The Relationships of Sleep Quality Length and Napping To Physic

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Doctoral Dissertations Graduate School
Spring 2013
The relationships of sleep quality, length, and

napping to physical performance
Rebecca M. Hoffmann
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THE RELATIONSHIPS OF SLEEP QUALITY, LENGTH,
AND NAPPING TO PHYSICAL
PERFORMANCE
By
Rebecca M. Hoffmann, B.S., M.A., M. S.
A Dissertation Presented in Partial Fulfillment

of the Requirements for the Degree
Doctor of Philosophy
COLLEGE OF EDUCATION
LOUISIANA TECH UNIVERSITY
May 2013
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We hereby recommend that the dissertation prepared under our supervision
Rebecca M. Hoffmann
entitled__________________________________________________________________________
The Relationships of Sleep Quality/Length and Napping to Physical
Performance
be accepted in partial fulfillment of the requirements for the Degree of
Doctor of Philosophy
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ertation Research
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Dean o f the College

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ABSTRACT
College students suffer from more sleep disturbances than the general population.
Sleep difficulties can lead to lower levels of performance, memory, and cognitive ability.
Sleep quality is known to impact individuals’ physical and psychological health. The
relationship between sleep variables (i.e., sleep quality, sleep length, sleepiness, and a
nap/relaxation) and physical performance (i.e., flexibility, grip strength, and peak
performance) has not been fully examined. The purpose of this study was to explore the
relationship between sleep quality, sleep length, and sleepiness and physical performance
(e.g., flexibility, grip strength, and peak power), as well as to determine if a short nap
diminishes the effect of poor sleep on the same physical performance measures.
Participants of this study were students at a mid-sized southern United States
university who were recruited from classes in the College of Education. The relationship
between sleep quality, length, and sleepiness and flexibility, grip strength, vertical jump
height, and peak power was assessed using the Sleep Quality Index, the Adult Sleep-
Wake Scale, the Sleep Habits Questionnaire, the Epworth Sleepiness Scale, the
Karolinska Sleepiness Scale, hand dynamometer, vertical jump test, and sit-and-reach
box. A two-way analysis of variance (ANOVA) was conducted to determine the effect of
a nap/relaxation on flexibility, grip strength, vertical jump height, and peak power, with
gender as an independent variable. Correlations were also conducted to determine the
relationship between sleep quality, sleep duration, and sleepiness and flexibility, grip
strength, and peak power.

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Finally, the author of this Dissertation reserves the right to publish freely, in the
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TABLE OF CONTENTS
ABSTRACT............................................................................................................................. iii
LIST OF TABLES..................................................................................................................xii
CHAPTER 1 INTRODUCTION..............................................................................................1
Statement of the Problem....................................................................................................5
Justification..........................................................................................................................7
Literature Review ............................................................................................................... 7
Stages of Sleep.............................................................................................................. 7
N aps.......................................................................................................................10
Physiological Processes of Sleep-Wake Cycle.........................................................11
Autonomic Nervous System................................................................................ 11
Homeostatic Drive................................................................................................12
Circadian Rhythm.................................................................................................14
The Theories o f Sleep Function.................................................................................18
The Restoration M odel........................................................................................ 18
The Neurotransmitter Replenishment Theory................................................... 19
The Evolutionary/Circadian Sleep Models.........................................................19
The Developmental M odel.................................................................................. 19
The Learning M odel............................................................................................ 20
Sleep Difficulties of College Students...................................................................... 22
Factors that Affect Sleep in College Students......................................................... 26
v
vi
Effects of Inadequate Sleep Length.......................................................................... 31
Sleep and Health.........................................................................................................32
Sleep and Obesity/Health Status......................................................................... 40
Sleep and Learning/Academic Performance............................................................ 45
Sleep Quality and Physical Performance..................................................................51
Napping and Physical Performance......................................................................... 52
Relaxation................................................................................................................... 54
Relaxation Techniques......................................................................................... 54
Guided Imagery................................................................................................... 56
Hypotheses........................................................................................................................ 57
Hypothesis 1A.............................................................................................................57
Hypothesis IB .............................................................................................................57
Hypothesis 1C.............................................................................................................57
Hypothesis ID .............................................................................................................57
Justification of Hypotheses 1A, IB, 1C, and ID ...............................................58
Hypothesis 2A.............................................................................................................58
Hypothesis 2B.............................................................................................................58
Hypothesis 2C.............................................................................................................59
Hypothesis 2D.............................................................................................................59
Justification of Hypotheses 2A, 2B, 2C, and 2 D ...............................................59
Hypothesis 3A.............................................................................................................59
Hypothesis 3B.............................................................................................................60
Hypothesis 3C.............................................................................................................60
vii
Hypothesis 3D............................................................................................................. 60
Justification of Hypotheses 3A, 3B, 3C, and 3D ............................................... 60
Hypothesis 4A............................................................................................................. 60
Hypothesis 4B ............................................................................................................. 61
Hypothesis 4C ............................................................................................................. 61
Hypothesis 4D............................................................................................................. 61
Justification of Hypotheses 4A, 4B, 4C, and 4 D ............................................... 61
CHAPTER 2 METHOD......................................................................................................... 62
Participants......................................................................................................................... 62
Measures............................................................................................................................ 62
Demographics F orm ...................................................................................................62
Sleep Quality Index....................................................................................................63
Adult Sleep-Wake Scale............................................................................................ 64
Sleep Habits Questionnaire........................................................................................ 65
Epworth Sleepiness Scale.......................................................................................... 66
Karolinska Sleepiness Scale...................................................................................... 67
Physical Performance Measures...................................................................................... 67
Hand Grip Dynamometer........................................................................................... 67
Sit-and-Reach Test...................................................................................................... 68
Vertec Vertical Jump Device..................................................................................... 69
Estimated Peak Pow er................................................................................................69
Procedure........................................................................................................................... 69
Recruitment of Participants....................................................................................... 70
Control Group............................................................................................................. 71
Experimental Group....................................................................................................71
Hand Dynamometer Test Procedure......................................................................... 72
Vertical Jump Test Procedure....................................................................................72
Sit-and-Reach Test Procedure...................................................................................73
Risks and Benefits......................................................................................................73
CHAPTER 3 RESULTS.........................................................................................................74
Participants........................................................................................................................ 74
Overall Sam ple...........................................................................................................74
Control Group.............................................................................................................75
Experimental Group................................................................................................... 75
Descriptive Statistics, Reliabilities, and /-tests for Overall Sample............................. 76
Descriptive Statistics, Reliabilities, and /-tests for Overall Sample by Gender............77
Examination of Gender Differences for Overall Sample...............................................79
Descriptive Statistics, Reliabilities, and /-tests for Control Group............................... 79
Descriptive Statistics, Reliabilities, and /-tests for Control Group byGender............. 80
Examination of Gender Differences for Control Group................................................ 82
Descriptive Statistics, Reliabilities, and /-tests for Experimental Group.................... 82
Descriptive Statistics, Reliabilities, and /-tests for Experimental Group by Gender...83
Examination of Gender Differences for Experimental Group...................................... 85
Homogeneity o f Variance................................................................................................ 85
Correlations between Variables.......................................................................................86
Correlations between Variables with M ales................................................................... 88

Correlations between Variables with Females................................................................90
Hypothesis 1A................................................................................................................... 92
Hypothesis IB ................................................................................................................... 92
Hypothesis 1C................................................................................................................... 94
Hypothesis ID ................................................................................................................... 94
Hypothesis 2A................................................................................................................... 95
Hypothesis 2B ................................................................................................................... 96
Hypothesis 2C................................................................................................................... 99
Hypothesis 2D..................................................................................................................101
Hypothesis 3A ..................................................................................................................102
Hypothesis 3B..................................................................................................................103
Hypothesis 3C..................................................................................................................104
Hypothesis 3D..................................................................................................................105
Hypothesis 4A ..................................................................................................................106
Hypothesis 4B ..................................................................................................................107
Hypothesis 4C ..................................................................................................................110
Hypothesis 4D..................................................................................................................112
CHAPTER 4 DISCUSSION.................................................................................................114
General Overview of Results......................................................................................... 114
Hypothesis One................................................................................................................117
Hypothesis 1A........................................................................................................... 117
Hypothesis IB ........................................................................................................... 118
Hypothesis 1C........................................................................................................... 119

X
Hypothesis ID ............................................................................................................119
Hypothesis Tw o...............................................................................................................120
Hypothesis 2A ............................................................................................................120
Hypothesis 2B ............................................................................................................121
Hypothesis 2C ............................................................................................................122
Hypothesis 2D............................................................................................................123
Hypothesis Three.............................................................................................................123
Hypothesis 3A ............................................................................................................123
Hypothesis 3B............................................................................................................124
Hypothesis 3C............................................................................................................124
Hypothesis 3D............................................................................................................125
Hypothesis Four...............................................................................................................125
Hypothesis 4A............................................................................................................125
Hypothesis 4B ............................................................................................................126
Hypothesis 4C ............................................................................................................127
Hypothesis 4D............................................................................................................127
Implications..................................................................................................................... 127
Limitations....................................................................................................................... 130
Suggestions for Future Research................................................................................... 134
APPENDIX A HUMAN USE COMMITTEE APPROVAL FORM................................137
APPENDIX B INFORMED CONSENT FORM ............................................................... 139
APPENDIX C DEMOGRAPHICS FORM .........................................................................141
APPENDIX D SLEEP QUALITY INDEX.........................................................................143

xi
APPENDIX E ADULT SLEEP-WAKE SCALE............................................................... 145
APPENDIX F SLEEP HABITS QUESTIONNAIRE........................................................149
APPENDIX G EPWORTH SLEEPINESS SCALE...........................................................151
APPENDIX H KAROLINSKA SLEEPINESS SCALE................................................... 153
APPENDIX I SCRIPT FOR RECRUITING PARTICIPANTS........................................155
APPENDIX J ACTIVE DYNAMIC WARM-UP PROCEDURE....................................157
REFERENCES......................................................................................................................159
LIST OF TABLES
Table 1 Descriptive Statistics, Reliabilities, and t-tests fo r

Overall Sam ple.............................................................................................. 76
Table 2 Descriptive Statistics, Reliabilities, and t-tests for

Overall Sample by Gender............................................................................ 78
Table 3 Descriptive Statistics, Reliabilities, and t-tests fo r

Control Group................................................................................................ 80

Control Group by Gender............................................................................. 81

Experimental G roup......................................................................................83

Experimental Group by Gender.................................................................... 84
Table 7 Summary o f Correlations, Means, and Standard Deviations

fo r Scores on All Measures fo r Overall Sample..........................................87

fo r Scores on All Measures fo r Overall Sample with Males Only............. 89

fo r Scores on All Measures fo r Overall Sample with Females Only.........91
xii
CHAPTER 1
INTRODUCTION
Sleep is a natural reversible state of unconsciousness in which individuals rest
their minds and bodies. Sleep is also an active process during which complex
physiological, neurological, and hormonal changes transpire. Sleep has been found to be
imperative to learning and cognitive functioning, as well as physical and emotional
health. Difficulty sleeping is one of the most common and consistently increasing health
complaints among young adults (Hicks, Mistry, Lucero, Lee, & Pelligrini, 1989). Many
college students do not get enough sleep and may not realize the impact that lack of sleep
has on their functioning.
College years are a time of transition that entails multifaceted challenges in
academic, social, psychological, and developmental adjustment. In response to newfound
personal stressors and environmental variables, college students may compensate with
modification of sleep behaviors and patterns. Brown, Soper, and Buboltz (2001) found
that one-third of college students report regular, severe sleep difficulties. Studies have
found that college students have more sleep problems than the general population. The
National Sleep Foundation recommends that adults 18-54 years of age sleep between
seven and 8.5 hours per night. Coren (1994) indicated that over 30% o f college students
reported having difficulty sleeping. Buboltz, Brown, and Soper (2001) noted that over
70% of college students have regular sleep difficulties. In comparison to the general
1
2
population, college students tend to have more difficulty sleeping (Buboltz et al., 2001;
Coren, 1994; Lack 1986).
Sleep is an important and essential function of humans, comprising nearly one-
third of our lives. Though sleep is understood to be necessary, the specific physiologic
function of sleep remains unknown (Sejnowski & Destexhe, 2000). Disruption of sleep
has been demonstrated to have adverse neurocognitive effects. For example, meta
analyses have shown reductions in performance on cognitive and motor tasks after sleep
deprivation (Philibert, 2005; Pilcher & Huffcutt, 1996). A lack of sleep alters
physiological states that affect cognitive functioning, metabolism, inflammation, and
neurobehavioral functioning (Dimitrov, Lange, Tieken, Fehm, & Bom, 2004).
Research has shown that impaired sleep has adverse effects on cognitive
performance, mood, and other physiological and psychological aspects of human
functioning (Alapin et al., 2000; Forbes et al., 2008; Jean-Louis, von Gizycki, Zizi, &
Nunes, 1998; Kahn-Greene, Killgore, Kamimori, Balkin, & Killgore, 2007; Pilcher,
Ginter, & Sadowsky, 1997; Pilcher & Ott, 1998; Tomasi et al., 2009; Van Dongen,
Maislin, Mullington, & Dinges, 2003; Yegneswaran & Shapiro, 2007). A sleep-deprived
person is likely to demonstrate impaired judgment as well as declines in executive
function, working memory and higher-level cognitive functions (Akerstedt, Kecklund,
Alfredsson, & Selen, 2007; Durmer & Dinges, 2005). Engle-Friedman et al. (2003)
reported that sleep loss in college students resulted in choice of behaviors that take a
lesser amount of effort and that those who are sleep deprived do not perceive a reduction
in their effort. These effects in a college setting may lead students to attribute poor
3
academic performance to their own abilities when poor sleep may be the source of
suboptimal functioning.
Relatively mild sleep deprivation, restriction to six hours of sleep per night,
resulted in decrements in neurocognitive task performance during an experimental sleep
deprivation protocol (Van Dongen et al., 2003). Further, insufficient sleep has been
implicated as a contributing factor in motor vehicle accidents and a number of industrial
accidents, including the Chernobyl nuclear disaster and Challenger shuttle explosion
(Lyznicki, Doege, Davis, & Williams, 1998; Mitler et al., 1988; Young, Blustein, Finn, &
Palta, 1997). More recent literature suggests that short sleep duration is also a risk factor
for cardiovascular outcomes, glucose dysregulation, and even death (Ayas et al., 2003;
Gottlieb et al., 2005; Patel et al., 2004).
Though too little sleep has a number of health consequences, many people do not
get enough sleep each night. As more and more is packed into the days, the time allotted
for sleep is curtailed. The 2008 National Sleep Poll, an annual survey of sleep habits of
Americans, found that 44% of Americans average less than seven hours of sleep a night
on work days. Only recently has there been more of a focus placed on the college-aged
population, 44% of whom reported enough severe daytime sleepiness that it interferes
with normal daily functioning (USDHHS, 2003).
Individuals commonly complain about sleep quality; 15-35% of the adult
population complains of frequent disturbances in their sleep quality, such as difficulty
falling asleep and remaining asleep (Bixler, Kales, Soldatos, Kales, & Healey, 1979;
Karacan et al., 1976; Karacan, Thomby, & Williams, 1983; Lugaresi et al., 1983;
Mellinger, Balter, & Uhlenhuth, 1985; Welstein, Dement, Redington, & Guilleminault,
4
1983). Sleep quality includes several aspects of sleep, such as sleep length, sleep latency,
number of awakenings, as well as depth of restfulness of sleep (Buysse, Reynolds, Monk,
Berman, & Kupfer, 1989).
Studies have reported a high prevalence of sleep problems and sleep-related
disturbances among young adults (Ohayon, Roberts, Zulley, Smime, & Priest, 2000;
Racinais, Hue, Blonc, & Le Gallais, 2004; Yang, Wu, Hsieh, Liu, & Lu, 2003). Poor
sleep quality can contribute to problems in many different aspects of a young adult’s life.
College students often report poor sleep quality, irregular sleep habits, and daytime
sleepiness (Alapin et al. 2000; Buboltz et al., 2001; Campos-Morales, Valencia-Flores,
Castano-Meneses, Castaneda-Figueiras, & Martinez-Guerrero, 2005; Carney, Edinger,
Meyer, Lindman, & Istre, 2006; Pilcher, Schoeling, & Prosansky, 2000; Yang et al.,
2003).
Global trends of working more and the increase in domestic and social demands
have resulted in sleep reduction and daytime sleepiness, which has stimulated interest in
conducting research on the benefits of brief naps. Naps as brief as 19.8 (Gillberg,
Kecklund, Axelsson, & Akerstedt, 1996), 10.8 (Home & Ryner, 1996), 10.2 (Takahashi
& Arito, 2000), 10 (Tietzel & Lack, 2001; Tietzel & Lack, 2002), and 9.1 (Hayashi,
Motoyoshi, & Hori, 2005) minutes have been found to improve alertness and
performance in individuals whose sleep was restricted. The improvement in alertness and
performance due to taking a brief nap could also benefit physical performance. In
addition, brief naps in the workplace have been found to be beneficial during a nightshift
(Purnell, Feyer, & Herbison, 2002; Signal & Gander, 2002).

5
Research on meditation has found that the conscious mind may play a role in
enhancing psychological and physical health (Chiesa & Serretti, 2010; Goldin, Ramel, &
Gross, 2009; Perlman, Salomons, Davidson, & Lutz, 2010; Zeidan, Gordan, Merchant, &
Goolkasian, 2010). Autogenic training (Schultz & Luthe, 1959), which produces
sensations of warmth and heaviness in the athlete's body, has been widely used by
European athletes to aid in the control of psycho-physiological activation levels (Cox,
2012).
Statement of the Problem
There are many studies that have examined the effects of physical activity on
sleep. However, few studies have examined the effects of sleep on physical performance.
In addition, many o f those studies had very few participants. Of the few studies
conducted, Racinais and colleagues (2004) found a relationship between sleep
deprivation and poor shuttle run performance in 22 adult athletes. Reilly and Piercy
(1994) determined that there was a significant effect of sleep loss on bench press, leg
press, and dead lift performance with eight male participants. In addition, sprint times
were found to be improved by a post-lunch nap following partial sleep loss with 20
young males (Waterhouse, Atkinson, Edwards, & Reilly, 2007).
The relationship between sleep and physical performance has not been fully
examined. Sleep quality has been found to be more salient to college students’ health, life
satisfaction, levels of tension and depression, and psychological well-being (Pilcher et al.,
1997), as well as general cognitive performance (Pilcher & Walters, 1997). Sleep quality
is known to impact individuals’ physical and psychological health (Pilcher et al., 1997).
A study with female college students in Taiwan found that individuals with poor sleep
6
quality had poorer flexibility, poorer muscular endurance, and lower cardiovascular
fitness compared to individuals with good sleep quality (Lee & Lin, 2007). However,
males were not included in this study, nor were sleep duration and sleepiness examined.
Daytime sleepiness in older adults was associated with physical functional impairments
and decreased exercise frequency (Chasens, Sereika, Weaver, & Umlauf, 2007).
Researchers have examined college students’ sleep habits, sleep patterns, and
sleep difficulties (Buboltz et al., 2001; Caldwell, 2002; Coren, 1994; Lack, 1986;
Trockel, Barnes, & Egget, 2000). Studies have indicated that college students have more
sleep difficulties than the general population (Buboltz et al., 2001; Coren, 1994; Lack,
1986). Sleep habits were the most predictive of college students’ academic performance
out of all health related behaviors (Trockel et al., 2000). In addition, fatigue may be
caused by a slight reduction in sleep duration, especially when paired with an erratic
sleep schedule. Caldwell (2002) found that 75% of college students experiencing fatigue
even when they get seven hours per night of sleep, combined with having a varying
schedule.
Many studies have examined the effects of sleep on academic performance, but
have neglected studying the effects of sleep on physical performance (Curcio, Ferrara, &
De Gennaro, 2005; Gomes, Tavares, & de Azevedo, 2011; Lowry, Dean, & Manders,
2010; Peters, Joireman, & Ridgeway, 2005; Singleton & Wolfson, 2009). However,
many of the same impaired functions disrupted by poor sleep are the same in physical
performance as academic performance. For example, lack of sleep alters physiological
states that affect cognitive functioning, metabolism, inflammation, and neurobehavioral
functioning (Dimitrov et al., 2004).

7
The primary purpose of this study is to determine if a short nap diminishes the
effect of poor sleep on physical performance, as well as to explore the relationship
between sleep quality and physical performance (e.g., flexibility, grip strength, and peak
power) and sleep length and physical performance. More research is needed to clearly
delineate the effects of these sleep variables on the physical performance variables. This
study will add to the existing sleep literature and initiate new knowledge on the
relationships between sleep and physical performance.
Justification
In regard to physical performance, there is little information about the effects of
limited sleep loss (Legar, Metlaine, & Choudat, 2005) and of any effects that naps may
have. Such information would be valuable when there is a requirement for physical
activity in individuals who are suffering from some degree of sleep loss. Additionally, it
is also relevant to athletes, because even small differences in physical performance may
mean the difference in winning or losing. Sleep may have a greater impact on the athlete
when they are in unfamiliar surroundings, feeling apprehensive the night before a
competition or game, or not being accustomed to noise from sports fans. Sleep can also
be affected when there is a time zone change or they have to awaken earlier than usual.
These things can all influence the athlete’s physical performance.
Literature Review
Stages of Sleep
According to the 2007 American Academy of Sleep Medicine (AASM) standards,
individuals cycle through three stages of sleep, known as non-rapid eye movement
8
(NREM) sleep, and rapid eye movement (REM) sleep. The NREM stages are referred to
as: N l, N2, and N3. Stage 3 of NREM sleep (N3) is also called delta sleep or slow-wave
sleep (SWS) (Sibler et al., 2007). NREM sleep comprises 75% o f the night, whereas
REM sleep accounts for 25% o f the night. The order that an individual cycles through
stages of sleep is N l, N2, N3, back to N2, and then REM.
Individuals cycle through these stages of sleep on average approximately every 90
to 110 minutes (Caldwell, 2003; Carlson, 1999). Each cycle of REM sleep lasts
approximately 20-30 minutes; therefore, individuals typically experience four or five
cycles of REM sleep per night. Individuals experience a greater amount of deep sleep
(stage N3) earlier in the sleep cycle, but have longer periods of REM sleep later in the
sleep cycle and prior to natural awakening. We enter NREM sleep when we start to fall
asleep.
Upon falling asleep, individuals enter Stage N l sleep as their muscles begin to
relax and there is a loss o f alertness. There is a transition from alpha waves having a
frequency of eight to 13 Hz, which is common in the state of wakefulness, to theta waves
having a frequency of 4-7 Hz, on an EEG (Carlson, 1999). A common sign of disturbed
sleep is a greater percentage of Stage N l sleep (Soldatos & Paparrigopoulos, 2005).
Research indicates that individuals with insomnia often spend more time in stage N l
sleep than those without insomnia (Carskadon & Dement, 2000). Therefore, they usually
obtain more sleep than they realize, but it may not be good quality sleep.
Stage N2 typically lasts for 10 to 25 minutes in young adults (Carlson, 1999).
Stage N2 o f sleep is characterized by sleep spindles and K complexes. Sleep spindles are
short bursts of EEG waves that occur between two and five times per minute during the
9
stages o f non-REM sleep, but predominantly in stage N2. The K complexes are abrupt,
sharp waves. These two types of wave bursts are associated with keeping an individual in
a sleeping state (Bowersox, Kaitlin, & Dement, 1985; Steriade & McCarley, 1990). This
stage accounts for 45-55% of total sleep in adults.
Stage N3 is also known as slow wave sleep and is the deepest level of sleep. In
this stage of sleep, delta waves are present, which are slow, high amplitude waves (less
than 3.5 Hz) that constitute more than 50% of brain waves during this stage (Carlson,
1999). After approximately 45 minutes in stage N3, an individual cycles back to stage N2
(Carlson, 1999). During the second time in stage N2 of sleep, the K complexes and
spindles give way to the rapid eye movements of REM sleep.
REM is the stage of sleep in which people dream and it accounts for 20-25% of
total sleep time in most adults (Carlson, 1999). REM sleep is known as paradoxical sleep
because beta waves are present but the brain paralyzes muscular activity to protect
individuals from injury through acting out dreams. The rapid eye movements will return
to K complexes and spindles return and the individual enters stage two of sleep once
again and repeats the cycle. When this cycle is disrupted individuals may experience
numerous sleep disturbances.
Following total sleep deprivation, REM sleep does not return to normal until the
second night thereafter (Carlson, 1999). This demonstrates how the body places
precedence on the physical health systems which are restored during the first stages of
sleep. Therefore, a person with chronic poor sleep habits may remain physically healthy
while the consequences of REM sleep deprivation (e.g., concentration, learning, and
mood difficulties) may not be readily attributed to inadequate sleep.

10
The utility o f REM sleep is substantiated by studies of selective sleep deprivation.
Researchers have reported that REM sleep is important for consolidating newly learned
information (De Koninck, Lorrain, Christ, Proulx, & Coulombe, 1989; Kami, Tanne,
Rubenstien, Askenasy, & Sagi, 1994; Nesca & Koulack, 1994). Studies of students have
also shown that those deprived of REM sleep perform worse on academic tests than those
who were not deprived (Kami et al., 1994; Pilcher & Huffcutt, 1996; Pilcher & Ott, 1998;
Pilcher & Walters, 1997; Smith & Lapp, 1991).
Naps. Short daytime naps of less than 30 minutes, which rarely contain Slow-
Wave Sleep (SWS), have been widely reported to have positive effects on daytime
alertness (Takahashi, 2003). The recuperative effects of daytime naps of less than 30
minutes have been confirmed by research. These shorts naps are mainly composed of
stage 1 and stage 2 sleep. Tietzel and Lack (2002) examined whether 30 seconds or 90
seconds of stage 1 sleep had recuperative effects and found that these ultra-brief naps had
no recuperative power. They also found that a 10-minute brief nap had a recuperative
effect, suggesting that the recuperative power of a short nap depends on stage 2 sleep, not
stage 1. However, they did not show the sleep variables of the 10-minute nap. A study by
Hayashi and colleagues (2005) examined whether the recuperative effects of short naps
depend upon which o f the sleep stages are present in the nap (i.e., stage 1 or 2 sleep).
Participants in this study were 10 university students. The results suggest that stage 2
sleep has recuperative power, while these recuperative effects are limited in stage 1 sleep.
It has been reported that the recuperative effects of sleep depend on SWS and that this is
also the case for daytime naps (Mednick, Nakayama, & Stickgold, 2003; Tilley,
Donohoe, & Hensby, 1987).

