s parents pack their children off to
college this week, they would be wise to add one more piece of
advice to protect the health of their offspring: make sure to get
eight or more hours of sleep every night.
Like many college students, Jenny Waller, 21, is something of a
night owl. In her first weeks at the University of Michigan a few
years ago, Miss Waller rarely went to bed before 3 or 4 in the
"In college," she said, "your mom isn't there to tell you to go
to bed, and for me, things only got worse. Within a month, I was
staying up all night, going to bed at 9 a.m. and pretty much missing
all of my classes. Many nights I would sit with my textbooks, but I
couldn't concentrate. I wouldn't let myself get to bed until I
finished the work.
"But it was a vicious cycle. The later I stayed up, the worse my
concentration got, making studying pretty much impossible. I would
read the same paragraphs over and over, and pretty much cried about
Three months later, Miss Waller was told that she had clinical
depression, and she temporarily withdrew from college.
Her history is not uncommon. In the last few years, mental health
professionals have asked whether sleep deprivation plays a role in
the increase in cases of depression reported on campuses.
According to a study by psychologists at Kansas State University
and published in February in Professional Psychology, the number of
college-age students treated for depression has doubled since 1989.
The study involved more than 10,000 students at more than 100
That incidence is twice the rate for the general population: one
in 10 men and one in four women will have a clinical depressive
episode in their lifetimes. Since 1989, the number of college
students consulting doctors for sleep problems increased even more,
some experts say.
"There's no question that college kids are sleeping less than
they used to," said Dr. Roseanne Armitage, director of the Sleep and
Chronophysiology Laboratory at the University of Michigan Depression
Last year, college students averaged 6 to 6.9 hours of sleep a
night, far less than the suggested 8 to 9.25 and down from 7 to 7.5
in the 1980's.
Psychiatrists are not certain whether sleep problems are a
potential cause or a symptom of depression. Treating depression with
antidepressants is not always as effective for sleep problems as for
other symptoms. Some medications like the widely prescribed
selective serotonin reuptake inhibitors can actually cause insomnia.
Many experts have even succeeded with patients with severe
depression for short periods by depriving them of sleep.
The role of sleep disturbances in depression has, however, gained
the interest of neuroscientists since a study from the National
Institute of Mental Health in 1989 reported that sleep disturbances
lasting longer than two weeks increased the risk of developing many
psychiatric illnesses, especially depression.
"A good analogy," Dr. Armitage said, "would be having a high
serum cholesterol and the risk of heart attacks. Just because you
have a high cholesterol level does not necessarily mean you are
definitely going to have a heart attack. But it is a definite risk
factor. The same could be said for sleep disturbances and the risk
of developing depression."
Dr. John F. Greden, chairman of the psychiatry department at the
University of Michigan, said: "We have pretty good evidence that
staying up late all night and then trying to catch up with an
erratic schedule of naps quickly creates a situation called delayed
sleep phase insomnia. This is the kiss of death for mood
Many students stay up until 3 a.m., sleep until 1 p.m., try to
catch up with a nap and then do it again night after night, Dr.
Greden said. But getting back on schedule for 8 or 9 a.m. classes is
difficult. The students' sleep is perpetually disrupted, as if they
had jet lag, and especially for those with a vulnerability to
depression, the patterns are highly likely to be a risk factor.
Nor are long vacations like summer breaks good ways to catch
"We know very little about what transpires during the summer,
when most students return home," Dr. Greden added. "But, if sleep
problems persist because of untreated depression, students are
likely to return back to campus in autumn even more vulnerable."
Dr. Fred B. Newton, the director of student counseling at Kansas
State and a co-author of the study published in February, said:
"Good mental and physical health requires a semblance of harmony and
balance in your life. That includes adequate sleep and diet. College
does not always promote this."
Dr. Sherry A. Benton, a psychologist at Kansas State and another
co-author of the study, said students today faced more diverse and
challenging pressures than students 20 years ago.
"Some academic programs," Dr. Benton said, "consider a student to
be a slacker if he or she doesn't stay up all night studying.
College is more expensive than ever, and there are more students
working jobs to pay tuition, in addition to the usual desires to
socialize, pursue extracurricular activities, 24-hour access to the
Internet and the enormous pressure for students to get all A's in
order to succeed, to get into medical, law or even graduate school.
Something has to go, and most often it is sleep."
Dr. Mary Alice Carskadon, a professor of psychology at Brown who
is a leading researcher of college students' sleep patterns, said
many signs pointed to a connection between insufficient sleep and
"Every study we have ever done over the past decade on high
school and college students shows the less sleep they get the more
depressed mood they report," Dr. Carskadon said. "It is a persistent
and strong association that we are able to measure in all the
different ways we have looked at this population's sleep patterns
from surveys to sleep diaries to manipulating their sleep in the
"At Brown, the median bedtime is 2 a.m. That means half the kids
are going to bed later than that, and often these kids cannot stay
awake during their classes. We've stopped 8 a.m. classes, and
frankly, the 9 a.m. classes are a struggle for many of our
Dr. David F. Dinges, chief of the sleep and chronobiology
division at the University of Pennsylvania, has conducted studies
that show that frequent episodes of depressed moods can at a minimum
cause significant problems for students, especially when they are
learning concepts and concentrating on homework.
Jodi Keller, 19, an undergraduate at Michigan, attributes her
first serious episode of depression to a lack of sleep and the
overcrowded schedules that most students accept as normal routine.
"When short of time," Ms. Keller said, "it's always sleep that I
sacrifice first. I can't remember how many all-nighters I have
pulled in order to complete my schoolwork and get good grades."
Another Michigan undergraduate, Victoria Chien, 21, has been
treated for serious episodes of clinical depression since she was
17. Miss Chien said, "When I don't get adequate rest, my depression
becomes much more severe."
Nevertheless, she remains active in the late-night culture.
"Sleep deprivation," Miss Chien said, "is a pretty big problem
for me. I try to make it up over the weekends, but it doesn't help