Abstract
A growing body of research has demonstrated links between sleep problems and symptoms of depression and anxiety in community and clinical samples of adolescents and young adults. Scant longitudinal research, however, has examined reciprocal associations over socio-contextual shifts such as the transition to college. Using multiple methods of assessment (e.g., actigraphy, subjective report), the current study assessed whether sleep quantity, quality or variability changed over the transition to college and investigated the potential cross-lagged relationships between adolescents’ sleep and symptoms of anxiety and depression. The participants (N = 82; 24 % male) were studied at three time points over approximately 1 year: spring of their senior year of high school (T1), fall of their first year of college (T2), and spring of their first year of college (T3). Sleep minutes, sleep efficiency, wake time variability and anxiety increased over the transition to college. Subjective reports of sleep problems decreased. Cross-lagged panel models indicated significant relationships between subjective sleep quality and anxiety symptoms over time where subjective sleep problems at T1 were associated with anxiety at T2, and anxiety at T2 was associated with subjective sleep problems at T3. In contrast, greater depressive symptoms at T1 preceded increases in subjective sleep problems, sleep latency and sleep start time variability at T2. Importantly, there were concurrent associations between symptoms of anxiety or depression at T2 and sleep efficiency, sleep start time variability, and subjective sleep problems. These findings suggest that, overall, sleep quantity and quality improved over the transition to college, although the overall amounts of sleep were still below developmental recommendations. However, for some youth, the first semester of college may be a sensitive period for both sleep problems and symptoms of anxiety. In contrast, depressive symptoms were stable across time but were associated with worsening sleep problems in the first semester of college. Implications for future prevention and intervention programs should include strategies to help youth cope effectively with adjustment like increased sleep variability and symptoms of anxiety associated with the transition to college.
Similar content being viewed by others
Notes
The following algorithm was used where A denotes activity counts and E denotes epoch: A = E − 2(1/25) + E − 1(1/5) + E + E + 1(1/5) + E + 2(1/25).
References
Acebo, C., Sadeh, A., Seifer, R., Tzischinsky, O., Wolfson, A. R., Hafer, A., et al. (1999). Estimating sleep patterns with activity monitoring in children and adolescents: How many nights are necessary for reliable measures? Sleep, 22(1), 95–103.
Alfano, C. A., Zakem, A. H., Costa, N. M., Taylor, L. K., & Weems, C. F. (2009). Sleep problems and their relation to cognitive factors, anxiety, and depressive symptoms in children and adolescents. Depression and Anxiety, 26, 503–512.
Ari, L. L., & Shulman, S. (2012). Pathways of sleep, affect, and stress constellations during the first year of college: Transition difficulties of emerging adults. Journal of Youth Studies, 15(3), 273–292.
Buckhalt, J. A., El-Sheikh, M., & Keller, P. (2007). Children’s sleep and cognitive functioning: Race and socioeconomic status as moderators of effects. Child Development, 78(1), 213–231.
Buysse, D. J., Reynolds, C. F, I. I. I., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.
Carskadon, M. A. (2011). Sleep in adolescents: The perfect storm. Pediatric Clinics of North America, 58(3), 637–647.
Carskadon, M. A., Wolfson, A. R., Acebo, C., Tzischinsky, O., & Seifer, R. (1998). Adolescent sleep patterns, circadian timing, and sleepiness at a transition to early school days. Sleep, 21(8), 871–881.
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Cole, D. A., & Maxwell, S. E. (2003). Testing mediational models with longitudinal data: Questions and tips in the use of structural equation modeling. Journal of Abnormal Psychology, 112(4), 558–577.
Compas, E. B., Wagner, B. M., Slavin, L. A., & Vannatta, K. (1986). A prospective study of life events, social supports, and psychological symptomatology during the transition from high school to college. American Journal of Community Psychology, 14(3), 241–257.
Coulombe, J. A., Reid, G. J., Boyle, M. H., & Racine, Y. (2010). Concurrent associations among sleep problems, indicators of inadequate sleep, psychopathology, and shared risk factors in a population-based sample of healthy Ontario children. Journal of Pediatric Psychology, 35(7), 790–799.
Cousins, J. C., Whalen, D. J., Dahl, R. E., Forbes, E. E., Olino, T. M., Ryan, N. D., et al. (2011). The bidirectional association between daytime affect and nighttime sleep in youth with anxiety and depression. Journal of Pediatric Psychology, 36(9), 969–979.
Dahl, R. E. (1996). The regulation of sleep and arousal: Development and psychopathology. Development and Psychopathology, 8(1), 3–27.
Dahl, R. E., & Lewin, D. S. (2002). Pathways to adolescent health: Sleep regulation and behavior. Journal of Adolescent Health, 31(65), 175–184.
