Qualidade de sono e sonolência diurna em estudantes universitários:  testando um modelo explicativo

Erlândio Andrade de Sousa; Leogildo Alves Freires; Gleidson Diego Lopes Loureto; Júlio Cezar Albuquerque da Costa

doi:10.22235/cp.v17i2.2630

Autores/as

Erlândio Andrade de Sousa Universidade Federal de Roraima https://orcid.org/0000-0002-7126-5036
Leogildo Alves Freires Universidade Federal de Alagoas https://orcid.org/0000-0001-5149-2648
Gleidson Diego Lopes Loureto Universidade Federal de Roraima https://orcid.org/0000-0002-0889-6097
Júlio Cezar Albuquerque da Costa Universidade Federal de Alagoas https://orcid.org/0000-0002-6730-2156

DOI:

https://doi.org/10.22235/cp.v17i2.2630

Palabras clave:

Calidad del sueño, Somnolencia diurna, estrés académico, estudiantes universitarios

Resumen

Este estudio tuvo como objetivo evaluar, vía modelaje por ecuaciones estructurales, un modelo explicativo de la calidad del sueño y somnolencia diurna excesiva en estudiantes universitarios brasileños (N = 407). Los participantes respondieron al Índice de la Calidad del Sueño de Pittsburgh (PSQI), a la Escala de Somnolencia de Epworth (ESS-BR), Cuestionarios de Salud General (QSG-12), la Escala de Evaluación de Fatiga (EAF), la Escala de Estrés Académico (EEA), el Cuestionario sobre el Tiempo de Uso de Drogas (QTUDR) e informaciones demográficas. Los análisis de correlaciones y regresiones ofrecieron respaldo para la elaboración de un modelo explicativo que incluye como variables explicativas el malestar psicológico, el estrés académico y el uso de cafeína como predictores de la calidad de sueño y esta última juntamente con la fatiga, lo que explica la somnolencia diurna. Este modelo presentó índices adecuados de ajuste a los datos empíricos. Se puede concluir que niveles mayores de estrés académico, malestar psicológico, fatiga y uso de cafeína de asocian a índices menores de calidad del sueño entre estudiantes universitarios. Tales resultados ponen en evidencia la importancia de considerar tanto variables individuales cuanto contextuales para entender el ciclo vigilia-sueño en el ámbito académico. Estas variables deben ser consideradas en estudios posteriores que busquen aplicar y evaluar posibles acciones futuras de intervención.

Descargas

Los datos de descargas todavía no están disponibles.

Biografía del autor/a

Leogildo Alves Freires, Universidade Federal de Alagoas

Psicólogo, Doutor em Psicologia Social pela Universidade Federal da Paraíba (UFPB) e professor do Instituto de Psicologia da Universidade Federal de Alagoas (UFAL).

Gleidson Diego Lopes Loureto, Universidade Federal de Roraima

Psicólogo, Doutor em Psicologia Social da Universidade Federal da Paraíba (UFPB) e professor do curso de Psicologia do Centro Universitário UNIFIP (Patos, PB).

Júlio Cezar Albuquerque da Costa, Universidade Federal de Alagoas

Psicólogo, formado pela Universidade Federal de Alagoas (UFAL) e membro do Laboratório Alagoano de Psicometria e Avaliação Psicológica (LAPAP-UFAL).

Citas

Ackermann, S. & Rasch, B. (2014). Differential effects of non-REM and REM sleep on memory consolidation? Current Neurology and Neuroscience Reports, 14(2),1-10. https://doi.org/10.1007/s11910-013-0430-8

Åkerstedt, T., Axelsson, J., Lekander, M., Orsini, N., & Kecklund, G. (2014). Do sleep, stress, and illness explain daily variations in fatigue? A prospective study. Journal of Psychosomatic Research, 76(4), 280-285. https://doi.org/10.1016/j.jpsychores.2014.01.005

Al-Kandari, S., Alsalem, A., Al-Mutairi, S., Al-Lumai, D., Dawoud, D., & Moussa, M. (2017). Association between sleep hygiene awareness and practice with sleep quality among Kuwait University students. Sleep Health, 3(5), 342-347. https://doi.org/10.1016/j.sleh.2017.06.004

Almojali, A. I., Almalki, S. A., Alothman, A. S., Masuadi, E. M., & Alaqeel, M. K. (2017). The prevalence and association of stress with sleep quality among medical students. Journal of Epidemiology and Global Health, 7(3), 169-174. http://dx.doi.org/10.1016/j.jegh.2017.04.005

