causes and outcomes of sleep deprivation, resulting in the research question being, ‘what are the causes of sleep deprivation?’ A thematic map was developed using thematic analysis (Braun & Clarke, 2006) which displayed 2 main themes within the data: lifestyle and technology.
Figure 1 – Thematic map illustrating common themes
Lifestyle
The theme lifestyle highlighted the difficulty that undergraduates face trying to get into a good routine of distributing their time between work and good quality sleep whilst maintaining a social life. There were various answers when asked why they don’t achieve their desired amount of sleep; procrastination, varying lecture times and rumination. Kent et al. (2015) showed social relationships and support can positively impact sleep quality however problems with friendships could cause individuals to overthink at night disrupting their sleep pattern.
‘Problems with friendships and relationships… When I’m with a group of friends, they might see us as anti-social if I’m just not talking if I don’t feel like talking because I’m tired so it kinda affects maybe what they think of us’ – Participant C
Thomsen et al. (2003) found rumination was associated with negative moods (e.g. problems with friendships) and sleep quality, supporting the theme lifestyle.
Short naps (20-30 minutes) taken during the day enhance alertness and performance, however longer than this can cause sleep inertia and may intensify problems of getting to sleep in the evening (National Sleep Foundation, 1990).
‘All the time, like in the afternoon… about an hour or two hours… I’ll set an alarm and just go for a quick nap’ – Participant B
‘Normally I just nap during the day which I never used to do. My uni work suffers because I’m sleeping instead of working and attending lectures.’ – Participant A
Students become more tired after consuming alcohol, so this may lead to naps the following day, which taken too late, could affect evening sleep. The impact of alcohol consumption was reported to improve participants sleep latency, however, the quality of their sleep wasn’t improved as they didn’t feel satisfied the next day but in fact felt drowsier.
‘Usually a bottle of wine and around 6 vodka shots with mixers… I think it makes me go to sleep faster like it makes me more tired the next day but it doesn’t actually affect my actual like quality of sleep.’ – Participant A
‘Like a 4 pack and then trebles all night… makes me sleep better on the night, but then that day after I feel awful, it makes me proper tired and dopey.’ – Participant B
Peeke et al. (1980) found evidence supporting this theme that both alcohol and sleep deprivation cause reduced performance, decreased alertness and other cognitive impairments and the combination of the two produce antagonistic effects such as heart rate, alertness and reaction time which will ultimately affect university work.
Lifestyle shows that the main explanations for sleep deprivation are rumination, napping and alcohol. Overthinking about problems was linked to negative moods and decreased sleep quality indicating this was a cause. Taking long naps can increase sleepiness and make students more tired than before and drinking alcohol was shown to hinder performance due to the lack of sleep quality, suggesting these are factors of sleep deprivation.
Technology
Technology distracted participants and decreased their likelihood of a set sleeping schedule. Services such as Netflix and YouTube distract students to stay up later causing an insufficient amount of sleep.
‘I don’t really have a set sleeping pattern either; normally I spend a few hours watching Netflix each night or just procrastinating on social media.’ – Participant A
Phones are used for the internet and social media as well as calls and texts meaning everything is more accessible and available to the current generation. 4/5 adults have a smartphone and admit regularly checking updates, including in the middle of the night (BBC News, 2016) which will ultimately affect sleep quality.
‘Yeah, all the time. Probably an hour in bed at least, just sit on my phone… watching videos and stuff before bed… just natural habit’ – Participant B
‘More than I should do, I go to bed at midnight and end up like being on it like 2 in the morning and stuff on YouTube.’ – Participant C
‘Like so long…Half a day maybe more? I use my phone to write lectures on so I use my phone a lot. Everything is done by phone now really.’- Participant D
High amounts of mobile use affect the quality but not the length of sleep (White et al., 2011) leading researchers to explore artificial bright light on mobile phones. This supports technology as it suppressed melatonin secretion (Lewy et al., 1980) so individuals stayed up later because they didn’t feel tired.
Technology has become a big cause of sleep deprivation as 77% of millennials own smartphones, spending more time than any other age group on their phone (Experian, 2014). This increases exposure to bright light causing people to stay up longer and sleep patterns to change.
This study was conducted in a qualitative manner using a 1:1 semi-structured interview approach to allow uninterrupted, ecologically valid information to be shared with follow-up questions being easier to ask for further details and accuracy. However, the study was limited by the poorly constructed interview schedule containing a large number of closed questions disabling participants to fully elaborate and articulate their experiences, leading to a shorter interview time.
A pilot study should be carried out to improve this research in order to identify issues with and refine, the interview schedule before use in the full study. Also, a larger sample size should be explored to see if the same findings are produced. The findings of this study are useful for further research to see how deprivation can be managed to ensure students well-being. Universities can demonstrate support by offering counselling services to recognise patterns of behaviour that may be the source of sleep disturbance. Students should become more aware of their sleep patterns and put in place measures, such as using their phone less at night, so sleep latency is reduced.
The purpose of the study was to discover the causes of sleep deprivation among first-year students in the UK due to the lack of qualitative research, which developed the research question, ‘what are the causes of sleep deprivation in students?’ 1:1 semi-structured interviews were conducted on 4 participants which revealed common themes of lifestyle and technology that were influences of disturbed sleep. Participants expressed the daily excessive mobile use suggesting technology was the major cause. However, participants were unable to expand on their answers due to the closed nature of the questions which limited the findings. Nonetheless, the results displayed further research should take place in order to manage students’ health and well-being which can be supported by universities through offering counselling.