Short naps of approximately 10 minutes do not contain SWS, suggesting that
stage 2 sleep during a daytime nap, independent of SWS, has recuperative effects.
However, delta- and theta-band EEG activities during the waking-sleeping transition
period intensify rapidly during stage 2 sleep (Morikawa, Hayashi, & Hori, 1997). It could
be argued that background EEG delta activity during stage 2 sleep might contribute to the
recuperative effects of the daytime short nap. Spectral analysis of EEG during the nap
might be required. The study by Hayashi and colleagues (2005) confirmed that stage 2
sleep plays an important role in the restorative function of sleep and that a minimum of
three minutes of stage 2 sleep had recuperative effects of daytime alertness and
performance after restricted nocturnal sleep, while these effects were limited in stage 1
sleep.
Physiological Processes of the Sleep-Wake Cycle
There are three main physiological processes that directly affect the sleep-wake
cycle (National Institute of Health, 1998; Refinetti, 2000). They are the autonomic
nervous system, homeostatic drive for sleep, and circadian rhythm (National Institute of
Health, 1998; Refinetti, 2000). These are especially important, because sleep difficulties
typically result from a disruption in any of these processes.
Autonomic Nervous System. The autonomic nervous system is a subcomponent
o f the peripheral nervous system that controls individual’s level of arousal in reaction to
both environmental and internal stimuli. The autonomic system is further broken down
into the sympathetic system, which activates vital systems of the human body in response
to a stressor or anticipated danger and the parasympathetic system, which relaxes the
body. Sleep is associated with increased parasympathetic and decreased sympathetic

12
functioning (Parmeggiani, 1994). Electrical stimulation of parasympathetic activating
systems in the brain results in behavioral signs of sleeps in mammals. Specifically,
stimulation of the anterior hypothalamic and preoptic areas of the brain produces
parasympathetic signs such as a slower heart rate, lower blood pressure, and constriction
of the pupils (Parmeggiani, 1994).
On the other hand, many aspects of the sympathetic nervous system’s response to
stressors can be extremely disruptive to sleep. This response can occur just as readily to
imagined stressors as real environmental stressors. In fact, even the frustrations
associated with transient difficulties falling asleep or worries that develop as people are
trying to fall asleep can significantly impair the ability to fall asleep or stay asleep
(Parmeggiani, 1994). While most people occasionally have difficulty sleeping, it is when
such difficulties become behaviorally associated with the bedroom that chronic sleep
problems may develop. As a result, transient sleep difficulties can turn into chronic
insomnia (Hauri, 1991).
In summary, the autonomic nervous system plays a strong role in the ability to fall
and stay asleep. This system is organized to react immediately and can rapidly impair
sleep (Parmeggiani, 1994). However, autonomic relaxation is not the only factor that can
influence sleep readiness. This is important since people do not want to fall asleep any
time they begin to feel relaxed. On the other hand, people who have not slept for several
days may fall asleep relatively quickly even if under stress. The homeostatic drive thus
plays a key role in sleep propensity and can help regulate the sleep cycle.
Homeostatic Drive. The longer people remain awake the sleepier they become
(Carskadon & Dement, 1981). Periods of sleep deprivation result in shorter sleep onset
13
and even more rapid entry into deep sleep (Roehrs, Carskadon, Dement, & Roth, 2000).
In people without sleep disorders the need for sleep can often be inferred by the length of
time it takes to fall asleep or sleep latency. In addition to experimental evidence, this
makes intuitive sense and is most likely what contributed to Aristotle’s hypnotoxin theory
of sleep (Thorpy, 1991). While the term toxic may be a little strong, it does appear that
certain substances accumulate in the body while awake and are reduced during sleep.
Such substances promote sleepiness and are partially responsible for the decreased sleep
latency after sleep deprivation. When the body and brain are in the awakened stage,
ongoing metabolic activity breaks down adenosine monophosphate (AMP) into
adenosine. Adenosine is accumulated as the day progresses. This buildup of adenosine
leads to inhibition of the basal forebrain, part of the brain responsible for alertness. As
adenosine levels increase, the propensity to maintain alertness decreases, resulting in
increased drowsiness and sleep (Porkka-Heiskanen, 1999). While asleep, the metabolic
activity responsible for the buildup of adenosine decreases, thereby, allowing the body to
return to lower adenosine levels and increase alertness.
Additionally, type d2 prostaglandins, are endogenous hormones that promote
sleep. Prostaglandins (d2) stimulate neurons that inhibit the arousal response of certain
hypothalamic cells (Scamel et al., 1998). These chemicals are present throughout most of
the body. Prostaglandins are a natural by-product of immune system activity. Normally,
healthy people produce prostaglandins, but they are produced at a faster rate when the
immune system is fighting infection. This is why people often feel sleepier when ill. The
increased levels of prostaglandins that are produce while an individual is fighting an
infection tends to override the normal sleep-wake cycle and may lead to sleep at
14
inappropriate times. Additionally, prostaglandins (d2) may also play a key role in
promoting sleep in a person who has been awake for an extended period of time (Ram et
al., 1997), as their levels of prostaglandins are relatively high since they have not slept
and given the body time to reduce the level of prostaglandins.
While the autonomic nervous system can influence people’s ability to fall asleep
by affecting levels of arousal (Parmeggiani, 1994), the homeostatic processes plays a
strong role in the tendency to fall asleep. However, entering a state of relaxation after a
night of sleep deprivation still does not ensure eight hours of restful sleep outside of the
normal sleep-wake schedule (Parmeggiani, 1994). Timing that is consistent with the
circadian rhythm or sleep-wake cycle, is the third factor required for good sleep (Cohen
& Albers, 1991; Gillette & McArthur, 1996).
Circadian Rhythm. The natural environment provides living organisms with a
variety of external stimuli, many of which follow a rhythmic pattern (e.g., the lunar-tidal,
solar-daily, and seasonal-yearly patterns of light). Such patterns are quite predictable, and
animals have adapted their physiology to contend with these environmental changes
(Strubbe & Woods, 2004). Humans too have adapted to the natural rhythms in the
environment. Similar to most other animals, human beings have a number of biological
rhythms that serve as internal clocks. These rhythms vary in length, including annual
rhythms (e.g., the secretion of testosterone in males) and monthly rhythms (e.g., the
menstrual cycle in women). However, many biological rhythms are circadian rhythms
that follow approximately 24-hour cycles. Sleep follows a circadian rhythm, but one to
which human beings continue to adapt. The natural sleep-wake cycle follows a rhythm
that is closer to a 25-hour cycle, and thus must be reset on a daily basis. The normal
15
period of inactivity starts several hours after dark and persists for some time into the
daylight portion of the day (Boivin, Duffy, Kronauer, & Czeisler, 1994). Our internal
clock is re-synchronized to a 24-hour cycle by external cues such as light. These external
cues are commonly referred to as zeitgebers (German for “time givers”) (Aschoff, 1979).
It has been shown with several species of animals (including humans) that a brief period
of bright light will reset circadian rhythms after a maintained period of constant darkness
(Aschoff, 1979). With the help of sunlight as a natural zeitgeber, human beings have
adapted to a 24-hour sleep-wake cycle.
The portion of the brain that appears primarily to be responsible for regulation of
circadian rhythms is the suprachiasmatic nucleus (SN), which is located in the
hypothalamus (Refinetti & Menaker, 1992). The SN controls patterns of sleeping and
waking primarily by regulation of the secretion of the hormone melatonin from the pineal
gland. The SN becomes less active a few hours before a person’s regular bedtime, while
the pineal gland begins to release melatonin into the blood stream, causing the person to
become sleepy within about an hour (Cajochen, Kraeuchi, & Wirz-Justice, 1997). Near a
person’s normal waking time, production of melatonin decreases and the person becomes
more alert. The SN follows a seasonal rhythm as well, secreting larger amounts of
melatonin during the winter to account for the longer periods of darkness (Ralph &
Lehman, 1991). If the SN is damaged, the flow of melatonin goes largely unregulated.
Subsequently, people with such damage have difficulties maintaining alertness during the
day (Cohen & Albers, 1991).
The SN receives messages from a bundle of nerves called the retinohypothalamic
tract, which extends from the non-visual photoreceptors in the retina of the eye. Refinetti
16
and Menaker (1992) that when this bundle of nerves is damaged, circadian rhythms
become free running, and resistant to zeitgebers. However, the retinohypothalamic track
appears to be able to receive input from non-visual photoreceptors in the skin as well as
the retina. Campbell and Murphy (1998) found that when a bright light was focused
behind the knees (without contact with the eyes) of human subjects that were kept in dim
light for several days, circadian rhythms of the participants were reset. Circadian rhythms
did not reset in the control group, which did not receive the light treatment.
Another circadian rhythm in humans that has been closely linked with sleep is
body temperature rhythm. It is easiest to fall asleep when body temperature is near its low
point (Campbell & Zulley, 1989). During sleep, muscular activity is almost non-existent.
Thus, a major source o f body heat is basically turned off, and body heat production is
reduced. While heat production is down, cooling production continues. The shivering
response to cooler temperatures is not active during sleep, yet the sweating response
remains, and can promote cooling. These processes help maintain the general decline in
body temperature during sleep (Hobson, 1995). During REM sleep, central temperature
control is essentially lost and reliant upon the environment or arousal to maintain stable
body temperature. It is believed neurons that control heat in the hypothalamus are rested
during REM sleep to enable them to control temperature more effectively during
wakefulness (Parmeggiani, 1977). This theory is further supported by sleep deprivation
studies that have shown that prolonged sleep deprivation generally results in a significant
drop in body temperature (Home, 1988). A study of extreme sleep deprivation in rats
indicates that if an animal is deprived of sleep for long enough, the animal apparently will
die from complications resulting from the loss o f ability to conserve body heat
17
(Rechtschaffen, Gilliand, Bergmann, & Winter, 1983). The precise relationship between
thermoregulation and sleep remains unclear, but it is evident that body temperature
relates to the sleep-wake cycle, and that sleep may be crucial for thermo regular
maintenance.
Circadian rhythms are of varying importance for human being and animal
functioning. However, circadian rhythms can become desynchronized with those in the
external environment when people change their daily routines, which can result in sleep
disturbances (Carlson, 1999). Modem society often has demands that do not match
natural circadian rhythms. This is evident in people who perform shift work and must
change from working during the day to night. Night shift workers often drive home
during the morning daylight. Since daylight is a natural zeitgeber, this may cause sleep
difficulties. Additionally, night workers often attempt to shift back into a daytime
schedule during days off, causing further circadian rhythm disruptions, and making it
utterly impossible to adjust fully to one schedule of sleep and wakefulness (Akerstedt,
1988). Poor daytime sleep and circadian rhythm disruption have been linked to poor job
performance, higher rates of traffic accidents, and health complications (Monk, Folkard,
& Wedderbum, 1996). Studies have also shown a significant relationship between shift
work and health complications, including headaches, gastric problems, and chronic
cardiovascular difficulties (Parkes, 1999; Smith, Folkard, & Fuller, 2003). Additionally,
Mitler and colleagues (1988) have found that engineering and industrial disasters happen
most frequently between the hours of midnight and 6:00 a.m.

18
The Theories of Sleep Function
Approximately one-third of our lives are spent sleep; therefore, it must serve an
important purpose. However, we do not know all of the benefits of sleep. There are
different theories o f sleep function, including the restoration model, the neurotransmitter
replenishment theory, the evolutionary/circadian sleep models, the developmental model,
and the learning model.
The Restoration Model. The restoration model suggests that we need to sleep in
order to recover from daily physical activity (Hess, 1965; Walker, 2008). If this theory is
correct, it would mean that the activity that wears down the body should increase sleep.
Research conducted on sleep-deprivation supports this view, indicating that if we want to
function at our best, we need sleep. A study of ultra-marathon runners, ages 18-26 years,
found that they slept much longer and spend a greater percentage of time in slow-wave
sleep on the two nights following their 57-mile run (Shapiro, Bortz, Mitchell, Bartel, &
Jooste, 1981). A meta-analysis of 38 studies found that on the days that individuals
exercised, they tend to sleep approximately 10 minutes longer (Youngstedt, O’Conner, &
Dishman, 1997).
It is not precisely known what gets restored during sleep, but researchers report
that a cellular waste product called adenosine plays a role (Alam et al., 2009). During
sleep, it is thought that neurotoxins are neutralized and tissue restitution occurs (Adam &
Oswald, 1977; Hartmann, 1973). Another possibility is that sleep evolved as a means for
the body to conserve energy during the night to aid in thermoregulation during the coldest
part of the day (Hobson, 1995).

19
The Neurotransmitter Replenishment Theory. The neurotransmitter
replenishment theory suggests that aminergic neurons stop firing during sleep to allow
their neurotransmitter supply to regenerate (Hobson, 1995). Neurotransmitters may be
depleted if there is a limited supply, because neurons continuously fire during
wakefulness. Most neurons in the body show decreases in activity during sleep.
Aminergic neurons that release norepinephrine and serotonin stop firing altogether which
provides a resting period so that these neurotransmitters can regenerate. It is hypothesized
that aminergic neurons continue to generate norepinephrine and serotonin while resting.
This allows these neurotransmitters, believed to be involved in learning and memory
(Siegel & Rogawski, 1988), to create a reserve necessary to assist in cognitive activities
the next day.
The Evolutionary/Circadian Sleep Models. The evolutionary/circadian sleep
models emphasize that the main purpose of sleep is to increase an individual’s chance of
survival in relation to environmental demands (Webb, 1974). Prehistorically, individuals
were not active at night, because it would have been more dangerous to be hunting, food
gathering, and traveling at night. Over the course of evolution, each species developed a
circadian sleep-wake pattern that was adaptive in terms of its status as predator or prey,
its food requirements, and its methods of defense from attack. Sleep may also have
evolved as a mechanism to conserve energy. The body’s metabolic rate is approximately
9-25% slower during sleep than during wakefulness (Reich, Geyer, & Kamovsky, 1972;
Wouters-Adriaens & Westerterp, 2006).
The Developmental Model. The developmental model suggests that sleep has a
vital role in brain development (Carlson, 1999; Hobson, 1995). Current theories focus on
20
REM sleep because of its prominence in utero and infancy (Hobson, 1995). The fetus
spends up to 80% of its time in REM sleep (Inoue et al., 1986; Petre-Quadens & DeLee,
1974; Roffwarg, Muzio, & Dement, 1966). This falls to 70% during early infancy and
further declines to 30% at six months of age. This corresponds to the most active period
of brain development. It is hypothesized that the activation during REM sleep provides an
opportunity for the brain to practice future behaviors (Roffwarg et al., 1966). When fetal
lambs were observed through Plexiglas windows implanted in the uterine wall, they were
seen making chest breathing movements during REM sleep during brain development;
they fail to explain the reason REM sleep is present in adults.
The Learning Model. The learning model suggests that the main function of
sleep is to facilitate memory consolidation and integration (Carlson, 1999; Greenberg &
Pearlman, 1974). Animal studies have suggested that REM sleep aids learning (Carlson,
1999). Animals deprived of REM sleep during training were found to learn tasks more
slowly (Smith, 1996). Daytime learning in humans also appears to be hindered by lack of
sleep (Hobson, 1995). Steriade and McCarley (1990) found that as neural pathways are
strengthened, a new protein structure is created, which in turn allows new information to
be stored in the brain. Therefore, a new memory is formed. Due to the instability of the
new protein structure, it must be refreshed. The new neural pathways formed by learning
information appear to be activated during REM sleep. This could be a reason REM sleep
is crucial to learning and memory. It has been suggested that during REM sleep, the brain
is aroused and begins to process information stored in memory which may reinforce both
new and old memories (Antrobus, 1986). Students who demonstrated a significant
increase in REM sleep followed a period of intense learning were found to perform
21
significantly better on an examination than students who did not show an increase in
REM sleep (De Koninck et al., 1989).
The relationship between REM sleep and the integration of new information into
long-term memory is not limited to the period immediately following learning. Research
suggests this relationship extends well beyond the night the information was originally
integrated (Buboltz et al., 2006). Smith and Lapp (1991) found that after students studied
for final exams, during the five-day period following exams, REM sleep actually
increased. As REM sleep increased, there was no concomitant increase in amount of
sleep, nor was there an increase in number of REM sleep periods. These findings suggest
that information was being integrated into long-term memory well after the exam.
Because the increases in REM density occurred later in the evening, those individuals
getting a full night of sleep profited from the increase in memory consolidation occurring
after the initial learning period (Buboltz et al., 2006; Smith & Lapp, 1991). Therefore,
students who cram for exams (i.e. study for long periods immediately prior to an exam)
may miss out on the potential benefits of several nights of increased REM sleep.
In addition to the potential benefits of several nights of increased REM sleep,
students who cram for exams by staying up all night also suffer a complete lack of REM
sleep and the consequence this has on memory integration. Research suggests that lack of
REM sleep coupled with sleep loss and/or poor sleep quality, are associated with
significant impairments in cognitive functioning (Buboltz et al., 2006). Logical reasoning
and decision-making in adults were demonstrated to be impacted be a single night of
sleep loss (Blagrove & Akehurst, 2001; Harrison & Home, 1999). Sleep deprivation also
appears to have a negative effect on working memory (short-term memory used for
22
thinking and problem-solving). Sleep loss due to poor sleep quality is also linked to poor
cognitive functioning, false recall of recently learned words, and decreased visuomotor
skill (Roediger & McDermott, 1995).
Sleep Difficulties of College Students
Most studies exploring the sleep habits and difficulties of college students focus
on describing general sleep difficulties rather than supplying information about the
prevalence of diagnosis. Considering that these studies report results recorded primarily
through self-report, describing rather than diagnosing is more appropriate.
From 1969 through 1989, there was a notable decline in the average length of
time students’ sleep. Hicks and Pellegrini (1991) point out that the median hours of
students sleep was 7.75 hours in 1969, 7.13 hours in 1979 and 6.75 hours in 1989. In
1969, 9% o f students reported their average sleep duration as less than 6.5 hours of sleep.
However, in 1979,26.9% of students reported receiving less than 6.5 hours sleep. The
amount of sleep continued to decline through 1989, during which 41.5% of students
reported consistently receiving less than 6.5 hours of sleep. This is supported by re
analyzing the data found in the Hicks and Pellegrini’s (1991) study which demonstrates
that the mean hours of sleep was fairly close to the median hours reported. In 1969 mean
hours of sleep was 7.50 (SD = .92), in 1979 the mean was 7.18 (SD = 1.67) and in 1989
the mean was 6.8 (SD = 1.01). While these findings do not include sleep quality indices,
they certainly present an alarming trend in college students sleep habits. Further, this
trend discounts the idea that poor sleep is simply a part of students’ lives - it was not for
the majority of students in 1969.

23
Hicks and Pellegrini’s (1991) study is not the first to demonstrate that sleep
difficulties are becoming an increasing problem for college students. Over thirty years
ago, Domino and Fogl (1980) noted their surprise at the lack of normative sleep studies
for college students and thus proceeded to explore sleep habits and patterns of college
students. They developed and administered a sleep scale they called the SQ 51, which
was administered to random sample of undergraduate students that consisted of 60 males
and 71 females. The results indicated that 7% used medication for sleep difficulties, 13%
reported their sleep was usually restless, and 39% reported that they often had highly
irregular sleep schedules (Domino & Fogl, 1980).
Several years later, in a sample of Australian college students, Lack (1986) found
that the most commonly reported symptoms were difficulty falling asleep (18%), early
morning awakening (13.2%), general sleep difficulties (12.8%), and difficulty staying
asleep (9%). Only 8% reported never having had sleep difficulties. Notably, when sleep
complaints were examined for each student, 17% of the students had symptoms
consistent with Delayed Sleep Phase Syndrome (DSPS). This is more than twice the
estimated prevalence for the general population, which is about 6-7% (American
Psychiatric Association, 1994, Lack, 1986). Further, it is noteworthy that students who
met the criteria for Delayed Sleep Phase Syndrome had lower grades, greater feelings of
drowsiness, and irritability when compared to the rest of the sample. In addition to the
general findings, older subjects reported less sleep during the week, reduced perceived
need of sleep, and greater drowsiness during the day. Younger subjects reported more
variability in their sleep habits, longer sleep onset and greater difficulty falling asleep.
Females reported a greater perceived need for sleep, but reported less total sleep time in
24
general and received less adequate sleep on weekends. Females also indicated more
frequent naps, greater irritability, and were more likely to describe themselves as
insomniacs than males. There were no significant gender differences for sleep onset time,
difficulty falling asleep, difficulty staying asleep, or sleep depth (Lack, 1986).
Brown and colleagues (2001) found that a sample of US college students also
reported a higher prevalence of Delayed Sleep Phase Syndrome than the general
population. These results showed a lower prevalence rate of DSPS than the Australian
sample but higher rates o f some specific sleep complaints. Sleep difficulties most
commonly reported “frequently” or “almost always” were early morning awakenings
(25.5%), general sleep difficulties (21.9%) difficulty falling asleep (19.5%), daytime
napping (15.1%), and difficulty staying asleep (10.9%). Generally, however, the findings
support a consistent pattern of poor sleep habits in college students in these two
geographically diverse samples. Students in the US sample went to bed later on the
weekend than the week and received less sleep during the week. Additionally, females
reported more frequent difficulties falling asleep and staying asleep than males.
Buboltz and colleagues (2001) found that only 11% of college students reported
symptoms consistent with good sleep quality, 73% of the sample reported moderate sleep
problems, and 15% of the sample had symptoms consistent with poor sleep quality,
according to a standardized sleep quality measure. Compared to the general adult
population, these students reported 60% greater incidence of poor sleep quality, than the
original standardization sample of working adults.
Another study (Hawkins & Shaw, 1992) examined sleep logs at three different,
week-long periods during the academic semester. The sleep logs were comprised of a
25
seven-item questionnaire that included items regarding the amount o f time in bed, level
o f satisfaction with sleep and questions related to sleep quality and quantity. The amount
o f time in bed declined as the semester progressed and the demands placed on
respondents increased. However, with the decreased time in bed, also came a decrease in
the amount of nocturnal awakenings. At the same time, students rating of sleep quality
did not change throughout the semester. It should be noted that the authors’ definition of
sleep quality was based on one item that asked, basically how good their sleep was. Thus,
these sleep quality findings are difficult to compare with other studies since researchers
usually include the length of time to fall asleep, number of nocturnal awakenings,
morning status, and general sleep satisfaction in their definitions of sleep quality. Despite
some of the limitations with certain aspects of their study, it is clear that there was a
noteworthy decrease in sleep length as the semester progressed.
Brown, Buboltz, and Soper (2002) explored the combined relationship of sleep
quality, quantity, and sleepiness on students’ academic performance. They found that
students’ ratings of sleepiness became higher as the academic quarter progressed. There
was also a reduction in the length of sleep from the beginning (M = 8.26 hours) to the end
(M - 6.81 hours) of the quarter. Using the Sleep Quality Index (Urponen, Partinen,
Vuori, & Hasan, 1991) 16.7% of the students were classified as poor sleepers, while
about 12% had symptoms consistent with Delayed Sleep Phase Syndrome. Only 8.9% of
those surveyed reported that their sleep was free from difficulties. The prevalence of
symptoms was similar in this study to previous prevalence studies in college students.
After reviewing the prevalence of sleep difficulties in students, especially their
inconsistent sleep wake schedules, it seems likely that discrepancies between students’
26
social and academic schedules may negatively impact sleep quality. There is, in fact,
empirical support for this contention. Students who were able to sleep late in the morning
due to classes scheduled later in the day had more consistent sleep-wake schedules than
those required to awaken for early morning classes. Further, students who had morning
responsibilities showed evidence of partial sleep deprivation during the week. These
results indicate that students may have healthier sleep habits if they are able to take
classes and work later in the day (Machado, Varella, & Andrade, 1998).
That a high percentage of college students have poor sleep quality and habits is
probably not a surprise for most students and faculty. However, it is surprising that
despite both the empirically demonstrated high prevalence of sleep difficulties and
intuitive sense that students do not sleep well, there do not seem to be any studies that
focus on developing interventions to reduce student sleep difficulties. Nor does there
appear to be many studies suggesting that colleges and universities are concerned about
students sleep habits.
Factors that Affect Sleep in College Students
Over the past 25 years, there have been numerous studies exploring the sleep
habits, patterns, and difficulties of college students. Studies on sleep deprivation,
variation, and reduction have illuminated the numerous aversive effects that poor sleep
quality and habits can have on students (Dinges, Whitehouse, Ome, & Orne, 1988; Kami
et al., 1994; Kelly, Kelly, & Clanton, 2001; Lack, 1986; Pilcher & Huffcutt, 1996;
Pilcher & Walters, 1997). Sleep difficulties take a variety of forms. There is a plethora of
potential contributing factors that are salient in a college student population which may
27
impact their sleep habits and quality and in turn interfere with their functioning in a
number of areas.
For many late adolescents, beginning college is a major life transition. Often this
involves living away from family and friends for the first time. Depending upon the
intensity, level of emotional preparation, and the relationship between the student and
parents, separation from home can be a particularly difficult transition for many students
(Hoffman & Weiss, 1987; Lopez, Campbell, & Watkins, 1988; Rice, Cole, & Lapsley,
1990). A host of other factors have been identified that can affect social life and
adjustment to college, including level of self-esteem (Bettencourt, Charlton, Eubanks,
Kemahan, & Fuller, 1999), perfectionistic tendencies (Chang & Rand, 2000), and
masculinity and femininity traits (Sharpe & Heppner, 1991). Although there are many
individual factors that can affect adjustment, the research ultimately suggests that for
many the transition to college life can be a very difficult period.
College is also a time o f other transitions. Students are given responsibility for
various aspects of their lives, including sleep habits and patterns. Although many young
adults relish their autonomy and independence, they nevertheless are subjected to
substantial social and academic demands (Kleeman & Richardson, 1985; Russell &
Petire, 1992). Many college freshmen live away from their families for the first time and
may be involved with a barrage of social activities, such as fraternities and sororities, and
academic and athletic clubs. This is often in the midst of adjusting to new surroundings,
making new acquaintances, choosing a class schedule, and meeting the challenge of
college academic requirements. Given the varying schedules to which college students
28
are often subjected, it is not surprising that this population encounters a great deal of
sleep difficulties.
The demands of college adjustment bring potential for high levels of stress. Stress
and worry have been linked to poor sleep quality (McCann & Stewin, 1987). Sleep and
stress among college students appears to bring potential for a spiraling effect as changes
in sleep patterns, in and of themselves, are often identified as stressful. A study by Ross,
Neibling, and Hechert (1999) investigated 40 potential stressful situations that are
commonly faced by college students, including interpersonal, intrapersonal, academic,
and environmental sources o f stress. Of the 40 potential stressors, change in sleeping
habits was identified as one of the top five sources of stress for college students.
While many students may stay up late on weekends to engage in social events,
they also frequently engage in late night study sessions to meet academic responsibilities,
with some students reporting depriving themselves of sleep for 24-48 hours around
examination periods (Hawkins & Shaw, 1992). Since many students may be able to
identify changes in sleep habits as a source of stress, they may seek ways to combat this
potential stressor. A common method used to compensate for lost sleep during the week
is to sleep later on the weekends in an attempt to “catch up on sleep” (Machado et al.,
1998; Pilcher & Walters, 1997). Unfortunately, this type of variable sleep pattern is
conducive to a condition known as Delayed Sleep Phase Syndrome (DSPS), (Brown et
al., 2001; Lack, 1986). DSPS is a circadian rhythm disorder resulting in excessive
morning drowsiness and difficulty falling asleep on weeknights.
Another factor related to sleep difficulties among college students is the use of
alcohol and sleep medication. Research indicates that the overall prevalence of binge
29
drinking (five or more drinks in a row) among college students is approximately 40-45%
(O’Malley & Johnston, 2002; Wechsler, Davenport, Dowdall, Moeykens, & Castillo,
1994; Wechsler et al., 2002; Wechsler & Nelson, 2008). Alcohol can expedite sleep onset
and, depending on the quantity, can increase the amount of slow wave sleep a person
obtains. However, the effects are paradoxical in that they actually decrease the amount of
REM sleep, and can be associated with insomnia (Roehrs & Roth, 1997). While students
who binge drink may believe they are benefiting from alcohol induced sleep because they
fall asleep faster and may sleep longer, alcohol can inhibit the most important stage of
sleep. Furthermore, students who reported drinking more alcoholic beverages fell asleep
in class more often than those who drank less (Jean-Louis et al., 1998). Sleep medications
also can have paradoxical effects. Students who choose to use sleep medications for sleep
difficulties are in danger of exacerbating the problem. While sleep medications often
leave individuals feeling less than alert due to the residual effects of the drug, most over
the counter sleep medications can also inhibit REM sleep. Even short-term use of sleep
medications can result in rebound insomnia (insomnia symptoms that are more severe
than the originals) upon discontinuation of the medication (Roehrs, Vogel, & Roth,
1990). Pharmacological treatments have demonstrated little, if any, effectiveness in
treating long-term sleep problems (Morin & Wooten, 1996).
While some college students use medication to induce sleep at night, others use
stimulants to stay awake during the day. The most common stimulant among college
students is undoubtedly caffeine (Gilbert, 1986). One study found that 42% of college
students drank coffee and 29% drank tea on a regular basis (Mathieson, Faris, Stam, &
Egger, 1992). Even in fairly mild doses (100-150 mg., about one cup of brewed coffee)
30
caffeine has been shown to cause sleep disturbances, including delayed sleep onset,
reduced sleep time, increased number of spontaneous awakenings, and increased amounts
of light sleep (Caldwell, 2003; Pressman & Orr, 1997). The duration of caffeine activity
in adults is 3-5 hours, but people can experience effects for up to 10 hours. Thus, even
one cup of coffee in the afternoon can disrupt sleep, but this may depend on the
individual’s sensitivity to caffeine (Nehlig, Daval, & Debry, 1992). People who use
caffeine on a regular basis may develop a tolerance to the drug, and be less likely to have
sleep difficulties than people that use caffeine occasionally. However, frequent caffeine
users tend to have more sleep disruptions than non-users (Roehrs & Roth, 1997).
The use of illicit stimulants is also common among college students. Low and
Gendaszek (2002) found that 35% of students from a small liberal arts college reported
using prescription amphetamines at least once in the past year without a prescription.
Similarly, 34% of the sample reported using cocaine or methylenedioxymethampheta
mine (MDMA) in the past year, and 8% reported using at least once a week. While the
full effects of illicit stimulants are unknown, oftentimes these substances have much
longer lasting effects than milder stimulants such as caffeine, and thus have potential to
cause even greater sleep difficulties.
Cigarette smoking may be related to sleep difficulties. A total of 28% of college
smokers report they began smoking regularly after reaching college age (Wechsler,
Rigotti, Glendhill-Hoyt, & Lee, 1998). Considering the massive amounts of negative
exposure in the media and warning labels directly on packages, it is probably safe to
assume that college students are aware of the potential detrimental health effects of
smoking (i.e., cardiovascular disease, emphysema, lung cancer, etc.). However, students
31
may not be cognizant of the fact that nicotine is a stimulant. While, ironically, heavy
smoking (more than 15 cigarettes a day) does not appear to affect sleep, light smoking
has recently been linked with insomnia (Riedel, Durrence, Lichstein, Taylor, & Bush,
2004). Perhaps light smokers have not built up a tolerance to the drug, resulting in a
stronger reaction to the stimulatory effect. Thus, students who have recently begun
smoking and students who only smoke occasionally may be suffering from symptoms of
insomnia and be completely unaware of this potential source of the problem.
Effects of Inadequate Sleep Length
In a sample o f healthy adults (ages 21-38 years), restriction to four or six hours of
sleep duration per night over two weeks resulted in significant and cumulative deficits in
performance on cognitive tasks. These results of chronic sleep deprivation were
comparable to those found with total sleep deprivation for one to two days (Van Dongen
et al., 2003). Individuals who are sleep deprived demonstrate impaired judgments and are
more likely to make mistakes. Research has shown that an individual who stays awake
for 24 hours has a reduction in hand-eye coordination similar to an individual who had a
blood alcohol content o f 0.08% (Maruff, Falleti, Collie, Darby, & McStephen, 2005) and
cognitive impairment similar to an individual with blood alcohol content o f 0.05%
(Falleti, Maruff, Collie, Darby, & McStephen, 2003).
Students who sleep for less than six hours per night are prone to miss one or more
o f their REM sleep periods, because REM sleep occurs in the latter part of an eight hour
sleep period at this developmental stage in young adulthood (Kami et al., 1994; Smith &
Lapp, 1991). Supporting that REM sleep is vital to memory consolidation of newly
32
learned material, students who receive more REM sleep demonstrate better learning
efficiency (De Koninck et al., 1989).
Students who do not get a full night of sleep may be unknowingly weakening
their ability to learn new information. Also, students who do not sleep as well the night
before an exam will more likely demonstrate a decrease in test performance (De Koninck
et al., 1989; Pilcher & Ott, 1998). Additionally, college students who sleep less than six
hours per night or more than nine hours per night are more likely to have mild depressive
symptoms compared to students sleeping between six and nine hours per night (Buela-
Casal, Miro, Ianez, & Catena, 2007).
Sleep and Health
Research suggests that there is a relationship between sleep and quality/length and
physical health. One study liked chronic insomnia to coronary artery disease (Bonnet &
Arand, 1998). In a sample of over 5000 individuals over the age of 65 a link was found
between poor sleep quality and decreased physical healthy including cardiovascular
disease (Asplund, 2000; Newman, Enright, Manolio, & Haponik, 1997). Sleep difficulties
were also linked to cardiovascular disease in a sample of adults (Appels & Mulder,
1984).
One sleep disorder in particular that can lead to health difficulties is sleep
disordered breathing (e.g. sleep apnea). Mild sleep disordered breathing has been shown
to be associated with an increase in complaints of bodily pain in children as young as five
years o f age (Rosen, Palermo, Larkin, & Redline, 2002). Mild sleep disordered breathing
has also been associated with lower scores on a health-related quality o f life measure in a
sample of five to 17 year olds as well as a sample of 30 to 60 year olds (Finn, Young,
33
Palta, & Fryback, 1998). Mild sleep disordered breathing is even associated with other
chronic conditions such as arthritis, angina, hypertension, diabetes, and back problems.
In a sample of 5,090 Japanese white collar workers poor sleepers were more
likely to take sick leave, suffer physically and psychologically poor health and have
problems in work related activities and personal relationships (Doi, Minowa, & Tango,
2003). The specific factor that was related to poor sleep quality was hypertension.
Edell-Gustafsson (2002) also examined the relationship between sleep and health
in a sample of 40 men ages 45-70 who were about to undergo a coronary artery bypass
surgery in Sweden. He found that pooper overall physical health was significantly related
to longer sleep latency. These individuals displayed a decreased percentage of phases
three and four sleep.
Individuals who reported poor sleep quality also endorsed more physical illness
(Lund, Reider, Whiting, & Prichard, 2010). In this study, 12% of poor sleepers reported
missing class three times or more in the last month due to illness compared to only 4% of
the rest of the sample. In a sample of junior high students, a relationship was found
between sleep quality and physical health with participants who reported poor sleep
quality also reported a higher number of illnesses and lower scores on measures of
general health (Tanaka et al, 2003). In a community sample, any sleep problems,
inadequate sleep, difficulty falling asleep, and persistent nightmares were all associated
with higher rates of migraines (Vgontzas, Cui, & Merikangas, 2008).
There has been growing interest in sleep quality and quantity as they relate to
obesity. One longitudinal study found that in young adults (under age 40 years) there was
a negative correlation between sleep length and BMI (Hasler et al., 2004). This finding
34
has very important implications' for college students who have been shown to have a
higher degree of sleep difficulties than the general public. If this contributes to a higher
rate of obesity, this could mean that college students are at a higher risk for numerous
health complications that result from obesity.
Many early studies examined the relationship between sleep and health from a
biomedical model (Parmeggiani, 1977; Roffwarg et al., 1966; Sassin et al., 1969; Webb
& Agnew, 1974). This model purports that health and illness are a function of biology, or
that poor health is always the result of pathogens (Engel, 1977). Additionally, the
biomedical model biological processes are essentially independent from psychological
and social processes. However, recent research has shown that physiological health can
be greatly impacted by psychological factors (e.g., placebo effects), and that
psychological health can influence physiological health (e.g., biological illness resulting
in depression). Thus, psychologists (and many physicians alike) have begun to approach
the topic of health from a much broader biopsychosocial model. This model suggests that
health can best be explained by examining biological processes, psychological processes,
and social influences (Peterson, 1997). In this section, the relationship between sleep and
health will be examined from each of the components of the biopsychosocial model.
Among the most common sleep disorders is insomnia, with prevalence estimates
that range between 15% to 20% for chronic insomnia, and 30% to 40% for transient or
occasional insomnia (Mellinger et al., 1985). Chronic insomnia has been linked with the
coronary artery disease (Bonnet & Arand, 1998). In addition to adversely affecting
physiological health, insomnia can also affect mood, relationships, and overall
psychological well-being (Lacks, 1987; Sloan & Shapiro, 1993).

