Adequate sleep is crucial for health and cognitive performance, yet university students often experience inadequate sleep. In Singapore, academic pressures and long work hours exacerbate sleep issues. This study explores sleep health among university students, focusing on cultural, behavioural and environmental factors, and its impact on occupational balance.
Method:
A mixed-methods study using a convergent parallel design was conducted at a Singapore university. Students from Health and Social Sciences and Engineering faculties participated in an anonymous survey on sleep quality and severity of symptoms of depression, anxiety and stress. Separate focus groups were conducted to understand students’ sleep experiences.
Results:
A total of 147 students completed the survey; 36 joined focus groups. Key findings include (1) Sleep Quality and Daytime Functioning – 79% of participants reported difficulties maintaining enthusiasm, and 52.4% experienced daytime sleepiness at least once in the past month, impacting academic performance and social balance. (2) Sleep and Health – poor overall sleep quality was significantly correlated with emotional distress. (3) Sleep and Social Availability – Social commitments often dictated sleep times, affecting overall sleep quality.
Conclusion:
Addressing sleep challenges can enhance academic performance and overall well-being among university students. Interventions addressing sleep quality should consider cultural and societal influences on occupational balance.
AhmedNSadatMCukorD (2017) Sleep knowledge and behaviors in medical students: Results of a single center survey. Academic Psychiatry41: 674–678.
2.
ArmandMABiassoniFCorriasA (2021) Sleep, well-being and academic performance: A study in a Singapore residential college. Frontiers in Psychology12: 672238.
3.
BrowningJLudwigREakmanA, et al. (2024) Restful rehabilitation: Sleep’s essential role in occupational therapy education, intervention, and research. The American Journal of Occupational Therapy78: 7806347020.
4.
BuysseDJ (2014) Sleep health: Can we define it? Does it matter?Sleep37: 9–17.
5.
ChandlerLPatelCLoveckaL, et al. (2022) Improving university students’ mental health using multi-component and single-component sleep interventions: A systematic review and meta-analysis. Sleep Medicine100: 354–363.
6.
ChenZFooZSTTangJY, et al. (2023) Sleep quality and burnout: A Singapore study. Sleep Medicine102: 205–212.
7.
ClarkeVBraunV (2022) Thematic Analysis: A Practical Guide. London: Sage.
8.
CreswellJW (2021) A Concise Introduction to Mixed Methods Research. London: Sage publications.
9.
CreswellJWPothCN (2016) Qualitative Inquiry and Research Design: Choosing among Five Approaches. London: Sage publications.
10.
DunleavyGTononACChuaAP, et al. (2019) A multifactorial approach to sleep and its association with health-related quality of life in a multiethnic Asian working population: A cross-sectional analysis. International Journal of Environmental Research and Public Health16: 4147.
11.
EakmanAM (2016) A subjectively-based definition of life balance using personal meaning in occupation. Journal of Occupational Science23: 108–127.
12.
EganMYToal-SullivanDKesslerD, et al. (2023) Student-led occupational performance coaching in a university setting. British Journal of Occupational Therapy86: 413–422.
13.
EspirituEWChangP-FEvettsCL, et al. (2024) Efficacy of occupation-based intervention in promoting well-being among occupational therapy graduate students. OTJR: Occupational Therapy Journal of Research. Epub ahead of print 11 October 2024. DOI: 10.1177/15394492241287712.
14.
FaulknerS (2022) Sleep and occupational performance are inseparable: Why occupational therapy practice and research should consider sleep and circadian rhythm. British Journal of Occupational Therapy85: 305–307.
15.
Gallego-GómezJIGonzález-MoroMTRGonzález-MoroJMR, et al. (2021) Relationship between sleep habits and academic performance in university nursing students. BMC Nursing20: 100.
16.
GooYSShrivastavaAMSolivenRC (2018) Get 8nough sleep. Singapore: Nanyang Technological University.
17.
