Data shows that irregular sleep can be linked to cardiovascular illnesses and increased reports of mental health issues such as depression and anxiety. Although the data that links physical problems with sleep irregularity was gathered through the use of the Sleep Regularity Index (SRI), which is independent of the duration of sleep, other sources, such as the study by Philips, et al., 2017, reported that the regularity of sleep had a greater impact than the length of sleep on mental wellbeing. This topic is significant to me as, during the HSC, I sacrificed many hours of sleep in favour of studying, which invariably had an impact on both my physical and mental wellbeing. After weeks of getting approximately 5 hours of sleep each night, having finished my HSC exams, I transitioned to the recommended 9 hours of sleep per night. However, the time at which I would go to sleep ranged from 9:00 pm to 3:00 am and I would wake up more tired despite having slept more hours. This theme was explored 5 months ago by Sam Downing in his media release for Nine: “Going to bed at the same time every night might be as important as how long you sleep.” (Downing, 2018) This topic is thus significant as it allows for analysis, with an objective lens, of the impact of irregular sleep patterns on students and their wellbeing.
Research Question: Does regular sleep improve student physical and mental wellbeing?
Impacts of Irregular Sleep on Physical Wellbeing
The aforementioned media release had a heavy focus on cardiovascular health and was pertaining to adults aged 50 and over, stating that regular sleep improves both the quality of sleep and long term health. It suggested that “those with irregular sleep patterns had higher blood sugar, higher blood pressure, and higher odds of a heart attack or stroke than those who went to bed and woke up at the same time everyday.” (Downing). However, it also emphasised the inability to definitively identify sleep irregularity as a contributing factor to obesity, depression, or cardiovascular illnesses, instead highlighting it as merely a correlating factor.
Sleep irregularity has a significant association to adverse effects physical health, specifically increased risks of obesity and cardiovascular disease. An American study of adults ages 45-84 examined the relationship between sleep and cardiovascular health using a relatively new measure of sleep regularity, the SRI, which is independent of the number of hours slept. Instead, the SRI determines the “percentage probability of a person being asleep (or awake) at any two time points 24 hours apart.” (Phillips et al., 2017). The SRI therefore acts as an indication of poor sleep quality and a misalignment of circadian rhythms, not the duration of time spent sleeping. The study further showed that among college students, the irregularity of sleep and varied patterns of light exposure could be linked to delays in melatonin secretion, and by extension delays in the onset of sleep. As most students have set times to wake up, this results in a decreased sleep duration. Shorter sleep durations have been significantly associated with increased levels of circulating interleukin-6, which is in turn linked to increased susceptibility to diabetes mellitus (Hall, Brindle & Buysse, 2018). The text’s secondary objective, to analyse the relationship between SRIs and cardiometabolic risk, engages with the physical wellbeing aspect of the research question. Here, it was predicted that high incidents of sleep irregularity would be accompanied by incidents of cardiovascular disease, greater body mass indexes, hypertension, fasting blood glucose, and haemoglobin A1C, thus highlighting the potential for a negative impact on physical health as a result of sleep irregularity (Phillips, et al). Multiple sources reported a correlation between increased sleep irregularity and decreased physical wellbeing.
Impacts of Sleep Irregularity on Mental Wellbeing
The aforementioned study by Phillips identified a correlation between SRIs indicative of irregular sleep patterns, depressive symptoms and perceived stress levels, thus supporting the notion that more regular sleep would improve mental wellbeing (Phillips, et al). A four year study examining the “Relationship of Persistent and Temporary Sleep Problems to Psychiatric Symptoms” found that 67% of adolescents with multiple sleep problems were also diagnosed with an anxiety and/or depressive disorder, suggesting a correlation between irregular sleep and compromised mental wellbeing. The study involved children and their parents reporting any sleep problems via an “assessment of sleep problems” questionnaire, and the teachers of the children complete an “assessment of psychiatric symptoms” questionnaire. This facilitated an analysis of the relationship between sleep regularity and anti-social behaviour as perceived by the teachers. Here, it was found that “both current and persistent sleep disturbances were associated with the broad range of mental health problems reported by teachers.” (Paavonen et al., 2003). A study by Milojevich & Lukowski, 2018, complements the above study of the link between sleep issues and mental health problems, examining the mental health of undergraduate students with generally healthy sleeping habits. Here, 69 university students with pretty good sleeping habits were asked to complete questionnaires about their sleep quality and mental health. Milojevich conducted preliminary research which showed that “Nighttime sleep duration was negatively associated with total problems and the frequency of nighttime sleep disruptions was positively associated with total problems.” meaning simply that the analysis using syndrome scales shows that irregularities in sleep patterns impacted more negatively than sleep duration on the sample size (Milojevich & Lukowski, 2016). Here, the relationship between sleep irregularity and mental wellbeing indicates a negative correlation, implying that irregular sleep does not improve student mental wellbeing.