Doane, L. D., & Thurston, E. C. (2014). Associations among sleep, daily experiences, and loneliness in adolescence: Evidence of moderating and bidirectional pathways. Journal of Adolescence, 37, 145–154.
Drummond, S. P. A., & Brown, G. G. (2001). The effects of total sleep deprivation on cerebral responses to cognitive performance. Neuropsychopharmacology, 23(S5), S68–S73.
Eisenberg, D., Gollust, S. E., Golberstein, E., & Hefner, J. L. (2007). Prevalence and correlates of depression, anxiety, and suicidality among university students. American Journal of Orthopsychiatry, 77(4), 534–542.
Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8, 430–457.
Fuligni, A. J., & Hardway, C. (2006). Daily variation in adolescents’ sleep, activities, and psychological well-being. Journal of Research on Adolescence, 16(3), 353–378.
Furr, S. R., Westefeld, J. S., McConnell, G. N., & Jenkins, J. M. (2001). Suicide and depression among college students: A decade later. Professional Psychology: Research and Practice, 32(1), 97.
Galambos, N. L., Howard, A. L., & Maggs, J. L. (2010). Rise and fall of sleep quantity and quality with student experiences across the first year of university. Journal of Research on Adolescence, 21(2), 324–349.
Galambos, N. L., Vargas Lascano, D. I., Howard, A. L., & Maggs, J. L. (2013). Who sleeps best? Longitudinal patterns and covariates of change in sleep quantity, quality, and timing across four university years. Behavioral Sleep Medicine, 11(1), 8–22.
Gregory, A. M., Caspi, A., Eley, T., Moffitt, T. E., O’Connor, T. G., & Poulton, R. (2005). Prospective longitudinal associations between persistent sleep problems in childhood and anxiety and depression disorders in adulthood. Journal of Abnormal Child Psychology, 33(2), 157–163.
Gregory, A. M., & O’Connor, T. G. (2002). Sleep problems in childhood: A longitudinal study of developmental change and association with behavioral problems. Journal of the American Academy of Child and Adolescent Psychiatry, 41(8), 964–971.
Gregory, A. M., Rijsdijk, F. V., Lau, J. Y., Dahl, R. E., & O’Connor, T. G. (2009). The direction of longitudinal associations between sleep problems and depressive symptoms: A study of twins aged 8 to 10 years. Sleep, 32(2), 189–199.
Gregory, A. M., & Sadeh, A. (2012). Sleep, emotional and behavioral difficulties in children and adolescents. Sleep Medicine Reviews, 16, 129–136.
Gress-Smith, J. L., Roubinov, D. S., Adreotti, C., Compas, B. E., & Lueken, L. J. (2013). Prevalence, severity and risk factors for depressive symptoms and insomnia in college undergraduates. Stress Health. doi:10.1002/smi.2509.
Gupta, N. K., Mueller, W. H., Chan, W., & Meininger, J. C. (2002). Is obesity associated with poor sleep quality in adolescents? American Journal of Human Biology, 14(6), 762–768.
Haraszti, R. A., Ella, K., Gyongyosi, N., Roenneberg, T., & Kaldi, K. (2014). Social jetlag negatively correlates with academic performance in undergraduates. Chronobiology International, 31, 1–10.
Hartley, M. T. (2012). Assessing and promoting resilience: An additional tool to address the increasing number of college students with psychological problems. Journal of College Counseling, 15, 37–51.
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1–55.
Jansson-Frogmark, M., & Lindbloom, K. (2008). A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. Journal of Psychosomatic Research, 64, 443–449.
Jean Louis, G., von Gizycki, H., Zizi, F., & Nunes, J. (1998). Mood states and sleepiness in college students: Influences of age, sex, habitual sleep, and substance use. Perceptual and Motor Skills, 87, 507–512.
Johnson, E. O., Chilcoat, H. D., & Breslau, N. (2000). Trouble sleeping and anxiety/depression in childhood. Psychiatry Research, 94, 93–102.
Johnson, E. O., Roth, T., & Breslau, N. (2006). The association of insomnia with anxiety disorders and depression: Exploration of the direction of risk. Journal of Psychiatric Research, 40, 700–708.
Jonge, J., Dormann, C., Janssen, P. P., Dollard, M. F., Landeweerd, J. A., & Nijhuis, F. J. (2001). Testing reciprocal relationships between job characteristics and psychological well-being: A cross-lagged structural equation model. Journal of Occupational and Organizational Psychology, 74(1), 29–46.
Kahn, M., Sheppes, G., & Sadeh, A. (2013). Sleep and emotions: Bidirectional links and underlying mechanisms. International Journal of Psychophysiology, 89, 218–228.
Kelly, R. J., & El-Sheikh, M. (2014). Reciprocal relations between children’s sleep and their adjustment over time. Developmental Psychology, 50(4), 1137–1147.