35
Sleep difficulties have been linked to a variety of physiological ailments in
various populations. A condition that often causes sleep difficulty is sleep-disordered-
breathing. Although sleep disordered breathing can be caused by respiratory disease, it is
generally associated with sleep apnea; a condition in which an individual’s airway is
obstructed during sleep, and the individual is awakened several times a night due to lack
o f oxygen (Thorpy & Yager, 2001). One study found that children as young as five years
old with mild-sleep-disordered-breathing (MSDB) reported significantly more bodily
pain complaints (Rosen et al., 2002). MSDB was also related to lower scores on a
measure of health-related quality of life for children ages 5-17, and increased effects were
apparent with more severe sleep disordered breathing. A study involving adults 30-60
years of age reported similar results, with even mild cases of sleep disordered breathing
resulting in decrements on a general health survey (Finn et al., 1998). The severity of
health problems related to poor sleep resulting from sleep disordered breathing is noted in
the fact that the magnitude of decrements on the health survey were comparable to other
chronic conditions, such as: arthritis, angina, hypertension, diabetes, and back problems.
Sleep difficulties appear to have an impact on physiological health in people of all
ages. In a study involving junior high school students, a link was found between general
quality of sleep and physiological health, with adolescents who reported poor sleep also
reporting a higher number of illnesses and lower scores on a measure of general health
(Tanaka, et al, 2003). Poor sleep has been linked with poor health in the geriatric
population, as well. Two studies, each consisting of over 5,000 participants over the age
of 65, linked poor sleep to reduced physical health, including limitations in activities of
daily living, and increased reports of cardiovascular disease (Asplund, 2000; Newman et
36
al., 1997). Research by Appels and Mulder (1984) found that sleep difficulties in adults
were related to cardiovascular disease, while Elashoff et al. (1983) found an association
between sleep and gastrointestinal disorders.
Another interesting area that is gaining a great deal of attention is the possible link
between sleep quality and length and obesity. Research is beginning to emerge indicating
that individuals who sleep less on a regular basis tend to increase their body mass index
(BMI). Hasler et al. (2004) in a longitudinal study found that short sleep duration was
associated with an increase in BMI for younger adults, but that the association
disappeared for individuals over the age of 40. This finding was consistent with previous
research that had examined the relationship between sleep length and obesity. The
finding that sleep is related to BMI or obesity in younger adults points to age-specific
pathophysiologic mechanisms of obesity (Comings, Gade, MacMurray, Muhleman, &
Peters, 1996). Taken together these results may indicate that the amount o f sleep that a
younger individual receives may be related to obesity. This may be especially important
in the college population as results have consistently shown that students tend to sleep
less than the general population. The finding that sleep duration is related to obesity may
have numerous implications for health as obesity has been shown to be a major
contributor to a variety o f health difficulties.
Another common source of sleep difficulties is the lack of a consistent sleep
schedule that disrupts the body’s natural sleep circadian rhythm. Having wake times that
vary even just a couple of hours can greatly affect sleep quality and cause sleep
disturbances (Lack, 1986). Ultimately, inconsistent sleep schedules can result in
decreased physiological, psychological, and social health. When it comes to college

37
students, the research clearly indicates that poor sleep habits and patterns are associated
with a variety of difficulties. Among these are increased tension, depression, decreased
psychological well-being, and generally lower life satisfaction (Pilcher et al., 1997). In a
study by Taub and Hawkins (1979), young adults who reported irregular sleeping
schedules had lesser tendencies toward achievement potential, intellectual efficiency,
self-control, and sociability. One of the more serious disruptions to a regular sleep
schedule is shift work. Studies have shown a significant relationship between shift work
and health complications, including headaches, gastric problems, depressed cellular
immune function, respiratory tract infections, and chronic cardiovascular difficulties
(Irwin etal., 1994; Parkes, 1999).
In terms of psychological health, a clear relationship has been established between
poor sleep quality and negative mood states (Bonnet, 1985; Gau, 2000; Gray & Watson,
2002; Lacks & Morin, 1992; Pilcher & Huffcutt, 1996). The most common negative
mood state associated with poor sleep is depression. Unfortunately, the direction of the
sleep/depression relationship (whether depression causes sleep difficulties, sleep
difficulties cause negative mood, or they interact) remains unclear. However, since sleep
difficulties are one of the hallmark symptoms of depression (APA, 1994), it is certainly
possible that the relationship is cyclical, in that depressed mood can lead to poor sleep
quality, and in return poor sleep quality can exacerbate negative mood states.
Albeit somewhat counterintuitive, there also appears to be a link between sleep
deprivation and decreased symptoms of depression. Studies have shown that short-term
sleep deprivation is correlated with positive changes in both thought content, as well as
improvement on clinical assessments of depression (Kraft, 1984; Vein & Airapetov,

38
1984). Although it is not clear why symptoms of depression often decrease following
sleep deprivation, researchers suggest that neurophysical and biochemical processes that
occur during sleep, are responsible for one’s emotional state (Vein & Airapetov, 1984).
Not surprisingly, research on REM sleep deprivation (rather than total sleep) appears to
have an effect on depressive symptoms. The negative emotion connected with
emotionally important memories appears to decrease following sleep deprivation
(Greenberg, Pearlman, Schwartz, & Grossman, 1983). However, positive changes in
mood due to short-term sleep deprivation appear to be ephemeral, as individuals in these
studies tend to return to baseline levels of depression after a regular night of sleep (Kraft,
1984; Vein & Airapetov, 1984).
There is also a body of research linking sleep quality with clinical (abnormal)
aspects of psychological health. Poor sleepers not only tend to have higher scores on
scales of depression than good sleepers, they also have been shown to score higher on
scales that measure symptoms of anxiety, and social introversion (Aikens & Mendelson,
1999; Monroe, 1967). Similarly, poor sleep appears to be related to Type A personality.
Type A behavior involves a chronic, incessant, struggle to achieve more and more in less
time, which can result in health difficulties (Friedman & Rossman, 1974; Krantz, Arbrier,
Davia, & Parker, 1988).
In addition to the manifestations of health difficulties that appear to be related to
poor sleep, sleep loss may have adverse effects on normal growth and development, as
well as maintaining a healthy immune system. Both protein synthesis and growth
hormones play a substantial role in physical growth, and are at their highest levels during
REM sleep (Parker et al., 1980; Sassin et al, 1969). After only a few nights of poor sleep,
39
metabolic and hormonal function can be adversely affected (Murphy, 2000).
Additionally, the number of natural killer T-cells that are crucial to the body’s immune
system in fighting infection have been shown to be reduced up to 50% in individuals who
obtain less than six hours o f sleep (Irwin et al., 1996). Subsequently, loss of sleep can
exacerbate existing health difficulties, including hypertension and Type II diabetes,
resulting in more severe complications (Murphy, 2000).
The literature also suggests a relationship between sleep habits and social and
psychological health. As early as in pre-adolescence, poor sleep quality has been linked
with poor mental health (Meijer, Habekothe, & Van Den Wittenboer, (2000). One study
involving college students found that individuals considered to be psychologically
healthy reported increased somatic complaints, greater tendency toward obsessive-
compulsive activities, higher levels of interpersonal reactivity, more symptoms of
depression and anxiety, and higher social discomfort, after only a single night of poor
sleep (Zammit, 1988). Additionally, Carpenter (2001) noted that Attention Deficit
Hyperactivity Disorder is often associated with sleep difficulties. Poor sleep may
exacerbate health difficulties in individuals who are afflicted with psychological
disorders. The relationship between traumatic stress symptoms and health functioning
was fully mediated by sleep in a study comprised of urban police officers with
posttraumatic stress symptoms; only those who reported poor sleep also reported somatic
health problems (Mohr et al., 2003).
College students who are able to fall asleep faster and who have fewer sleep
disturbances also have been found to report fewer mental and social health difficulties
(Lowry, Dean, & Manders, 2010). Recent studies also have linked sleep loss to changes
40
in mood, personality, and cardiovascular disease (Blagrove & Akehurst, 2001; Boland et
al., 2002; Taylor & McFatter, 2003). Sleep loss, whether due to sleep disorders,
deprivation, or poor quality, appears to have a negative impact on the total functioning of
humans. Ultimately, poor sleep habits and patterns, as well as sleep difficulties, appear to
have significant adverse effects across measures of physical, mental and social health.
Sleep and Obesity/Health Status. Research has indicated that sleep difficulties
have made a serious impact on various aspects of human functioning (Pilcher & Walters,
1997). These studies examined the effects of sleep quality on an individual’s ability to
function. Sleep quality is generally defined by the number of nighttime awakenings
(including the amount o f time required to return to sleep), sleep latency (the amount of
time required to fall asleep, a feeling of fatigue/restfulness upon awakening in the
morning, sleep duration (the amount of time in a sleeping state) and a general satisfaction
with the sleep received (Pilcher & Walters, 1997).
Studies o f sleep quality and obesity often focused on the relationship of sleep
quality and eating behaviors. Hicks, McTighe, and Juarez (1986) found that college
students with poor sleep quality were more likely to stray from eating three meals per day
and were more likely to snack than those with good sleep quality. More recently, Tanaka
and colleagues (2002) showed that junior high school students who were poor sleepers
were less likely to eat breakfast and had poorer overall dietary habits than the good
sleepers. Specifically, this line of research suggests that sleep quality relates to eating
behavior, and thus weight gain/obesity.
A new line of obesity research has related a specific aspect of sleep quality, sleep
duration, to weight gain and obesity. Evidence from laboratory studies with animals and
41
humans indicate a link between sleep deprivation and an increased body weight
(Gangwisch, Malaspina, Boden-Albala, & Heymsfield, 2005). Further, based on results
from a longitudinal study, Kripke, Garfinkel, Wingard, Klauber, and Marler (2002) found
consistent increases in BMI among individuals who habitually slept less than seven hours
a night. Along these lines, Hasler and colleagues (2004) found results in a 13-year
longitudinal study that indicated as the amount of sleep per night decreased, BMI
increased. Finally, Taheri, Lin, Austin, Young, and Mignot (2004) found that individuals
who slept less than the recommended eight hours a night showed increased BMI, which
was proportional to the amount of decreased in sleep time.
The results of the preceding studies indicate that sleep durations of less than seven
to eight hours are associated with an increased BMI (Kripke et al., 2002; Taheri, Zeitzer,
& Mignot, 2002) and with obesity (Gangwisch et al., 2005; Hasler et al., 2004). Although
the precise mechanism relating lowered sleep duration to weight gain/obesity remains
unclear, recent research has indicated a hormonal component involving leptin and ghrelin
(Prinz, 2004).
Lower levels of leptin, a peptide hormone responsible for suppressing food intake
and increasing energy levels (Prinz, 2004), has been related to increased BMIs and sleep
duration of less than eight hours (Spiegel, Tasali, Penev, & Van Cauter, 2004; Taheri et
al., 2004). Conversely, higher levels of ghrelin, a peptide hormone responsible for
stimulating appetite, fat production, and body growth (Prinz, 2004), have been related to
increased BMIs and less than eight hours of sleep (Speigel, Tasali, Penev, & Van Cauter,
2004; Taheri et al., 2004). Spiegel and colleagues (2004) found that young men who had
their sleep curtailed had lower levels of leptin, increased ghrelin levels and increased
42
appetite and hunger ratings. It was noted that the men in the experimental condition
reported craving sweets and high starch food compared to controls. Research has
indicated that those with sleep restriction or decreased sleep show a decrease in insulin
response to glucose (Spiegel, Leproult, & Van Cauter, 1999). This typical hormone
pattern found in individuals with decreased sleep is a pattern that consistently has been
associated with decreased energy expenditure and increased appetite and obesity (Prinz,
2004).
In adults, less than seven hours of sleep per night can effect normal growth and
development as well as the maintenance of a healthy immune system. Both protein
synthesis and growth hormones play a substantial role in physical growth, and are
secreted at their highest level during REM sleep (Parker et al., 1980; Sassin et al., 1969),
which occurs at a higher frequency at the end of the sleep cycle. Further, individuals who
obtain less than six hours of sleep can have 50% reduction in natural killer T-cells that
aid the body’s immune system in fighting infections (Irwin et al., 1996). Finally, Taylor
and McFatter (2003) linked sleeplessness to cardiovascular disease.
During the sleep period following a night of sleep deprivation, SWS predominates
over the other stages and significantly less REM sleep takes place (Angus, Heslegrave, &
Myles, 1985; Bonnet, 2000). Stage four sleep increases after unusually high amounts of
exercise (Trinder, Paxton, Montgomery, & Fraser, 1985). Additionally, the greatest
amounts of growth hormone are released during SWS (Sassin et al., 1969). These
findings demonstrate the important role played by SWS in maintaining physical health.
The literature also suggests a relationship between sleep quality and psychological
health. Poor sleep quality has been linked with poor mental health as early as
43
preadolescence, with a clear relationship established between poor sleep quality and
negative mood states for adults, as well (Bonnet, 1985; Gau, 2000; Gray & Watson,
2002; Lacks & Morin, 1992; Pilcher & Huffcutt, 1996). Stress and worry have been
linked to poor sleep quality (McCann & Stewin, 1987), as have increased tension,
decreased psychological well-being, and general lower life satisfaction (Pilcher et al.,
1997). Similarly, poor sleep appears to be related to Type A personality, the latter
involving a chronic incessant struggle to achieve more and more in less time, which can
result in health difficulties (Krantz et al., 1988). Buboltz and colleagues (2006) found that
college students who were able to fall asleep faster with fewer sleep disturbances had
fewer mental and social health difficulties. In a study by Taub and Hawkins (1979),
adults who reported irregular sleeping schedules demonstrated fewer tendencies toward
achievement potential, intellectual efficiency, self-control, and sociability.
Research on sleep deprivation and psychological health has demonstrated that
sleep deprivation of only one night is related to increased excitability and impulsiveness
(Sicard, Jouve, & Blin, 2001; Vein, Dallakyan, Levin, & Skakun, 1983). One study
involving psychologically healthy college students found a relationship between sleep
loss and decreased psychological health, with increased somatic complaints, obsessive-
compulsive activities, higher levels of interpersonal reactivity, and higher social
discomfort after only a single night of sleep loss (Zammit, 1988). Other studies have
linked sleep loss to changes in mood (Blagrove & Akehurst, 2001).
Cognitive skills also are affects by poor sleep quality perhaps due to a relationship
of cognitive abilities and REM sleep (Pilcher & Walters, 1997). Research has
demonstrated that the last half of a full night’s sleep, specifically REM sleep, may be the
44
most important in the learning process (Smith & Lapp, 1991). When this sleep is
terminated prematurely, cognitive abilities are negatively affected. Blagrove and
Akehurst (2001) and Harrison and Home (2000) found dramatic negative effects on
cognitive functioning, impacting logical reasoning and decision making in adults
following the loss of only one night of sleep. Adults reporting excessive sleepiness also
report negative effects on working memory (short-term memory used for thinking and
problem solving), psychomotor reactivity, and increased suggestibility (Blagrove &
Akehurst, 2001). Other studies have shown that sleep difficulties can significantly impair
academic performance, learning, visuomotor skills, and general cognitive ability
(DeKonick, Lorrain, Christ, Proulx, & Coulombe, 1989; Lack, 1986; Schredl, Weber, &
Heuser, 1998). Attention is susceptible to partial sleep deprivation, poor cognitive
functioning, as well as false recall of recently learned words and decreased visuomotor
skill (Grosvenor & Lack, 1984; Kami et al., 1994; Webb & Agnew, 1974).
There also is a body of research linking sleep quality with clinical (abnormal)
aspects of psychological health. Studies indicate a relationship between higher rates of
anxiety in poor sleepers (Aikens & Mendelsen, 1999; Monroe, 1967; Zammit, 1988).
Carpenter (2001) also found that Attention Deficit Hyperactivity Disorder is often
associated with deficits in sleep quality. Further, in a study comprised of urban police
officers with posttraumatic stress symptoms, only those who reported poor sleep quality
also reported somatic health problems (Mohr et al., 2003).
The studies of sleep disturbances and depression have yielded contradictory
results. Aikens and Mendelson (1999) found higher rates of depression were associated
with deficits in sleep quality. Zammit (1988) confirmed these results by finding increased
45
symptoms of depression after sleep loss. However, Kraft (1984) found that short-term
sleep deprivation was linked with decreased symptoms of depression. This contradiction
indicates the need for further research on the psychological effects of sleep disturbances.
Sleep and Learning/Academic Performance
The link between sleep and cognitive performance has been well documented
(Kami et al., 1994; Ohayon, Caulet, Philip, Guilleminault, & Priest, 1997; Smith & Lapp,
1991). REM sleep has been shown to be the most critical part of the sleep process, in
terms o f consolidating memory and learning experiences from the prior day into long
term memory. REM sleep is also the most difficult to obtain in sufficient quantities, due
to the nuances of the sleep cycle. REM occurs at the end of each sleep cycle; for the first
few complete cycles, there is a quite limited amount of REM sleep occurring at the end of
each cycle. However, if a person remains asleep long enough the amount of time spent in
REM sleep becomes longer. After about 7-8 hours of sleep, the amount of REM sleep is
then sufficient to integrate the complex material acquired during the day into long-term
memory.
Animal studies have suggested that REM sleep aids learning (Carlson, 1999). In
a study on learning in rats it was found that rats learning a complex maze made the
largest gains in learning following the largest periods of REM sleep (Bloch, Hennevin, &
Leconte, 1977). Animals deprived of REM sleep on the other hand were found to learn
the task more slowly. Daytime learning in humans also appears to be hindered by lack of
sleep (Hobson, 1995). As the neural pathways are strengthened a new protein structure is
created which in turn allows the new information to be stored in the brain in the form of
memory (Steriade & McCarley, 1990). It appears that the new protein structure must be
46
refreshed to remain strong due to its instability. It is during REM sleep that new neural
pathways formed by learning information appear to be activated. This could be why REM
sleep is crucial to learning and memory. It has also been suggested that during REM sleep
the brain is aroused and begins to process information stored in memory, which may
reinforce both old and new memories as well as recently learned material (Antrobus,
1986). This may explain the large amounts of time that infants and young children spend
in REM sleep. They are consolidating new information and building new neural
pathways at prolific rates. This would give further credence to the importance of REM
sleep in the learning process of college students given that the college environment
represents a substantial increase in the cognitive demands placed on students relative to
high school.
Additionally, there appears to be greater learning efficiency among those who
obtain sufficient REM sleep. De Koninck et al, (1989) found that among students
enrolled in a 6-week French immersion course, those students who demonstrated
increased REM sleep the night following intensive learning periods were better able to
recall newly acquired information, with lower error rates as well, than were students who
did not demonstrate comparable increases in REM sleep. It should also be noted that this
study also found that increases in other stages of sleep did not result in any improvements
in memory whatsoever, further underscoring the importance of REM.
The relationship between REM sleep and the integration of information into long
term memory is not limited to the period immediately following learning. In fact,
research suggests that this relationship extends well beyond the night that the information
was integrated. For instance, Smith and Lapp, (1991) found that when students studied
47
for final exams, that REM sleep actually increased in density in the five-day period after
their exams had taken place. Despite this increased REM sleep density, there was no
concomitant increase in the amount of sleep per se, nor was there any increase in the
number of REM sleep periods. Additionally, these periods of increased REM sleep
density were occurring in the latter part of the evening. Taken together, these findings
suggest that information was still being integrated into long-term memory well after the
exam, and since the increases in REM density were occurring later in the evening, this
means that only those individuals who were getting a full night of sleep were able to
profit from this increase in memory consolidation which was occurring after the initial
learning period. It naturally follows from these studies that students who cram, that is
study for long periods immediately prior to an exam, are missing out on the potential
benefits of several nights of increased REM sleep. These findings could also be used to
explain the superiority of distributed practice over mass practice. Individuals who spread
their learning and studying over several nights prior to an exam will get the benefits of
the increase in REM sleep density and improve the integration of new memories and
learned material (Smith & Lapp, 1991).
Considering the importance of REM sleep in improving the integration of
material into long-term memory, the question of what effects the complete lack of REM
sleep might have on memory integration naturally follows. This question would be moot
were it not for the fact that cramming for exams is virtually synonymous with the college
experience and it occurs at all levels of education and across all ability and motivation
levels. It is important to remember that this cramming can affect sleep in different ways;
for instance, some students may study for several hours into the early morning and then
48
get a few hours o f sleep, while others may simply skip sleep altogether. In either case,
students are losing out on REM sleep. In fact, research has borne out that both REM sleep
loss and/or poor sleep quality are associated with significant impairments in cognitive
functioning. A night of sleep loss has been shown to impact logical reasoning and
decision making negatively in adults (Blagrove & Akehurst, 2001; Harrison & Home,
1999). Sleep deprivation appears to affect working memory negatively (short-term
memory used for thinking and problem solving), psychomotor reactivity, and increase
suggestibility (Blagrove & Akehurst, 2000; Sagaspe, Charles, Taillard, Bioulac, &
Phillip, 2003). Sleep loss due to poor quality of sleep has also been linked to poor
cognitive functioning, false recall of recently learned words, and decreased visuomotor
skill (Roediger & McDermott, 1995).
The impact of sleep deprivation or partial sleep deprivation and poor quality of
sleep goes beyond just memory consolidation and acquisition of new knowledge.
Research has indicated that poor sleep is related to impairments in attention and
concentration ability during the day, results in less vigilance, longer reaction times and
perceptual distortions (Home, 1988; Pilcher & Huffcutt, 1996; Tilley & Brown, 1992).
Additionally, even a single night of restricted sleep has been shown to result in decreases
in verbal creativity, abstract thinking and concept formation (Randazzo, Muehlbach,
Schweitzer, & Walsh, 1998). These researchers also noted that sleep deprived individuals
also had difficulty verbally expressing their ideas or thoughts. This may have
implications for students in the learning environment as the impact of poor sleep quality
may interfere with their ability to ask questions and clarify important information that
may be necessary for optimal performance. As if the problem of sleep deprivation and
49
poor sleep quality impact on various aspects of performance were not enough. Students
who were sleep deprived or had poor quality of sleep rated their performance after
completion of a cognitive task as significantly better than individuals who were not sleep
deprived. They also rated their concentration and attention level as being higher than non
sleep deprived individuals. In actuality their performance was just the opposite. It was
found that the sleep deprived individuals performed lower on the actual cognitive task
and showed signs o f concentration and attention problems while attempting the task
(Pilcher & Walters, 1997). These findings are very disturbing. If students believe that
their performance is superior when they are sleep deprived or under poor sleep quality
conditions there is little impetus for them to alter their sleep habits or seek professional
help. In conjunction with this students may make inaccurate attributions about the causes
of their actual performance. It is likely that students will attribute their poor performance
to such things as poor instruction, lack of resources, or not enough study time, but not to
poor sleep habits and quality which may be a major contributing factor to their poor
performance.
Although, the link between cognitive performance and REM sleep have been
fairly well established, it is much more difficult to establish the relationship as clearly
between sleep difficulties (e.g., decreased REM) and other more global measures of
cognitive performance such as Grade Point Average (GPA). Jenkins, Buboltz, and
Wilkinson, 2003 reported that the majority of studies that have examined the relationship
between REM sleep and cognitive performance have been conducted in laboratory
settings and have been able to manipulate the actual amount of time that individuals have
been able to spend in REM sleep. Moving outside of the laboratory environment brings
50
numerous issues that may create difficulties. The conclusions drawn may not be as
specific due to lack of experimental control, but similar patterns have emerged in the
research on the relationship between sleep habits and quality and academic performance.
Overall, the results have been fairly consistent with findings indicating that students who
report poor sleep quality and habits have lower overall GPA’s (Jenkins, Buboltz, &
Wilkinson, 2003).
In examination of the few studies that have explored this relationship a variety of
findings related to various sleep habits and quality have emerged. It is clear that no one
particular form of sleep difficulty is responsible for lower GPA’s. Lack (1986) found that
students who met the criteria for Delayed Sleep Phase Syndrome (DSPS) had
significantly lower grades, greater feelings of drowsiness, and irritability when compared
to the rest of the sample. However, he did not find any relationship between grades and
overall sleep quality.
In a study o f health related variables students who went to sleep later on
weekdays and also who awoke later on weekdays showed a significant negative
correlation with GPA (Trockel et al., 2000). These findings indicate that the sleep-wake
schedule of students may have a negative impact on academic performance. Lowry and
colleagues (2010) examined the relationship between overall sleep quality and GPA.
They found that overall sleep quality was significantly negatively related to GPA. Their
study examined all aspects of sleep quality and would go counter to some of the findings
of Lack (1986) which did not find a relationship between sleep quality and grades.
Finally, Gray and Watson (2002) examined the relationship between sleep quality,
sleep length, sleep schedule and GPA. Their findings were somewhat mixed compared to
51
the previous findings. They did not find any significant relationship between overall sleep
quality or sleep length and GPA. However, they did find a significant negative
correlation between sleep schedule and GPA. It should however, be noted that the
correlations between sleep quality and length and GPA were in the negative direction, but
did not reach significance. Taken together it appears clear that sleep difficulties and
quality have an impact on student GPA. The exact nature of this relationship is difficult
to determine at this time due to the limited number of studies and the fact that the studies
have all been correlational in nature.
The evidence is clear: sleep is essential to high-caliber academic performance,
because sleep in general and REM sleep in particular are essential to the acquisition of
long-term memory and integration of new material. Even when examined outside of the
laboratory findings are fairly consistent that sleep difficulties in various forms impact the
GPA’s of students.
Sleep Quality and Physical Performance
Sleep quality and physical fitness are important for young adults’ growth and
health. However, little research has examined the relationship between sleep quality and
physical fitness in young adults. Lee and Lin (2007) conducted a study with 291 female
college students in Taiwan, which investigated the association between subjective sleep
quality and physical fitness. The Chinese version of the Pittsburgh Sleep Quality Index
(PSQI) was used to measure sleep quality. The results indicate that participants with poor
sleep quality had a significant short distance for the sit-and-reach (flexibility), fewer
repetitions for the curl up test (muscular strength and endurance), and a longer time to
52
finished the 800-m run/walk test (cardiovascular fitness) than participants with good
sleep quality.
Poor sleep has been associated with reduced physical function in older adults
(Foley, Ancoli-Isreal, Britz, & Walsh, 2004; Foley, Monjan, & Brown, 1995; Kutner,
Ory, Baker, & FICSIT Group, 1994; Whitney et al., 1998), although all of these studies
used subjective measures of sleep. Abnormal sleep patterns were reported by over 15% of
older adults who also indicated ambulatory limitations (Rantanen et al., 2003). Studies
using objective measures of sleep and physical functioning are needed.
Goldman et al. (2007) examined the association between disturbed sleep and
daytime physical functioning in 2,889 older women. The study used actigraphs to assess
sleep variables. Gait speed, chair stands, and grip strength were the neuromuscular
performance measures. The results indicate that participants with poor sleep walked
slower, took longer to complete chair stands, and had lower grip strength. The
participants with a total sleep time between 6.0 and 7.5 hours tended to perform better on
neuromuscular performance. In addition, participants with more fragmented sleep (as
measured by minutes of wake after sleep onset) had worse neuromuscular performance
and were more likely to have functional impairments. Finally, women who took a nap
greater than or equal to one-hour had a higher chance of having a functional limitation
than those who took less than a 30-minute nap.
Napping and Physical Performance
A short nap is effective for recovery of attention, concentration, and brain
function (Shirakawa, Takase, Tanaka, & Yamamoto, 1999), all of which are used in
53
physical performance. Tietzel and Lack (2001) have reported that sleep inertia occurs
after a 30-minute nap, while that is not the case for a 10-minute nap.
Sleep inertia is a state of lowered arousal that an individual experiences
immediately upon awakening (Tassi & Muzet, 2000). The longer the nap, the greater the
chance there is of experiencing more effects of sleep inertia. Even naps of 30 minutes in
length show negative effects of sleep inertia (Tietzel & Lack, 2001). Brooks and Lack
(2006) found that out of 5-, 10-, 20-, and 30-minute naps, the 10-minute nap produced
immediate improvements in sleep latency, subjective sleepiness, fatigue, vigor, and
cognitive performance, and it was the most effective nap duration. There was evidence of
sleep inertia effects following the 30-minute nap; however, there was no evidence of
sleep inertia effects after the other naps.
The aim of the study by Waterhouse and colleagues (2007) was to examine the
effects of a post-lunch nap on alertness and performance after partial sleep loss.
Participants in this study were 20 males in Libya. The physical performance measures
used were handgrip strength and sprint running times over two and 20 m. Results
indicated that naps produced an improvement in sprint performance after sleep loss
during the previous night. In contrast, a nap did not improve grip strength; there was
actually a decline in grip strength. Because the researchers examined each score on the
hand dynamometer instead of taking the best of the three scores, this decline could be
explained by muscle fatigue. Additionally, naps improved alertness and decreased
sleepiness.
54
Relaxation
Relaxation techniques encompasses several types of relaxation designed to
decrease physiological arousal, which can assist in decreasing the time it takes to fall
asleep (Morin & Wooten, 1996). Research has demonstrated a relationship between
physiological arousal and sleep quality (Bonnet & Arand, 1995; Monroe 1967).
Relaxation techniques decrease sleep latency (Bootzin & Perlis, 1992; Friedman, Bliwise,
Yesavage, & Salom, 1991; Hryshko-Mullen, Broeckl, Haddock, & Peterson, 2000;
Morin, Culbert, & Schwartz, 1994; Morin & Woten, 1996). Relaxation is a popular
clinical and educational tool that benefits health, well-being, and performance (Khasky &
Smith, 1999).
Relaxation Techniques. Relaxation techniques focus on decreasing arousal level
to induce sleep onset. Different relaxation techniques include progressive muscle
relaxation, deep breathing, and mental imagery. Progressive muscle relaxation (PMR)
teaches individuals to recognize and manage physical muscle tension by systematically
tensing and relaxing the major muscle groups (Stepanski, 2000). Deep breathing is
another relaxation technique that is often combined with PMR. Mental imagery is a
technique that decreases cognitive arousal, such as racing thoughts or worrying, by
visualizing oneself in a specific scene that is associated with a calm relaxed state. Mental
imagery may entail imagining oneself on a beach or other pleasant place like lying in the
sun, if it is a positive situation for the individual. Imagining feeling o f warmth also help.
Behavioral approaches tend to work well with simple physical restlessness, while
imagery is effective for people who have both mental and physical restlessness, such as
ruminating about the day's events (Morin & Wooten, 1996).