Alotaibi, A. D., Alosaimi, F. M., Alajlan, A. A., & Bin Abdulrahman, K. A. (2020). The relationship between sleep quality, stress, and academic performance among medical students. Journal of Family & Community Medicine, 27(1), 23-28. https://doi.org/10.4103/jfcm.JFCM_132_19

Amaral, A. M. L. (2018). Qualidade do sono, higiene do sono e temperamento: Um estudo com estudantes universitários portugueses [Dissertação de mestrado, Universidade de Lisboa]. Repositório da Universidade de Lisboa. http://hdl.handle.net/10451/33273

Amaro, J. R. M. S. & Dumith, S. C. (2018). Sonolência diurna excessiva e qualidade de vida relacionada à saúde dos professores universitários. Jornal Brasileiro de Psiquiatria, 67(2), 94-100. https://doi.org/10.1590/0047-2085000000191

Angelin, T. J., Mota, K. R., Santos Júnior, V. E., Silva, L., & Heimer, M. V. (2020). Evaluation of sleep quality and daytime sleepiness in dentistry students. Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 20, 1-7. https://doi.org/10.1590/pboci.2020.122

Araújo, M. F. M. D., Lima, A. C. S., Alencar, A. M. P. G., Araújo, T. M. D., Fragoaso, L. V. C., & Damasceno, M. M. C. (2013). Evaluación de la calidad del sueño de estudiantes universitarios de Fortaleza-CE. Texto & Contexto-Enfermagem, 22(2), 352-360. https://doi.org/10.1590/S0104-07072013000200011

Bertolazi, A. N. (2008). Tradução, adaptação cultural e validação de dois instrumentos de avaliação do sono: Escala de Sonolência de Epworth e Índice de Qualidade de Sono de Pittsburgh [Tese de doutorado]. Universidade Federal do Rio Grande do Sul.

Bertolazi, A. N., Fagondes, S. C., Hoff, L. S., Pedro, V. D., Menna Barreto, S. S., & Johns, M. W. (2009). Validação da escala de sonolência de Epworth em português para uso no Brasil. Jornal Brasileiro de Pneumologia, 35(9), 877-883. https://doi.org/10.1590/S1806-37132009000900009

Bonnet, M. H. & Arand, D. L. (1992). Caffeine use as a model of acute and chronic insomnia. Sleep, 15(6), 526-536. https://doi.org/10.1093/sleep/15.6.526

Brown, F. C., Buboltz Jr, W. C., & Soper, B. (2002). Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behavioral Medicine, 28(1), 33-38. http://doi.org/10.1080/08964280209596396

Brus, C. P. (2006). Seeking balance in graduate school: A realistic expectation or a dangerous dilemma? New Directions for Student Services, 2006(115), 31-45. https://doi.org/10.1002/ss.214

Buysse, D. J., Reynolds III, C. F., Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193-213. https://doi.org/10.1016/0165-1781(89)90047-4

Cardoso, H. C., Bueno, F. C. D. C., Mata, J. C. D., Alves, A. P. R., Jochims, I., Vaz Filho, I. H. R., & Hanna, M. M. (2009). Avaliação da qualidade do sono em estudantes de Medicina. Revista Brasileira de Educação Médica, 33(3), 349-355. https://doi.org/10.1590/S0100-55022009000300005

Cheng, S. H., Shih, C.-C., Lee, I. H., Hou, Y.-W., Chen, K. C., Chen, K.-T., Yang, Y. K., & Yang, Y. C. (2012). A study on the sleep quality of incoming university students. Psychiatry Research, 197(3), 270-274. https://doi.org/10.1016/j.psychres.2011.08.011

Christodoulou, N., Maruani, J., d’Ortho, M. -P., Lejoyeux, M., & Geoffroy, P.A. (2023). Sleep quality of medical students and relationships with academic performances. L'Encéphale, 49(1), 9-14. https://doi.org/10.1016/j.encep.2021.09.006

Curcio, G., Ferrara, M., & De Gennaro, L. (2006). Sleep loss, learning capacity and academic performance. Sleep Medicine Reviews, 10(5), 323-337. https://doi.org/10.1016/j.smrv.2005.11.001

Danda, G. D. N., Ferreira, G. R., Azenha, M., Souza, K. D., & Bastos, O. (2005). Sleep-wake cycle pattern and excessive daytime sleepiness in medical students. Jornal Brasileiro de Psiquiatria, 54(2), 102-106.

Fife-Schaw, C. (2010). Modelos quasi-experimentais. Em G. M. Breakwell., S, Hammond., J. A. Smith & V. G. Haase (Eds.), Métodos de pesquisa em psicologia (pp. 100-115). Artmed.