Kerr, S., Johnson, V. K., Gans, S. E., & Krumrine, J. (2004). Predicting adjustment during the transition to college: Alexithymia, perceived stress, and psychological symptoms. Journal of College Student Development, 45(6), 593–611.
Krystal, A. D., & Edinger, J. D. (2008). Measuring sleep quality. Sleep Medicine, 9(1), 10–17.
Larose, S., & Boivin, M. (1998). Attachment to parents, social support expectations, and socioemotional adjustment during the high school-college transition. Journal of Research on Adolescents, 8(1), 1–27.
Lau, E. Y. Y., Wong, M. L., Ng, E. C. W., Hui, C. H., Cheung, S. F., & Mok, D. S. Y. (2013). “Social jetlag” in morning-type college students living on campus: Implications for physical and psychological well-being. Chronobiology International, 30(7), 910–918.
Liu, X. (2004). Sleep and adolescent suicidal behavior. Sleep-New York Then Westchester, 27, 1351–1358.
Loehlin, J. C. (2004). Latent variable models: An introduction to factor, path, and structural equation analysis (4th ed.). Mahwah, NJ: Erlbaum.
Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behavioral Research Therapy, 33(3), 335–343.
Lund, H. G., Reider, B. D., Whiting, A. B., & Prichard, J. R. (2010). Sleep patterns and predictors of disturbed sleep in a large population of college students. Journal of Adolescent Health, 46, 124–132.
Maslowsky, J., & Ozer, E. J. (2014). Developmental trends in sleep duration in adolescence and young adulthood: Evidence from a national United States sample. Journal of Adolescent Health, 54(6), 691–697.
McLaughlin, K. A., & Nolen-Hoeksema, S. (2011). Rumination as a transdiagnostic factor in depression and anxiety. Behaviour Research and Therapy, 49, 186–193.
Mezick, E. J., Matthews, K. A., Hall, M., Strollo, P. J., Buysse, D. J., Kamarck, T. W., et al. (2008). Influence of race and socioeconomic status on sleep: Pittsburgh SleepSCORE Project. Psychosomatic Medicine, 70(4), 410–416.
Moo-Estrella, J., Perez-Benitez, H., Solis-Rodriguez, F., & Arankowsky-Sandoval, G. (2005). Evaluation of depressive symptoms and sleep alterations in college students. Archives of Medical Research, 36, 393–398.
Moore, M., Kirchner, H. L., Drotar, D., Johnson, N., Rosen, C., Ancoli-Israel, S., et al. (2009). Relationships among sleepiness, sleep time, and psychological functioning in adolescents. Journal of Pediatric Psychology, 34(10), 1175–1183.
Muthén, L. K., & Muthén, B. (2012). Mplus short courses: Exploratory factor analysis, confirmatory factor analysis, and structural equation modeling for continuous outcomes. Recuperado em novembro.
National Sleep Foundation. (2006). Summary of findings: 2006 Sleep in America poll. Retrieved from http://sleepfoundation.org/sites/default/files/2006_summary_of_findings.pdf.
National Sleep Foundation. (2011). How much sleep do we really need? Retrieved from http://www.sleepfoundation.org/article/how-sleep-works/howmuch-sleep-do-we-really-need.
Nyer, M., Farabaugh, A., Fehling, K., Soskin, D., Holt, D., Papakostas, G. I., et al. (2013). Relationship between sleep disturbance and depression, anxiety, and functioning in college students. Depression and Anxiety, 30, 873–880.
Oakley, N. R. (1997). Validation with polysomnography of the Sleepwatch sleep/wake scoring algorithm used by the Actiwatch activity monitoring system. Bend: Mini Mitter, Cambridge Neurotechnology.
Ochsner, K. N., Ray, R. D., Cooper, J. C., Robertson, E. R., Chopra, S., Gabrieli, J. D., et al. (2004). For better or for worse: Neural systems supporting the cognitive down- and up-regulation of negative emotion. Neuroimage, 23, 483–499.
Oginska, H., & Pokorski, J. (2006). Fatigue and mood correlates of sleep length in three age-social groups: School children, students, and employees. Chronobiology International, 23(6), 1317–1328.
Orsal, O., Orsal, O., Alparslan, G. B., & Unsal, A. (2012). Evaluation of the relation between quality of sleep and anxiety among university students. HealthMed, 6(7), 2244–2255.
Orzech, K. M., Salafsky, D. B., & Hamilton, L. A. (2011). The state of sleep among college students at a large public university. Journal of American College Health, 59(7), 612–619.
Perlman, C. A., Johnson, S. L., & Mellman, T. A. (2006). The prospective impact of sleep duration on depression and mania. Bipolar Disorders, 8, 271–274.