55
For all relaxation approaches it is beneficial for the therapist or counselor to first
instruct the individual how to relax using the chosen technique in session. Homework
geared toward between-session practice with a review at the next session for fine tuning
and feedback can facilitate effectiveness. In each instance close monitoring on the part of
the therapist tends to increase compliance and effectiveness of relaxation techniques.
Counselors are encouraged to help individuals create their own relaxation tapes.
Making a tape encourages individuals to import their interests and ideas into their
treatment. For deep muscle relaxation audio-taping the individual session exercise and
giving the tape to the individual for home practice can be beneficial. Listening to a tape
when attempting to fall asleep takes less cognitive effort than trying to remember the
steps to relaxation taught by a therapist (Buboltz et al., 2002). Further, expecting those
with sleep difficulties to spend hours in therapy learning relaxation techniques may
simply create a situation for non-compliance, whereas creating a relaxation tape enables
them to continue treatment with less professional monitoring. No matter what approach
to relaxation that is used by the therapist and individual, it is important that the individual
consistently apply the approach on a regular basis. Without consistent application,
effectiveness of relaxation techniques to reduce sleep difficulties diminishes.
Efficacy studies generally support the use of relaxation therapies to decrease sleep
latency (Bootzin & Perlis, 1992; Morin & Wooten, 1996). However, not all individuals
with sleep difficulties are physiologically hyper-aroused. Some studies demonstrate
relationships between poor sleep quality and physiological arousal (Bonnet & Arand,
1995; Monroe, 1967). Relaxation therapies are likely to work for physiologically aroused
individuals that are experiencing sleep difficulties. On the other hand, some people are
56
not physiologically aroused, but are cognitively aroused. For such people, cognitive
therapeutic interventions may be more appropriate.
Guided Imagery. Guided imagery encompasses versatile mental techniques of
visualization and imagining and has become a powerful and very effective therapeutic
tool that is often applied in health and sport psychology. Guided imagery is a mental
technique that allows athletes to focus on and imagine a particular physical behavior,
action or task, integrating mind-body sensory and neuro-physiological functions
(Richardson & Latuda, 1995). The purpose of guided imagery is to evoke and imagine
physical features of a desired technical skill or sport related technical execution by
utilizing physiological arousal in imaginative and confirmative visualization that
increases technical ability, self-confidence and motivational factors (Law, Driediger,
Hall, & Forwell, 2006; Mamassis & Doganis, 2004).
Guided imagery is also an active mental process that is often used in relaxation
procedures with athletes in order to regulate their arousal before competition, lessen
maladaptive behaviors, balance negative thoughts as well as to enhance concentration and
focus (Peluso, Ross, Gfeller, & La Voie, 2005; Vempati & Telles, 2002; Watanabe et al.,
2006). Thus, guided imagery synthesizes multipurpose modalities which can be applied
for relaxation purposes in order to reduces stress and balance psycho-physiological
arousal before competitions as well as improve exercise-motor behaviors, rehearse
specific technical skills, strengthen psycho-neuromuscular functions, and reinforce
cognitive, concentrative, motivational and learning abilities of athletes (Giacobbi, Foore,
& Weinberg, 2004; Martin, Moritz, & Hall, 1999; Utay & Miller, 2006).
57
Hypotheses
The literature suggests that there is a relationship between sleep and physical
performance. However, an exhaustive review of the literature was unable to produce a
single study that examined the effects of sleep quality, sleep length, sleepiness, and a
nap/relaxation on flexibility, grip strength, and peak performance. Because previous
research suggests certain relationships between components of this study, specific
hypotheses can be posited.
Hypothesis 1A
A nap/relaxation will be related to flexibility in the lower back and hamstrings.
More specifically, individuals in the experimental group who take a 10-minute
nap/relaxation will have significantly higher scores on the sit-and-reach test.
Hypothesis IB
A nap/relaxation will be related to grip strength in the hand and forearm. More
specifically, individuals in the experimental group who take a 10-minute nap/relaxation
will have significantly higher scores on the hand dynamometer test.
Hypothesis 1C
A nap/relaxation will be related to vertical jump height. More specifically,
individuals in the experimental group who take a 10-minute nap/relaxation will have
significantly higher scores on the vertical jump test.
Hypothesis ID
A nap/relaxation will be related to peak power. More specifically, individuals in
the experimental group who take a 10-minute nap/relaxation will have significantly
higher scores on estimated peak power.

58
Justification of Hypotheses 1A, IB, 1C, and ID. Naps as brief as 19.8 (Gillberg
et al., 1996), 10.8 (Home & Ryner, 1996), 10.2 (Takahashi & Arito, 2000), 10 (Tietzel &
Lack, 2001; Tietzel & Lack, 2002), and 9.1 (Hayashi, Motoyoshi, & Hori, 2005) minutes
have been found to improve alertness and performance in individuals whose sleep was
restricted. The improvement in alertness and performance due to taking a brief nap could
also benefit physical performance. Waterhouse and colleagues (2007) found that naps
produced an improvement in sprint performance after sleep loss during the previous
night.
Relaxation is a popular clinical and educational tool that benefits health, well
being, and performance (Khasky & Smith, 1999) and similar to a short nap in its effects.
Guided imagery is also an active mental process that is often used in relaxation
procedures with athletes in order to regulate their arousal before competition, lessen
maladaptive behaviors, balance negative thoughts, and enhance concentration and focus
(Peluso et al., 2005; Vempati & Telles, 2002; Watanabe et al., 2006).
Hypothesis 2A
Poor sleep quality will be significantly related to flexibility in the lower back and
hamstrings. More specifically, an individual who is a poor sleeper will have significantly
lower scores on the sit-and-reach test.
Hypothesis 2B
Poor sleep quality will be significantly related to grip strength in the hand and
forearm. More specifically, an individual who is a poor sleeper will have significantly
lower scores on the hand dynamometer test.

59
Hypothesis 2C
Poor sleep quality will be significantly related to vertical jump height. More
specifically, an individual who is a poor sleeper will have significantly lower scores on
the vertical jump test.
Hypothesis 2D
Poor sleep quality will be significantly related to peak power. More specifically,
an individual who is a poor sleeper will have significantly lower scores on estimated peak
power.
Justification for Hypotheses 2A, 2B, 2C, and 2D. Brown and colleagues (2002)
found that when compared to the general adult population, college students have a
decreased level of sleep quality. Poor sleep quality adversely affects visual-motor
reaction time, critical thinking abilities, vigilance, attention to task, and reaction time
(Taub, 1980). All of these are important in physical performance. Lee and Lin (2007)
found that female college students in Taiwan with poor sleep quality had a significantly
shorter distance for the sit-and-reach (flexibility), fewer repetitions for the curl up test
(muscular strength and endurance), and a longer time to finished the 800-m run/walk test
(cardiovascular fitness) than participants with good sleep quality.
Hypothesis 3A
Sleep duration will be related to flexibility in the lower back and hamstrings.
More specifically, individuals with shorter sleep duration will have significantly lower
scores on the sit-and-reach test.

60
Hypothesis 3B
Sleep duration will be related to grip strength in the hand and forearm. More
specifically, individuals with shorter sleep duration will have significantly lower scores
on the hand dynamometer test.
Hypothesis 3C
Sleep duration will be related to vertical jump height. More specifically,
individuals with shorter sleep duration will have significantly lower scores on the vertical
jump test.
Hypothesis 3D
Sleep duration will be related to peak power. More specifically, individuals with
shorter sleep duration will have significantly lower scores on estimated peak power.
Justification for Hypotheses 3A, 3B, 3C, and 3D. A study reported that the
duration of average night's sleep for college students in 1989 was 6.5 hours, representing
a decrease of about one hour per night over the previous 20 year period (Hicks &
Pellegrini, 1991). This drop is particularly notable since individuals who report sleeping
six hours or less have a greater incidence of cognitive and emotional difficulties (Hicks &
Gilliland, 1981; Taub & Berger, 1973). This increase in cognitive difficulties can impact
physical performance.
Hypothesis 4A
Sleepiness will be significantly related to flexibility in the lower back and
hamstrings. More specifically, individuals with higher levels of sleepiness will have
significantly lower scores on the sit-and-reach test.

61
Hypothesis 4B
Sleepiness will be significantly related to grip strength in the hand and forearm.
More specifically, an individual with higher levels of sleepiness will have significantly
lower scores on the hand dynamometer test.
Hypothesis 4C
Sleepiness will be significantly related to vertical jump height. More specifically,
individuals with higher levels of sleepiness will have significantly lower scores on the
vertical jump test.
Hypothesis 4D
Sleepiness will be significantly related to peak power. More specifically,
individuals with higher levels of sleepiness will have significantly lower scores on
estimated peak power.
Justification for Hypotheses 4A, 4B, 4C, and 4D. Insufficient sleep and daytime
sleepiness rank among the most frequent o f sleep problems reported by college students
(Buboltz et al., 2001; Lack, 1986). Particularly relevant to college students, cognitive
performance effects of sleep deprivation reveal a "fatigue effect," which become worse as
time on the task increases. Furthermore, tasks may be undertaken in an effective manner,
but performance declines as the task duration extends (Durmer & Dinges, 2005). This
decline in performance can include physical performance.

CH APTER 2
M ETHOD
This section describes the methods that were used to collect and analyze the data.
The section includes participants, measures, and the procedure.
Participants
Participants were 98 students at a mid-sized southern university in the United
States who were recruited from classes in the College of Education. Participants were
informed that their participation was voluntary. The study, measures, and materials were
approved by the university’s institutional review board (Appendix A). Prior to
participating in the study, participants were asked to read and sign the consent form
(Appendix B) and were notified of their right to refuse participation. In addition, the
informed consent documents and data were stored separately to ensure confidentiality.
Measures
Demographics Form
The researcher constructed a demographics form (Appendix C), which is
comprised of eight items. These items inquire about gender, age, race/ethnic origin,
school classification, height, weight, NCAA athlete, and sports.
62
63
Sleep Quality Index
The Sleep Quality Index (SQI; Urponen et al., 1991) was used to assess sleep
quality and general sleep difficulties (Appendix D). The SQI consists of eight self-report
items with three response categories, which are weighted as 0,1, or 2 (with a response of
two indicating the most common or severe symptom). On item 1, participants choose
from three responses: “< 10 minutes,” “ 11-30 minutes,” and “ >30 minutes.” The
response categories for items 2-5 and item 7 are: “no,” “< three days/week,” and “3-7
days/week.” For item 6, the response choices are: “very or mostly alert,” “don’t know,”
and “very or mostly tired.” The response categories for item eight are: “no,”
“occasionally,” and “at least once per week.” Sample items include: “Time to fall
asleep,” “Difficulties falling asleep during the past three months,” and “Wake up too
early in the morning during the past three months.”
The eight items are added together to provide a total sleep quality score. Sleep
quality is categorized based on the following scores: 0-1 indicates good sleep quality, 2-8
indicates occasional sleep difficulties, and 9-16 indicates poor sleep quality. The SQI was
divided into good sleep quality and poor sleep quality for analysis. Participants were
categorized as having good sleep quality if they had a SQI score of 0-8, and they were
labeled as having poor sleep quality if they had a SQI score of 9-16. The means for good
sleep quality (M= 3.67, SD = 2.07) and poor sleep quality (M= 11.15, SD = 1.68) do not
overlap. The SQI has a Cronbach's alpha of .73 for men and .75 for women, indicating an
acceptable internal consistency. Validity is supported by the significant positive
relationship between sleep quality score and subjective health (Urponen et al., 1991). The
64
test-retest reliability coefficients range from .74 to .96 with undergraduate college
students, and have a mean of .84 (Jenkins, 2005).
Adult Sleep-Wake Scale
The Adult Sleep-Wake Scale (ADSWS; Fortunato, LeBourgeois, & Harsh, 2008)
is a 25-item self-report questionnaire developed to measure sleep quality in adults during
the past week (Appendix E). The ADSWS consists of five behavioral dimensions: going
to bed, falling asleep, maintaining sleep, reinitiating sleep, and returning to wakefulness.
The Going to Bed dimension includes the transitions from wakefulness to sleep and the
transition from sleep to wakefulness is the Returning to Wakefulness dimension. The
sleep initiation at the beginning of the sleep period is the Falling Asleep dimension and
the Maintaining Sleep dimension is the maintenance of sleep. The Reinitiating Sleep
dimension is when an individual returns to sleep after an awakening during the sleep
period.
The ADSWS has participants rate how frequently certain sleep-related behaviors
occurred on a 6-point Likert scale, with the following response options: Never (has not
happened), Once in a while (happened 20% o f the time), Sometimes (happened 40% o f
the time), Quite Often (happened 60% o f the time), Frequently, if not always (happened
80% o f the time), and Always (happened 100% o f the time). On the going to bed scale, a
sample item includes: “When it is time to go to bed, I want to stay up and do other
things.” A sample item on the falling asleep scale is: “When I’m in bed and it is time to
fall asleep, I am not sleepy.” The following is a sample item on the maintaining sleep
scale: “After I fall asleep, during the night I toss and turn in bed.” A sample item on the
reinitiating sleep scale is: “After waking up during the night, I have a hard time going
65
back to sleep.” On the returning to wakefulness scale, a sample item includes: “In the
morning, I wake up and feel ready to get up for the day.” A total score was calculated for
the ADSWS by summing the scores of the subscales and conducting a median split. The
individuals above the median were put in the good sleep quality group and individuals
below the median were put in the poor sleep quality group. The ADSWS was divided into
good sleep quality and poor sleep quality for analysis. Participants were categorized as
having good sleep quality if they had an ADSWS total score of 105 and above, and they
were labeled as having poor sleep quality if they had an ADSWS score of 104 and below.
The means for good sleep quality (M = 119.92, SD = 10.28) and poor sleep quality (M =
88.40, SD = 11.87) do not overlap.
The ADSWS has a high level of internal consistency with an alpha o f 0.83 to 0.90
(Fortunato et al., 2008). Test-retest reliability coefficients range from .67 to .82. The
coefficient alpha estimates of reliability for each of the five behavioral dimensions are as
follows: going to bed = .83; falling asleep = .84; maintaining sleep = .83; reinitiating
sleep = .89; and returning to wakefulness = .90. The ADSWS was established to have
valid indicators of sleep wake patterns (Fortunato et al., 2008).
Sleep Habits Questionnaire
The Sleep Habits Questionnaire (SHQ; Buboltz et al., 2001) is a 9-item
questionnaire used to measure sleep habits and sleep length (Appendix F). The SHQ is
based on the instrument designed by Lack (1986). The items are open-ended for
indicating wake-up times, bedtimes, usual amount o f sleep, and other sleep-wake habits
for the week and weekend (Buboltz et al., 2001). Sample items include “On the average,
what time during the week do you go to bed,” “On the average, what time during the
66
weekend do you wake up,” and “On the average, how many hours of sleep do you get
during the week.” Individuals who slept less than six hours per night were put in the short
sleep group, individuals who slept 6-9 hours per night were put in the average sleep
group, and individuals who slept more than nine hours per night were placed in the long
sleep group. The means for the short sleep group (M= 4.93, SD = 1.03), average sleep
group (M = 7.72, SD = 1.12), and long sleep group (M = 9.79, SD = 0.63) do not overlap.
Epworth Sleepiness Scale
The Epworth Sleepiness Scale (ESS; Johns, 1991) is an 8-item self-report
questionnaire used to assess daytime sleepiness in adults (Appendix G). Participants
indicate how likely they are to doze off or fall asleep in different situations using a 4-
point Likert scale with ratings of 0 (would never doze) to three (high chance of dozing).
A score o f 0 = no chance o f dozing, 1 = slight chance of dozing, 2 = moderate chance of
dozing, and 3 = high chance of dozing. A total score of 0-10 means the person is within
the normal range for sleepiness, 10-12 is in the borderline range, and 12-24 is abnormal.
The average is a score o f seven or 8. The ESS takes approximately three to five minutes
to complete. The ESS was divided into low, medium, and high levels of sleepiness for
analysis. Participants were categorized as having low levels of sleepiness if they had an
ESS score of 0-10, they were labeled as having medium levels of sleepiness if they had
an ESS score of 10-12, and an ESS score of 12-24 indicated high levels of sleepiness.
The ESS has a high level of internal consistency as measured by Cronbach's alpha
of 0.88 (Johns, 1992). Correlations between the ESS total scores and sleep latency were
measured by polysomnography [r(138)= -0.379, p<0.001], as well as Multiple Sleep

67
Latency Test scores [r(27)= -0.514, p<0.01), and demonstrate convergent construct
validity.
Karolinska Sleepiness Scale
The Karolinska Sleepiness Scale (KSS; Akerstedt & Gillberg, 1990) is a one item
scale that measures sleepiness and alertness (Appendix H). The scale is structured in a
Likert format with the following response choices: 1 = extremely alert, 3 = alert, 5 =
neither alert nor sleepy, 7 = sleepy, but no difficulty remaining awake, and 9 = extremely
sleepy, fighting sleep. Even number responses are options as well; however, in contrast to
the odd numbered responses, they do not have labels attached. Kaida et al. (2006)
conducted a study where they found that the KSS was closely related to EEG and
behavioral variables, indicating a high validity in measuring sleepiness. Individuals who
had a score of 1-3 were placed in the low sleepiness group, scores of 4-6 represented the
medium sleepiness group, and scores 7-9 indicated the high sleepiness group.
Physical Performance Measures
Hand Grip Dynamometer
A hand grip dynamometer was used to assess grip strength, which measures hand
and forearm muscular strength in kilograms (kg). Hand-grip dynamometry is a useful
assessment tool for multiple purposes in clinical practice, including the assessment of
upper limb impairment; in evaluating work capacity for those with hand injuries and
other work-related injuries; the evaluation of people with other impairments and
disabilities such as rheumatoid arthritis, chronic fatigue syndrome, developmental
disabilities, muscular dystrophy, and stroke; determining the efficacy of different
treatments for people with a range of disabilities; part of an overall fitness assessment;
68
and in determining the level of effort exerted (Innes, 1999). The intra-class correlation
coefficients (ICC) with the dominant hand were 0.92 during the pre-fatigue maximal
contraction and 0.92 during the post-fatigue maximal contraction, indicating high
reliability (Reuter, Massy-Westropp, & Evans, 2011). The muscle fatigue protocol
consisted of ten 30-second sub-maximal isometric contractions. The intra-class
correlation coefficients (ICC) with the non-dominant hand were 0.97 during the pre
fatigue maximal contraction and 0.95 during the post-fatigue maximal contraction,
indicating high reliability (Reuter et al., 2011). Pre- and post-fatigue maximal contraction
measurements using linear regression demonstrated excellent reliability (Reuter et al.,
2011 ).
Sit-and-Reach Test
To measure flexibility, specifically in the lower back and hamstring muscles, a
sit-and-reach box was utilized and measured in centimeters (cm). The sit-and-reach box
is a solid box approximately 30 cm tall. It has measurement markers on the top and
extends 26 cm over the front edge of the box toward the individual. The individuals
removed their shoes and sat on the floor with their legs stretched out in front of them with
knees straight and feet flat against the front end of the box. They lean forward at the hips
in a slow steady movement and slide their hands up the measurement markers as far as
they can go.
According to the American College of Sports Medicine’s (ACSM; 2006)
Guidelines for Exercise Testing and Prescription, the sit-and-reach test scores for adult
males are: above 34 cm = excellent flexibility, 28 to 34 cm = above average, 23 to 27 cm
= average, 16 to 22 cm = below average, and below 16 cm = poor flexibility. The adult

69
female sit-and-reach test scores are: above 37 cm = excellent flexibility, 33 to 36 cm =
above average, 29 to 32 cm = average, 23 to 28 cm = below average, and below 23 cm =
poor flexibility.
Previous studies indicate consistently high reliability estimates (.96 < R < .99) for
the sit-and-reach test (Bravo et al., 1994; Jackson & Baker, 1986; Jackson & Langford,
1989; Shaulis, Golding, & Tandy, 1994). Studies have found moderate validity as a
measure of hamstring flexibility and relativity low validity of as a measure of lower back
flexibility (Jackson & Baker, 1986; Jackson & Langford, 1989).
Vertec Vertical Jump Device
The Vertec vertical jump measures vertical jump height and was used to estimate
peak power. The Vertec vertical jump measures vertical jump height in inches (in). The
Vertec is an adjustable metal pole standing upright with several horizontal vanes at the
top. The vanes are spaced a half inch apart and rotate when touched to indicate the height
reached. The correlation coefficient has been reported as 0.91, indicating good reliability
(Leard et al., 2007).
Estimated Peak Power
Peak power was estimated using the following formula, which was based on the
Vertical Jump Test mentioned above: 65.1 x (jump height in cm) + 25.8 x (body mass in
kg) - 1413.1 = Peak Power (Canavan & Vescovi, 2004). The estimated peak power was
measured using watts (W).
Procedure
The researcher obtained approval from the university’s Institutional Review
Board (IRB) prior to the start of data collection.

70
Recruitment of Participants
After consulting with instructors of college of education classes, announcements
were made in classes regarding participation in this research. A script was read to recruit
participants (Appendix I). Potential volunteers were informed of the purpose of the study
and were provided with information about the location and times when they may
participate. They were instructed to wear comfortable clothing that they can stretch in
during the study. Participants were informed that they would receive extra credit for their
participation in this project with approval from the instructor. The amount o f extra credit
awarded to the students was predetermined by each instructor. An alternative extra credit
activity was offered by their instructor for those who chose not to participate in this
study. They were reminded that participation in this project is voluntary and that no
identifying information was collected. They were also informed that they would not be
penalized for not volunteering and that they may stop at any time without penalty. When
each participant signed up for a date and time to participate in the research study, they
also provided their name, email address, and telephone number. The participants’ email
addresses and phone numbers were requested for contact by the researcher the night prior
to the test date to remind them about the study and to wear comfortable clothing.
Students arrived at a designated classroom in the gymnasium at the appointed
time and date. Once the students were seated, a script was read to the participants
regarding their participation. Participants were then asked to read the consent form. After
reading the consent form, the researcher asked what questions they had, and then they
were asked to sign and date the consent form. Written informed consent was then
obtained from each participant, and they received a copy of the consent form. The data
71
and the participants’ identification numbers were kept confidential. Participants were
randomly assigned to either the experimental or control group.
Control Group
Once the participants signed an Informed Consent Form, they were taken from the
classroom to the gymnasium where they were led through an active dynamic warm-up.
Next, they completed the hand dynamometer test, the sit-and-reach test, and the vertical
jump test. These measures were conducted to address practice effects, and were not used
as pre-test scores. Finally, they returned to the classroom, and were instructed to read a
newspaper for 10 minutes, which was provided to them. They were not allowed to sleep.
Next, they were asked to complete the questionnaires about sleepiness. They were then
taken from the classroom to the gymnasium where they were led through an active
dynamic warm-up. Next, they completed the hand dynamometer test, the sit-and-reach
test, and the vertical jump test. The scores from these measures were analyzed in the
results. Finally, the participants went back to the classroom to complete the remaining
questionnaires. The procedure for the active dynamic warm-up can be found in Appendix
J.
Experimental Group
Once the participants signed an Informed Consent Form, they were taken from the
classroom to the gymnasium where they were led through an active dynamic warm-up.
Next, they completed the hand dynamometer test, the sit-and-reach test, and the vertical
jump test. These measures were conducted to address practice effects, and were not used
as pre-test scores. Finally, they returned to the classroom, and were instructed to get as
comfortable as possible in their chairs and close their eyes while they listened to a guided
72
relaxation or took a nap for 10 minutes. The lights in the classroom were turned off
during the guided relaxation. Next, they were asked to complete the questionnaires about
sleepiness. They were then taken from the classroom to the gymnasium where they were
led through an active dynamic warm-up. Next, they completed the hand dynamometer
test, the sit-and-reach test, and the vertical jump test. The scores from these measures
were analyzed in the results. Finally, they went back to the classroom to complete the
remaining questionnaires.
Hand Dynamometer Test Procedure
The procedure to measure grip strength was using the Jamar hand dynamometer.
The participants were seated without an armrest with their dominant arm at a 90 degree
angle and used their dominant hand to apply as much grip pressure as possible on the
dynamometer. The researcher used the words “Harder, harder, relax” as a standard verbal
command for every participant. The researcher recorded the maximum reading (kg). The
participant repeated the test three times after 20 seconds of rest between each trial. The
researcher used the highest recorded value to assess the participant’s performance.
Vertical Jump Test Procedure
The participants did three maximum jumps using a Vertec vertical jump device.
The participants began in a standing position and performed a crouching action (counter
movement) before jumping for maximal height using a Vertec vertical jump device. They
were given three attempts at the maximal jump with 15 seconds of rest time between
jumps.
73
Sit-and-Reach Test Procedure
According to the American College of Sports Medicine, the sit-and-reach test
procedure involves having the participant sit on the floor without shoes on, with their legs
stretched out straight ahead. The soles of the feet are placed flat against the sit-and-reach
box at the 26-cm mark. Both knees should be locked and pressed flat to the floor. Next,
the participant slowly reaches forward along the measuring line with both hands (palms
facing downwards) as far as possible. The participant keeps their hands parallel and not
leading with one hand. The fingertips can be overlapped. The participant exhale and drop
their head between their arms when reaching. After two practice reaches, the participant’s
third reach, held for 1-2 seconds, was recorded as the participant’s score.
Once they finished completing the physical activities, the researcher had
participant sign their name on the instructors’ extra credit form. The researcher returned
extra credit forms to the corresponding instructor.
Risks and Benefits
Potential risks include emotional distress or discomfort associated with
completing questionnaires and performing fitness activities. In attempts to minimize
potential risks, participants were reassured that these questions are common in this area
of research and that feelings of discomfort are not unusual. Participants were provided
with a list of local mental health services, in which the participants may contact if
needed. Participants were informed that any professional services sought will be at their
own expense. Benefits of participation include earning extra credit and contributing to the
field of psychology.
CHAPTER 3
RESULTS
Participants
Overall Sample
Participants were 98 undergraduate and graduate students at a mid-sized southern
university in the United States. There were 50 female (50.5%) and 48 male (48.5%)
participants. The average age of the participants was 22.5 years (SD = 5.01, range: 17 to
47). In terms of ethnicity, 65 were Caucasian (65.7%), 26 were African American
(26.3%), 2 were Asian/Pacific Islander (2.0%), two were Hispanic (2.0%), and two
indicated Other (2.0%). The sample was comprised of individuals from all academic
classifications, 24.2% freshman (n = 24), 7.1% sophomores (n =7), 18.2% juniors (n -
18), 28.3% seniors (n = 28), and 20.2% graduate students (n = 20).
The average weight of the participants was 165 pounds (SD = 44.9, range: 91 to
320). The average Body Mass Index (BMI) of the participants was 25.8 (SD - 5.9, range:
17.7 to 49.6). The average BMI for the male participants was 26.8 (SD = 5.9, range: 18.7
to 47.2) For female participants, the average BMI was 24.7 (SD = 6.1, range: 17.7 to
49.6) The average height of the participants was 169 cm or 5-feet - seven inches (SD =
9.87, range: 141 cm or 4’8” to 190.5 or 6’3”).
74
75
Control Group
The control group consisted of 19 (42.2%) females and 26 (57.8%) males with an
average age of 21.4 (SD = 4.0; range: 17 to 37). The control group was 75.6% Caucasian,
20% African American, 2.2% Hispanic, and 2.2% Other. The control group was
comprised of 37.8% freshman, 6.7% sophomores, 17.8% juniors, 24.4% seniors, and
13.3% graduate students
In the control group, the average weight of the participants was 166.8 pounds (SD
= 36.9, range: 106 to 261). The average Body Mass Index (BMI) of the participants was
25.5 (SD = 4.5, range: 18.8 to 35.9). The average height of the participants was 171 cm or
5-feet 7-inches (SD = 9.59, range: 155 or 5 T ’ to 190.5 or 6’3”).
Experimental Group
The experimental group consisted of 31 female (58.5%) and 22 male (41.5%)
participants. The average age of the participants was 23.5 years (SD = 5.59, range: 18 to
47). The majority of the participants in the experimental group were Caucasian (58.5%),
with African American (32.1%), Asian/Pacific Islander (3.8%), Hispanic (1.9%), and
Other (1.9%). The experimental group was comprised of individuals from all academic
classifications, 13.2% were freshman, 7.5% were sophomores, 18.9% were juniors,
32.1% were seniors, and 26.4% were graduate students.
The average weight of the participants in the experimental group was 163 pounds
(SD = 51.05, range: 91 to 319.5). The average BMI of the participants in the experimental
group was 25.9 (SD = 6.90. range: 17.7 to 49.6). The average height o f the participants in
the experimental group was 167.7 cm or 5-feet 6-inches (SD = 9.89, range: 141 cm or
4’8” to 190.5 cm or 3’3”).

