How to Enhance Sleep for Athletes? A Narrative Review of Sleep Hygiene and Sleep Extension Practices

The effectiveness of sleep education programs in improving sleep hygiene knowledge, sleep behavior practices and/or sleep quality of college students: a systematic review protocol

Poor sleep quality, often resulting from poor sleep hygiene, is common among medical students. Educational interventions aimed at improving sleep knowledge are beneficial for sleep quality in healthy populations. However, sleep education is often given minimal attention in medical school curriculums. The aim of the study was to explore whether a short educational intervention could improve sleep knowledge, and consequently sleep quality, among medical students. We recruited preclinical- and clinical-stage medical students during the 2017-2018 academic year. Students completed a demographic survey, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Assessment of Sleep Knowledge in Medical Education (ASKME) questionnaire. Students then attended a lecture on the physiology and importance of sleep. To assess the efficacy of the intervention, questionnaires were repeated 4 months thereafter. A total of 87 students (31 preclinical) with a mean age of 25.86 years (standard deviation [SD], 3.33), 51 of whom were women, participated in the study. At baseline, students had poor sleep quality with a PSQI mean score of 5.9 (SD, 2.37), without significant sleepiness, and a mean ESS score of 8.86 (SD, 4.32). The mean ASKME scores were consistent with poor sleep knowledge at 11.87 (SD, 4.32). After the intervention, the mean ASKME results improved to 14.15 (SD, 4.5; P < .001), whereas sleep quality did not. The effect was similar in preclinical and clinical medical students. Sleep knowledge was inadequate among medical students, who also experienced poor sleep quality. A short educational intervention improved sleep knowledge but was insufficient at improving sleep quality. Further studies are needed to determine which interventions may provide benefit in both sleep knowledge and sleep quality.

Poor sleep quality is a common problem among medical students and often leads to daytime hypersomnolence and fatigue. Having a good sleep hygiene is considered to be an effective way to improve sleep quality. The purpose of this study is to assess students' sleep hygiene awareness and practices and evaluate their sleep quality. The association of sleep quality with sleep hygiene awareness and practice was also explored. The study was a cross-sectional, self-administered, and questionnaire-based study. A total of 262 UniKL RCMP MBBS students were recruited to complete sleep questionnaires adopted from internationally recognized instruments, like Sleep Hygiene Index (SHI); to assess sleep hygiene and Pittsburgh Sleep Quality Index (PSQI); to assess sleep quality. It was found that more than half of the participants (57.3%) had good knowledge on sleep hygiene. However, most of them (82.4%) had poor sleep hygiene practice. 65.6% of the students were also found to have poor sleep quality. Sleep quality was strongly correlated with sleep hygiene practice (p&lt; 0.01) but not with sleep hygiene knowledge (p&gt; 0.05). Appropriate measures and sleep hygiene education should be emphasized in order to raise awareness on the importance of adopting a good practice of sleep hygiene among the students.

Association between sleep hygiene awareness and practice with sleep quality among Kuwait University students

Background: Chronic sleep deprivation is a prevalent yet treatable condition among young adults and teenagers, often resulting from various sleep disorders that negatively affect overall wellbeing in this age group. Sleep quality refers to an individual’s overall satisfaction with different aspects of their sleep experience, while sleep hygiene encompasses easily modifiable pre-sleep behaviors that support healthy sleep patterns. This study aims to assess health professional students’ sleep quality and hygiene practices and evaluate the correlation between these two factors. Materials and Methods: This prospective, observational, and cross-sectional study involved 320 health professional students who completed a self-administered questionnaire. The Pittsburgh sleep quality index(PSQI) was used to assess sleep quality, while the sleep hygiene index (SHI) was used to evaluate sleep hygiene practices. Data were recorded in Excel and analyzed by a statistician. Results: Of the 320 participants, 74.4% (238 students) exhibited a moderate SHI, 13.4% (43 students) had a fair SHI, 11.6% (37 students) demonstrated excellent sleep hygiene, and 0.6% (2 students) showed poor sleep hygiene. Additionally, 63.8% (204 students) reported poor sleep quality, while 36.3% (116) experienced good sleep quality. Conclusion: Most health professional students followed moderate sleep hygiene practices and reported poor sleep quality. Statistical analysis revealed a significant positive correlation between sleep hygiene and sleep quality, suggesting that improving sleep hygiene practices may lead to better sleep quality.