Phinney, J. S., & Haas, K. (2003). The process of coping among ethnic minority first-generation college freshman: A narrative approach. The Journal of Social Psychology, 143(6), 707–726.
Pilcher, J. J., Ginter, D. R., & Sadowsky, B. (1997). Sleep quality versus sleep quantity: Relationships between sleep and measures of health, well-being and sleepiness in college students. Journal of Psychosomatic Research, 42(6), 583–596.
Prather, A. A., Bogdan, R., & Hariri, A. R. (2013). Impact of sleep quality on amygdala reactivity, negative affect, and perceived stress. Psychosomatic Medicine, 75(4), 350–358.
Pryor, J. H., Hurtado, S., DeAngelo, L., Blake, L. P., & Tran, S. (2010). The American freshman: National norms fall 2010. Higher Education Research Institute, University of California.
Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.
Regenstein, Q., Nataranjan, V., Pavlova, M., Kawaski, S., Gleason, R., & Koff, E. (2010). Sleep debt and depression in female college students. Psychiatry Research, 176, 34–39.
Roberts, R. E., Andrews, J. A., Lewinsohn, P. M., & Hops, H. (1990). Assessment of depression in adolescents using the Center for Epidemiologic Studies Depression Scale. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(2), 122–128.
Roberts, R. E., Roberts, C. R., & Chen, I. G. (2001). Functioning of adolescents with symptoms of disturbed sleep. Journal of Youth and Adolescence, 30(1), 1–18.
Roberts, R. E., Roberts, C. R., & Chen, I. G. (2002). Impact of insomnia on future functioning of adolescents. Journal of Psychosomatic Research, 53, 561–569.
Sadeh, A., Gruber, R., & Raviv, A. (2003). The effects of sleep restriction and extension on school-age children: What a difference an hour makes. Child Development, 74(2), 444–455.
Sadeh, A., Hauri, P. J., Kripke, D. F., & Lavie, P. (1995). The role of actigraphy in the evaluation of sleep disorders. Sleep, 18(4), 288–302.
Sadeh, A., Raviv, A., & Gruber, R. (2000). Sleep patterns and sleep disruption in school-age children. Developmental Psychology, 36(3), 291–301.
Shochat, T., Cohen-Zion, M., & Tzischinsky, O. (2014). Functional consequences of inadequate sleep in adolescents: A systematic review. Sleep Medicine Reviews, 18(1), 75–87.
Suen, L. K. P., Hon, L. K. E., & Tam, W. W. S. (2008). Association between sleep behavior and sleep-related factors among university students in Hong Kong. Chronobiology International, 25(5), 760–775.
Tavernier, R., & Willoughby, T. (2014). A longitudinal examination of the bidirectional association between sleep problems and social ties at university: The mediating role of emotion regulation. Journal of Youth and Adolescence, 1–14. doi:10.1007/s10964-014-0107-x.
Thomas, M., Sing, H., Belenky, G., Holcomb, H., Mayberg, H., Dannals, F., et al. (2000). Neural basis of alertness and cognitive performance impairments during sleepiness. I. Effects of 24 h of sleep deprivation on waking human regional brain activity. Journal of Sleep Research, 9, 335–352.
Tremaine, R. B., Dorrian, J., & Blunden, S. (2010). Subjective and objective sleep in children and adolescents: Measurement, age, and gender differences. Sleep and Biological Rhythms, 8, 229–238.
Urry, H. L., van Reekum, C. M., Johnstone, T., Kalin, N. H., Thurow, M. E., Schaefer, H. S., et al. (2006). Amygdala and ventromedial prefrontal cortex are inversely coupled during regulation of negative affect and predict the diurnal pattern of cortisol secretion among older adults. Journal of Neuroscience, 26, 4415–4425.
Wang, M., & Saudino, K. J. (2011). Emotion regulation and stress. Journal of Adult Development, 18(2), 95–103.
Wittmann, M., Dinich, J., Merrow, M., & Roenneberg, T. (2006). Social jetlag: Misalignment of biological and social time. Chronobiology International, 23(1–2), 497–509.
Acknowledgments
The authors thank Michael R. Sladek and Scott Van Lenten for comments on earlier drafts of this manuscript. This research was conducted with the support of the Institute for Social Science Research at Arizona State University (LD, Principal Investigator).
Author contributions
LD conceived of the study, participated in its design, led coordination and data collection and drafted the manuscript; JGS participated in the design of the study, helped draft the manuscript and performed the statistical analysis; RS participated in the design and helped draft the manuscript. All authors read and approved the final manuscript.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Doane, L.D., Gress-Smith, J.L. & Breitenstein, R.S. Multi-method Assessments of Sleep over the Transition to College and the Associations with Depression and Anxiety Symptoms. J Youth Adolescence 44, 389–404 (2015). https://doi.org/10.1007/s10964-014-0150-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10964-014-0150-7