76
Descriptive Statistics, Reliabilities, and /-tests for Overall Sample
Table 1 presents the overall sample’s reliability coefficients, means, standard
deviations, and ranges for the Adult Sleep-Wake Scale (ADSWS), the Sleep Quality
Index (SQI), the Sleep Habits Questionnaire (SHQ), the Epworth Sleepiness Scale (ESS),
and the Karolinska Sleepiness Scale (KSS). The current sample was compared to
normative samples using one-sample /-tests with adult populations.
Table 1
Descriptive Statistics, Reliabilities, and t-tests fo r Overall Sample
Measures M SD Range a /
SQI Total 4.69 3.27 0-14 .75 -1.21
ADSWS Going to bed 19.64 5.54 7-30 .87 3.47**
ADSWS Falling asleep 22.00 4.97 10-30 80 2.59**
ADSWS Maintaining sleep 21.92 5.29 6-30 .84 3.59**
ADSWS Reinitiating sleep 23.77 5.35 12-30 .90 4.01**
ADSWS Returning to awake 16.51 6.43 5-30 .91 0.79
SHQ Weekday 7.13 1.76 2-14 -1.37
SHQ Weekend 8.39 1.91 2-15 1.01
ESS Total 9.38 3.30 3-20 .58 10.44**
KSS 5.22 1.83 1-9 -2.60*
Note. SQI = Sleep Quality Index; ADSWS = Adult Sleep-Wake Scale; SHQ = Sleep Habits
Questionnaire; ESS = Epworth Sleepiness Scale; KSS = Karolinska Sleepiness Scale. * p < .05
two-tailed, ** p < .01 two-tailed.
With respect to the ADSWS, a one sample /-test revealed the current sample
means on the Going to Bed subscale, Falling Asleep subscale, Maintaining Sleep
subscale, and Reinitiating Sleep subscale were significantly higher than the
standardization sample o f undergraduate college students (Fortunato et al., 2008) (See
Table 1). The ESS mean o f the current sample was 9.38 (SD = 3.30), which was
significantly higher than the standardization sample of adults (M = 5.9; Johns,

77
1991), /(l, 97) = 10.44,/? < .01. The KSS mean was 5.22 (SD = 1.83), which was
significantly higher than the standardization sample of adults (M = 5.7; Kaida et al.,
2006), /( 1,96) = -2.60,p < . 05.
Descriptive Statistics, Reliabilities, and /-tests for Overall Sample by Gender
deviations, and ranges by gender for the variables in this study. With respect to the
ADSWS, the means for males on the Going to Bed subscale, Falling Asleep subscale,
Maintaining Sleep subscale, Reinitiating Sleep subscale, and Returning to Wakefulness
subscale were significantly higher than the standardization sample of undergraduate
college students (Fortunato et al., 2008) (See Table 2). The means for females on the
Going to Bed subscale and Maintaining Sleep subscale were significantly higher than the
standardization sample of undergraduate college students (Fortunato et al., 2008). The
mean for males’ and females’ ESS was significantly higher than the standardization
sample o f adults (Johns, 1991) (See Table 2). The KSS mean for males was significantly
lower than the standardization sample of adults (Kaida et al., 2006).
Vertical Jump Test means for males and females were significantly lower than
another sample, which included young adult medical students and their spouses
(Patterson & Peterson, 2004) (See Table 2). For estimated Peak Power, the means for
males and females were significantly lower than the standardization sample, which
included young adult medical students and their spouses (Patterson & Peterson, 2004).
Table 2
Descriptive Statistics, Reliabilities, and t-tests for Overall Sample by Gender
M SD Range a /
Measures Male Female Male Female Male Female Male Female Male Female
SQI Total 4.21 5.19 3.10 3.40 0-14 0-14 .72 .76 -1.99 0.18
ADSWS Going to bed 19.90 19.40 6.05 5.06 7-30 9-29 .90 .82 2.52* 2.37*
ADSWS Falling asleep 22.67 21.36 4.34 5.47 10-30 10-30 .71 .84 3.14** 0.85
ADSWS Maintaining sleep 21.94 21.90 5.05 5.55 6-30 12-30 .82 .8 6 2 .6 6 * 2.42*
ADSWS Reinitiating sleep 24.96 22.62 5.00 5.48 12-30 12-30 .89 .90 4.66** 1.32
ADSWS Returning to awake 17.96 15.12 6.32 6.28 5-30 5-27 .87 .93 2.15* -0.99
SHQ Weekday 7.13 7.12 1.85 1.69 2 -1 1 4-14 -0.90 -1.03
SHQ Weekend 8 .1 0 8 .6 6 1.97 1.83 2 -1 2 4.5-15 -0.30 1.80
ESS Total 8.63 1 0 .1 0 3.09 3.36 3-15 4-20 .51 60 6 . 1 1 ** 8.84**
KSS 4.75 5.67 1.80 1.76 1 -8 3-9 -3.65** -0 . 1 1
Grip Strength Right Hand 59.21 33.88 10.51 6.77 27-76 21-46 .97 .97 -40.29 -37.40
Grip Strength Left Hand 54.23 31.33 9.24 5.94 24-68 21-44 .93 .97 -37.29 -34.58
Sit and Reach 29.44 35.56 8 .1 1 8.30 11.5-47 15.5-50 .99 .99 -1.34 1.33
Vertical Jump 16.49 12.79 4.26 4.32 7-23.5 4-22.5 -9.29** -2.14*
Peak Power 3493 2387 731 907 1482-4972 395-4487 -12.29** -4.38**
Note. SQI = Sleep Quality Index; ADSWS = Adult Sleep-Wake Scale; SHQ = Sleep Habits Questionnaire; ESS = Epworth Sleepiness Scale; KSS
= Karolinska Sleepiness Scale. * p < .05 two-tailed, ** p < .01 two-tailed.
-j
00
79
The means for males’ and females’ grip strength on both the right and left hands were
significantly lower than the standardization sample of adults (Mathiowetz, Kashman,
Volland, Weber, Dowe, & Rogers, 1985) (See Table 2).
Examination of Gender Differences for Overall Sample
Table 2 presents the descriptive statistics for the control group. An analysis of
variance (ANOVA) was conducted to determine which variables in the overall sample
were significantly different according to gender. The following variables significantly
differed based on gender: KSS Score F (l, 95) = 6.51,/? < .05, ESS Total F( 1, 96) = 5.11,
p < .05, ADSWS Reinitiating Sleep Subscale F (l, 96) = 4.86, p < .05, ADSWS Returning
to Wakefulness Subscale F (l, 96) = 4.96,p < .05, Sit-and-Reach Test F( 1, 96) = 13.63,/?
< .01, Vertical Jump Test F (l, 96) = 18.21,/? < .01, estimated Peak Power F (l, 96) =
43.96,/? < .01, Grip Strength on the Right Hand F (l, 93) = 195.92,/? < .01, and Grip
Strength on the Left Hand F (l, 93) = 207.23,/? < .01.
Descriptive Statistics, Reliabilities, and /-tests for Control Group
Table 3 presents the control group’s reliability coefficients, means, standard
and the Karolinska Sleepiness Scale (KSS). The control group was compared to
normative samples using one-sample /-tests.
With respect to the ADSWS, a one sample /-test revealed the control group means
on the Going to Bed subscale, Maintaining Sleep subscale, and Reinitiating Sleep
subscales were significantly higher than the standardization sample (Fortunato et al.,
2008) (See Table 3). The ESS mean was significantly higher than the standardization
80
sample (Johns, 1991). The mean of the KSS was significantly higher than the
standardization sample (Kaida et al., 2006).
Table 3
Descriptive Statistics, Reliabilities, and t-tests for Control Group
Measures M SD Range a t
SQI Total 4.64 3.33 0-14 .78 -0.92
ADSWS Going to bed 21.29 5.69 7-30 .89 4.23’**
ADSWS Falling asleep 2 2 .0 2 5.29 10-30 .87 1 .6 8
ADSWS Maintaining sleep 21.82 5.10 11-30 .78 2.40*
ADSWS Reinitiating sleep 23.36 5.47 12-30 .90 2.15*
ADSWS Returning to awake 17.73 6.93 5-30 .89 1 .6 8
SHQ Weekday 7.15 1.58 2 - 1 1 .2 -0.95

SHQ Weekend 8.16 1.84 2 -1 2 -0 . 1 1
ESS Total 9.11 3.16 3-15 .57 6.81**
KSS 4.77 1.85 1-9 -3.32**
Note. SQI = Sleep Quality Index; ADSWS = Adult Sleep-•Wake Scale; SHQ = Sleep Habits
Questionnaire; ESS = Epworth Sleepiness Scale; KSS = Karolinska Sleepiness Scale.
Descriptive Statistics, Reliabilities, and t-tests for Control Group by Gender
deviations, and ranges by gender for the Adult Sleep-Wake Scale (ADSWS), the Sleep
Quality Index (SQI), the Sleep Habits Questionnaire (SHQ), the Epworth Sleepiness
Scale (ESS), the Karolinska Sleepiness Scale (KSS), the Sit-and-Reach Test, the Vertical
Jump Test, estimated Peak Power, the Grip Strength with the Right Hand, and the Grip
Strength with the Left Hand.
With respect to the ADSWS, the means for males on the Going to Bed subscale,
Falling Asleep subscale, Maintaining Sleep subscale, Reinitiating Sleep subscale, and
Returning to Wakefulness subscale were significantly higher than the standardization
sample (Fortunato et al., 2008) (See Table 2). The means for females on the Going to Bed
subscale and Maintaining Sleep subscale were significantly higher than the
Table 4
Descriptive Statistics, Reliabilities, and t-tests fo r Control Group by Gender
M SD Range a t
SQI Total 4.19 5.26 3.58 2.94 0-14 0 -1 1 .80 .71 -1.29 0.24
ADSWS Going to bed 21.65 6.47 4.54 11-27 .95 3.12** 2 9 7 **
20.79 7-30 .73
ADSWS Falling asleep 22.65 21.16 5.25 5.37 10-30 13-30 .8 6 .87 1.90 0.37
ADSWS Maintaining sleep 21.58 22.16 4.73 5.70 11-30 14-30 .75 .83 1.70 1.65
ADSWS Reinitiating sleep 24.81 21.37 5.23 5.29 12-30 13-30 .87 .90 3.13** -0.19
ADSWS Returning to awake 19.92 14.74 6.65 6.29 6-30 5-26 .8 6 .90 3.01** -0 . 8 8
SHQ Weekday 6.99 7.36 1.62 1.55 2 -1 1 5-11 - 1 .2 0 -0 . 0 2
SHQ Weekend 8 .0 0 8.38 2.05 1.53 2 -1 2 5-10 -0.47 0.55
ESS Total 8 .8 8 9.42 3.31 3.01 3-15 4-15 .58 .57 4.59** 5.11**
KSS 4.42 5.28 1.81 1.84 1 -8 3-9 -3.59** -0.97
Grip Strength Right Hand 60.15 37.53 11.50 5.93 27-76 27-46 .97 .97 -26.99** -24.17**
Grip Strength Left Hand 55.08 33.84 10.61 5.27 24-68 27-44 .96 .97 -23.75** -22.45**
Sit and Reach 28.94 35.55 7.76 7.74 11.5-46 15.5-47 .99 .99 -1.35 .8 8
Vertical Jump 16.65 1 2 .2 1 4.42 4.27 7-23.5 4-19.5 -9.29** -1.93*
Peak Power 3510 2260 750 753 1880-4729 863-3313 -8.70** -3.98**
= Karolinska Sleepiness Scale. * p < .05 two-tailed, ** p < .01 two-tailed.
82
standardization sample (Fortunato et al., 2008). The mean for males’ and females’ ESS
was significantly higher than the standardization sample (Johns, 1991) (See Table 4). The
KSS mean for males was significantly lower than the standardization sample (Kaida et
al., 2006).
Vertical Jump Test mean for males was significantly lower than another sample
(Patterson & Peterson, 2004) (See Table 4). For males and females, the estimated Peak
Power means were significantly lower than the standardization sample (Patterson &
Peterson, 2004). The males and females, the mean Grip Strength on the right and left
hands were significantly lower than the standardization sample (Mathiowetz et al., 1985).
Examination of Gender Differences for Control Group
Table 4 presents the descriptive statistics for the control group. An analysis of
variance (ANOVA) was conducted to determine which variables in the control group
were significantly different according to gender. The following variables significantly
differed based on gender: ADSWS Reinitiating Sleep Subscale F ( l , 43) = 4.70, p < .05,
ADSWS Returning to Wakefulness Subscale F (l, 43) = 6.99, p < .01, Sit-and-Reach
Test F( 1,43) = 1.99,p < .01, Vertical Jump Test F (l, 43) = 11.39,/? < .01, estimated
Peak Power F (l, 43) = 30.41,/? < .01, Grip Strength on the Right Hand F (l, 43) = 61.40,
p < .01, and Grip Strength on the Left Hand F (l, 43) = 64.18,/? < .01.
Descriptive Statistics, Reliabilities, and /-tests for Experimental Group
Table 5 presents the experimental group’s reliability coefficients, means, standard
83
and the Karolinska Sleepiness Scale (KSS). The experimental group was compared to
normative samples using one-sample /-tests.
Table 5
Descriptive Statistics, Reliabilities, and t-tests for Experimental Group
Measures M SD Range a /
SQI Total 4.74 3.26 0-14 .73 -0.78
ADSWS Going to bed 18.25 5.06 9-29 .82 0.79
ADSWS Falling asleep 21.98 4.73 10-30 .73 1.97
ADSWS Maintaining sleep 2 2 .0 0 5.48 6-30 .8 8 2 .6 6 *
ADSWS Reinitiating sleep 24.11 5.27 12-30 .90 3.47**
ADSWS Returning to awake 15.47 5.84 5-27 .92 -0 . 6 6
SHQ Weekday 7.11 1.92 3-14 -0.99
SHQ Weekend 8.58 1.96 4.5-15 1.43
ESS Total 9.60 3.42 4-20 .60 7.88**
KSS 5.58 1.75 3-9 -0.48
Note. SQI = Sleep Quality Index; ADSWS = Adult Sleep-■Wake Scale; SHQ = Sleep Habits
Questionnaire; ESS = Epworth Sleepiness Scale; KSS = Karolinska Sleepiness Scale. * p < .05
two-tailed, **p < . 0 1 two-tailed.
With respect to the ADSWS, a one sample /-test revealed the experimental group
means on the Maintaining Sleep subscale and Reinitiating Sleep subscale were
significantly higher than the standardization sample (Fortunato et al., 2008) (See Table
5). The ESS mean was significantly higher than the standardization sample (Johns, 1991).
Descriptive Statistics, Reliabilities, and /-tests for Experimental Group by Gender
Table 6 presents the experimental group’s reliability coefficients, means, standard
deviations, and ranges by gender for the Adult Sleep-Wake Scale (ADSWS), the Sleep
Quality Index (SQI), the Sleep Habits Questionnaire (SHQ), the Epworth Sleepiness
Scale (ESS), the Karolinska Sleepiness Scale (KSS), the Sit-and-Reach Test, the Vertical
Jump Test, estimated Peak Power, the Grip Strength with the Right Hand, and the Grip
Strength with the Left Hand.

Table 6
Descriptive Statistics, Reliabilities, and t-tests fo r Experimental Group by Gender
M SD Range a t
SQI Total 4.23 5.14 2.51 3.74 1-11 0-14 .56 .79 -1.63 0.06
ADSWS Going to bed 17.82 18.55 4.87 5.25 10-26 9-29 .77 .85 0.11 0.90
ADSWS Falling asleep 22.68 21.48 3.08 5.61 17-28 10-30 .22 .83 3.02** 0.78
ADSWS Maintaining sleep 22.36 21.74 5.49 5.55 6-30 12-30 .88 .88 2.02 1.75
ADSWS Reinitiating sleep 25.14 23.39 4.82 5.23 15-30 12-30 .91 .90 3.44** 1.80
ADSWS Returning to awake 15.64 15.35 5.14 6.37 5-22 5-27 .86 .95 -0.33 -0.56
SHQ Weekday 7.30 6.97 2.11 1.78 3-11 4-14 -0.16 -1.24
SHQ Weekend 8.23 8.82 1.91 1.99 5-12 4.5-15 0.09 1.77
ESS Total 8.32 10.52 2.85 3.54 4-14 4-20 .42 .62 3.98** 7.26**
KSS 5.14 5.90 1.75 1.70 3-8 3-9 -1.51 0.67
Grip Strength Right Hand 58.05 31.48 9.30 6.27 38-74 21-46 .96 .96 -31.01** -33.45**
Grip Strength Left Hand 53.19 26.69 7.32 5.86 38-66 21-44 .87 .96 -32.13** -28.76**
Sit and Reach 30.02 35.56 8.65 8.75 13.5-47 18-50 .99 .99 -0.53 1.00
Vertical Jump 16.30 13.15 4.14 4.38 7-22 4-22.5 -6.69** -1.21
Peak Power 3472 2465 726 993 1482-4972 395-4487 -8.51** -2.71*
= Karolinska Sleepiness Scale. * p < .05 two-tailed, **p < .01 two-tailed.
00
4^
85
With respect to the ADSWS, the means for males on the Falling Asleep subscale
and Reinitiating Sleep subscale were significantly higher than the standardization sample
(Fortunato et al., 2008) (See Table 6). The mean for males’ and females’ ESS were
significantly higher than the standardization sample (Johns, 1991)
Vertical Jump Test mean for males was significantly lower than another sample
(Patterson & Peterson, 2004) (See Table 6). For estimated Peak Power, the mean for
males and females were significantly lower than the standardization sample (Patterson &
Peterson, 2004). For males and females, the mean Grip Strength on both the Right and
Left Hands were significantly lower than the standardization sample (Mathiowetz et al.,
1985).
Examination of Gender Differences for Experimental Group
Table 6 presents the descriptive statistics for the experimental group. An analysis
of variance (ANOVA) was conducted to determine which variables in the experimental
group were significantly different by gender. The following variables significantly
differed based on gender: ESS Total F( 1, 51) = 5.80, p < .05, Sit-and-Reach Test .F(l, 51)
= 5.21 ,/? < .05, Vertical Jump Test F (l, 51) = 6.96, p < .05, estimated Peak Power F(\,
51) = 16.39,/? < .01, Grip Strength on the Right Hand F( 1, 48) = 145.78, p < .01 and Grip
Strength on the Left Hand F(\, 48) = 158.79, p < .01 (See Table 6).
Homogeneity of Variance
A Levene’s test of homogeneity of variance was conducted to examine if the
groups differed significantly on any of the variables at time one. The test revealed that the
group averages were not significantly different on any of the variables at time one: SQI
Total, F( 1,93) = .10,/? >.05; ADSWS Going to Bed, F(1, 96) = .20,/? >.05; ADSWS
86
Falling Asleep, F (l, 96) = .39,/? >.05; ADSWS Maintaining Sleep, F( 1, 96) = .09,
p >.05; ADSWS Reinitiating Sleep, F (l, 96) = .00, p >.05; ADSWS Returning to
Wakefulness, F (l, 96) - 2.06, p >.05; SHQ Weekdays, F( 1, 95) = .13, p >.05; SHQ
Weekend, F( 1,96) = .42,/? >.05; KSS Score, F( 1, 95) = .03,p >.05; ESS Total F (l, 96) =
.06, p >.05; Sit-and-Reach, F (l, 96) = .15, p >.05; Grip Strength Right, F (l, 93) = .50,
p >.05; Grip Strength Left, F (l, 93) = .08,/? >.05; Vertical Jump, F (l, 96) = .05,/? >.05;
Peak Power F (l, 96) = .37,/? >.05.
Correlations between Variables
Table 7 presents the correlations between all of the study variables. The SQI total
score was significantly negatively correlated with the ADSWS Going to Bed, Falling
Asleep, Maintaining Sleep, Reinitiating Sleep, and Returning to Wakefulness Subscales,
as well as with the SHQ during the week and on weekends.
The SHQ sleep length during the week was positively correlated with the
ADSWS Reinitiating Sleep Subscale, as well as with the SHQ during the weekends. The
SHQ sleep length during the weekends was positively correlated with the ADSWS
Maintaining Sleep Subscale and was negatively correlated with the ADSWS Returning to
Wakefulness Subscale. As would be expected, the ADSWS subscales all correlated at
minimal to moderate levels.
The KSS Scale and the ESS Scale were positively correlated. The KSS Scale was
negatively correlated with both the ADSWS Going to Bed and Returning to Wakefulness
Subscales, as well as with both the Grip Strength Right Hand and Left. The ESS Scale
was negatively correlated with the ADSWS Returning to Wakefulness Subscale, as well
as with the Grip Strength Right Hand and Left Hand.

Table 7
Summary o f Correlations, Means, and Standard Deviations fo r Scores on All Measures fo r Overall Sample
M easures 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1. SQI —
2. SH Q W eek -.30** —
3. SH Q W eekend -.26* .46** --
4. K SS .20 -.07 .05 _

5. ESS -.06 -.09 .13 .28** —
6. A D SW S B ed -.25** .10 .07 -.22* -.07 —
7. A D SW S Fall -.59** .03 .05 -.19 -.14 .34** —
8. A D SW S M ain -.63** .13 .20* .03 .17 .43** .55** —
9. A D SW S Rein -.50** .21* .17 -.10 -.04 .35** .62** .61** —
10. A D SW S R et -.31** -.04 -.27** -.28** -.32** .28** .27** .12 .20* _
11. Sit and Reach -.12 -.05 .09 .02 .12 .03 .10 .14 .09 -.12 —
12. V ertical Jum p -.20 .21* .09 -.07 -.09 .13 .14 16 .35** .22* -.06 —
13. G rip Strength RH -.10 -.04 -.06 -.28** -.22* -.03 .11 .07 .10 .12 -.25* .36** —
14. G rip Strength LH -.06 -.01 -.08 -.26* -.20* -.01 .09 -.08 .13 .14 -.24* .40** .96** —
15. P eak Pow er -.08 .13 .02 -.07 -.14 .10 .12 .07 .21* .06 -.23* .90** .59** .60** —
M 4.69 7.13 8.39 5.22 9.38 19.64 22.00 21.92 23.77 16.51 32.56 14.60 46.41 4 2 .6 6 2929
SD 3.27 1.76 1.91 1.83 3.30 5.54 4.97 5.29 5.35 6.43 8.72 4 .6 6 15.47 13.85 992
N o te: SQI = Sleep Quality Index; KSS = Karolinska Sleepiness Scale; ESS = Epworth Sleepiness Scale; ADSWS = Adult Sleep-Wake Scale
(ADSWS Bed = Going to Bed Subscale; ADSWS Fall. = Falling Asleep Subscale; ADSWS Main. = Maintaining Sleep Subscale; ADSWS Rein. =
Reinitiating Sleep Subscale; ADSWS Ret. = Returning to Wakefulness Subscale); Grip Strength RH = Right Hand; Grip Strength LH = Left Hand;
Sleep Length W = Week; Sleep Length WE = Weekends
* p < .05 two-tailed, ** p < .01 two-tailed.
88
The Sit-and-Reach Score was negatively correlated with Grip Strength Right
Hand, Grip Strength Left Hand, and Peak Power. The Vertical Jump Score was positively
correlated with the Grip Strength Right Hand and Grip Strength Left Hand, as well as the
ADSWS Reinitiating Sleep and Returning to Wakefulness Subscales. The estimated Peak
Power Score was positively correlated with the ADSWS Reinitiating Sleep Subscale,
Vertical Jump score, Grip Strength Right Hand, and Grip Strength Left Hand.
Correlations between Variables with Males
Table 8 presents the correlations between all of the study variables with males.
The males’ SQI total score was significantly negatively correlated with the SHQ
(Weekdays), SHQ (Weekends), Sit-and-Reach Test, as well as the ADSWS Falling
Asleep, Maintaining Sleep, and Reinitiating Sleep Subscales. The males’ SHQ
(Weekdays) was significantly positively correlated with SHQ (Weekends) and the
ADSWS Reinitiating Sleep Subscale. The males’ SHQ (Weekends) was significantly
negatively correlated with the ADSWS Returning to Wakefulness Subscale. As would be
expected, the ADSWS subscales all correlated at minimal to moderate levels.
The males’ KSS Scale and the ESS Scale were significantly positively correlated.
The males’ KSS Scale was significantly negatively correlated with both the ADSWS
Falling Asleep and Returning to Wakefulness Subscales. The males’ ESS Scale was
significantly negatively correlated to the ADSWS Falling Asleep Subscale.
Males’ Grip Strength with the Right Hand was significantly positively correlated
with Grip Strength with the Left Hand. The males’ Vertical Jump Score was significantly
positively correlated with estimated Peak Power.

Table 8
Summary o f Correlations, Means, and Standard Deviations fo r Scores on All Measures fo r Overall Sample with Males Only
M easures 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1. SQI —
2. SH Q W eek -.29* —
3. SH Q W eekend -.35* .55** _

4. K SS .20 .06 -.07 —
5. E SS -.09 -.07 .02 .30* —
6. A D SW S B ed -.10 .02 -.08 -.19 -.07 —
7. A D SW S Fall -.49** .09 .04 -.29* -.32* .33* —
8. A D SW S M ain -.54** .15 .03 .00 .13 .43** .51** —
9. A D SW S R ein -.32* .34* .11 -.04 -.17 .29* .56** .50** —
10. A D SW S R et -.17 -.20 -.31* -.42** -.20 .29* .29* .02 .03 —
11. Sit and R each -.35* -.06 .08 -.03 .05 .08 .09 .20 .15 -.07 —
12. G rip S trength R H -.08 -.13 .23 -.10 -.07 .05 .10 -.08 -.01 -.04 .07 —
13. G rip S trength LH .07 -.08 .21 -.08 .03 .12 .04 -.10 .06 .00 .09 .84** -
14. V ertical Jum p -.04 .13 -.03 -.01 -.10 .10 .12 .03 .28 .17 .12 -.02 .04 —
15. P eak P ow er .12 .02 -.05 -.07 -.09 .04 .03 -.07 .15 .16 -.10 .20 .20 .80** -
M 4.21 7.13 8.10 4.75 8.63 19.90 22.67 21.94 2 4.96 17.96 29.44 59.21 54.23 15.49 3493
SD 3.10 1.85 1.97 1.80 3.09 6.05 4.34 5.05 5.00 6.32 8.11 10.51 9.24 4 .2 6 731
N ote. SQI = Sleep Quality Index; SHQ = Sleep Habits Questionnaire; KSS = Karolinska Sleepiness Scale; ESS = Epworth Sleepiness Scale;
ADSWS = Adult Sleep-Wake Scale (ADSWS Bed = Going to Bed Subscale; ADSWS Fall. = Falling Asleep Subscale; ADSWS Main. =
Maintaining Sleep Subscale; ADSWS Rein. = Reinitiating Sleep Subscale; ADSWS Ret. = Returning to Wakefulness Subscale); Grip Strength RH
= Right Hand; Grip Strength LH = Left Hand. * p < .05 two-tailed, ** p < .01 two-tailed
00
vO
90
Correlations between Variables with Females
Table 9 presents the correlations between all of the study variables with females.
The females’ SQI total score was significantly negatively correlated with SHQ during the
week, as well as with the ADSWS Going to Bed, Falling Asleep, Maintaining Sleep,
Reinitiating Sleep, and Returning to Wakefulness Subscales. SHQ during the week was
significantly positively correlated with SHQ during the weekends. The SHQ during the
weekends was significantly positively correlated with the ADSWS Going to Bed,
Maintaining Sleep, and Reinitiating Sleep Subscales. As would be expected, the ADSWS
subscales all correlated at minimal to moderate levels. The ESS Scale was significantly
negatively correlated to the ADSWS Returning to Wakefulness Subscale.
The Grip Strength with the Right Hand was significantly negatively correlated to
both the ADSWS Going to Bed and Reinitiating Sleep Subscales. As would be expected,
the Grip Strength with the Right Hand was significantly positively correlated to the Grip
Strength with the Left Hand. The Grip Strength with the Left Hand was significantly
negatively correlated to both the ADSWS Going to Bed Subscale and ADSWS
Reinitiating Sleep Subscale.
In addition, the Grip Strength with the Left Hand and the estimated Peak Power
were significantly positively correlated. The Vertical Jump score was positively
correlated with both the ADSWS Maintaining Sleep and Reinitiating Sleep Subscales, as
well as estimated Peak Power.

