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      Quality of Sleep and Depression in College Students: A Systematic Review

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          Abstract

          Background:

          Nowadays, sleep-related problems are a prevalent occurrence among university students. Poor sleep quality is one of the most studied aspects of sleep complaints, affecting from 10% to 50% of this population. Poor sleep quality consequences are many and have a profound impact in the student's psychobiological health. University students live through a period of psychological challenge and adaptation, since the transition from high school to professional life. Abrupt autonomy challenges students to deal with many choices, from their academic and social life to their intimate habits. Frequently, sleep hygiene is neglected, or they are unable to use proper coping mechanisms, resulting in disturbing consequences that could impact their lives as adults. Research has found a significant association between sleep quality and depression or depressive symptoms, but this relationship is still somewhat difficult to interpret.

          Objective:

          The objective of this review is to appraise the current knowledge around the relationship of sleep with depression in this group of young adults. Data Source: Articles included in Medline database.

          Methods:

          After a careful search, the articles selected aimed mainly college students. The studies had sleep quality and depression objectively assessed, focused in the relationship between both, and addressed possible influencing factors.

          Results:

          The current literature still supports a bidirectional relationship between sleep and depression, however, the importance of sleep quality is becoming a very relevant variable.

          Conclusion:

          Education and the application of policies regarding sleep hygiene may prevent, in some cases, the development of depression and improve the quality of sleep in other cases. Future research should clarify the relationship between sleep problems and depression in a way they could be prevented or, at least, minimalized with effective and achievable interventions.

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          Most cited references38

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          Relationship of Smartphone Use Severity with Sleep Quality, Depression, and Anxiety in University Students

          Background and Aims The usage of smartphones has increased rapidly in recent years, and this has brought about addiction. The aim of the current study was to investigate the relationship between smartphone use severity and sleep quality, depression, and anxiety in university students. Methods In total, 319 university students (203 females and 116 males; mean age = 20.5 ± 2.45) were included in the study. Participants were divided into the following three groups: a smartphone non-user group (n = 71, 22.3%), a low smartphone use group (n = 121, 37.9%), and a high smartphone use group (n = 127, 39.8%). All participants were evaluated using the Pittsburgh Sleep Quality Index, Beck Depression Inventory, Beck Anxiety Inventory; moreover, participants other than those in the smartphone non-user group were also assessed with the Smartphone Addiction Scale. Results The findings revealed that the Smartphone Addiction Scale scores of females were significantly higher than those of males. Depression, anxiety, and daytime dysfunction scores were higher in the high smartphone use group than in the low smartphone use group. Positive correlations were found between the Smartphone Addiction Scale scores and depression levels, anxiety levels, and some sleep quality scores. Conclusion The results indicate that depression, anxiety, and sleep quality may be associated with smartphone overuse. Such overuse may lead to depression and/or anxiety, which can in turn result in sleep problems. University students with high depression and anxiety scores should be carefully monitored for smartphone addiction.
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            Sleep quality versus sleep quantity: relationships between sleep and measures of health, well-being and sleepiness in college students.

            Two studies assessed whether measures of health, well-being, and sleepiness are better related to sleep quality or sleep quantity. In both studies, subjects completed a 7-day sleep log followed by a battery of surveys pertaining to health, well-being, and sleepiness. In subjects sleeping an average of 7 hours a night, average sleep quality was better related to health, affect balance, satisfaction with life, and feelings of tension, depression, anger, fatigue, and confusion than average sleep quantity. In addition, average sleep quality was better related to sleepiness than sleep quantity. These results indicate that health care professionals should focus on sleep quality in addition to sleep quantity in their efforts to understand the role of sleep in daily life.
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              Low Physical Activity and High Screen Time Can Increase the Risks of Mental Health Problems and Poor Sleep Quality among Chinese College Students

              Objective To test the independent and interactive associations of physical activity (PA) and screen time (ST) with self-reported mental health and sleep quality among Chinese college students. Method Data were collected in October, 2013. The gender, age, residential background, body mass index (BMI), perceived family economy and perceived study burden were obtained from a total of 4747 college students (41.6% males and 58.4% females). The outcomes were self-reported PA status, ST, anxiety, depression, psychopathological symptoms and sleep quality. Analyses were conducted with logistic regression models. Results Overall, 16.3%, 15.9% and 17.3% of the students had psychological problems, such as anxiety, depression and psychopathological symptoms, respectively. The prevalence of poor sleep quality was 9.8%. High ST was significantly positively associated with anxiety (OR=1.38, 95%CI: 1.15-1.65), depression (OR=1.76, 95%CI: 1.47-2.09), psychopathological symptoms (OR=1.69, 95%CI: 1.43-2.01) and poor sleep quality (OR=1.32, 95%CI: 1.06-1.65). High PA was insignificantly negatively associated with anxiety, depression, psychopathological symptoms and poor sleep. Low PA and high ST were independently and interactively associated with increased risks of mental health problems and poor sleep quality (p<0.05 for all). Conclusion Interventions are needed to reduce ST and increase PA in the lifestyles of young people. Future research should develop and measure the impacts of interventions and their potential consequences on sleep, health, and well being.
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                Author and article information

                Journal
                Sleep Sci
                Sleep Sci
                ssci
                Sleep Science
                Brazilian Association of Sleep and Latin American Federation of Sleep
                1984-0659
                1984-0063
                Jul-Aug 2018
                Jul-Aug 2018
                : 11
                : 4
                : 290-301
                Affiliations
                [1 ] Faculty of Medicine, University of Porto, Department of Clinical Neurosciences and Mental Health - Porto - Porto - Portugal.
                Author notes
                Corresponding author: João Dinis. E-mail: joaodinis@ 123456protonmail.com
                Article
                10.5935/1984-0063.20180045
                6361309
                30746048
                6e9c438b-8bc8-4a9b-b65d-7c7b73b98002

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivative License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium provided the original work is properly cited and the work is not changed in any way.

                History
                : 03 June 2018
                : 07 September 2018
                Categories
                Review

                sleep hygiene,depression,students,universities
                sleep hygiene, depression, students, universities

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