Analysis of Sources
Nine News is not typically a source I would rely on in analysing a medical issue. However, despite the article’s attention-grabbing headlines which are generally associated with clickbait and fake news, Downing continually linked to his sources, adding validity to his claims. The main point of divergence between the medial release and the scientific journals is the structure and parlance. Unlike the study in nature, Downing’s media release was not broken into the subsections of “introduction”, “method”, “results” and so on. Instead, it guided the reader through the implications of the study whilst using conversational language to promote a greater understanding for those who do not have a scientific grounding.
This study was particularly useful as it was the source that inspired the initial media release. An analysis of the methodology applied by the study showed the SRI to be a suitable measure of the irregularity of sleep on a day to day basis. Furthermore, it engaged with both the mental and physical aspects of wellbeing that were identified in the research question. This was the most useful source in analysing the impact on physical wellbeing as the majority of studies are focused on the mental health aspects. Additionally, Phillip’s study was funded by the National Institutes of Health. This suggests there is no obvious ulterior motives or bias that could impact on the validity of the study. However, the use of the study is limited as it was conducted primarily on adults over 50 and thus is not representative of the typical student demographic.
Paavonen et al:
Titled “Four-Year Follow-Up Study of Sleep and Psychiatric Symptoms in Preadolescents: Relationship of Persistent and Temporary Sleep Problems to Psychiatric Symptoms”, Juulia Paavonen and others’ 4 year research study aimed to “assess sleep problems longitudinally at the ages of 8 and 12 years and to describe the spectrum of teacher-reported psychiatric symptoms in relation to previous, current, or persistent sleep disturbances reported by the children or parents.” Here, the engagement with the mental wellbeing of the children coupled with the quality of sleep made it useful for answering the research question. However, the “sleep problems” identified broader than what I had wished to address in this report.
Milojevich’s study regarding the “Sleep and Mental Health in Undergraduate Students with Generally Healthy Sleep Habits” appeared immediately useful because it engaged with mental health and students in relation to sleep patterns. Specifically, I chose it because it was one of the few studies that was conducted specifically on students as opposed to adolescents in general. However, significant additional research was required to fully understand the results of the study - in particular to understand the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS).
Martica H. Hall and others’ study titled “Sleep and Cardiovascular Disease: Opportunities for Psychology” was funded by the National Institute of Heart, Lung, and Blood Disorders and the National Institute on Aging, decreasing the likelihood of bias or motive influencing the data. Furthermore, the study is referenced throughout, giving it credibility. The source was useful in reaffirming the relationship between sleep and cardiovascular disease whilst also providing a scientific explanation of the increased risk of obesity in terms of the resulting higher levels of interleukin-6.
Initially I was having trouble picking a research question that is not too specific, but also not too general. I was also trying to find a topic that I could aptly cover/answer in under 2000 words. I did a bit of preliminary research on the different topics that interested me to figure out which argument would be most interesting. During this time I came across the media release by Sam Downing from which I derived my research question. To get an idea of what the report would look like, I gathered the articles I planned to use and summarised them into dot points so I could map the logical progression of key points. From here, I was able to start writing the body content. However, I was unsure of to engage with all required aspects of the assessment or how to fluently transition from the media release into the articles found via the Medline database. After receiving feedback on my assessment so far during scenario group session 5, I re-structured my assignment to attempt to make it read more cohesively. Previously, I had divided the report into sections that focused on individual articles so I could examine the data, relate it to the question, and then assess the relevance/usefulness of the source. Now, applying the feedback, the report is structured into three sub-sections: “Physical Impacts of Sleep Irregularity”, “Mental Impact of Sleep Irregularity” and then finally an analysis of the quality of each of the respective sources.
The quality of different sources was determined by investigating and then evaluating the methods and motivations for each of the referenced studies. Additionally, media articles tend to use more simplistic language which is suitable for conveying an idea to the general public but maintains the risk of compromising the integrity of the study by oversimplifying it with the aim to make it more accessible to the public.
During the process of writing the report, I learnt the importance of distinguishing between different types of media. I found that google searches could not be relied upon for articles that referenced their sources throughout. Instead, I would search Medline for the referenced article. For example, the Nine media release referenced the study by Phillips but linked to an article which referenced Nature citing Phillips. I also learnt the value in receiving constructive feedback. Not only did this allow me to see my article from the perspective of others, but also it gave me the opportunity to leverage the advice of my peers to give my report a more defined structure and coherence.