Behaviorally Induced Insufficient Sleep Syndrome and Insomnia: Prevalence and Relationship to Depression in College Students

Background: College students are at increased risk for general sleep issues as well as specific disorders, including Behaviorally Induced Insufficient Sleep Syndrome (BISS) and insomnia. These disorders can have deleterious daytime consequences, which can be compounded by exacerbating depression. The present study aims to establish college prevalence of BISS/insomnia, to characterize sleep characteristics in this sample, and to compare depression across BISS/insomnia. Methods: Data from a college risk behaviors and health study (n=989) was used. Insomnia and BISS were defined as mutually exclusive disorders, using ICD-10/DSM-5 criteria, and Pittsburg Sleep Quality Index items. Results: Overall, the results of this study characterize sleep in college students as commonly insufficient, with moderate sleep quality, normal sleep latency, and high levels of daytime sleepiness. A majority (~68%) of students were categorized as normal sleepers, followed by insomnia (~22%), and BISS (~10%). Insomnia was associated with the most depression, followed by BISS, and normal sleep, after controlling for gender and ethnicity. BISS and insomnia predicted depressive symptoms over and above potent risk and demographic factors, including ethnicity, gender, binge drinking, anxiety, and interpersonal trauma exposure. Conclusion: These findings reinforce the importance of incorporating sleep screening into depression treatment (and vice-versa) in college students. Future research can extend the present study’s findings by utilizing a longitudinal design, including additional measures, and evaluating screening/clinical interventions for this population