Sleep

Study: Sleep and stress levels

College students can take many steps in their everyday lives to improve their mental health, one of the main factors is sleep (1).

Poor sleep in college students can impact tension, irritability, depression, confusion, reduced life satisfaction, or poor academic performance (2).

Yet more than 75% of students report getting less than 8 hours of sleep on average on weeknights over the last 2 weeks according to the Fall 2024 ACHA-NCHA IIIb Reference Group survey of 33,763 college students across 48 institutions (3).

A recent study looked at sleep and stress levels (4)

32 college students recorded their daily sleep duration using a wristband for six days and took a survey of stress, resilience, and sleep quality.

What were the results? 

  • Poor sleep quality is associated with greater perceived stress (4)

  • Lack of sleep can make students more vulnerable to stressful situations(4)

  • Insufficient sleep for five consecutive nights can alter the evaluation of neutral and pleasant stimuli, leading to a more negative perception (4)

  • Improving self control impacted the relationship between sleep and stress (4)

What are some caveats?

  • The findings of this study build on another study which showed that sleep deprivation can increase the stress hormone cortisol by up to 21% (5)
  • This is 1 small study and further research is needed
  • Participants were recruited through convenience sampling, which may introduce selection bias (4)
  • While sleep duration was measured objectively using a Fitbit, and self-reported data  of the study can be subject to inaccuracies due to bias and social desirability bias(4)

Strategies to manage stress can be found here: https://u.osu.edu/emotionalfitness/2014/08/15/stress-and-what-to-do-about-it/

Strategies for sleep can be found here: https://u.osu.edu/emotionalfitness/2017/12/31/poor-sleep-and-poor-grades-might-go-together/

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By Ryan S Patel DO, FAPA OSU-CCS Psychiatrist

Contact: patel.2350@osu.edu

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes.  With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Patel R. Mental Health For College Students Chapter 7. Sleep strategies to improve mental health.
  2. Buboltz WC Jr, Brown F, Soper B. Sleep habits and patterns of college students: a preliminary study. J Am Coll Health. 2001 Nov;50(3):131-5. doi: 10.1080/07448480109596017. PMID: 11765249.
  3. American College Health Association. American College Health Association-National College Health Assessment III: Reference Group Executive Summary Fall 2024. Silver Spring, MD: American College Health Association; 2025.
  4. Tafoya SA, Aldrete-Cortez V, Tafoya-Ramos F, Fouilloux-Morales C, Díaz-Olavarrieta C. Sleep and Perceived Stress: An Exploratory Mediation Analysis of the Role of Self-Control and Resilience among University Students. Int J Environ Res Public Health. 2023 Aug 11;20(16):6560. doi: 10.3390/ijerph20166560. PMID: 37623146; PMCID: PMC10454638.
  5. Lamon S, Morabito A, Arentson-Lantz E, Knowles O, Vincent GE, Condo D, Alexander SE, Garnham A, Paddon-Jones D, Aisbett B. The effect of acute sleep deprivation on skeletal muscle protein synthesis and the hormonal environment. Physiol Rep. 2021 Jan;9(1):e14660. doi: 10.14814/phy2.14660. PMID: 33400856; PMCID: PMC7785053.

Does Tart cherry juice help with sleep?

About 14% of young adults reported sleep difficulties (1)

There are many non medication strategies that can help improve sleep, and these have been discussed previously (2).

One study looked at tart cherry juice and its impact on sleep.

Why tart cherry juice?

Previous studies reported the positive effects of consumption of tart cherry juice on recovery in cyclists, soccer players, and marathoners (3,4,5). In addition, a study on healthy people reported that consumption of tart cherry juice can quickly promote sleep, cognition, and a decrease in the level of oxidative stress and training-related muscle damage (6,7).

Interestingly, tart cherry contains high concentrations of melatonin (8).  Melatonin is both a supplement and a substance created in the human body that helps to induce sleep (9,10).