Background: Psychological stress and poor sleep quality are interrelated and disproportionately affect adults who have multiple risk factors of cardiovascular disease (CVD). Sleep hygiene practices, such as maintaining an optimal household environment and engaging in healthy bedtime behaviors, are essential to sleep health. These practices may also impact psychological stress; however, their relationships remain under-studied. This study aimed to examine the associations among sleep hygiene practices, sleep quality, and psychological stress in adults with multiple CVD risk factors. Methods: Adults diagnosed with hypertension and type 2 diabetes completed an online survey (N = 300). Psychological stress and sleep quality were assessed using the Perceived Stress Scale 4 and the Pittsburgh Sleep Quality Index, respectively. A sleep hygiene instrument was used to examine 8 individual factors focusing on negative household environment (safety, physical comfort, temperature, and light) and poor in-bed behaviors (watching TV, playing video games, using screens, and eating). Multiple regression was employed to examine the association of each sleep hygiene factor with sleep quality and psychological stress. Subsequently, mediation analyses were conducted to examine the mediating role of sleep in the association between the composite sleep hygiene score and psychological stress. Results: Of the sample, 78% reported poor sleep quality and 44% reported high psychological stress. Individual sleep hygiene factors (e.g., unsafe household and eating at bedtime), as well as the composite sleep hygiene score, were significantly associated with poorer sleep quality and higher psychological stress. Sleep quality partially mediated the association between the composite sleep hygiene score and psychological stress (Indirect effect: 0.183; 95% bootstrap confidence interval: 0.057-0.339). Conclusions: The findings showed strong links between sleep hygiene practices, sleep quality, and psychological stress. Although causality cannot be inferred, current evidence suggests that promoting sleep hygiene education and implementing strategies to enhance sleep quality may alleviate psychological burdens in adults with multiple CVD risk factors.

Introduction Despite being used and widely recommended since the 1970s, few studies have examined whether adherence to sleep hygiene practices affect objectively measured sleep in non-clinical populations. While individual components of sleep hygiene such as limiting caffeine and alcohol consumption are clearly related to sleep by plausible physiological and psychosocial mechanisms, the real-world evidence of overall sleep hygiene practices on sleep is surprisingly inconsistent. Here, we examined the association between self-reported sleep hygiene practices and objectively measured sleep in a general population. Methods Responses to a survey on sleep hygiene were used and matched with objective sleep data, resulting in data from 720 users (mean age: 52.5 ± 15.9, 63.4% female). Objective sleep data across 92,808 nights were included in the analysis from the PSG-validated SleepScore Mobile Application, which uses a non-contact sonar-based method to capture sleep-related metrics and self-reported lifestyle. Self-reported sleep hygiene practices were assessed with 13-items on a 5-point scale ranging from “Never” to “Always”. Descriptive statistics and linear regressions were used for the analysis, controlling for age and gender. Results Overall, the top three most frequented poor sleep hygiene practices were going to bed at different times (29.7%), overthinking/worrying in bed (24.0%), and waking at different times (22.7%). Linear regressions revealed a significant negative association between composite sleep hygiene scores and objective sleep measures, whereby poorer sleep hygiene was associated with significant reductions in total sleep time (ß=-0.89, SE=0.33, p&amp;lt; 0.01), REM duration (ß=-0.24, SE=0.10, p&amp;lt; 0.05), and SleepScore (ß=-0.15, SE=0.05, p&amp;lt; 0.01), an objective sleep quality metric. No significant associations were observed between individual sleep hygiene factors and objectively measured sleep. Conclusion While we could not identify a relationship between individual hygiene factors and sleep, poorer aggregated sleep hygiene scores were associated with poorer objectively measured sleep. Thus, sleep health may not be defined by one single behavior, but rather by the sum of its parts. Future work should examine the efficacy of personalized sleep hygiene factors in sub-clinical populations, where targeted sleep hygiene education may be preferred given it is more intuitive and less burdensome than other behavioral interventions. Support (if any) SleepScore Labs

A BSTRACT Background: Medical students are particularly susceptible to poor physical and mental health due to inadequate sleep. Aim: This study aimed to evaluate sleep behaviours such as sleep quality, sleep hygiene awareness, and practices among medical students at an institution in Himachal Pradesh. Methodology: The study encompassed all MBBS students enrolled at the institute during the study period. It examined the association between sleep quality and sleep hygiene awareness and practices. Validated tools such as the Pittsburgh Sleep Quality Index (PSQI) and Sleep Hygiene Awareness and Practice Scale (SHAPS) were used for assessment. Results: Participants from each academic year were included, and the median global PSQI score was 7.91, with scores above 5 indicating poor sleep quality. A total of 241 students (76.75%) were identified as poor sleepers, while 73 students (23.24%) were classified as good sleepers. Sleep hygiene practice (SHP) score (14.39) was higher in poor sleepers in comparison with good sleepers (8.72), while sleep hygiene awareness (SHA) score (21) was similar in both groups. Discussion: Poor sleep hygiene practices were significantly associated with poor sleep quality, whereas no significant relationship was observed between sleep quality and SHA. Additionally, there was no significant difference in sleep behaviours between genders. However, first-year and fourth-year students exhibited significantly poorer sleep quality and sleep hygiene practices compared to students in other academic years. Conclusion: Findings highlight the importance of addressing sleep health alongside academic demands to improve students’ overall well-being and academic performance. Interventions like awareness campaigns and the creation of a supportive learning environment that prioritizes student well-being should be considered.