Table 9
Summary o f Correlations, Means, and Standard Deviations fo r Scores on All Measures fo r Overall Sample with Females Only
M easures 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1. SQI 1
2. SH Q W eekdays -.31* 1
3. SH Q W eekend -.22 .35* 1
4. K SS .13 -.20 .09 1
5. ESS -.10 -.10 .18 .17 1
6. A D SW S B ed -.42** .21 .29* -.23 -.06 1
7. A D SW S Fall -.66** -.03 .10 -.06 .04 .36* 1
8. A D SW S M ain -.73** .11 .38** .05 .22 .44** 59** 1
9. A D SW S Rein -.62** .09 .31* -.06 .16 .42** .64** .72** 1
10. A D SW S Ret -.39** .12 -.18 -.06 -.36** .27 .22 .21 .29* 1
11. Sit and Reach -.04 -.05 .01 -.12 .05 .02 .21 .10 .21 -.02 1
12. G rip Strength R H .26 .01 -.08 -.11 -.08 -.36* -.20 -.24 -.43** -.23 .08 1
13. G rip Strength LH .26 .06 -.10 -.07 -.13 -.37* -.21 -.24 -.41** -.22 .10 .92** 1
14. V ertical Jum p -.25 .10 .27 .09 .08 .14 .09 .31* .31* .12 .07 -.03 .07 1
15. P eak Pow er .01 .05 .17 .21 .06 -.04 -.07 .04 .02 -.05 -.03 .24 .33* .851** 1
M 5.19 7.12 8.66 5.67 10.10 19.40 21.36 21.90 22.62 15.12 35.56 33.88 31.33 12.790 2387
SD 3.40 1.69 1.83 1.76 3.36 5.06 5.47 5.55 5.48 6.28 8.30 6.77 5.94 4 .3 2 0 907
Note. SQI = Sleep Quality Index; SHQ = Sleep Habits Questionnaire; KSS = Karolinska Sleepiness Scale; ESS = Epworth Sleepiness Scale;
ADSWS = Adult Sleep-Wake Scale (ADSWS Bed = Going to Bed Subscale; ADSWS Fall. = Falling Asleep Subscale; ADSWS Main. =
Maintaining Sleep Subscale; ADSWS Rein. = Reinitiating Sleep Subscale; ADSWS Ret. = Returning to Wakefulness Subscale); Grip Strength RH
= Right Hand; Grip Strength LH = Left Hand. * p < .05 two-tailed, ** p < .0 1 two-tailed.
92
Hypothesis 1A
Hypothesis 1A stated that participants in the experimental group who took a 10-
minute nap/relaxation period would have significantly higher scores on the sit-and-reach
test compared to the control group. To test this hypothesis, a two-way ANOVA was
performed with gender and participant group (control or experimental) as the independent
variables, and the Sit-and-Reach Test as the dependent variable. This hypothesis was not
supported. There was a significant main effect for gender on the Sit-and-Reach Test, F( 1,
94) = 12.75,/? < .01. There was a non-significant main effect for the participant group on
the Sit-and-Reach Test, F (l, 94) = 0.10,/? >.05. There was also a non-significant
interaction effect between the participant group and gender on the Sit-and-Reach Test,
F (l, 94) = 0.10,/? >.05. Results show that males in the experimental group (n = 22; M =
30.02) did not have significantly higher sit-and-reach scores compared to males in the
control group (n = 26; M - 28.94). In addition, females in the experimental group (n =
31; M = 35.56) did not have significantly higher sit-and-reach scores than females in the
control group (n = 19; M = 35.55).
Hypothesis IB
Hypothesis IB stated that participants in the experimental group who took a 10-
minute nap/relaxation period would have significantly higher scores on the hand
dynamometer test on both right and left hands. Two separate two-way ANOVAs were
performed. One two-way ANOVA was performed with gender and participant group
(control or experimental) as the independent variables, and the Hand Dynamometer Test
on the right hand as the dependent variable. Another two-way ANOVA was performed
93
with gender and participant group (control or experimental) as the independent variables,
and the Hand Dynamometer Test on the left hand as the dependent variable.
This hypothesis was supported (with the Hand Dynamometer Test on the right
hand). For the Hand Dynamometer Test on the right hand, there was a significant main
effect for gender, F (l, 91) = 187.91,/? < .01. In addition, there was a significant main
effect for the participant group on the Hand Dynamometer Test on the right hand, F( 1,
91) = 5.16,/? < .05. There was a non-significant interaction effect between the participant
group and gender on the Hand Dynamometer Test on the right hand, F (l, 91) = 1.20,
p >.05. Results show that hand dynamometer scores on the right hand are significantly
higher with males in the experimental group (n = 21; M = 58.05) compared to males in
the control group (n = 26; M = 60.15). Females in the experimental group (n = 29; M —
31.48) also have significantly higher hand dynamometer scores on the right hand than
females in the control group (n = 19; M = 37.53).
This hypothesis was not supported (with the Hand Dynamometer Test on the left
hand). There was a significant main effect for gender on the Hand Dynamometer Test on
the left hand, F (l, 91) = 196.55,/? < .01. There was a non-significant main effect for the
participant group on the Hand Dynamometer Test on the left hand, F (l, 91) = 3.58,
p >.05. In addition, there was a non-significant interaction effect between the participant
group and gender on the Hand Dynamometer Test on the left hand, F(\, 91) = 0.50,
p >.05. Results show that males in the experimental group (n = 21; M = 53.19) did not
have significantly higher hand dynamometer scores on the left hand compared to males in
the control group (n = 26; M = 55.08). In addition, females in the experimental group
94
(n = 29; M = 29.67) did not have significantly higher hand dynamometer scores on the
left hand than females in the control group (n = 19; M = 33.84).
Hypothesis 1C
Hypothesis 1C stated participants in the experimental group who took a 10-
minute nap/relaxation period would have significantly higher scores on the Vertical Jump
Test compared to the control group. To test this hypothesis, a two-way ANOVA was
performed with gender and participant group (control or experimental) as the independent
variables, and the Vertical Jump Test as the dependent variable. This hypothesis was not
supported. There was a significant main effect for gender on the Vertical Jump Test, F (l,
94) = 18.30,/? < .01. There was a non-significant main effect for the participant group on
the Vertical Jump Test, F (l, 94) = 0.11,/? >.05. In addition, there was a non-significant
interaction effect between the participant group and gender on the Vertical Jump Test,
F( 1,94) = 0.53,/? >.05. Results show that males in the experimental group (n = 22;
M = 16.30) did not have significantly higher vertical jump scores compared to males in
the control group (n = 26; M = 16.65). Additionally, females in the experimental group
(n = 31; M = 13.15) did not have significantly higher vertical jump scores than females
in the control group (n = 19; M ~ 12.21).
Hypothesis ID
Hypothesis ID stated participants in the experimental group who took a 10-
minute nap/relaxation period would have significantly higher scores on Estimated Peak
Power. A two-way ANOVA was performed with gender and participant group (control or
experimental) as the independent variables, and Estimated Peak Power as the dependent
variable. This hypothesis was not supported. There was a significant main effect for
95
gender on Estimated Peak Power, F (l, 94) = 43.73,/? < .01. There was a non-significant
main effect for the participant group on Estimated Peak Power, F (l, 94) = 0.24,/? >.05.
Additionally, there was a non-significant interaction effect between the participant group
and gender on Estimated Peak Power, F( 1, 94) = 0.50,/? >.05. Results show that males in
the experimental group (n = 22; M = 3472) did not have significantly higher estimated
peak power scores compared to males in the control group (n = 26; M = 3510). Females
in the experimental group (n = 31; M = 2465) did not have significantly higher estimated
peak power scores than females in the control group (n = 19; M = 2260).
Hypothesis 2A
Hypothesis 2A stated that individuals with poor sleep quality will have
significantly lower scores on the Sit-and-Reach Test compared to individuals with good
sleep quality (as measured by the SQI and the ADSWS). To test this hypothesis, two
separate two-way ANOVAs were performed. One two-way ANOVA was performed with
gender and sleep quality (SQI scores were divided into good and poor sleep quality
categories) as the independent variables, and the Sit-and-Reach Test as the dependent
variable. Another two-way ANOVA was performed with gender and sleep quality
(ADSWS scores were divided into good and poor sleep quality categories) as the
independent variables, and the Sit-and-Reach Test as the dependent variable.
The results of the two-way ANOVA did not support this hypothesis using the
SQI. There was a significant main effect for gender on the Sit-and-Reach Test, F (l, 91) =
8.39,/? < .01. There was a non-significant main effect for sleep quality (as measured by
the SQI) on the Sit-and-Reach Test, F (l, 91) = 0.81,/? >.05. There was also a non
significant interaction effect between sleep quality (as measured by the SQI) and gender
96
on the Sit-and-Reach Test, F(\, 91) = 0.08,/? >.05. Male poor sleepers (n = 5; M = 26.80)
(as measured by the SQI) did not have significantly lower scores on the Sit-and-Reach
Test compared to male good sleepers (n = 43; M = 29.74). Female poor sleepers (n = 8;
M = 34.75) (as measured by the SQI) did not have significantly lower scores on the Sit-
and-Reach Test than female good sleepers (n = 39\ M - 36.32).
Additionally, the results of the two-way ANOVA did not support this hypothesis
using the ADSWS. There was a significant main effect for gender on the Sit-and-Reach
Test, F (l, 94) = 13.98,/? < .01. There was a non-significant main effect for sleep quality
(as measured by the ADSWS) on the Sit-and-Reach Test, F( 1, 94) = 0.73, p >.05. In
addition, there was a non-significant interaction effect between sleep quality (as
measured by the ADSWS) and gender on the Sit-and-Reach Test, F (l, 94) = 0.04,/? >.05.
Male poor sleepers (n = 22; M = 28.84) (as measured by the ADSWS) did not have
significantly lower scores on the sit-and-reach test compared to male good sleepers
(n = 26; M = 29.94). Female poor sleepers (n = 28; M = 34.79) (as measured by the
ADSWS) did not have significantly lower scores on the sit-and-reach test than female
good sleepers (n = 22; M = 36.55).
Hypothesis 2B
Hypothesis 2B stated that the individuals with poor sleep quality will have
significantly lower scores on the Hand Dynamometer Test (right and left hand). Four
separate two-way ANOVAs were performed. The first ANOVA was performed with
gender and sleep quality (SQI scores were divided into good and poor sleep quality
categories) as the independent variables, and the Hand Dynamometer Test on the right
hand as the dependent variable. The second ANOVA was performed with gender and
97
sleep quality (SQI scores were divided into good and poor sleep quality categories) as the
independent variables, and the Hand Dynamometer Test on the left hand as the dependent
variable. The third ANOVA was performed with gender and sleep quality (ADSWS
scores were divided into good and poor sleep quality categories) as the independent
variables, and the Hand Dynamometer Test on the right hand as the dependent variable.
The fourth ANOVA was performed with gender and sleep quality (ADSWS scores were
divided into good and poor sleep quality categories) as the independent variables, and the
Hand Dynamometer Test on the left hand as the dependent variable.
The results of the two-way ANOVA did not support this hypothesis using the SQI
and the Hand Dynamometer Test on the right hand. There was a significant main effect
for gender on the Hand Dynamometer Test on the right hand, ^(1, 88) = 74.58, p < .01.
There was a non-significant main effect for sleep quality (as measured by the SQI) on the
Hand Dynamometer Test on the right hand, F( 1, 88) = 0.07, p >.05. In addition, there was
a non-significant interaction effect between sleep quality (as measured by the SQI) and
gender on the Hand Dynamometer Test on the right hand, F{ 1, 88) = 0.96, p >.05. Males
in the Poor Sleep Group (n = 5; M = 56.20) (as measured by the SQI) did not have
significantly lower scores on the Hand Dynamometer Test on the right hand compared to
males in the Good Sleep Group (n = 42; M = 59.57). Females in the Poor Sleep Group (n
= 8; M = 35.25) (as measured by the SQI) did not have significantly lower scores on the
Hand Dynamometer Test on the right hand than females in the Good Sleep Group
(n = 37; M = 33.27).
The results of the two-way ANOVA did not support this hypothesis using the SQI
and the Hand Dynamometer Test on the left hand. There was a significant main effect for
98
gender on the Hand Dynamometer Test on the left hand, F(l, 88) = 97.94, p < .01. There
was a non-significant main effect for sleep quality (as measured by the SQI) on the Hand
Dynamometer Test on the left hand, F( 1, 88) = 0.79, p >.05. In addition, there was a non
on the Hand Dynamometer Test on the left hand, F (l, 88) = 0.05,p >.05. Males in the
Poor Sleep Group (n = 5; M = 56.60) (as measured by the SQI) did not have significantly
lower scores on the Hand Dynamometer Test on the left hand compared to males in the
Good Sleep Group (n = 42; M = 53.95). Females in the Poor Sleep Group (n = 8; M =
32.38) (as measured by the SQI) did not have significantly lower scores on the hand
dynamometer on the left hand in comparison to females in the Good Sleep Group (n = 37;
M = 30.76).
using the ADSWS and the Hand Dynamometer Test on the right hand. There was a
significant main effect for gender on the Hand Dynamometer Test on the right hand, F( 1,
91) = 200.64, p < .01. There was a non-significant main effect for sleep quality (as
measured by the ADSWS) on the Hand Dynamometer Test on the right hand, F(\, 91) =
0.86, p >.05. In addition, there was a non-significant interaction effect between sleep
quality (as measured by the ADSWS) and gender on the Hand Dynamometer Test on the
right hand, F (l, 91) = 2.48,/? >.05. Males in the Poor Sleep Group (n = 22; M = 58.59)
(as measured by the ADSWS) did not have significantly lower scores on the Hand
Dynamometer Test on the right hand compared to males in the Good Sleep Group
(n = 25; M = 59.76). In addition, females in the Poor Sleep Group (n = 27; M = 35.85)
(as measured by the ADSWS) did not have significantly lower scores on the Hand
99
Dynamometer Test on the right hand than females in the Good Sleep Group (n = 21;
M = 31.33).
ADSWS and the Hand Dynamometer Test on the left hand. There was a significant main
effect for gender on the Hand Dynamometer Test on the left hand, F (l, 91) = 212.86,
p <.01. There was a non-significant main effect for sleep quality (as measured by the
ADSWS) on the Hand Dynamometer Test on the left hand, F (l, 91) = 0.28,/? >.05. In
measured by the ADSWS) and gender on the Hand Dynamometer Test on the left hand,
F (l, 91) = 3.76,/? >.05. Males in the Poor Sleep Group (n = 2 2; M= 53.05) (as measured
by the ADSWS) did not have significantly lower scores on the Hand Dynamometer Test
on the left hand compared to males in the Good Sleep Group (n = 25; M - 55.28).
Additionally, females in the Poor Sleep Group (n = 27; M= 33.04) (as measured by the
ADSWS) did not have significantly lower scores on the Hand Dynamometer Test on the
left hand in comparison to females in the Good Sleep Group (n = 21; M = 29.14).
Hypothesis 2C
Hypothesis 2C stated that individuals with poor sleep quality will have
significantly lower scores on the Vertical Jump Test compared to individuals with good
sleep quality. Two separate two-way ANOVAs were performed. One two-way ANOVA
was performed with gender and sleep quality (SQI scores were divided into good and
poor sleep quality categories) as the independent variables, and the Vertical Jump Test as
the dependent variable. Another two-way ANOVA was performed with gender and sleep
100
quality (ADSWS scores were divided into good and poor sleep quality categories) as the
independent variables, and the Vertical Jump Test as the dependent variable.
SQI. There was a significant main effect for gender on the Vertical Jump Test, F (l, 91) =
14.21,/? < .01. There was a non-significant main effect for sleep quality (as measured by
the SQI) on the Vertical Jump Test, F(l, 91) = 1.77,/? >.05. There was also a non
on the Vertical Jump Test, F (l, 91) = 1.80,/? >.05. The male poor sleepers (n = 5;
M = 16.50) from the SQI did not have significantly lower scores on the Vertical Jump
Test compared to male good sleepers (n = 43; M = 16.49). Female poor sleepers (n = 8;
M = 9.81) from the SQI did not have significantly lower scores on the Vertical Jump Test
than female good sleepers (n = 39; M = 13.31).
using the ADSWS. There was a significant main effect for gender on the Vertical Jump
Test, F (l, 94) = 16.80,/? < .01. There was a non-significant main effect for sleep quality
(as measured by the ADSWS) on the Vertical Jump Test, F (l, 94) = 2.00,/? >.05. In
measured by the ADSWS) and gender on the Vertical Jump Test, F(l, 94) = 0.03,/? >.05.
Male poor sleepers (n = 22; M = 15.91) from the ADSWS did not have significantly
lower scores on the Vertical Jump Test in comparison to male good sleepers (n = 26; M =
16.98). Female poor sleepers (n = 28; M = 12.18) from the ADSWS did not have
significantly lower scores on the Vertical Jump Test compared to female good sleepers
(n =22; M= 13.57).
101
Hypothesis 2D
Hypothesis 2D stated that the individuals with poor sleep quality will have
significantly lower scores on estimated Peak Power compared to individuals with good
sleep quality. To test this hypothesis, two separate two-way ANOVAs were performed.
One two-way ANOVA was performed with gender and sleep quality (SQI scores were
divided into good and poor sleep quality categories) as the independent variables, and
estimated Peak Power as the dependent variable. Another two-way ANOVA was
performed with gender and sleep quality (ADSWS scores were divided into good and
poor sleep quality categories) as the independent variables, and estimated Peak Power as
the dependent variable.
SQI. There was a significant main effect for gender on estimated Peak Power, F ( l , 91) =
26.26, p < .01. There was a non-significant main effect for sleep quality (as measured by
the SQI) on estimated Peak Power, F (l, 91) = 0.00,/? >.05. In addition, there was a non
on estimated Peak Power, ,F(1,91) = 0.31, p >.05. Males in the Poor Sleep Group (n = 5;
M = 3604) from the SQI did not have significantly lower scores on Peak Power compared
to males in the Good Sleep Group (n = 43; M - 3480). Females in the Poor Sleep Group
(n = 8; M = 2197) from the SQI did not have significantly lower scores on Peak Power
compared to females in the Good Sleep Group (n = 39; M = 2350).
using the ADSWS. There was a significant main effect for gender on estimated Peak
Power, F (l, 94) = 43.03,/? < .01. There was also a non-significant main effect for sleep
102
quality (as measured by the ADSWS) on estimated Peak Power, F( 1, 94) = 0.05, p >.05.
There was also a non-significant interaction effect between sleep quality (as measured by
the ADSWS) and gender on estimated Peak Power, F(1, 94) = 0 A \ , p > .05. Males in the
Poor Sleep Group (n = 2 2 ; M = 3483) from the ADSWS did not have significantly lower
scores on Peak Power compared to males in the Good Sleep Group (n = 26; M = 3501).
Females in the Poor Sleep Group (n = 28; M = 2428) from the ADSWS did not have
significantly lower scores on Peak Power than females in the Good Sleep Group (n = 22;
M = 2335).
Hypothesis 3A
Hypothesis 3A stated that individuals with shorter sleep duration will have
significantly lower scores on the Sit-and-Reach Test compared to individuals with longer
sleep duration. To test this hypothesis, a two-way ANOVA was performed with gender
and sleep duration (SHQ scores were divided into short, medium, and long sleep duration
categories) as the independent variables, and the Sit-and-Reach Test as the dependent
variable. The results of the two-way ANOVA did not support this hypothesis. There was
a significant main effect for gender on the Sit-and-Reach Test, F( 1,91) = 6.14, p < .05.
There was a non-significant main effect for the participant group on the Sit-and-Reach
Test, F(2, 91) = 0.47, p >.05. There was also a non-significant interaction effect between
the participant group and gender on the Sit-and-Reach Test, F(2, 91) = 0.66, p >.05. Male
short sleepers (n = 12; M = 29.71) did not have significantly lower scores on the Sit-and-
Reach Test in comparison to male long sleepers (n = 7 ; M = 29.29) or male medium
sleepers (n = 29; M = 29.36). Female short sleepers (n = 14; M = 32.64) did not have
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significantly lower scores on the Sit-and-Reach Test compared to female long sleepers
(n = 3; M = 36.17) or female medium sleepers (n = 32; M = 36.75).
Hypothesis 3B
Hypothesis 3B stated that individuals with shorter sleep duration will have
significantly lower scores on the Hand Dynamometer Test (right and left hand) compared
to individuals with longer sleep duration. Two separate two-way ANOVAs were
performed. One two-way ANOVA was performed with gender and sleep duration (SHQ
scores were divided into short, medium, and long sleep duration categories) as the
independent variables, and the Hand Dynamometer Test on the right hand as the
dependent variable. Another two-way ANOVA was performed with gender and sleep
duration (SHQ scores were divided into short, medium, and long sleep duration
categories) as the independent variables, and the Hand Dynamometer Test on the left
hand as the dependent variable.
The results of the two-way ANOVA did support this hypothesis on the right hand.
There was a significant main effect for gender on the Hand Dynamometer Test on the
right hand, F (l, 88) = 73.69, p < .01. There was a non-significant main effect for sleep
duration on the Hand Dynamometer Test on the right hand, F(2, 88) = 0.01,/? >.05. In
addition, there was a significant interaction effect between sleep duration and gender on
the Hand Dynamometer Test on the right hand, F(2, 88) = 4.22,/? < .05. Male short
sleepers (n = 11; M = 58.27) did not have significantly lower scores on the Hand
Dynamometer Test with the right hand compared to male long sleepers (n = 7; M =
52.71) or male medium sleepers (n = 29; M = 61.14). Female short sleepers (n = 13;
M - 35.62) did not have significantly lower scores on the Hand Dynamometer Test with
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the right hand compared to female long sleepers (n = 3; M = 41.67) or female medium
sleepers (n = 31; M = 32.61).
The results of the two-way ANOVA did not support this hypothesis on the left
hand. There was a significant main effect for gender on the Hand Dynamometer Test on
the left hand, F (l, 88) = 82.52, p < .01. There was a non-significant main effect for sleep
duration on the Hand Dynamometer Test the left hand, F(2, 88) = 0.27, p >.05. In
addition, there was a non-significant interaction effect between sleep duration and gender
on the Hand Dynamometer Test on the left hand, F(2, 88) = 2.11,p >.05. Male short
sleepers (n = 11; M - 54.00) did not have significantly lower scores on the Hand
Dynamometer Test with the left hand compared to male long sleepers (n = 7; 51.29)
or male medium sleepers (n = 29; M = 55.03). Additionally, female short sleepers (n =
13; M = 32.77) did not have significantly lower scores on the Hand Dynamometer Test
with the left hand compared to female long sleepers (n = 3; M = 38.00) or female medium
sleepers (n = 31; M = 30.32).
Hypothesis 3C
Hypothesis 3C stated that individuals with shorter sleep duration will have
significantly lower scores on the Vertical Jump Test compared to individuals with longer
sleep duration. To test this hypothesis, a two-way ANOVA was performed with gender
and sleep duration (SHQ scores were divided into short, medium, and long sleep duration
categories) as the independent variables, and the Vertical Jump Test as the dependent
variable. The results of the two-way ANOVA did not support this hypothesis. There was
a significant main effect for gender on the Vertical Jump Test, F (l, 91) = 8.46,/? < .01.
There was a non-significant main effect for sleep duration on the Vertical Jump Test, F(2,
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91) = 1.61,/? >.05. Additionally, there was a non-significant interaction effect between
sleep duration and gender on the Vertical Jump Test, F(2, 91) = 0.02,/? >.05. Males in the
Short Sleep Group (n = 12; M = 16.13) did not have significantly lower scores on the
Vertical Jump Test compared to males in the Long Sleep Group (n = 7; M = 18.64) or
males in the Medium Sleep Group (n = 29; M = 16.12). In addition, females in the Short
Sleep Group (n = 14; M ~ 12.57) did not have significantly lower scores on the Vertical
Jump Test in comparison to females in the Long Sleep Group (n = 3; M = 15.5) or
females in the Medium Sleep Group (n = 32; M = 12.44).
Hypothesis 3D
Hypothesis 3D stated that individuals with shorter sleep duration will have
significantly lower scores on estimated Peak Power compared to individuals with longer
sleep duration. A two-way ANOVA was performed with gender and sleep duration (SHQ
scores were divided into short, medium, and long sleep duration categories) as the
independent variables, and estimated Peak Power as the dependent variable. The results
of the two-way ANOVA did not support this hypothesis. There was a significant main
effect for gender on estimated Peak Power, F (l, 91) = 13.85,/? < .01. There was a non
significant main effect for sleep duration on estimated Peak Power, F(2, 91) = 2.14,
p >.05. There was also a non-significant interaction effect between sleep duration and
gender on estimated Peak Power, F(2, 91) = 1.36,/? >.05. Males in the Short Sleep Group
(n = 12; M = 3498) did not have significantly lower scores on estimated Peak Power
compared to males in the Long Sleep Group (n = 7; M = 3594) or males in the Medium
Sleep Group (n = 29;M = 3466). In addition, females in the Short Sleep Group (n = 14;
M = 2596) did not have significantly lower scores on estimated Peak Power in
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comparison to females in the Long Sleep Group (n = 3; M = 3225) or females in the
Medium Sleep Group (n = 32; M = 2196).
Hypothesis 4A
Hypothesis 4A stated that individuals with higher levels of sleepiness will have
significantly lower scores on the Sit-and-Reach Test compared to individuals with lower
levels of sleepiness. To test this hypothesis, two separate two-way ANOVAs were
performed. One two-way ANOVA was performed with gender and sleepiness (KSS
scores were divided into high, medium, and low sleepiness categories) as the independent
variables, and the Sit-and-Reach Test as the dependent variable. Another two-way
ANOVA was performed with gender and sleepiness (ESS scores were divided into high,
medium, and low sleepiness categories) as the independent variables, and the Sit-and-
Reach Test as the dependent variable.
KSS. There was a significant main effect for gender on the Sit-and-Reach Test, F (l, 91)
= 10.97, p < .01. There was a non-significant main effect for sleepiness (as measured by
the KSS) on the Sit-and-Reach Test, F{2, 91) = 0.10,/? >.05. There was also a non
significant interaction effect between sleepiness (as measured by the KSS) and gender on
the Sit-and-Reach Test, F(2, 91) = 0.28,/? >.05. Males in the KSS High Sleepiness Group
(n = 12; M = 30.58) did not have significantly lower scores on the Sit-and-Reach Test
compared to the males in the Low Sleepiness Group (n = 16; M = 29.53) or males in the
Medium Sleepiness Group (n = 20;M = 28.68). In addition, females in the KSS High
Sleepiness Group (n = 17; M = 34.68) did not have significantly lower scores on the Sit-
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and-Reach Test in comparison to females in the Low Sleepiness Group (n = 8;
M - 36.56) or females in the Medium Sleepiness Group (n = 24; M = 35.50).
using the ESS. There was a significant main effect for gender on the Sit-and-Reach Test,
F (l, 92) = 9.26, p < .01. There was a non-significant main effect for sleepiness (as
measured by the ESS) on the Sit-and-Reach Test, F (2,92) = 0.56, p >.05. In addition,
there was a non-significant interaction effect between sleepiness (as measured by the
ESS) and gender on the Sit-and-Reach Test, F{2, 92) = 0.09,/? >.05. The ESS male High
Sleepiness Group (n = 7; M = 29.07) did not have significantly lower scores on the Sit-
and-Reach Test in comparison to the male Low Sleepiness Group (n = 35; M = 29.29) or
male Medium Sleepiness Group (n = 6; M - 30.75). The ESS female High Sleepiness
Group (n = 11; M = 35.05) did not show significantly lower scores on the Sit-and-Reach
Test compared to the female Low Sleepiness Group (n = 28; M = 34.73) or the female
Medium Sleepiness Group (n = 11; M = 38.18).
Hypothesis 4B
Hypothesis 4B stated that individuals with higher levels of sleepiness will have
significantly lower scores on the Hand Dynamometer Test (right and left hand) compared
to individuals with lower levels of sleepiness. Four separate two-way ANOVAs were
performed. The first two-way ANOVA was performed with gender and sleepiness (KSS
variables, and the Hand Dynamometer Test on the right hand as the dependent variable.
The second two-way ANOVA was performed with gender and sleepiness (KSS scores
were divided into high, medium, and low sleepiness categories) as the independent
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variables, and the Hand Dynamometer Test on the left hand as the dependent variable.
The third two-way ANOVA was performed with gender and sleepiness (ESS scores were
divided into high, medium, and low sleepiness categories) as the independent variables,
and the Hand Dynamometer Test on the right hand as the dependent variable. The fourth
two-way ANOVA was performed with gender and sleepiness (ESS scores were divided
into high, medium, and low sleepiness categories) as the independent variables, and the
Hand Dynamometer Test on the left hand as the dependent variable.
KSS and the Hand Dynamometer Test on the right hand. There was a significant main
effect for gender on the Hand Dynamometer Test on the right hand, F (l, 88) = 167.20,
p <.01. There was a non-significant main effect for sleepiness (as measured by the KSS)
on the Hand Dynamometer Test on the right hand, F(2, 88) = 1.78,p >.05. Additionally,
KSS) and gender on the Hand Dynamometer Test on the right hand, F(2, 88) = 1.79,
p >.05. The KSS male High Sleepiness Group (n = 11; Af = 55.45) did not have
significantly lower scores on the Hand Dynamometer Test on the right hand compared to
the male Low Sleepiness Group (n = 16; M = 57.44) or male Medium Sleepiness Group
(n = 20; M = 62.70). In addition, the KSS female High Sleepiness Group (n = 17;
M = 32.71) did not have significantly lower scores on the Hand Dynamometer Test on
the right hand compared to the female Low Sleepiness Group (n = 8; M = 35.75) or
female Medium Sleepiness Group (n = 22; M = 33.55).
KSS and the Hand Dynamometer Test on the left hand. There was a significant main
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effect for gender on the Hand Dynamometer Test on the left hand, F( 1, 88) = 173.34,
p < .01. There was a non-significant main effect for sleepiness (as measured by the KSS)
on the Hand Dynamometer Test on the left hand, F{2, 88) = 0.61,/? >.05. Additionally,
KSS) and gender on the Hand Dynamometer Test on left hand, F(2, 88) = 0.34, p >.05.
The KSS male High Sleepiness Group (n = 11; M = 52.45) have significantly lower
scores on the left hand in comparison to the male Low Sleepiness Group (n = 16; M =
53.50) or male Medium Sleepiness Group (n = 20; M - 55.80). In addition, the KSS
female High Sleepiness Group (n = 17; M = 30.41) have significantly lower scores on the
left hand in comparison to the female Low Sleepiness Group (n = 8; M = 32.13) or
female Medium Sleepiness Group (n = 22; M = 31.36).
The results of the two-way ANOVA did not support this hypothesis using the ESS
and the Hand Dynamometer Test on the right hand. There was a significant main effect
for gender on the Hand Dynamometer Test on the right hand, F (l, 89) = 115.02,/? < .01.
There was a non-significant main effect for sleepiness (as measured by the ESS) on the
Hand Dynamometer Test on the right hand, F(2, 89) = 0.86, p >.05. In addition, there was
a non-significant interaction effect between sleepiness (as measured by the ESS) and
gender on the Hand Dynamometer Test on the right hand, F(2, 89) = 0.01, p >.05. The
ESS male High Sleepiness Group (n = 7\ M = 56.29) did not have significantly lower
scores on the Hand Dynamometer Test on the right hand compared to the male Low
Sleepiness Group (n = 35; M = 59.86) or male Medium Sleepiness Group (n = 5;
M = 58.80). In addition, the ESS female High Sleepiness Group (n = 10; M = 31.70) did
not have significantly lower scores on the Hand Dynamometer Test on the right hand
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compared to the female Low Sleepiness Group (n = 28; M = 34.61) or female Medium
Sleepiness Group (n = 10; M = 34.00).
The results of the two-way ANOVA did not support this hypothesis using the ESS
and the Hand Dynamometer Test on the left hand. There was a significant main effect for
gender on the Hand Dynamometer Test on the left hand, F( 1, 89) = 125.27,/? < .01.
There was a non-significant main effect for sleepiness (as measured by the ESS) on the
left hand, F(2, 89) = 0.42,/? >.05. In addition, there was a non-significant interaction
effect between sleepiness (as measured by the ESS) and gender on the Hand
Dynamometer Test on left hand, F(2, 89) = 0.18,/? >.05. The ESS male High Sleepiness
Group (n = 7;M = 53.57) have significantly lower scores on the left hand in comparison
to the male Low Sleepiness Group (n = 35; M = 54.49) or male Medium Sleepiness
Group (n = 5; M = 53.40). In addition, the ESS female High Sleepiness Group (n = 10;
M = 28.90) have significantly lower scores on the left hand in comparison to the female
Low Sleepiness Group (n = 28; M = 31.96) or female Medium Sleepiness Group (n = 10;
M = 32.00).
Hypothesis 4C
Hypothesis 4C stated that individuals with higher levels of sleepiness will have
significantly lower scores on the Vertical Jump Test compared to individuals with lower
levels of sleepiness. To test this hypothesis, two separate two-way ANOVAs were
performed. One two-way ANOVA was performed with gender and sleepiness (KSS
variables, and the Vertical Jump Test as the dependent variable. Another two-way
ANOVA was performed with gender and sleepiness (ESS scores were divided into high,
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medium, and low sleepiness categories) as the independent variables, and the Vertical
Jump Test as the dependent variable.
KSS. There was a significant main effect for gender on the Vertical Jump Test, F{ 1,91) =
14.58,/? < .01. There was a non-significant main effect for sleepiness (as measured by the
KSS) on the Vertical Jump Test, F(2, 91) = 0.17,/? >.05. Additionally, there was a non
the Vertical Jump Test, F(2,91) = 1.24,/? >.05. The KSS male High Sleepiness Group (n
= 12; M = 15.46) did not have significantly lower scores on the Vertical Jump Test in
comparison to the male Low Sleepiness Group (n = 16; M = 16.22) or male Medium
Sleepiness Group (n = 20; M - 17.33). In addition, the KSS female High Sleepiness
Group (n = 17; M= 13.76) did not have significantly lower scores on the Vertical Jump
Test in comparison to the female Low Sleepiness Group (n = 8; M - 12.13) or female
Medium Sleepiness Group (n = 24; M= 12.35).
ESS. There was a significant main effect for gender on the Vertical Jump Test, F (l, 92) =
ESS) on the Vertical Jump Test, F(2, 92) = 0.84,/? >.05. There was also a non-significant
interaction effect between sleepiness (as measured by the ESS) and gender on the
Vertical Jump Test, F(2, 92) = 1.02,/? >.05. The ESS male High Sleepiness Group (n = 7;
M = 16.64) did not have significantly lower scores on the Vertical Jump Test compared to
the male Low Sleepiness Group (n = 35; M = 16.49) or the male Medium Sleepiness
Group (n = 6; M = 16.33). In addition, the ESS female High Sleepiness Group (n = 11;
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M = 12.55) did not have significantly lower scores on the Vertical Jump Test in
comparison to the female Low Sleepiness Group (n = 28; M = 11.93) or the female
Medium Sleepiness Group (n = 11; M = 15.23).
Hypothesis 4D
Hypothesis 4D stated that individuals with higher levels of sleepiness will have
significantly lower scores on estimated Peak Power compared to individuals with lower
levels o f sleepiness. Two separate two-way ANOVAs were performed. One two-way
ANOVA was performed with gender and sleepiness (KSS scores were divided into high,
medium, and low sleepiness categories) as the independent variables, and estimated Peak
Power as the dependent variable. Another two-way ANOVA was performed with gender
and sleepiness (ESS scores were divided into high, medium, and low sleepiness
categories) as the independent variables, and estimated Peak Power as the dependent
variable. The results of the two-way ANOVA did not support this hypothesis using the
KSS. There was a significant main effect for gender on estimated Peak Power, F (l, 91) =
KSS) on estimated Peak Power, F(2, 91) = 0.74,/? >.05. In addition, there was a non
estimated Peak Power, F(2,91) = 3.02,/? >.05. The KSS male High Sleepiness Group (n
= 12; M = 3188) did not have significantly lower estimated Peak Power scores compared
to the male Low Sleepiness Group (n = 16; M = 3399) or the male Medium Sleepiness
Group (n = 20; M = 3751). In addition, the KSS female High Sleepiness Group (n = 17;
M = 2669) did not have significantly lower estimated Peak Power scores in comparison
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to the female Low Sleepiness Group (n = 8; M = 2107) or the female Medium Sleepiness
Group (n = 24; M = 2281).
using the ESS. There was a significant main effect for gender on estimated Peak Power,
F (l, 92) = 26.04,/? < .01. There was a non-significant main effect for sleepiness (as
measured by the ESS) on estimated Peak Power, F(2, 92) = 1.57,/? >.05. There was also
a non-significant interaction effect between sleepiness (as measured by the ESS) and
gender on estimated Peak Power, F(2, 92) = 1.01,/? >.05. The ESS male High Sleepiness
Group (n = 7; M = 3419) did not have significantly lower estimated Peak Power scores in
comparison to the male Low Sleepiness Group (n = 35; M = 3497) or the male Medium
Sleepiness Group (n = 6; M = 3553). In addition, the ESS female High Sleepiness Group
(n = 11; M = 2180) did not have significantly lower estimated Peak Power scores
compared to the female Low Sleepiness Group (n = 28; M - 2249) or the female Medium
Sleepiness Group (n = 11; M = 2946).

