Abstract
Introduction
Reports of anxiety and stress are increasing among college-age students. Previous findings show bi-directional relationships with nighttime sleep loss and elevated anxiety and stress. Less is known about changes across the day (profiles) in anxiousness and stress, and their relationship to daytime sleepiness and fatigue profiles. The primary objective of this study was to examine these potential interactions.
Methods
Using an ecological momentary assessment design, university undergraduates (N=102, female= 77.5%) made smart phone ratings (0-9 Scale) of anxiousness, stressfulness, fatigue, sleepiness from Monday-Friday, six times per day. Participant were either Low-Anxious (0-1 score: n=34) or High-Anxious (>7 score; n=68) on the GAD-Q-IV Scale, had > 7h sleep per weeknight, and bed- and wake times between 06:30-09:30 and 22:30-02:00, respectively. Mean daytime profile interactions were examined using joint-trajectory longitudinal clustering.
Results
Clustering identified two subtypes, Lo (n=46) and Hi (n=56), which differed primarily in their quadratic curve levels, and in times of highest and lowest ratings. Subtypes differed (p<.001) in overall mean ratings of anxiousness (Lo=1.6±0.9, Hi=3.6±1.1), stressfulness (Lo=2.0±0.9, Hi=4.3±1.1), fatigue (Lo=2.4±1.0, Hi=4.4±1.0), and sleepiness (Lo=2.9±1.0, Hi=4.3±1.1). Subtypes were similar in age (Lo=18.6±0.9, Hi=18.9±1.3), morningness-eveningness BALM (Lo=33.2±4.1, Hi=32.1±5.1) and MEQ (Lo=47.5±6.2, Hi=47.7±6.8) scores, and hours sleep (Lo=8.5±0.8, Hi=8.4±0.9). Notably, more females were Hi subtype (83.9%) than Lo subtype (69.6%). Also, GAD-Q-IV scores differed within subtypes: Hi (80.4% High-Anxiety, 19.6% Low-Anxiety) versus Lo (50.0% for both High- and Low-Anxiety).
Conclusion
Despite apparent adequate nightly sleep, elevated anxiousness and stressfulness may be accompanied by increased daytime fatigue and sleepiness in college students. Furthermore, standardized clinical tests designed to identify levels of anxiety and stress may not align with daily experiences of those states. Better understanding of concomitant daytime profiles of anxiousness, stress, sleepiness, and fatigue could facilitate treatment development and reduce the burden on student counseling centers.
Support
None