Introduction College students are at risk for sleep disturbances that may influence academic performance and cognitive function. Poor sleep hygiene and sleep quality over time results in inadequate sleep and daytime sleepiness, which, if not addressed, eventually leads to sleep deprivation and adverse health effects. The current study aims to identify if sleep hygiene practices and self-efficacy relate to poor and good sleepers categorized according to the Pittsburg Sleep Quality Index (PSQI) Score &amp;gt; or &amp;lt; 5) among a sample of college students. Methods Secondary analysis of baseline data from college student participants aged 18-26 from an intervention study was used. All participants completed demographic, sleep hygiene, and sleep quality assessments. (e.g., Sleep hygiene index [SHI], Self-efficacy for sleep hygiene inventory [SHESHI], and PSQI). Descriptive statistics were calculated for demographic, sleep quality, and sleep hygiene variables. Results The sample (n=119) included 15 Freshmen, 30 Sophomores, 52 Juniors, and 21 Seniors, of which 26 were male and 93 female college students. The total sample mean age=20.6 y +2.0, range: 18-26; 82.4% were White, 55% worked part-time, and 69.8% considered themselves night owls. Data were examined to determine if poor and good sleepers differed across key demographic variables. There were no statistically significant differences between the groups. The sample comprised 47.0 % (n=56) poor sleepers and 52.9% (n=63) good sleepers. A Mann-Whitney U test was run to determine if there were differences in self-efficacy scores and sleep hygiene practices between poor and good sleepers. Mean rank self-efficacy scores for poor sleepers (44.15) were significantly lower than for good sleepers (74.09), U=876, z = -4.725, p &amp;lt;.001. Mean rank sleep hygiene index scores for poor sleepers (76.05) were significantly higher than good sleepers (45.73) U=865, z = -4.793, p &amp;lt;.001. Conclusion Preliminary descriptive findings highlight significant characteristics of sleep hygiene efficacy in college students with good and poor sleep. All surveys were subjective measures. Future use of an objective measure of actual sleep time and sleep health index would add to an understanding of sleep issues in college students. Support (if any) N/A

This study aimed to test the mediating and moderating effects of sleep hygiene practice on the relationship between anxiety and insomnia severity in hospital nurses. A cross-sectional survey was employed, and a convenience sample was recruited from one regional hospital in Taiwan. Participants completed the following self-report questionnaires over a 3-month period in 2009: the Insomnia Severity Index, the Beck Anxiety Inventory, and Sleep Hygiene Awareness and Practice Scale. The results indicated that nurses with more anxiety tended to have higher insomnia severity. Further, nurses with poor sleep hygiene practice had more insomnia. Sleep hygiene practice partially mediated the effects of anxiety on insomnia severity. Also, sleep hygiene practice was a moderator in the relationship between anxiety and insomnia severity with age and work units as covariates. Sleep hygiene practice mediated and moderated the relationship between anxiety and insomnia severity after controlling the variables of age and work units. Continuing to learn and train sleep hygiene practice might promote nurses' sleep hygiene, and thereby ameliorate anxiety and reduce the risk of insomnia.

Background Adolescents often experience irregular sleep schedules and poor sleep quality due to academic pressure, digital media use, and poor bedtime practices. These sleep disruptions impact their mental health, cognitive function, and emotional regulation. Sleep hygiene, a set of behavioral and environmental practices conducive to quality sleep, is increasingly recognized as a modifiable factor in promoting healthy sleep in this population. Region-specific evidence using standardized tools is limited in India. Aim To assess the role of sleep hygiene in promoting healthy sleep habits among adolescents aged 10–18 years attending the pediatric outpatient department. Objectives To determine sleep patterns among adolescents using the Children’s Report of Sleep Patterns (CRSP) questionnaire.To assess sleep hygiene practices and identify factors influencing sleep hygiene among adolescents. Materials And Methods A cross-sectional study was conducted over six months at Shri Sathya Sai Medical College and Research Institute, Chengalpattu District. A total of 215 adolescents aged 10–18 years attending the pediatric OPD were recruited after obtaining informed assent. Data were collected using a pre-tested, semi-structured schedule incorporating the CRSP questionnaire, which assesses sleep patterns, hygiene behaviors, and sleep disturbances. Statistical analysis was done using SPSS v17, and associations between sleep hygiene and demographic and lifestyle variables were analyzed using the Chi-square test, with p &lt; 0.05 considered significant. Results Among 215 adolescents, the majority demonstrated irregular sleep patterns, with delayed bedtimes, reduced sleep duration, and increased screen time before bed. Poor sleep hygiene practices were observed in 62.3% of participants, including consumption of caffeinated drinks, inconsistent bedtime routines, and mobile phone usage in bed. Sleep disturbances such as difficulty initiating and maintaining sleep were reported by over one-third of respondents. Statistically significant associations were found between poor sleep hygiene and screen time exceeding 2 hours daily, caffeine intake, and lack of a consistent bedtime routine (p &lt; 0.05). Conclusion The study identified a high prevalence of poor sleep hygiene and associated sleep disturbances among adolescents. Behavioral factors such as prolonged screen exposure, dietary habits, and bedtime irregularity were found to influence sleep hygiene negatively. These findings highlight the urgent need for structured sleep education and behavioral interventions among school-going adolescents to promote healthy sleep practices.

