MARQUETTE - Nearly 30 percent of college students may be at risk for sleep disorders and the majority may not be getting enough sleep to excel in their studies, according to a study published in the September/October 2010 issue of the Journal of American College Health.
"Sleep problems have been associated with deficits in attention and academic performance," wrote Jane F. Gaultney, author of the study and associate professor at the University of North Carolina, Charlotte. "Among college students who carried a full academic load, those who reported poorer sleep quality were likely to perform worse on academic tests."
In her 2007-08 study of 1,845 students at a large public university, Gaultney looked for evidence of both medical and psychological disorders as indicated by self-reported symptoms. She found that 27 percent of the students were at risk for sleep disorders. These students also had lower grade point averages than those who reported no symptoms of sleep disorders.
Jason Hausmann, manager of the Sleep Lab at Marquette General Hospital, prepares equipment that staff uses. (Journal photo by Andy Nelson-Zaleski)
In Gaultney's study, 12 percent of the students surveyed reported symptoms of insomnia. This statistic is in line with the 10 to 15 percent of adults in the U.S. diagnosed with chronic insomnia. Among college students, however, sleep disorders often go undiagnosed. "You won't find them [sleep disorders] if no one is looking for them or expecting to find any. The same is true for children and adolescents," said Gaultney.
Locally, the Sleep Lab at Marquette General Hospital helps physicians diagnose sleep disorders in patients of all ages. They conduct sleep studies in which patient brain activity and vital signs are monitored closely as they sleep. From 2004 to 2010, about 10 percent of patients studied by the Sleep Lab were under the age of 30. Of these 335 patients, 50 met the criteria for a diagnosis of obstructive sleep apnea, said Jason Hausmann, manager of the Sleep Lab.
"Obstructive sleep apnea has been associated with cognitive deficits," wrote Gaultney. Of the 1,845 students she surveyed, 74 (4 percent) reported symptoms of OSA. A significant number of students at risk for the disorder were also in academic distress, with grade point averages under 2.0.
Unlike OSA, restless leg syndrome, reported by 8 percent of the students, was not as strongly associated with grades. This could be due to the fact that RLS does not always awaken the affected person. "They [RLS movements] would have to cause repeated arousal from sleep before they could create cognitive impairment and potentially affect GPA," said local neurologist, Debra Morley. Up to 10 percent of Americans may have RLS, according to the National Sleep Foundation.
"Restless Leg Syndrome is getting really prominent in younger individuals," said Hausmann. Though RLS can be diagnosed without a sleep study, its symptoms are often observed in patients studied by the Sleep Lab. Sixty-three of the 335 patients under 30 showed enough leg movements to warrant a diagnosis of RLS, he said.
Though they are often present, frequent leg movements are not the most common symptom of sleep disorders noted by the Sleep Lab. The majority of the Sleep Lab patients show signs of excessive daytime sleepiness and fatigue, said Hausmann. For 86 percent of the students surveyed by Gaultney, the No. 1 symptomatic complaint was waking up tired. This indicated to the researcher that the majority of the students were not getting a sufficient amount of sleep.
"The younger you are, the more sleep you need," said Morley, who has practiced neurology in the Upper Peninsula for more than 20 years. "Even when you're a college student, you still need seven to 10 hours of sleep. If you don't get that amount of sleep, you are going to be constantly hovering on the edge of drowsiness because you are deprived. You're just not going to be in the position to absorb new concepts."
Genna Kovach, a 21-year-old junior at Northern Michigan University, has first-hand experience with the effect that a sleep disorder can have on grades. In elementary school, she began to experience symptoms of narcolepsy. "I would kind of space out. I just lost my appetite and my whole attitude changed," Kovach said. When Kovach's worried mother took her to a doctor, the symptoms were dismissed as a virus.
But in middle school, Kovach's symptoms worsened. "I couldn't remember anything," said Kovach, "I went from being an A student to failing. I couldn't remember things from minutes, to hours, and days." After two visits with neurologists, Kovach was diagnosed with narcolepsy.
"It [narcolepsy] definitely affects my grades," said Kovach. "There are times when I just don't remember what has happened." But he English writing major has learned to cope with her narcolepsy. She keeps a recorder with her in class to document what her narcolepsy may cause her to miss, and keeps a positive attitude. "You get used to it," Kovach says. "Take it and run with it, try to make it easier, and move on."
Many sleep disorders can be treated with medications; disorders with psychological roots, such as some cases of insomnia, may be treated with behavioral and psychological therapy. Doctors at the Vielmetti Health Center can make referrals for Northern Michigan University students to the Sleep Lab at MGH.
"Identification and treatment of students with sleep disorders may produce benefits such as improved academic performance and better quality of life," wrote Gaultney. She suggests a straightforward approach to helping students with sleep disorders. "It seems reasonable for colleges to consider adding sleep screening and intervention early in students' academic experience. Sleep screening is low-cost and easy to implement."