Association of Stress, General Health, and Alcohol Use with Poor Sleep Quality among U.S. College Students

Background: Poor sleep among college students is a major, growing problem associated with lower academic performance, higher rates of health and emotional problems, and development of chronic sleep disorders. Purpose: Though previous studies have focused on individual colleges, our study purpose was to reveal the association of behaviors and function to sleep quality in a large sample of students from across the United States. Methods: We analyzed data from the Fall 2009 American College Health Association's National College Health Assessment-II survey using descriptive statistics, independent sample t tests, chi-square tests, and logistic regression to find a representative, matched sample of 14 870 college students, both with and without a sleep problem, measured by daytime sleepiness. Results: Our correlational analysis revealed that sleep quality decreased with increasing levels of stress or alcohol/cigarette use and with decreasing levels of general health (all Ps<.001). Discussion: College interventions should include efforts to address sleep quality to improve students' academic performance and long-term quality of life, especially for students experiencing substantial stress or poor general health. Translation to Health Education Practice: Educators, advisors, and leaders should incorporate sleep quality improvements into their services and programs for all students, especially students in at-risk groups.