Journal of Public Health and Epidemiology
Subscribe to JPHE
Full Name*
Email Address*

Article Number - 74E895E45007


Vol.8(6), pp. 202-210 , June 2014
DOI: 10.5897/JPHE2014.0620
ISSN: 2141-2316



Full Length Research Paper

Daytime sleepiness, circadian preference, caffeine consumption and use of other stimulants among Thai college students



Jason Tran
  • Jason Tran
  • Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, U.S.A.
  • Google Scholar
Somrat Lertmaharit
  • Somrat Lertmaharit
  • College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand.
  • Google Scholar
Vitool Lohsoonthorn
  • Vitool Lohsoonthorn
  • Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • Google Scholar
Wipawan C. Pensuksan
  • Wipawan C. Pensuksan
  • School of Nursing, Walailak University, Nakhon Si Thammarat, Thailand.
  • Google Scholar
Thanapoom Rattananupong
  • Thanapoom Rattananupong
  • Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
  • Google Scholar
Mahlet G. Tadesse
  • Mahlet G. Tadesse
  • Department of Mathematics & Statistics, Georgetown University, Washington, DC, U.S.A.
  • Google Scholar
Bizu Gelaye*
  • Bizu Gelaye*
  • Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, U.S.A.
  • Google Scholar
Michelle A. Williams
  • Michelle A. Williams
  • Department of Epidemiology, Multidisciplinary Health International Research Training Program, Harvard School of Public Health, Boston, MA, U.S.A.
  • Google Scholar







 Received: 21 January 2014  Accepted: 16 May 2014  Published: 30 June 2014

Copyright © 2014 Author(s) retain the copyright of this article.
This article is published under the terms of the Creative Commons Attribution License 4.0


This study was conducted to evaluate the prevalence of daytime sleepiness and evening chronotype and to assess the extent to which both are associated with the use of caffeinated stimulants among 3,000 Thai college students. Demographic and behavioral characteristics were collected using a self-administered questionnaire. The Epworth Sleepiness Scale and the Horne and OstbergMorningness-Eveningness Questionnaire were used to evaluate prevalence of daytime sleepiness and circadian preference. Multivariable logistic regression models were used to evaluate the association between sleep habits and consumption of caffeinated beverages. Overall, the prevalence of daytime sleepiness was 27.9% (95% CI: 26.2 to 29.5%) while the prevalence of evening chronotype was 13.0% (95% CI: 11.8 to 14.2%). Students who use energy drinks were more likely to be evening types. For instance, the use of M100/M150 energy drinks was associated with a more than 3-fold increased odds of evening chronotype (OR 3.50; 95% CI 1.90 to 6.44), while Red Bull users were more than twice as likely to have evening chronotype (OR 2.39; 95% CI 1.02 to 5.58). Additionally, those who consumed any energy drinks were more likely to be daytime sleepers. For example, Red Bull (OR 1.72; 95% CI 1.08 to 2.75) or M100/M150 (OR 1.52; 95% CI 1.10 to 2.11) consumption was associated with increased odds of daytime sleepiness. Our findings emphasize the importance of implementing educational and prevention programs targeted toward improving sleep hygiene and reducing the consumption of energy drinks among young adults.

Key words: Daytime sleepiness, Caffeine, stimulants, college students, morningness-eveningness.

AASM (2001). International Classification of Sleep Disorders, revised: Diagnostic and coding manual. Chicago, Illinois: American Academy of Sleep Medicine.
 
Adan A, Natale V (2002). Gender differences in morningness-eveningness preference. ChronobiolInt 19(4):709-720.
Crossref
 
Arria AM, Caldeira KM, Kasperski SJ, O'Grady KE, Vincent KB, Griffiths RR, Wish ED (2010). Increased alcohol consumption, nonmedical prescription drug use, and illicit drug use are associated with energy drink consumption among college students. J. Addict. Med. 4(2):74-80.
Crossref
 
Barion A, Zee PC (2007). A clinical approach to circadian rhythm sleep disorders. Sleep Med. 8(6):566-577.
Crossref
 
Basheer R, Strecker RE, Thakkar MM, McCarley RW (2004). Adenosine and sleep-wake regulation. Prog. Neurobiol. 73(6):379-396.
Crossref
 
Besoluk S, Onder I, Deveci I (2011). Morningness-eveningness preferences and academic achievement of university students.ChronobiolInt, 28(2):118-125.
Crossref
 
Buxton C, Hagan JE (2012). A survey of energy drinks consumption practices among student -athletes in Ghana: lessons for developing health education intervention programmes. J. Int. Soc. Sports Nutr. 9(1):9.
Crossref
 
Cannon ME, Cooke CT, McCarthy JS (2001). Caffeine-induced cardiac arrhythmia: an unrecognised danger of healthfood products. Med. J. Aust. 174(10):520-521.
Pubmed
 
Cheng SH, Shih CC, Lee IH, Hou YW, Chen KC, Chen KT, Yang YK, Yang YC (2012). A study on the sleep quality of incoming university students. Psychiatry Res. 197(3):270-274.
Crossref
 