HenninkMMKaiserBNWeberMB (2019) What influences saturation? Estimating sample sizes in focus group research. Qualitative Health Research29: 1483–1496.
18.
HirshkowitzMWhitonKAlbertSM, et al. (2015) National sleep foundation’s sleep time duration recommendations: Methodology and results summary. Sleep Health1: 40–43.
19.
KhamisH (2008) Measures of association: How to choose?Journal of Diagnostic Medical Sonography24: 155–162.
20.
KoaTLoJ (2022) Academic performance in school-age children: Association with sleep duration, but not study time. Sleep Medicine100: S190.
21.
LeuJRebello SalomeASargentGM, et al. (2023) Hard work, long hours, and Singaporean young adults’ health—A qualitative study. Frontiers in Public Health11: 1082581–1082581.
22.
LiuYChenJChenK, et al. (2023) The associations between academic stress and depression among college students: A moderated chain mediation model of negative affect, sleep quality, and social support. Acta Psychologica239: 104014.
23.
LoJCLeongRLFLohK-K, et al. (2014) Young adults’ sleep duration on work days: Differences between East and West. Frontiers in Neurology5: 81.
24.
MagnussonLHåkanssonCBrandtS, et al. (2021) Occupational balance and sleep among women. Scandinavian Journal of Occupational Therapy28: 643–651.
25.
MishraSLaplante-LévesqueABarbareschiG, et al. (2022) Assistive technology needs, access and coverage, and related barriers and facilitators in the WHO European region: A scoping review. Disability and Rehabilitation: Assistive Technology19: 474–485.
26.
MollayevaTThurairajahPBurtonK, et al. (2016) The Pittsburgh sleep quality index as a screening tool for sleep dysfunction in clinical and non-clinical samples: A systematic review and meta-analysis. Sleep Medicine Reviews25: 52–73.
27.
MonteiroEJosephJ (2023) A review on the impact of workplace culture on employee mental health and well-being. International Journal of Case Studies in Business, IT, and Education7: 291–317.
28.
NayarSStanleyM (2024) Qualitative Research Methodologies for Occupational Science and Occupational Therapy, 2nd edn.Milton Park, Abingdon, Oxon: Routledge.
29.
OeiTPSSawangSGohYW, et al. (2013) Using the depression anxiety stress scale 21 (DASS-21) across cultures. International Journal of Psychology48: 1018–1029.
30.
OhayonMWickwireEMHirshkowitzM, et al. (2017) National sleep foundation’s sleep quality recommendations: First report. Sleep Health3: 6–19.
31.
RidnerSLNewtonKSStatenRR, et al. (2016) Predictors of well-being among college students. Journal of American College Health64: 116–124.
32.
SchmicklerJMBlaschkeSRobbinsR, et al. (2023) Determinants of sleep quality: A cross-sectional study in university students. International Journal of Environmental Research and Public Health20: 2019.
33.
ScottAJWebbTLJamesMM-S, et al. (2021) Improving sleep quality leads to better mental health: A meta-analysis of randomised controlled trials. Sleep Medicine Reviews60: 101556.
34.
SeoSMattosMK (2024) The relationship between social support and sleep quality in older adults: A review of the evidence. Archives of Gerontology and Geriatrics117: 105179.
35.
SullivanSSCaoMT (2017) Sleep and health: Medical Students’ perspectives and lessons learned. Academic Psychiatry41: 679–681.
36.
TayEHKohYSVaingankarJA, et al. (2024) Association between sleep quality and quality of life in Singapore. Quality of Life Research33: 1707–1717.
37.
WangFBíróÉ (2021) Determinants of sleep quality in college students: A literature review. Explore17: 170–177.
38.
YangKMSmallfieldS (2020) Exploring sleep health among occupational therapy students. Journal of Occupational Therapy Education4: 1–19.
39.
YeoSCTanJLoJC, et al. (2020) Associations of time spent on homework or studying with nocturnal sleep behavior and depression symptoms in adolescents from Singapore. Sleep Health6: 758–766.
