ABSTRACT
Introduction:Mental health conditions such as anxiety represent a growing health concern for students in institutions of higher education. Postsecondary students are a vulnerable population that is increasingly recognized to be at risk for both mental health problems and significant sleep problems. While it has been hypothesized that poor sleep quality may be a risk factor for developing anxiety, little is known about the frequency and severity of sleep problems and their association with anxiety within the postsecondary student population. The aim of this systematic review was to synthesize the best evidence on the association between sleep quality and anxiety in postsecondary students. Materials and Methods: An experienced librarian developed systematic search strategies in four databases: MEDLINE, Embase, APA PsycInfo (through Ovid Technologies Inc.) and CINAHL, Cumulative Index to Nursing and Allied Health Literature (through EBSCOhost). Databases were searched from inception to September 2020. Random pairs of independent reviewers screened titles and s for eligibility and critically appraised all eligible studies. We assessed the quality of studies using the Scottish Intercollegiate Guidelines Network (SIGN) criteria for cohort studies, and the Hoy tool for cross-sectional studies. One author extracted and synthesized the results from all of the low and moderate risk of bias studies. We synthesized our results by study design and population. Results: Once duplicates were removed, a total of 3203 unique citations were screened. Fifty-one articles were eligible and critically appraised. Studies with low and moderate risk of bias were included in our final synthesis of which 24 were cross-sectional studies and four were cohort studies. With the exception of one study, all cross-sectional studies reported a statistically significant association between poor sleep quality and anxiety. All four of the cohort studies found that students who reported poor sleep quality were more likely to develop future anxiety and students with anxiety were more likely to develop future poor sleep quality. Conclusions: Poor sleep quality is associated with anxiety in postsecondary students. Due to the cross-sectional nature of most studies, we cannot determine the direction of this association. Future studies should focus on developing high-quality prospective cohort or longitudinal studies to help understand the impact and direction that this association has in postsecondary populations. This research has the potential to inform the development and design of mental health policies and programs that are created by postsecondary institutions to address the increasing rates of student mental health issues. Acknowledgements: Canadian Institutes of Health Research (CIHR) Operating Grant: Knowledge synthesis: COVID-19 in Mental Health & Substance Use;University of Ontario Institute of Technology;Institute of Disability and Rehabilitation Research.
ABSTRACT
Introduction: Students pursuing postsecondary education are a population at significant risk for both sleep problems and poor mental health outcomes such as depression and anxiety. Interventions such as sleep hygiene education and cognitive behavioural therapy (CBT) are commonly used treatments for sleep problems and have been effective in improving sleep and mental health in the university student population. Digitally-delivered CBT has also been shown to be effective in improving sleep in youth, however it has not been evaluated in the postsecondary student population. Materials and Methods: We conducted a systematic review of the quantitative and qualitative evidence on the effectiveness and user experiences of digital sleep interventions to improve sleep and mental health outcomes in postsecondary students. We searched MEDLINE, CINAHL, Embase, and APA PsycInfo for studies published from 2000 to 2021. We included randomized controlled trials (RCTs), cohort studies, case-control studies, qualitative studies, and mixed methods studies. Pairs of reviewers independently screened and critically appraised studies, and extracted data. We aimed to use a sequential approach at the review level to synthesize and integrate data across qualitative and quantitative research studies. Results: We screened 5361 citations and 58 full text articles. Eight relevant RCTs and one cohort study were critically appraised. Three interventions were assessed including CBT, digital sleep hygiene education, and relaxation music. Most studies were assessed as high risk of bias. Given the methodological limitations of the included studies, we are unable to conclude on the effectiveness of digital sleep interventions for postsecondary students. We did not identify any qualitative studies. Conclusions: Methodological limitations preclude firm conclusions. Further research is needed to assess the effectiveness of digital alternatives for delivering sleep interventions to improve sleep and mental health outcomes in postsecondary students. Qualitative studies exploring the views and preferences of students and providers are required to inform the development of novel interventions that are acceptable in this population. Acknowledgements: Canadian Institutes of Health Science (CIHR) Operating Grant: Knowledge Synthesis: COVID-19 in Mental Health & Substance Use
ABSTRACT
BackgroundThe residents of Victoria (Australia’s second most populous state), were subject to a hard lockdown for several months as they experienced a second wave of COVID-19. Victorians could only leave their homes for essential activities, were required to wear facemasks, remain within 5km of their homes and were subject to a nightly curfew. Elsewhere in Australia, COVID numbers remained low with no lockdown in place. We examined the impact of the lockdown on the sexual behaviour of Victorians compared with elsewhere in Australia.MethodsOur online survey was open for 2.5 weeks during the lockdown (August 13th to 31st). Participants aged 18+ were recruited via social media and asked to report on their current sexual practices. Logistic regression was used to calculate the difference in the proportion of practices between Victorians and non-Victorians.Results976 people completed the survey: 71% identified as female, 75% were aged 18–29 years, 61% resided in Victoria. Compared with elsewhere in Australia, Victorians were less likely to report sex in the last 4 weeks (54.8% vs 68.0%, diff=-13.3%, 95%CI -19.6, -6.9). Victorians were also less likely to report casual hook-ups (10.6% vs 17.3%;diff=-6.7%, 95%CI -12.5, -0.8) and sex with a fuckbuddy (10.6% vs 16.9%;diff=-6.2%, 95%CI-12.1,-0.4). There was no difference in dating app use in the last 4 weeks between Victorians and others (27.0% vs 26.6%;diff=0.4;95%CI -5.2,6.1), but Victorians were more likely to report using apps for virtual dates (15.7% vs 2.9%, diff=12.8%, 95%CI 6.2,19.3) and chatting (83.0% vs 72.5%;diff=10.5;95%CI 0.0,20.9) and less likely to use them for face-to-face dates (15.1% vs 56.9%;diff=-41.8%, 95%CI -52.9,-30.7).ConclusionsHard lockdowns impact sexual behaviour and practices. However, sexual activity did not stop completely, highlighting the importance of ensuring accessibility of sexual and reproductive health services during periods of restriction.