Chung KF, Cheung MM (2008). Sleep-wake patterns and sleep disturbance among Hong Kong Chinese adolescents. Sleep 31(2):185-194.
Pubmed
 
Doi Y, Inoue Y, Minowa M, Uchiyama M, Okawa M (2003). Periodic leg movements during sleep in Japanese community-dwelling adults based on the assessments of their bed partners. J. Epidemiol. 13(5):259-265.
Crossref
 
Giannotti F, Cortesi F, Sebastiani T, Ottaviano S (2002). Circadian preference, sleep and daytime behaviour in adolescence. J. Sleep Res. 11(3):191-199.
Crossref
 
Gooley JJ, Chamberlain K, Smith KA, Khalsa SB, Rajaratnam SM, Van Reen E, Zeitzer JM, Czeisler CA, Lockley SW (2011). Exposure to room light before bedtime suppresses melatonin onset and shortens melatonin duration in humans. J. Clin. Endocrinol. Metab, 96(3):E463-472. doi:10.1210/jc.2010-2098
Crossref
 
Horne JA, Ostberg O (1976). A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int. J. Chronobiol, 4(2):97-110.
Pubmed
 
Hsu CY, Gau SS, Shang CY, Chiu YN, Lee MB (2012). Associations between chronotypes, psychopathology, and personality among incoming college students.ChronobiolInt, 29(4):491-501.
Crossref
 
Ishak WW, Ugochukwu C, Bagot K, Khalili D, Zaky C (2012). Energy drinks: psychological effects and impact on well-being and quality of life-a literature review. Innov. Clin. Neurosci. 9(1):25-34.
Pubmed
 
James JE, Kristjansson AL, Sigfusdottir ID (2011). Adolescent substance use, sleep, and academic achievement: evidence of harm due to caffeine. J. Adolesc. 34(4):665-673.
Crossref
 
Johns MW (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540-545.
Pubmed
 
Kanerva N, Kronholm E, Partonen T, Ovaskainen ML, Kaartinen NE, Konttinen H, Broms U, Männistö S (2012). Tendency toward eveningness is associated with unhealthy dietary habits. ChronobiolInt. 29(7):920-927.
Crossref
 
Killgore WD, Kahn-Greene ET, Lipizzi EL, Newman RA, Kamimori GH, Balkin TJ (2008). Sleep deprivation reduces perceived emotional intelligence and constructive thinking skills. Sleep Med. 9(5):517-526.
Crossref
 
Kushida CA (2006). Countermeasures for sleep loss and deprivation. Curr. Treat Options Neurol. 8(5):361-366.
Crossref
 
Lohsoonthorn V, Khidir H, Casillas G, Lertmaharit S, Tadesse MG, Pensuksan WC, Rattananupong T, Gelaye B, Williams MA (2012). Sleep quality and sleep patterns in relation to consumption of energy drinks, caffeinated beverages, and other stimulants among Thai college students. Sleep Breath 17:1017-28.
Crossref
 
Lucassen EA, Zhao X, Rother KI, Mattingly MS, Courville AB, de Jonge L, Csako G, Cizza G; Sleep Extension Study Group (2013). Evening chronotype is associated with changes in eating behavior, more sleep apnea, and increased stress hormones in short sleeping obese individuals. PLoS One, 8(3):e56519.
Crossref
 
Lund HG, Reider BD, Whiting AB, Prichard JR (2010) Sleep patterns and predictors of disturbed sleep in a large population of college students. J Adolesc Health, 46(2):124-132.
Crossref
 
Luyster FS, Strollo PJ Jr, Zee PC, Walsh JK; Boards of Directors of the American Academy of Sleep Medicine and the Sleep Research Society (2012). Sleep: a health imperative. Sleep, 35(6):727-734.
Pubmed
 
Mak KK, Ho SY, Thomas GN, Lo WS, Cheuk DK, Lai YK, Lam TH (2010). Smoking and sleep disorders in Chinese adolescents. Sleep Med. 11(3):268-273.
Crossref
 
Malinauskas BM, Aeby VG, Overton RF, Carpenter-Aeby T, Barber-Heidal K (2007). A survey of energy drink consumption patterns among college students. Nutr. J. 6:35.
Crossref
 
Merikanto I, Lahti T, Kronholm E, Peltonen M, Laatikainen T, Vartiainen E, Salomaa V, Partonen T (2013). Evening types are prone to depression. ChronobiolInt, 30(5):719-725.
Crossref
 
Millman RP (2005). Excessive sleepiness in adolescents and young adults: causes, consequences, and treatment strategies. Pediatrics 115(6):1774-1786.
Crossref
 
Nakade M, Takeuchi H, Kurotani M, Harada T (2009). Effects of meal habits and alcohol/cigarette consumption on morningness-eveningness preference and sleep habits by Japanese female students aged 18-29. J PhysiolAnthropol, 28(2):83-90.
Crossref
 
Oginska H, Pokorski J (2006). Fatigue and mood correlates of sleep length in three age-social groups: School children, students, and employees. ChronobiolInt. 23(6):1317-1328.
Crossref
 
Pirrallo RG, Loomis CC, Levine R, Woodson BT (2012). The prevalence of sleep problems in emergency medical technicians. Sleep Breath 16(1):149-162.
Crossref
 
Pomeranz JL, Munsell CR, Harris JL (2013). Energy drinks: an emerging public health hazard for youth. J. Public Health Policy 34(2):254-271.
Crossref
 
Ribeiro JA, Sebastiao AM (2010). Caffeine and adenosine. J. Alzheimers Dis. 20 Suppl 1, S3-15.
 