Sleep hygiene is one factor that contributes to poor sleep in breast cancer survivors but is poorly measured. The purposes of this study were to (a) evaluate the psychometric properties of the Sleep Hygiene Awareness and Practice Scale (SHAPS) and (b) compare SHAPS scores between midlife women with and without breast cancer. Cross-sectional, descriptive data from a single-blinded, controlled hot flash intervention trial. 194 women (88 breast cancer survivors; 106 menopausal women). Reliability of the three sections of the SHAPS was inadequate with Cronbach's alphas ranging from 0.23 to 0.67. Sleep hygiene practices were modestly correlated with global sleep quality in both groups. Findings suggest the SHAPS would need to be revised to be a psychometrically sound measure of sleep hygiene awareness and practice.

College students are known for their variable sleep schedules. Such schedules, along with other common student practices (eg, alcohol and caffeine consumption), are associated with poor sleep hygiene. Researchers have demonstrated in clinical populations that improving sleep hygiene knowledge and practices is an effective treatment for insomnia. However, researchers who have examined relationships between sleep hygiene and practices in nonclinical samples and overall sleep quality have produced inconsistent findings, perhaps because of questionable measures. In this study, the authors used psychometrically sound instruments to examine these variables and to counter the shortcomings in previous investigations. Their findings suggest that knowledge of sleep hygiene is related to sleep practices, which, in turn, is related to overall sleep quality. The data from their regression modeling indicated that variable sleep schedules, going to bed thirsty, environmental noise, and worrying while falling asleep contribute to poor sleep quality.

BackgroundSleep is an important component of human biological functioning and is necessary for optimal health and the maintenance of cognitive and psychological functions. Sleep hygiene is a collective term for the behaviors and environmental factors associated with good sleep.ObjectivesTo assess the prevalence of poor sleep hygiene practices and poor sleep quality among medical students and to test the hypothesis that poor sleep hygiene is correlated with poor sleep quality.MethodsThis cross-sectional study was conducted among 504 medical students at Tanta University, Egypt, using a random two-stage cluster sampling technique. Two validated questionnaires were used, the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index (SHI), in addition to a sociodemographic section.ResultsThe prevalence of poor sleep quality among the study participants was 71.2%. A total of 93.6% of the participants reported having poor sleep hygiene. There was a statistically significant positive correlation between sleep hygiene practices and sleep quality (r = 0.366, p < 0.001). The prevalence of poor sleep quality was the highest among students in the first grade (83.6%) and decreased to 66.0% among students in the fifth grade (p = 0.012). Using the bed for activities other than sleeping or sex; thinking, planning, or worrying when in bed; and doing important work before bedtime were the three most prevalent negative sleep hygiene practices, affecting 59.3%, 58.9%, and 54% of the participants, respectively.ConclusionPoor sleep hygiene practices and poor sleep quality are highly prevalent among Egyptian medical students. Medical students in their early academic years had a greater prevalence of poor sleep quality. Future educational programs on sleep hygiene are needed to raise awareness and possibly improve overall sleep quality in this population.

Objective To explore the relationship between sleep hygiene awareness,acts and sleep quality.Methods 1602 medical specialist students were investigated by the Pittsburgh Sleep Quality Index(PSQI) and Sleep Hygiene Awareness and Practice(SHAP).Results Sleep hygiene awareness score (7.69±2.37) of students was low.The percentage of bad sleep hygiene practice was high.Logistic regression analysis showed sleep quality was correlative with bad sleep hygiene practice,such as worrying about the ability to sleep during the day or before sleep,drinking,light interference,noise interference,interferencing with the hostel dormitories.Conclusion Sleep quality was influenced by sleep hygiene awareness and practice. Key words: Sleep quality; Sleep hygiene awareness; Sleep hygiene practice