Sleep Quality during Exam Stress: The Role of Alcohol, Caffeine and Nicotine

Bert N Uchino,Matthias Zunhammer,Volker Busch,Peter Eichhammer

doi:10.1371/journal.pone.0109490

Abstract

Academic exam stress is known to compromise sleep quality and alter drug consumption in university students. Here we evaluated if sleeping problems and changes in legal drug consumption during exam stress are interrelated. We used the Pittsburgh Sleep Quality Index (PSQI) to survey sleep quality before, during, and after an academic exam period in 150 university students in a longitudinal questionnaire study. Self-reports of alcohol, caffeine, and nicotine consumption were obtained. The Perceived Stress Questionnaire (PSQ-20) was used as a measure of stress. Sleep quality and alcohol consumption significantly decreased, while perceived stress and caffeine consumption significantly increased during the exam period. No significant change in nicotine consumption was observed. In particular, students shortened their time in bed and showed symptoms of insomnia. Mixed model analysis indicated that sex, age, health status, as well as the amounts of alcohol and caffeine consumed had no significant influence on global sleep quality. The amount of nicotine consumed and perceived stress were identified as significant predictors of diminished sleep quality. Nicotine consumption had a small-to-very-small effect on sleep quality; perceived stress had a small-to-moderate effect. In conclusion, diminished sleep quality during exam periods was mainly predicted by perceived stress, while legal drug consumption played a minor role. Exam periods may pose an interesting model for the study of stress-induced sleeping problems and their mechanisms.

Highlights

A substantial proportion of university students report poor sleep due to academic stress mid-term, with negative consequences for academic performance and well-being [1]
Ahrberg et al (2012) [3] were the first to survey sleep-quality during exam stress with a longitudinal study design. They found that the sleep quality of medical students is reduced during exam periods and that poor sleep is associated with low academic performance
Astill et al (2013) [4] examined the effects of exam stress on sleep quality in high-school students in a longitudinal actigraphy study. They showed that exam stress reduces sleep duration, and the compensatory increase in sleep quality usually observed during periods of sleep withdrawal

Summary

Introduction

A substantial proportion of university students report poor sleep due to academic stress mid-term, with negative consequences for academic performance and well-being [1]. Ahrberg et al (2012) [3] were the first to survey sleep-quality during exam stress with a longitudinal study design They found that the sleep quality of medical students is reduced during exam periods and that poor sleep is associated with low academic performance. Astill et al (2013) [4] examined the effects of exam stress on sleep quality in high-school students in a longitudinal actigraphy study They showed that exam stress reduces sleep duration, and the compensatory increase in sleep quality usually observed during periods of sleep withdrawal. These studies indicate that academic exam stress may pose an effective model for the study of stressrelated sleeping problems with high external validity

Results

Discussion

Conclusion