Roehrs T, Roth T (2008). Caffeine: sleep and daytime sleepiness. Sleep Med Rev, 12(2), 153-162. doi:10.1016/j.smrv.2007.07.004
Crossref
 
Schneider ML, Vasconcellos DC, Dantas G, Levandovski R, Caumo W, Allebrandt KV, Hidalgo MP (2011). Morningness-eveningness, use of stimulants, and minor psychiatric disorders among undergraduate students. Int. J. Psychol. 46(1):18-23.
Crossref
 
Seifert SM, Schaechter JL, Hershorin ER, Lipshultz SE (2011). Health effects of energy drinks on children, adolescents, and young adults. Pediatrics 127(3):511-528.
Crossref
 
Shanahan TL, Kronauer RE, Duffy JF, Williams GH, Czeisler CA (1999). Melatonin rhythm observed throughout a three-cycle bright-light stimulus designed to reset the human circadian pacemaker. J. Biol. Rhythms 14(3):237-253.
Crossref
 
Slater G, Pengo MF, Kosky C, Steier J (2013). Obesity as an independent predictor of subjective excessive daytime sleepiness. Respir. Med. 107(2):305-309.
Crossref
 
Snel J, Lorist MM (2011). Effects of caffeine on sleep and cognition.Prog Brain Res, 190:105-117.
Crossref
 
Steptoe A, Peacey V, Wardle J (2006). Sleep duration and health in young adults. Arch. Intern. Med. 166(16):1689-1692.
Crossref
 
Stroe AF, Roth T, Jefferson C, Hudgel DW, Roehrs T, Moss K, Drake CL (2010).Comparative levels of excessive daytime sleepiness in common medical disorders.Sleep Med. 11(9):890-896.
Crossref
 
Taillard J, Philip P, Bioulac B (1999). Morningness/eveningness and the need for sleep. J. Sleep Res. 8(4):291-295.
Crossref
 
Taylor DJ, Clay KC, Bramoweth AD, Sethi K, Roane BM (2011). Circadian phase preference in college students: relationships with psychological functioning and academics. ChronobiolInt, 28(6):541-547.
Crossref
 
Tsai LL, Li SP (2004). Sleep patterns in college students: gender and grade differences. J. Psychosom Res. 56(2):231-237.
Crossref
 
WHO (1995). Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee.World Health Organizations, Geneva.
 
WHO (2004). Global status report on alcohol. World Health Organization, Department of Mental Health and Substance Abuse, Geneva.
 
Wittmann M, Paulus M, Roenneberg T (2010). Decreased psychological well-being in late 'chronotypes' is mediated by smoking and alcohol consumption. Subst Use Misuse 45(1-2):15-30.
Crossref
 
Wu S, Wang R, Ma X, Zhao Y, Yan X, He J (2012). Excessive daytime sleepiness assessed by the Epworth Sleepiness Scale and its association with health related quality of life: a population-based study in China. BMC Public Health, 12:849.
Crossref
 
Yang CM, Wu CH, Hsieh MH, Liu MH, Lu FH (2003). Coping with sleep disturbances among young adults: a survey of first-year college students in Taiwan. Behav. Med. 29(3):133-138.
Crossref
 
ZI (2007). US overtakes Thailand as world leader in energy drinks. [June 1, 2013]. http://www.zenithinternational.com/news/press.

 


APA Tran, J., Lertmaharit, S., Lohsoonthorn, V., Pensuksan, W. C., Rattananupong, T., Tadesse, M. G., Gelaye, B., & Williams, M. A. (2014). Daytime sleepiness, circadian preference, caffeine consumption and use of other stimulants among Thai college students. Journal of Public Health and Epidemiology, 8(6), 202-210.
Chicago Jason Tran, Somrat Lertmaharit, Vitool Lohsoonthorn, Wipawan C. Pensuksan, Thanapoom Rattananupong, Mahlet G. Tadesse, BizuGelaye and Michelle A. Williams. "Daytime sleepiness, circadian preference, caffeine consumption and use of other stimulants among Thai college students." Journal of Public Health and Epidemiology 8, no. 6 (2014): 202-210.
MLA Jason Tran, et al. "Daytime sleepiness, circadian preference, caffeine consumption and use of other stimulants among Thai college students." Journal of Public Health and Epidemiology 8.6 (2014): 202-210.
   
DOI 10.5897/JPHE2014.0620
URL http://www.academicjournals.org/journal/JPHE/article-abstract/74E895E45007

Subscription Form