CHAPTER 4
DISCUSSION
This last chapter discusses the general overview o f the results, followed by a
discussion of each hypothesis. The general implications for the study are also discussed,
followed by the limitations of the study and future directions.
General Overview of Results
The results o f this study revealed that the majority (68%) of participants
experienced occasional sleep difficulties, as measured by the SQI. Only 15% of the
sample reported good sleep quality and over 13% indicated that their sleep quality was
poor. This means that nearly nine out of 10 participants regularly experienced moderate
to poor sleep quality. An examination of item responses on the SQI revealed that over
25% of the participants experienced insomnia and 13% take sleep medication.
Additionally, over half of the participants indicated that they felt tired in the morning.
Almost 40% of the participants reported difficulty falling asleep and over 40% indicated
disturbed sleep. In addition, 33% of participants wake up during the night and over 40%
awaken too early in the morning. This may indicate that even though they are not having
major sleep problems, they are still experiencing sufficient sleep problems to feel tired in
the morning due to lack of sleep.
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115
The participants slept an average of seven hours 13 minutes a day on week nights
and eight hours 39 minutes on weekend nights. O f the participants, 26% slept six hours
30 minutes or less during the week, while 10% slept nine hours or more. According to the
National Sleep Foundation, an adult needs from seven to nine hours of sleep per night.
This indicates that 26% o f the participants in this study slept less than the recommended
amount. Over 35% reported experiencing sleepiness outside the normal range.
Additionally, the current sample had a higher average on the ESS and KSS compared to
other studies, which indicates these participants had a higher level of sleepiness. This
provides further evidence suggesting that participants are experiencing sleep difficulties.
The results also revealed that the current sample had significantly lower vertical
jump height, peak power, and grip strength compared to other studies. This difference in
grip strength, vertical jump height, and peak power in this sample, compared to other
studies, may be in part due to the sleep difficulties participants are experiencing. The
results were compared to other studies with similarly aged college students and were not
athletes or active Kinesiology students.
The relationship between sleep quality/sleepiness and physical performance
varied. Lower grip strength was associated with increased sleepiness, as measured by
both the ESS and KSS. According to the evolutionary/circadian rhythm models of sleep,
sleep may have evolved to conserve energy. According to Berger and Phillips (1995),
phylogenetic and ontogenetic associations between sleep and endothermy are consistent
with the hypothesis that sleep evolved in conjunction with endothermy to offset the high
energetic cost of endothermy. The electrophysiological and thermoregulatory continuum
of slow wave sleep, circadian torpor and hibernation substantiates a primordial link
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between sleep and energy conservation. Sleep constitutes a circadian and circannual
rhythm o f hypometabolic adaptation to biospheric energy cycles that is usually entrained
through light-mediated suppression of melatonin secretion. When energy stores decline,
energy is conserved by lowering body temperature (Tb) proportionally during sleep or by
increasing the daily duration of sleep. Those who are not sleepy tend to have better grip
strength because they conserved enough energy while they slept; therefore they were alert
and had energy to perform well on the grip strength test.
Vertical jump height was positively related to returning to sleep after an
awakening during the sleep period on the ADS WS. Vertical jump height was also
positively related to the transition from sleep to wakefulness on the ADSWS. It may be
that those who have reduced ability to reinitiate sleep following an awakening or to wake
up in the morning have difficulty generating the power for vertical jump height. In
addition, there was a significant positive relationship between peak power and returning
to sleep after awakening. This could mean that those who have difficulty reinitiating
sleep after an awakening have not slept through the proper sleep cycles, which in turn
may affect peak power.
There were no significant relationships between sleep duration (as measured on
the SHQ) and anaerobic performance, indicating that the length of time one sleeps may
not impact immediate, short-term physical activities. It could be that the time of day the
study was conducted affected physical performance. The data was collected from 8:00-
10:00am and 4:00-6:00pm. Most of the data was collected in the later afternoon/early
evening. Due to the time frame that most of the data was collected, the results could be
impacted by the “post-lunch dip,” which would reflect 12-hour biologic cycles of
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sleepiness (Hayashi, Morikawa, & Hori, 2002). It could also be that because the physical
performance measures were short in duration, the participants were able to perform even
though they were tired. Individuals may have been able to function well enough on the
physical performance measures because they were immediate, short-term physical
activities, despite their levels of sleepiness. However, it is possible that if the physical
performance measures were longer in duration, individuals may not have been able to
overcome the effects of sleepiness like they could in brief periods of time.
Hypothesis One
Hypotheses 1A through ID posited that individuals who took a 10-minute
nap/relaxation would have significantly better flexibility, grip strength, vertical jump
height, and peak power than individuals in the control group. Analysis indicated that the
10-minute nap/relaxation group did significantly improve grip strength (Hypothesis IB).
However, the 10-minute nap/relaxation group did not significantly impact flexibility
(Hypothesis 1A), vertical jump height (Hypothesis 1C), or peak power (Hypothesis ID).
Hypothesis 1A. Hypothesis 1A stated that a 10-minute nap/relaxation would
significantly improve flexibility. The results of the ANOVA did not support this
hypothesis. There are numerous sports in which flexibility plays an important role. Even
though a 10-minute nap/relaxation period did not significant improve flexibility, it still
could benefit athletes in sports where even a small amount of increase in flexibility could
assist them in performing better and perhaps even lead to winning.
The ineffectiveness o f this intervention for flexibility may be due to several
reasons. One reason is that there may be no effect of a nap/relaxation on flexibility.
Another possible reason is the 10-minute time frame of the nap/relaxation that was used.
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It is possible that a 10-minute nap/relaxation did not allow participants adequate time to
sleep; therefore, not improving alertness and flexibility. The nap/relaxation may have
been more effective if conducted over a longer period of time, allowing participants to
have the necessary sleep/relaxation time to increase their flexibility. In addition, the
sleep/relaxation may need to be monitored with an Actigraph to determine if individuals
are actually sleeping for 10 minutes. It is possible that by monitoring participants with an
Actigraph, it would be assured that they slept/relaxed for 10 minutes, which may have led
to them experiencing changes in their flexibility. Relaxation does not mean that muscles
are physically lengthening, which would result in improvements. Napping has been found
to increase alertness, memory, motor skills, decision-making, and mood, which are not
components in performing well on a sit-and-reach test.
Hypothesis IB. Hypothesis IB stated that a 10-minute nap/relaxation would
significantly improve grip strength. The results of the ANOVA did support this
hypothesis on the right hand, but not the left hand. This means that a 10-minute
nap/relaxation period may improve grip strength. The 10-minute nap/relaxation period
may have resulted in reduced muscle tension or increased focus, which enabled
participants to feel relaxed and improve their grip strength. Short daytime naps of less
than 30 minutes, which rarely contain SWS, have been shown to have positive effects on
daytime alertness (Takahashi, 2003). This has been experimentally confirmed after a
normal night of sleep in young adults and elderly individuals, after a restricted night of
sleep, and during prolonged sustained performance (Naitoh, Kelly, & Babkoff, 1992).
Tietzel and Lack (2002) found that a 10-minute brief nap had a recuperative effect,
suggesting that the recuperative power of a short nap depends on stage 2 sleep, not stage
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1. According to Hayashi et al. (2005), a daytime nap containing three minutes of stage 2
sleep has recuperative effects, whereas these effects are limited following only stage 1
sleep. However, these results are in contrast to Waterhouse, Atkinson, Edwards, and
Reilly (2007) who found that a post-lunch nap did not improve grip strength. In the study
by Waterhouse et al. (2007), there was actually a decline in grip strength. Because the
researchers examined the grip strength scores individually instead of taking the best of
the three scores, this decline could be explained by muscle fatigue (Waterhouse et al.,
2007).
Hypothesis 1C. Hypothesis 1C stated that a 10-minute nap/relaxation would
significantly improve vertical jump height. The results of the ANOVA did not support
this hypothesis. The ineffectiveness of this intervention for vertical jump height may be
due to several reasons. One reason is that there may be no effect of a nap/relaxation on
vertical jump height. It is also important to remember that the current sample had
significantly higher levels o f sleepiness than the standardization groups for the ESS and
KSS. This suggests that the current sample may not have been able to benefit from the
10-minute nap/relaxation, because they needed a longer nap/relaxation period to improve
their vertical jump height.
Hypothesis ID. Hypothesis ID stated that a 10-minute nap/relaxation would
significantly improve peak power. The results of the ANOVA did not support this
hypothesis. The ineffectiveness of this intervention for peak power may be due to several
reasons. One reason could be that there may be no effect of a nap/relaxation on peak
power. It may also be possible that the 10-minute nap/relaxation may have been
beneficial in different formats (e.g., Progressive Muscle Relaxation, Visual Imagery),

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instead of a guided breathing relaxation. In addition, it could be possible that the 10-
minute nap/relaxation would be more effective if participants would have been able to lie
down. Participants may have been able to fall asleep or feel more relaxed if they felt
comfortable by being able to lie down. By lying down, they may have achieved the
relaxation needed for improvement in peak power. Individuals are more likely to fall
asleep while lying down than sitting in a chair, because people regularly sleep lying down
and their bodies are cued to become sleepy when they lay down.
Hypothesis Two
Hypotheses 2A through 2D posited that individuals with good sleep quality would
have significantly better flexibility, grip strength, vertical jump height, and peak power
than individuals with poor sleep quality. Results revealed that sleep quality did not
significantly impact flexibility (Hypothesis 2A), grip strength (Hypothesis 2B), vertical
jump height (Hypothesis 2C), or peak power (Hypothesis 2D).
Hypothesis 2A. Hypothesis 2A stated that poor sleep quality will reduce
flexibility. The results of the ANOVA did not support this hypothesis. The hypothesis not
being significantly supported for flexibility may be due to the possibility that flexibility is
not affected by sleep quality. Sleep quality was assessed using the SQI and ADSWS, but
no significant results were found using the ADSWS and flexibility. However, the
participants with good sleep quality based on the SQI did have somewhat better
flexibility than participants with poor sleep quality, even though it was not statistically
significant. This could be an advantage to athletes in several sports in which flexibility is
important. Even though sleep quality did not significantly improve flexibility, getting a
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good night’s sleep could still be an advantage to athletes in sports where any increase in
flexibility could influence performance.
These results are in contrast to a study conducted by Lee and Lin (2007) who
found that that female Taiwan college students with poor sleep quality had a significantly
shorter distance for the sit-and-reach (flexibility) than females with good sleep quality.
The study by Lee and Lin (2007) used the Chinese version of the Pittsburgh Sleep
Quality Index (PSQI) to measure sleep quality and the current study used the SQL It is
possible that the different results are due to measurement issues as different scales were
used to assess sleep quality.
Hypothesis 2B. Hypothesis 2B stated that poor sleep quality will reduce grip
strength. The results of the ANOVA did not support this hypothesis. The hypothesis not
being significantly supported for grip strength may be due to the possibility that grip
strength is not affected by sleep quality. Sleep quality was assessed using the SQI and
ADSWS, but no significant results were found using the ADSWS and grip strength.
However, even though the results were not statistically significant, the participants with
good sleep quality did have a five point improvement in grip strength compared to
participants with poor sleep quality. This could mean that getting a good night’s sleep
may benefit athletes in sports in which an improvement in grip strength could impact
performance outcome. Dam, Ewing, Ancoli-Israel, Ensrud, Redline, and Stone (2008)
found that less REM sleep appeared to be associated with weaker grip strength in older
men. Therefore, another possible reason is that individuals with good sleep quality may
have more REM sleep, which could have improved grip strength. In addition, studies of
students have also shown that those deprived of REM sleep perform worse on academic
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tests than those who were not deprived (Kami et al., 1994; Pilcher & Huffcutt, 1996;
Pilcher & Ott, 1998; Pilcher & Walters, 1997; Smith & Lapp, 1991). Students who
demonstrated a significant increase in REM sleep followed a period of intense learning
were found to perform significantly better on an examination than students who did not
show an increase in REM sleep (De Koninck et al., 1989). Therefore, it is a possibility
that an increase in REM sleep could improve physical performance.
These results are also inconsistent with a study conducted by Goldman et al.
(2007) who found that older women with poor sleep quality (>1.6 hours of wake after
sleep onset) had 4% weaker grip strength than participants with good sleep quality. It is
possible that because physiological measures to assess sleep quality were not used, sleep
quality was not accurately measured. It is also possible that individuals could have
overcome the effects of poor sleep for a brief period of time and performed well enough
on the hand dynamometer. In addition, older women could be more easily affected by
poor sleep quality than college students, because college students may be more resilient
to the effects of sleep.
Hypothesis 2C. Hypothesis 2C stated that individuals with poor sleep quality will
have reduced vertical jump height. The results of the ANOVA did not support this
hypothesis. Sleep quality was assessed using the SQI and ADSWS, but no significant
results were found with vertical jump height. The hypothesis not being supported for
vertical jump height may be due to several reasons. There may be no effect of sleep
quality on vertical jump height. Another possible reason that this hypothesis was not
supported is that participants could have been tired from the dynamic warm-up,
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especially if they were not athletes. The warm-up may have tired people physically,
which could have hindered their vertical jump height.
Hypothesis 2D. Hypothesis 2D stated that poor sleep quality will reduce peak
power. The results of the ANOVA did not support this hypothesis. Sleep quality was
assessed using the SQI and ADSWS, but no significant results were found with peak
power. The hypothesis not being supported for peak power may be because there may be
no effect of sleep quality on peak power. The time of day could impact peak power. For
instance peak power may have been better in the morning than the afternoon, because
individuals may have been active all day and were tired by the time they participated in
the study. In addition, because peak power was based on a brief physical performance
measure and that people can overcome sleep issues for brief periods, sleep quality may
not have had a significant impact on peak power.
Hypothesis Three
Hypotheses 3A through 3D posited that individuals with short sleep duration
would have significantly reduced flexibility, grip strength, vertical jump height, and peak
power compared to individuals with long sleep duration. Results revealed that sleep
duration did not significantly impact flexibility (Hypothesis 3A), grip strength
(Hypothesis 3B), vertical jump height (Hypothesis 3C), or peak power (Hypothesis 3D).
Hypothesis 3A. Hypothesis 3A stated that long or average sleep durations would
significantly improve flexibility. The results of the ANOVA did not support this
hypothesis. The hypothesis not being supported for flexibility may be because flexibility
may not be affected by sleep duration. Another possible reason that this hypothesis was
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not supported is that individuals may not require the recommended number of hours of
sleep per night to let their muscles rest so that they are flexible.
Hypothesis 3B. Hypothesis 3B stated that longer sleep duration will significantly
improve grip strength. The results of the ANOVA did not support this hypothesis. The
hypothesis not being supported for grip strength may be because grip strength may not be
affected by sleep duration. Another possible reason that this hypothesis was not
supported is that the time o f day could impact grip strength. Goh, Tong, Lim, Low, and
Lee (2001) found that grip strength increased progressively during the day, but decreased
during the night. Cappaert (1999) found similar results, indicating that grip strength
peaked in the afternoon. Therefore, the time of day for testing could have impacted grip
strength performance. The post-nap dip could account for an increase in sleepiness,
which could have negatively impacted grip strength performance (Hayashi et al., 2002).
Additionally, this hypothesis may not have been supported possibly due to the increased
use of technology, such as typing on keyboards, which could contribute to the overuse of
individuals’ muscles and therefore decrease grip strength.
Hypothesis 3C. Hypothesis 3C stated that longer sleep duration will significantly
improve vertical jump height. The results of the ANOVA did not support this hypothesis.
The hypothesis not being supported for vertical jump height may be because sleep
duration does not have an effect on vertical jump height. These results are inconsistent
with a study conducted by Takeuchi, Davis, Plyley, Goode, and Shephard (1985) who
found that that sleep deprived males had significantly decreased vertical jump height. The
study by Takeuchi and colleagues (1985) had participants undergo 64 hours of sleep
deprivation. It is possible that short sleep duration (< six hours of sleep per night) does
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not have the same effect as prolonged sleep deprivation. In addition, individuals may
have reported what time they lay down in bed instead of when they actually fall asleep.
This could mean that these individuals are not actually long sleepers and the results may
not be significant.
Hypothesis 3D. Hypothesis 3D stated that longer sleep duration will significantly
improve peak power. The results of the ANOVA did not support this hypothesis. The
hypothesis not being supported for peak power may because sleep duration does not
affect peak power. Another possibility is that the long sleepers may be getting more REM
sleep, which could contribute to the increase in peak power. In addition, people may only
need a minimum amount of sleep for their muscles to recuperate, which could mean that
individuals with short sleep duration would not have a reduction in peak power.
Furthermore, peak power was estimated based on vertical jump height, and they are
positively correlated with each other. Is it not surprising that peak power did not
significantly improve when there was not a significant improvement in vertical jump
height.
Hypothesis Four
Hypotheses 4A through 4D posited that compared to individuals with higher
levels of sleepiness, individuals with lower levels of sleepiness will have significantly
better flexibility, grip strength, vertical jump height, and peak power. Results revealed
that sleepiness did not significantly impact flexibility (Hypothesis 4A), grip strength
(Hypothesis 4B), vertical jump height (Hypothesis 4C), or peak power (Hypothesis 4D).
Hypothesis 4A. Hypothesis 4A stated that higher levels of sleepiness will
significantly reduce flexibility. The results of the ANOVA did not support this
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hypothesis. The hypothesis not being supported for flexibility may be due to several
reasons. Flexibility may not be affected by sleepiness. Another possible reason that this
hypothesis was not supported is that the Sit-and-Reach Test was not long in duration.
Particularly relevant to college students, Durmer and Dinges (2005) found that cognitive
performance effects of sleep deprivation revealed a "fatigue effect," which became worse
as time on the task increased. Furthermore, performance declined as the task duration
extended. This decline in performance can include physical performance. Possibly
assessing measures o f flexibility that are longer in duration than a sit-and reach test
would result in a significant impact of sleepiness on flexibility. Therefore, it is possible
that higher levels of sleepiness may adversely affect flexibility if assessed in an extended
measure.
Hypothesis 4B. Hypothesis 4B stated that higher levels of sleepiness will
significantly impair grip strength. The results of the ANOVA did not support this
hypothesis. The hypothesis not being supported for grip strength may be because grip
strength is not affected by sleepiness. It is also possible that due to the short time frame to
complete the grip strength task, people were able to overcome sleepiness. Participants
may not have been able to overcome sleepiness during a longer task, such as long
distance running. Individuals participated in the dynamic warm-up twice within a two-
hour period, which may have countered the effects of sleepiness, as the warm-up
increased heart rate and physiological arousal. Research has shown that the active,
dynamic warm-up has demonstrated positive effects on performance. However,
participants in this study were not athletes; therefore, many of them are not likely to be
physically active and were not use to engaging in that type of physical activity. In
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addition, many of the male participants were competitive with one another during both of
the active, dynamic warm-ups. This could have led to an increase in heart rate and
physiological arousal, which may have temporarily diminished the effects of sleepiness.
Hypothesis 4C. Hypothesis 4C stated that higher levels of sleepiness will
significantly reduce vertical jump height. The results of the ANOVA did not support this
hypothesis. The hypothesis not being supported for vertical jump height may be due to
several reasons. There may be no effect of sleepiness on vertical jump height. Another
possible reason that this hypothesis was not supported is that the Vertical Jump Test is
too short and simplistic of a task to be impacted by sleepiness. In addition, sleepy
individuals may have been able to turn on the motivation in order to perform for a short
period o f time.
Hypothesis 4D. Hypothesis 4D stated that higher levels of sleepiness will
significantly reduce peak power. The results of the ANOVA did not support this
hypothesis. The hypothesis may not be supported for peak power because there may not
be a significant effect of sleepiness on peak power. It is also possible that sleepiness
affects tasks which are more cognitive in nature. Because there is not much of a cognitive
aspect to peak power, sleepiness may not have an impact on peak power.
Implications
This study has important implications for athletes. The fact that there was a
significant improvement in grip strength due to a 10-minute nap/relaxation highlights the
importance of sleep. These results could have an impact on sports such as baseball,
basketball, football, tennis, and wrestling, in which grip strength plays an important role.
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This suggests that athletes in these sports could potentially benefit from a 10-minute
nap/relaxation prior to competing.
Even though a 10-minute nap/relaxation period did not significantly improve
flexibility, it could still benefit athletes in several sports in which flexibility is important.
This could be an advantage to athletes in sports at the professional or collegiate levels
where even a small amount of difference could assist them in winning. At the
professional level, winning could affect millions of dollars. College scholarships may be
affected by whether or not the individual wins.
Sleep quality did improve flexibility and grip strength, even though it was not
significant. Long sleepers also had an improvement in grip strength, vertical jump height,
and peak power. In addition, average sleepers had an increase in flexibility and
individuals who were alert had better peak power. The implication of these results is that
getting a good night’s sleep could be an advantage to athletes in sports where any
increase in flexibility, grip strength, vertical jump height, or peak power could influence
performance outcome. This also could have implications in occupational tasks which
require grip strength, as well as activities of daily living, which may also have an impact
on possible work outcomes.
The current study had a higher average on the ESS and KSS compared to other
studies, indicating that this sample had a higher level of sleepiness than other samples.
Additionally, over 35% of this sample reported experiencing sleepiness outside the
normal range. Reduced sleep time has explained excessive sleepiness of several patient
and nonpatient groups. For example, a sample of sleep clinic patients was identified as
having excessive daytime sleepiness, which can be attributed to chronic insufficient sleep
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(Roehrs, Zorick, Sicklesteel, Wittig, & Roth, 1983). These patients had objectively
documented excessive sleepiness, “normal” nocturnal sleep with unusually high sleep
efficiency (time asleep-time in bed), and report about two hours more sleep on each
weekend day than each weekday. Regularizing bedtime and increasing time in bed
produces a resolution of these symptoms and normalizes Multiple Sleep Latency Test
(MSLT) results (Manber, Bootzin, Acebo, & Carskadon, 1996). Therefore, the increased
sleepiness of healthy young adults can be attributed to insufficient nocturnal sleep. When
the sleepiest 25% of a sample of young adults was given extended time in bed (10 hours)
for as long as five to 14 consecutive nights, their sleepiness was reduced to a level
resembling the general population mean (Roehrs, Shore, Papineau, Rosenthal, & Roth
1996). Therefore, reducing sleepiness can be done by regulating bedtime and extending
time in bed. Lower grip strength was associated with increased sleepiness in the current
study. It is possible that by reducing sleepiness, athletes may experience an increase in
their grip strength.
In the current study, vertical jump height was positively related to the transition
from sleep to wakefulness. It is possible that those who have reduced ability to wake up
in the morning are sleepy and therefore have difficulty generating the power for vertical
jump height. This could mean that by reducing sleepiness, athletes may be able to see an
increase in their vertical jump height. Therefore, it may be important for athletes to
regulate their bedtime and increase their time in bed in order to reduce sleepiness.
Bonnet and Arand (2005) found that a 5-minute walk immediately preceding
Multiple Sleep Latency Test (MSLT) evaluations masked the impact of a 50% reduction
o f nocturnal sleep and continued for at least 90 minutes after the task. This indicated that
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exercise before performing tasks provided a temporary reversal of some psychomotor
decline resulting from sleep loss. In the current study, individuals engaged in two
dynamic warm-ups (lasting 10-15 minutes each) in a two-hour time period prior to
participating in the physical performance tasks. Therefore, individuals’ performance may
not have shown a decrease because the psychomotor deficits were masked by
participating in the dynamic warm-ups. However, athletes who are competing in an event
that lasts longer than 90 minutes may not be able to mask the effects of sleep loss by
exercising beforehand. This could mean that if baseball players exercised before a game,
after 90 minutes, they may experience a decrease in grip strength, which could affect
their swing. The implication for baseball players is to get a good night’s sleep, so they do
not experience a reduction in grip strength. It is also possible that the results of the
current study could have been significant if individuals did not participate in the dynamic
warm-ups. It may also be that if the study tested participants several hours after the
dynamic warm-ups, then they may have had a decrease in grip strength because the
effects of sleep loss would not be masked by the warm-up.
Limitations
There are several limitations to the current study. One limitation is in regards to
the generalizability of the study. The current sample consisted of 98 undergraduate and
graduate students who ranged in age from 17 to 47. The sample is not representative of
the general population, due to the fact that the participants are all college students.
Therefore, it is not clear if the results would generalize to individuals with different levels
of education. In addition, it is unclear if the results would generalize to non-current
students. The participants attend a public university in the Southern United States.
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Therefore, the generalizability of the results to students attending private colleges and
universities, as well as universities and colleges outside the Southern United States, is
questionable.
Furthermore, other limitations of the study include the small sample with unequal
sample size and no pre-test was conducted to determine if groups differed beforehand,
even though random assignment of participants was implemented. Regarding the unequal
sample size, SPSS autocorrects the formula to calculate the sum of squares in unequal
sample sizes in two-way ANOVA analyses, which was used for this study. The study was
originally designed to be a within and between subjects design; however, due to the lack
of participants, it resulted in a post-test only study. Pre-test measures would have been
ideal to determine if the groups were different at the onset of the study. However, due to
the difficulty in recruiting participants, the post-tests were only conducted. Therefore, it
is difficult to determine what, if any, effects of the nap/relaxation condition had an effect
on physical performance.
Another limitation of the study is that, on the SHQ, only 26.3% of the participants
slept <6 hours per night, which is the number of hours used to classify an individual as
having a short sleep duration. On the SHQ, only 10.1% of the participants slept less than
nine hours per night, which indicates an individual as having a long sleep duration. Most
o f the participants (61.6%) had average sleep duration (greater than six and less than nine
hours of sleep per night). The current study may not have included enough individuals in
each group to determine if there was a significant change in physical performance, which
could mean that there was not enough power to indicate a significant effect in the results.
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An additional limitation of the current study is that all of the sleep-related data
was self-reported. Therefore, the results must be interpreted under the assumption that the
participants responded truthfully. Participants were told that their responses would be
kept confidential. Participants were instructed to detach their consent forms from the
questionnaire packet before turning it in, to ensure the confidentiality of their responses.
In addition, the questionnaires with the participant’s identification number did not include
any personal identifying information, which ensured that participant data was
anonymous. Despite these efforts, participants may not have responded truthfully.
Participants may have over-reported or under-reported their responses, because they
could have been inclined to respond in a socially desirable manner. Social desirability
was not controlled for in this study.
Another limitation is that participants may not have been motivated to take the
appropriate time to complete the questionnaires on sleep quality, sleep duration, and
sleepiness accurately. The participants may not have cared how they physically
performed on the Vertical Jump test, given that the current sample did not consist of
athletes and had significantly lower scores on physical performance measures than other
samples. Individuals’ level of motivation for participating in the study may have affected
the results as well. Due to participants being given extra credit for their participation;
their motive may have been to improve their grade instead of trying their best with the
physical performance measures, despite being encouraged to try their best on all
measures. Participants may not have tried hard enough to see an improvement in their
physical performance without the motivation to do their best.