Tart cherry juice has been shown to increase in the efficiency of objective sleep (11).

What was the study? (12)

22 participants were randomized to receive either 30 mls tart cherry juice or placebo given 5 times over 48 hours (12).

What was measured? (12)

Melatonin, stress hormone cortisol, and the quality of sleep after intermittent exhaustion exercise in female elite field hockey players (12).

What were the results? (12)

Tart cherry juice was found to improve sleep quality, but not affect changes in the levels of melatonin or the stress hormone, cortisol (12).

What are some caveats?

  • In my experience, some people may experience morning tiredness or vivid dreams.
  • This is a small study and further study is needed to verify the results.
  • Long term side effects are not known.
  • The benefit size may not be enough for everyone.
  • There are many factors impacting sleep and the combination of factors impacting any 1 person may not be the same as others, so the combination of strategies that work to help improve sleep may vary from person to person.

What are some helpful strategies for sleep?

The American Academy of Sleep Medicine suggests the following ways to improve sleep (13):

  • Keep a consistent sleep schedule.
  • Get up at the same time every day, even on weekends or during vacations.
  • Don’t go to bed unless you are sleepy.
  • Other strategies:

What are some helpful resources for sleep?

By Ryan S Patel DO, FAPA

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Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. Adjaye-Gbewonyo D, Ng AE, Black LI. Sleep difficulties in adults: United States, 2020. NCHS Data Brief, no 436. Hyattsville, MD: National Center for Health Statistics. 2022. DOI: https://dx.doi.org/10.15620/cdc:117490.
  2. Patel R. Mental Health For College Students  https://a.co/d/iXhbkAj
  3. Howatson G., McHugh M.P., Hill J.A., Brouner J., Jewell A.P., Van Someren K.A., Shave R.E., Howatson S.A. Influence of tart cherry juice on indices of recovery following marathon running.  J. Med. Sci. Sports. 2010;20:843–852. doi: 10.1111/j.1600-0838.2009.01005.x.
  4. Dimitriou L., Hill J.A., Jehnali A., Dunbar J., Brouner J., McHugh M.P., Howatson G. Influence of a montmorency cherry juice blend on indices of exercise-induced stress and upper respiratory tract symptoms following marathon running—A pilot investigation.  Int. Soc. Sports Nutr. 2015;12:22. doi: 10.1186/s12970-015-0085-8.
  5. Bell P.G., Stevenson E., Davison G.W., Howatson G. The effects of montmorency tart cherry concentrate supplementation on recovery following prolonged, intermittent exercise. 2016;8:441. doi: 10.3390/nu8070441.
  6. Jacob R.A., Spinozzi G.M., Simon V.A., Kelley D.S., Prior R.L., Hess-Pierce B., Kader A.A. Consumption of cherries lowers plasma urate in healthy women. J. Nutr. 2003;133:1826–1829. doi: 10.1093/jn/133.6.1826.
  7. Lynn A., Mathew S., Moore C.T., Russell J., Robinson E., Soumpasi V., Barker M.E. Effect of a tart cherry juice supplement on arterial stiffness and inflammation in healthy adults: A randomised controlled trial. Plant Foods Hum. Nutr. 2014;69:122–127. doi: 10.1007/s11130-014-0409-x.
  8. Burkhardt S., Tan D.X., Manchester L.C., Hardeland R., Reiter R.J. Detection and quantification of the antioxidant melatonin in Montmorency and Balaton tart cherries (Prunus cerasus)  Agric. Food Chem. 2001;49:4898–4902. doi: 10.1021/jf010321+.
  9. Hughes R.J., Sack R.L., Lewy A.J. The role of melatonin and circadian phase in age-related sleep-maintenance insomnia: Assessment in a clinical trial of melatonin replacement. 1998;21:52–68.
  10. Claustrat B., Brun J., Chazot G. The basic physiology and pathophysiology of melatonin. Sleep Med. Rev. 2005;9:11–24. doi: 10.1016/j.smrv.2004.08.001.
  11. Howatson G., Bell P.G., Tallent J., Middleton B., McHugh M.P., Ellis J. Effect of tart cherry juice (Prunus cerasus) on melatonin levels and enhanced sleep quality.  J. Nutr. 2012;51:909–916. doi: 10.1007/s00394-011-0263-7.
  12. Chung J, Choi M, Lee K. Effects of Short-Term Intake of Montmorency Tart Cherry Juice on Sleep Quality after Intermittent Exercise in Elite Female Field Hockey Players: A Randomized Controlled Trial. Int J Environ Res Public Health. 2022 Aug 18;19(16):10272. doi: 10.3390/ijerph191610272. PMID: 36011907; PMCID: PMC9408103.
  13. http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits

