We have read with interest the impressive study published in the Journal of Clinical Sleep Medicine by Hershner and O'Brien in which they demonstrated that an online healthy sleep education program lasting approximately 20 minutes improved sleep quality, depression and sleep behaviors.1 As emphasized by the authors, college students have a high prevalence of sleep deficiency, irregularity in sleep times and daytime somnolence.1 This can negatively impact academic and physical performance and mood. It may impair judgment and in combination with use of alcohol and other drugs possibly contribute to detrimental social interactions.2 Therefore, there is a need for educating college students about the importance of obtaining adequate amounts of good quality sleep and avoiding markedly irregular sleep/wake patterns. Unfortunately, studies of several other sleep intervention or knowledge programs showed mixed results or would be difficult to scale up to large numbers of students. Consequently, successful online programs should be ideal to fill this need. Impressively, the intervention study by Hershner and O'Brien motivated students to stop electronics use earlier and maintain a more consistent sleep-wake schedule with an earlier weekday wake time. Students who received the online education had a lower likelihood of insufficient sleep prior to examinations, had better sleep quality and lower depression scores. Similar to the authors' study, we also have data indicating that an online program, “Sleep 101,” can improve sleep knowledge and result in better sleep behaviors in college students.3 In our study of 804 college freshman, students indicated that their knowledge concerning sleep increased and that they were less likely “to pull an all-nighter” and to drive drowsy.
The challenge to all sleep intervention programs is not only to demonstrate efficacy, but to show effectiveness in the overall student population. In the study by Hershner and O'Brien, less than 50% of the 1,200 invited students completed initial surveys.1 Given the competing priorities of college students and the general perception that adequate sleep can be sacrificed in favor of other activities, low voluntary participation is to be expected. Unlike alcohol and sexual assault training, most colleges and universities are reluctant to impose a mandatory requirement for sleep education. The study by Hershner and O'Brien provides important evidence that an online sleep health intervention program improves both sleep and mental health in undergraduates. Perhaps it is time for college administrators to embrace mandatory sleep health education for all students. In the meantime, more studies are needed to strengthen the value proposition of such programs.
All authors have reviewed and approved this submission. The authors report no conflicts of interest.
Quan SF, Ziporyn PS, Czeisler CA. Sleep education for college students: the time is now. J Clin Sleep Med. 2018;14(7):1269.
Hershner S, O'Brien LM. The impact of a randomized sleep education intervention for college students. J Clin Sleep Med. 2018;14(3):337–347. [PubMed]
Czeisler CA. Duration, timing and quality of sleep are each vital for health, performance and safety. Sleep Health. 2017;1(1):5–8
Quan SF, Ziporyn PS. The impact of an online prematriculation sleep course (Sleep 101) on sleep knowledge and behaviors in college freshmen: a pilot study. Southwest J Pulm Crit Care. 2017;14(4):159–163