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An additional limitation is in regards to the time frame that the questionnaires
inquired about for this study. All of the sleep-related data was self-reported and the
questionnaires requested information over a specific period of time. Therefore, memory
bias could have impacted the results. Participants in this study may not have been
accurate or consistent in recalling or reporting their sleep quality, sleep length, or level of
sleepiness. The SQI asked respondents to assess their sleep quality over the past three
month and the ADSWS asked participants to assess their sleep quality over the past
week. It could be quite difficult for an individual to remember their sleep patterns over an
extended period of time.
Another limitation is that the current study was unable to use a force plate to
measure peak power. Therefore, peak power was estimated using a formula based on the
Vertical Jump Test. Future research should use an actual measure of peak power instead
of estimating peak power. However, the equations for estimated peak power do have a
high reliability.
An additional limitation is that the physical performance measures used in this
study do not require psychomotor reactivity and therefore may have not been impacted
by sleepiness. Blagrove and Akehurst (2001) found that adults reporting excessive
sleepiness also report negative effects on psychomotor reactivity. However, flexibility,
grip strength, vertical jump height, and peak power are not dependent on psychomotor
abilities. A tennis return, sprint start, and karate block are dependent on psychomotor
abilities and if those measures were used in this study, then they may have been
significantly affected by sleepiness.

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Another limitation is that the physical performance measures used in this study do
not require visual-motor reaction time, critical thinking abilities, vigilance, attention to
task, or reaction time; therefore, they may have not been impacted by sleep quality. Taub
(1980) found that poor sleep quality adversely affects visual-motor reaction time, critical
thinking abilities, vigilance, attention to task, and reaction time, which are all important
in physical performance. However, flexibility, grip strength, vertical jump height, and
peak power are not dependent on psychomotor abilities. A tennis return, sprint start, and
karate block do require visual-motor reaction time, critical thinking abilities, vigilance,
attention to task, or reaction time and if they were the measures used in this study, then
they may have been significantly affected by sleep quality.
An additional limitation is that the physical performance measures used in this
study do not require much cognitive skill and therefore may have not been impacted by
sleep duration. Hicks and Gilliland (1981), as well as Taub and Berger (1973), found that
individuals who report sleeping six hours or less have a greater incidence o f cognitive
difficulties. This increase in cognitive difficulties may impact physical performance.
However, flexibility, grip strength, vertical jump height, and peak power are not
dependent on cognitive skill. Hitting a baseball or throwing a football are more dependent
on cognitive skill, and they may have been significantly affected by sleep duration if they
were used in this study. It is important to note that given the limitations, the results of
this study do make an important contribution to the literature.
Suggestions for Future Research
Future research should be expanded to include a sample more representative of
the general population, including individuals of different educational level,

135
socioeconomic status, geographic region, and age. The study should also be replicated
with a larger sample size and pre-test measures to be able to determine if the sample sizes
are different prior to the experimental condition. In addition, future research should be
expanded to include individuals who are not currently students. These suggestions may
assist in improving the generalizability of study. It is also important that the effectiveness
of the 10-minute nap/relaxation be examined with a sample of more individuals
experiencing sleep difficulties. This will help ensure that the intervention has a chance to
be effective because the sample would represent equal sample sizes among the groups.
It is highly recommended that future research measure sleep quality and sleep
length using objective measures, such as an Actigraph. By using physiological measures
of sleep quality, it would greatly reduce human error, as well as the chance of memory
bias impacting the results. Physiological measures may also significantly reduce
individuals inaccurately assessing their sleep quality over time. Another way to assess
sleep length more accurately is through the use o f a sleep diary. Future research should
also examine other forms o f physical performance measures, such as additional anaerobic
or aerobic activities. Waterhouse and colleagues (2007) found that naps produced an
improvement in sprint performance after sleep loss during the previous night. However,
the current study did not measure sprinting, which is another anaerobic activity. Future
research could examine aerobic activity, such as long-distance running.
Future directions also could include comparing individuals who experience
anxiety to those who do not experience anxiety. Individuals who experience anxiety may
experience arousal, maladaptive behaviors, negative thoughts, and difficulty
concentrating, which could impede their physical performance. Guided imagery is often
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used in relaxation procedures with athletes in order to regulate their arousal before
competition, lessen maladaptive behaviors, and balance negative thoughts as well as to
enhance concentration and focus (Peluso et al., 2005; Vempati & Telles, 2002; Watanabe
et al., 2006). Therefore, individuals who experience anxiety may benefit from guided
imagery. Finally, it is unclear if a nap would have a beneficial effect on participants who
have been partially deprived of sleep compared to this without partial sleep deprivation.
Future research could examine physical performance between individuals who are
partially sleep deprived verses those who do not suffer from partial sleep deprivation.
With additional understanding o f the relationship between sleep and physical
performance, there are practical implications for athletes. Athletes in sports in which grip
strength plays an important role, such as baseball, basketball, football, tennis, and
wrestling, could potentially benefit from a 10-minute nap/relaxation prior to competing.
Getting a good night’s sleep also could be an advantage to athletes in sports where any
increase in flexibility, grip strength, vertical jump height, or peak power could influence
performance outcome.
APPENDIX A
HUMAN USE COMMITTEE
APPROVAL FORM
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LOUISIANA TECH
U N I V E R S I T Y
MEMORANDUM
OFFICE OF UNIVERSITY RESEARCH
TO: Ms. Rebecca Hoffmann and Dr. Walt Buboltz
FROM: Barbara Talbot, University Research
SUBJECT: HUMAN USE COMMITTEE REVIEW
DATE: December 19,2011
In order to facilitate your project, an EXPEDITED REVIEW has been done for your proposed
study entitled:
‘T h e Relation of Sleep Length/Quality and Napping on
Physical Performance’’
HUC 888
The proposed study’s revised procedures were found to provide reasonable and adequate
safeguards against possible risks involving human subjects. The information to be collected may
be personal in nature or implication. Therefore, diligent care needs to be taken to protect die
privacy of the participants and to assure that die data are kept confidential. Informed consent is a
critical part of the research process. The subjects must be informed dial their participation it
voluntary. It is important that consent materials be presented in a language understandable to
every participant If you have participants in your study whose first language is not English, be
sure that informed consent materials are adequately explained or translated. Since your reviewed
project appears to do no damage to the participants, the Human Use Committee grants approval
of the involvement of human subjects as outlined.
Projects should be renewed annually. This approve! was finalised on December 19, 2011 and
this project will need to receive a continuation review bp the IRS if the project, including data
analysis, continues beyond December 19, 2012. Any discrepancies in procedure or changes that
have been made including approved changes should be noted in the review application. Projects
involving NIH funds require annual education training to be documented. For more information
regarding this, contact the Office of University Research.
You are requested to maintain written records of your procedures, data collected, and subjects
involved. These records will need to be available upon request during the conduct of the study
and retained by the university for three years after the conclusion of the study. If changes occur
in recruiting of subjects, informed consent process or in your research protocol, or if
unanticipated problems should arise it is the Researchers responsibility to notify the Office of
Research or IRB in writing. The project should be discontinued until modifications can be
reviewed and approved.
If you have any questions, please contact Dr. Mary Livingston at 257-4315.
A MEMBER OF THE UNIVERSITY OF LOUISIANA SYSTEM
P.O. BOX 3092 • RUSTON, LA 71272 • TELEPHONE (SIS) 157-S07S • FAX (SIS) 257-5079
A N EQ U A L O rrO R T U N m UNIVERSITY
APPENDIX B
INFORMED CONSENT FORM
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HUMAN SUBJECTS CONSENT FORM

The following is a brief sum m ary of th e project in w hich you a re a sk ed to participate. P le ase read
th is inform ation before signing th e sta te m e n t below.______________________________________________
TITLE OF PROJECT: The Relation of Sleep Length/Quality and Napping on Physical Performance
PURPOSE OF STUDY/PROJECT: The purpose of this study is to examine the impact of sleep
quality/length and napping on physical performance.
PROCEDURE: Prior to participation, you must sign an informed consent. After consent forms are signed,
you will be asked to complete two questionnaires, participate in a dynamic warm-up, complete the hand grip
dynamometer test, sit-and reach test, and vertical jump and force plate test, take a nap or read a
newspaper, participate in a dynamic warm-up again, complete the hand grip dynamometer test, sit-and
reach test, and vertical jump and force plate test again, and complete a packet of surveys. You will be
making two trips from the classroom to the gymnasium, in one two-hour block of time. The maximum your
participation will take is two hours. Please answer the questions truthfully and to the best of your ability.
Surveys and informed consent forms will be collected separately. At the exit, you will be provided with
information regarding the availability of tutoring and counseling services and information regarding how to
obtain a summary of the results of the study. Data will be analyzed to determine relationships among the
variables.
INSTRUMENTS: The survey booklet includes general questions about your background and history, and
specific surveys about your sleep habits, physical activity, mood, and body image.
RISKS/ALTERNATIVE TREATMENTS: The participant u n d e rsta n d s th a t Louisiana Tech is n o t able to

offer financial c o m p en satio n n o r to a b so rb th e c o s ts of m edical treatm en t sh o u ld you be injured a s a
re su lt of participating in th is re se a rch . Participants might experience soreness, muscle/tendon strains or
soreness, and ligament sprains due to maximal jumps. In case of emergency, an individual certified in First
Aid and CPR will be on site during testing.
BENEFITS/COMPENSATION: Som e participants may be offered extra class credit for participation. If extra
credit is provided by your instructor, he/she must offer an alternative assignment for extra credit if you do not
choose to participate in this study.
I , _________________________________ , a tte s t with my sig n a tu re th a t I have read and u n d ersto o d the

following d escrip tio n o f th e study. "The Relation of Sleep Length/Quality a n d N apping on Physical
P erform ance," an d its p u rp o se s a n d m ethods. I u n d e rsta n d th a t my participation in th is re se a rc h is
strictly voluntary a n d mv participation o r refusal to participate in th is study will n o t affect mv
relationship with Louisiana Tech University. Further, I u n d e rsta n d th a t I m ay w ithdraw a t any tim e o r
refu se to a n sw e r any q u e stio n s w ithout penalty. Upon com pletion of th e study, I u n d e rsta n d th a t the
re su lts will be freely available to m e upon req uest. I u n d e rstan d th a t th e re su lts of my su rv ey will be
confidential, a c c e ssib le only to th e principal investigators, mvself. o r a legally ap p ointed
rep resen tativ e. I have n o t b een re q u ested to w aive nor d o I w aive any of my rig h ts related to
participating in th is study.
S ig n atu re of P articipant o r G uardian Date
CONTACT INFORMATION: The principal experim enters listed below may be c o n tac ted to an sw e r
q u e stio n s a b o u t th e research , s u b je c ts' rights, o r related m atters.
PROJECT DIRECTORS: R ebecca Hoffmann and Walt Buboltz, Ph.D.
EMAIL: rmr026@ latech.edu; buboltz@latech.edu
PHONE: (410) 581-3835; (318) 257-4039
M em bers of th e Hum an U se C om m ittee of Louisiana Tech University m ay a lso b e co n ta c te d if a

problem c a n n o t b e d isc u s s e d with th e experim enters:
Dr. Les Guice (318) 257-3056
Dr. Mary M. Livingston (318) 257-2292 or (318) 257-4315
APPENDIX C
DEMOGRAPHICS FORM
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Participant #:
Demographics Form
Please complete the following information.
1. What is your gender? 2. What is your age?

1. Male
2. Female
3. What is your race/ethnic origin? (Circle 4. What are you classified as?
all that apply) 1. Freshman
1. African American/Black 2. Sophomore
2. Asian/Pacific Islander 3. Junior
3. Caucasian/White 4. Senior
4. Hispanic 5. Graduate student
5. Native American
6. Other, please specify:
5. What is your height (feet/inches)? 6. What is your weight (in pounds)?
7. Are you an NCAA athlete? 8. If yes, then what sport do you play?
1. Yes
2. No
APPENDIX D
SLEEP QUALITY INDEX
143
144
Sleep Quality Index (SQI)
I n s t r u c t i o n s : P le a se a n s w e r th e fo llo w in g q u e s tio n s to th e b e s t o f y o u r a b ility b y c irc lin g th e

re s p o n s e th a t b e s t fits y o u . I f u n s u re , p le a s e g iv e y o u r b e s t g u e s s ._____________________________
1. Time to fall asleep
< 10 minutes 11-30 minutes >30 minutes
2. Suffered from insomnia during the past three months
No < 3 days/week 3-7 days/week
3. Difficulties falling asleep during the past 3 months
4. Disturbed night sleep during the past 3 months
5. Nocturnal awakening during the past 3 months
6. Tiredness in the morning during the past 3 months
Very or Mostly Alert Don’t Know Very or Mostly Tired
7. Wake up too early in the morning during the past 3 months
8. Use of sleeping medication during the past 3 months
No Occasionally At least once per week

APPENDIX E
ADULT SLEEP-WAKE SCALE
145
146
Adult Sleep-Wake Scale (ASWS)
D irec tio n s: U sing the choices below , circle how often the follow ing things have happened durine the past
week.
N ev e r - has not happened
O n ce in a w h ile - happened 20% o f the tim e
S o m etim es - happened 40% o f the tim e
Q u ite O fte n - happened 60% o f the tim e
F re q u e n tly , if n o t alw ay s - happened 80% o f the tim e
A lw ay s - happened 100% o f the tim e
Q uestions 1 - 5 are only about you Going to B ed at bedtim e.
W hen it is tim e to go to b e d ...
1 .) ... I w ant to stay up and do other things (fo r exam ple: read, work, o r w atch TV ).
N ever O nce in a w hile Som etim es Q uite O ften Frequently, i f n ot alw ays A lw ays
In gen eral...
2.) ...I have to m ake m y se lf go to bed.
N ever O nce in a w hile Som etim es Q uite O ften Frequently, i f not alw ays A lw ays
3 . ) . . . It is very hard for m e to go to bed on tim e.
4 . ) . . . I “put o f f ’ o r delay going to bed.
N ever O nce in a w hile Som etim es Q uite O ften Frequently, if not alw ays A lw ays
5.) How long do you usually “put o f f ’ or delay going to bed?
(a) < 15 min (b) 15-30 min (c) 30-45 min (d) 45-60 m in (e) 60-90 min (f) > 90 min
Rem em ber: T hink about the past week.
Q uestions 6 - 10 are only about you Falling Asleep after “ lights out.”
W hen I’m in bed and it is tim e to fall asleep ...
6 . ) . . . I am not sleepy.
7 . ) . .. I am unable to settle down.
147
In general...
8.) ...I try to m ake m y self go to sleep.
9 . ) . .. I fall asleep quickly.
10.) H ow long does it usually take you to fall asleep after “lights out” ?
(a) < 1 5 m in (b) 15-30 m in (c) 30-45 m in (d) 45-60 m in (e) 60-90 m in (f) >90 min
Q uestions 11 - 15 are only about how you Sleep during the night (som eone else could have told you
these things).
A fter 1 fall asleep, during the n ig h t...
1 1 .)... I toss and turn in bed.
12.) ...1 am very restless.
13.) ...I aw aken m ore than once.
In gen eral...
14.) ...I sleep w ithout arousals o r aw akenings.
15.) How often do you usually w ake up during the night?
(a) N ever (b) O nce (c) T w ice (d) 3 tim es (e) 4 tim es (f) M ore than 4 tim es
Rem em ber: T hink about the past week.
Q uestions 1 6 - 2 0 are only about you Going back to sleep after w aking up during the night.
A fter w aking up during the n ig h t...
1 6 .)... 1 have a hard tim e going back to sleep.
17.) ... I drift o ff back to sleep
148
1 8 .)... I am calm and relaxed.
19.) ...I roll over and go right back to sleep.
20.) H ow long does it usually take you to go back to sleep after w aking during the night?
(a) < 5 min (b) 5-10 min (c) 10-15 min (d) 15-20 m in (e) 20-30 m in (f) > 30 min
Q uestions 21-25 are only about you Waking Up in the morning.
In the m orning, I w ake u p ...
2 1 .) .. .and feel ready to get up for the day.
22.) ...re ste d and alert.
23.) ...a n d ju st ca n ’t get going.
In g en eral...
24.) ...I am slow -to-start in the morning.
25.) ...I find it difficult to get out o f bed in the morning.
APPENDIX F
SLEEP HABITS QUESTIONNAIRE
149
150
Sleep Habits Questionnaire (SHQ)
Instructions: Write in your answers to the following questions.
1. On the average, what time during the week do you go to bed?_________________
2. On the average, what time during the week do you wake u p ?_________________
3. On the average, what time during the weekend do you go to bed?_____________
4. On the average, what time during the weekend do you wake up?______________
5. On the average, how many hours of sleep do you get during the week?_________
6. On the average, how many hours of sleep do you get on the weekend?_________
7. Ideally I would like to g et hours of sleep during the week each night.
8. Ideally I would like to g et hours of sleep on the weekend each night.
9. About how many minutes does it take you to fall asleep after lying down in bed?
APPENDIX G
EPWORTH SLEEPINESS SCALE
151
152
Epworth Sleepiness Scale
How likely are you to doze off or fall asleep in the following situations, in contrast to
feeling just tired? This refers to your usual way of life in recent times. Even if you
haven’t done some o f these things recently try to work out how they would have affected
you.
Use the following scale to choose the most appropriate number for each situation:
0 = would never doze
1 = slight chance of dozing
2 = moderate chance of dozing
3 = high chance of dozing
It is important that you answer each question as best you can.
Situation Chance of Dozing (0-3)
Sitting and reading 0 2 3
Watching TV 0 2 3
Sitting, inactive in a public place 0 2 3

(e.g. a theatre or a meeting)
As a passenger in a car for an hour without a break
Lying down to rest in the afternoon when circumstances

Permit 0
Sitting and talking to someone 0 2 3
Sitting quietly after a lunch without alcohol 0 2 3
In a car, while stopped for a few minutes in the traffic 0 2 3
Copyright © MW Johns 1990-1997. Used under license.

APPENDIX H
KAROLINSKA SLEEPINESS SCALE
153
154
Karolinska Sleepiness Scale (KSS)
Directions: Please rate how sleepy you currently feel on the following scale by circling
the number.
(1) Extremely alert
(2)
(3) Alert
(4)
(5) Neither alert nor sleepy
(6)
(7) Sleep - but no difficulty remaining awake
(8)
(9) Extremely sleepy - fighting sleep

APPENDIX I
SCRIPT FOR RECRUITING PARTICIPANTS
155
156
Script for R ecruiting Participants
Hi, my name is Becky Hoffmann. I am a fourth year doctoral student here at
Tech. I am currently conducting research for my dissertation. Part of that includes
inviting students in Psychology and Kinesiology courses to participate in the research and
to offer you an opportunity to earn extra credit and contribute to the field of psychology.
I will be passing around a list of dates and times that you may sign-up to
participate. On the left side, please write down your name and telephone number next to
the date and time you wish to participate. Then, tear off the information on the right side
which lists the date and time you signed up for, as well as the location you will report to.
Please wear comfortable clothing that you can stretch in. I am requesting your phone
number, because you will receive a phone call the day before reminding you about the
time you signed up for and to wear comfortable clothing. If you are unavailable during
the dates and times listed and would still like to participate in the research, you can email
me to set up an alternative time. My email address is: rmr026@latech.edu. Your
participation in this study is voluntary. All information provided in this study will remain
anonymous and confidential. The amount of extra credit you receive will be determined
by your professor. What questions do you have? Thank you very much for signing up to
participate in this study.

APPENDIX J
ACTIVE DYNAMIC WARM-UP PROCEDURE
157
158
Active Dynamic Warm-up (Pre-Practice/Game)
1. Complete Jumping Jack Series

a. Jumping Jacks 2 x 10
b. Split Jack Forward 2 x 10
c. Highland Fling 2 x 10
d. Long Striders 2 x 10
2. Neck Clock 1 x 5 each
3. Shoulder Roll forward and backward 1 x 5 each
4. Long Arm Swings 1 x 5 each
5. Arm Circle Giant forward and backwards 1 x 10 each
6. Arm Hugs 1 x 10
7. Trunk Twists 1 x 5 each
8. Prisoner Squat Arms Forward 1x5
9. Heel to Toe Raise 1 x 5 each
10. Lunge Forward 1 x 5 each
11. Lunge Backwards 1 x 5 each
12. Lateral Lunge 1 x 5 each
13. Inverted Toe Touch 1 x 10 yd
14. Straight Leg March 1 x 10 yd
15. Quadricep Stretch Walking 1 x 10 yd
16. Knee Hug Walking 1 x 10 yd
17. Walking Lunge Same Elbow Same Leg 1 x 10 yd
18. Walking Lunge with Twist 1 x 10 yd
19. Prone Scorpion 1 x 5 each
20. Acceleration A Skip 1 x 10 yd
21. Butt Kickers 1 x 10 yd
22. Slow Backpedal 1 x 20 yd
23. Fast Backpedal 1 x 20 yd
24. Carioca 2 x 20 yd
25. Power Skip 1 x 20 yd
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The relationships of sleep quality, length, and

Follow this and additional works at: https://digitalcommons.latech.edu/dissertations

AND NAPPING TO PHYSICAL

Rebecca M. Hoffmann, B.S., M.A., M. S.

A Dissertation Presented in Partial Fulfillment

All rights reserved

INFORMATION TO ALL USERS

THE GRADUATE SCHOOL

August 23, 2012

We hereby recommend that the dissertation prepared under our supervision

The Relationships of Sleep Quality/Length and Napping to Physical

be accepted in partial fulfillment of the requirements for the Degree of

Recommendation concurred in:

Director o f Graduate Studies Dean o f the Graduate Scnoo

Dean o f the College

Participants of this study were students at a mid-sized southern United States

gender as an independent variable. Correlations were also conducted to determine the

strength, and peak power.

works must be appropriately referenced to this Dissertation.

literature, at any time, any or all portions of this Dissertation.

Statement of the Problem....................................................................................................5

Literature Review ............................................................................................................... 7

Physiological Processes of Sleep-Wake Cycle.........................................................11

Autonomic Nervous System................................................................................ 11

The Theories o f Sleep Function.................................................................................18

The Restoration M odel........................................................................................ 18

The Neurotransmitter Replenishment Theory................................................... 19

The Evolutionary/Circadian Sleep Models.........................................................19

The Developmental M odel.................................................................................. 19

The Learning M odel............................................................................................ 20

Sleep Difficulties of College Students...................................................................... 22

Factors that Affect Sleep in College Students......................................................... 26

Effects of Inadequate Sleep Length.......................................................................... 31

Sleep and Health.........................................................................................................32

Sleep and Obesity/Health Status......................................................................... 40

Sleep and Learning/Academic Performance............................................................ 45

Sleep Quality and Physical Performance..................................................................51

Napping and Physical Performance......................................................................... 52

Justification of Hypotheses 1A, IB, 1C, and ID ...............................................58

Justification of Hypotheses 2A, 2B, 2C, and 2 D ...............................................59

Justification of Hypotheses 3A, 3B, 3C, and 3D ............................................... 60

Justification of Hypotheses 4A, 4B, 4C, and 4 D ............................................... 61

Demographics F orm ...................................................................................................62

Sleep Quality Index....................................................................................................63

Adult Sleep-Wake Scale............................................................................................ 64

Sleep Habits Questionnaire........................................................................................ 65

Epworth Sleepiness Scale.......................................................................................... 66

Karolinska Sleepiness Scale...................................................................................... 67

Physical Performance Measures...................................................................................... 67

Hand Grip Dynamometer........................................................................................... 67

Vertec Vertical Jump Device..................................................................................... 69

Estimated Peak Pow er................................................................................................69

Hand Dynamometer Test Procedure......................................................................... 72

Vertical Jump Test Procedure....................................................................................72

Sit-and-Reach Test Procedure...................................................................................73

Risks and Benefits......................................................................................................73