Poor sleep and poor grades might go together

College students might stay up late or have an erratic sleep schedule for a variety of reasons.

A recent study looked at the impact of sleep pattern on grades.

Who was studied? (1,2)

  • 61 undergraduate students at Harvard college
  • They were asked to keep a sleep diary for 30 days.

What did the investigators find? (1,2)

Compared to peers, students reporting irregular patterns of sleep and wakefulness had:

  • Lower grade point averages.
  • Delays in the times people went to bed and woke up compared to more normal sleep/wake times.
  • Upto 3 hour delay in melatonin (sleep related hormone) release compared to students with regularly scheduled sleep and wakefulness pattern.

What are some caveats?

  • Poor sleep can impact almost every aspect of health and many parts of brain functioning, including learning, remembering, mood, energy level, decision making, etc.
  • This is a small study and does not prove cause-and-effect (2).
  • Students with erratic sleep schedules ended up sleeping the same number of hours as those with a regular sleep schedule. (1,2).
  • Study participants might have an erratic sleep schedule for a variety of reasons.

What are some ways of improving sleep?

The American Academy of Sleep Medicine suggests the following ways to improve sleep (3):

  • Keep a consistent sleep schedule.
  • Get up at the same time every day, even on weekends or during vacations.
  • Plan to get at least 7 hours of sleep.
  • Don’t go to bed unless you are sleepy.
  • If you don’t fall asleep after 20 minutes, get out of bed.
  • Establish a relaxing bedtime routine.
  • Use your bed only for sleep and sex.
  • Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
  • Limit exposure to bright light in the evenings.
  • Turn off electronic devices at least 30 minutes before bedtime.
  • Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
  • Exercise regularly and maintain a healthy diet.
  • Avoid consuming caffeine in the late afternoon or evening.
  • Avoid consuming alcohol before bedtime.
  • Reduce your fluid intake before bedtime.

Anything else?

  • Some people may need to eliminate caffeine or alcohol completely.
  • If you have to use electronics in the evenings, consider BLUEBLOCKERS.

Consider seeking professional help:

OSU Counseling and Consultation Service

OSU Wilce Student health center

https://ccs.osu.edu/self-help/sleep/

How is your sleep? How are your grades?

By R. Ryan Patel DO, FAPA OSU-CCS Psychiatrist

Disclaimer: This article is intended to be informative only. It is advised that you check with your own physician/mental health provider before implementing any changes. With this article, the author is not rendering medical advice, nor diagnosing, prescribing, or treating any condition, or injury; and therefore claims no responsibility to any person or entity for any liability, loss, or injury caused directly or indirectly as a result of the use, application, or interpretation of the material presented.

References:

  1. https://consumer.healthday.com/sleep-disorder-information-33/misc-sleep-problems-news-626/poor-sleep-habits-61-poor-grades-723563.html
  2. Phillips AJK, Clerx WM, O’Brien CS, et al. Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing. Scientific Reports. 2017;7:3216. doi:10.1038/s41598-017-03171-4.
  3. http://www.sleepeducation.org/essentials-in-sleep/healthy-sleep-habits