Fonseca, A. G. & Genzel, L. (2020). Sleep and academic performance: considering amount, quality and timing. Current Opinion in Behavioral Sciences, 33, 65-71. https://doi.org/10.1016/j.cobeha.2019.12.008

Fox, J. (2017). Using the R Commander: A Point-and-Click Interface or R. Chapman and Hall/CRC Press.

Freires, L. A., Sousa, E. A., Loureto, G. D. L., Monteiro, R. P., & Gouveia, V. V. (2018). Estresse acadêmico: adaptação e evidências psicométricas de uma medida. Psicologia em Pesquisa, 12(3), 22-32. https://dx.doi.org/10.24879/2018001200300532

Fujii, H., Fukuda, S., Narumi, D., Ihara, T., & Watanabe, Y. (2015). Fatigue and sleep under large summer temperature differences. Environmental Research, 138, 17-21. https://doi.org/10.1016/j.envres.2015.02.006

García, N. B. & Zea, R. M. (2011). Estrés Académico. Revista de Psicología Universidad Antioquia, 3(2), 65-82.

García-Ros, R., Pérez-González, F., Pérez-Blasco, J., & Natividad, L. A. (2012). Evaluación del estrés académico en estudiantes de nueva incorporación a la universidad. Revista Latinoamericana de Psicología, 44(2), 143-154.

Gardiner, C., Weakley, J., Burke, L. M., Roach, G. D., Sargent, C., Maniar, N., Townshend, A., & Halson, S. L. (2023). The effect of caffeine on subsequent sleep: A systematic review and meta-analysis. Sleep Medicine Reviews, 69, 101764. http://doi.org/10.1016/j.smrv.2023.101764

Gillin, J. C., Drummond, S. P. A., Clark, C. P., & Moore, P. (2005). Medication and substance abuse. Em M. H. Krygier, T. Roth & W. C. Dement (Eds.), Principles and Practice of Sleep Medicine (4a ed., pp. 1345-1358). Saunders.

Goldberg, D. (1972). The Detection of Psychiatric Illness by Questionnarie. Oxford United Press.

Hair, Jr., Black, W. C., Babin, B. J., & Anderson, R. E. (2014). Multivariate Data Analysis (7a ed.). Pearson Education Limited.

Hasel, K. M., Abdolhoseini, A., & Ganji, P. (2011). Hardiness training and perceived stress among college students. Procedia-Social and Behavioral Sciences, 30, 1354-1358. http://doi.org/10.1016/j.sbspro.2011.10.262

Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Publications.

Henriques, A. P. F. C. M. (2008). Caracterização do sono dos estudantes universitários do Instituto Superior Técnico [Dissertação de mestrado]. Universidade de Lisboa.

Huang, C. F., Yang, L. Y., Wu, L. M., Liu, Y., & Chen, H. M. (2014). Determinants of daytime sleepiness in first-year nursing students: a questionnaire survey. Nurse education today, 34(6), 1048-1053. http://doi.org/10.1016/j.nedt.2013.11.005

Johns, M. W. (1991). A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep, 14(6), 540-545. https://doi.org/10.1093/sleep/14.6.540

Kaneita, Y., Yokoyama, E., Harano, S., Tamaki, T., Suzuki, H., Munezawa, T., Nakajima, H., Asai, T., & Ohida, T. (2009). Associations between sleep disturbance and mental health status: A longitudinal study of Japanese junior high school students. Sleep Medicine, 10(7), 780-786. https://doi.org/10.1016/j.sleep.2008.06.014

Kaur, F. & Singh, A. (2017). Excessive daytime sleepiness and its pattern among Indian college students. Sleep Medicine, 29, 23-28. https://doi.org/10.1016/j.sleep.2016.08.020

Koohsari, M. J., Nakaya, T., McCormack, G. R., Shibata, A., Ishii, K., & Oka, K. (2021). Changes in workers' sedentary and physical activity behaviors in response to the COVID-19 pandemic and their relationships with fatigue: longitudinal online study. JMIR Public Health and Surveillance, 7(3), e26293. https://doi.org/10.2196/26293

Landmann, N., Kuhn, M., Piosczyk, H., Feige, B., Baglioni, C., Spiegelhalder, K., Frase, L., Riemann, D., Sterr. A., & Nissen, C. (2014). The reorganisation of memory during sleep. Sleep Medicine Reviews, 18(6), 531-541. https://doi.org/10.1016/j.smrv.2014.03.005

Lazarus, R. S. & Folkman, S. (1984). Stress, appraisal, and coping. Springer.

Lemma, S., Gelaye, B., Berhane, Y., Worku, A., & Williams, M. A. (2012). Sleep quality and its psychological correlates among university students in Ethiopia: a cross-sectional study. BMC psychiatry, 12(1), 1-7. https://doi.org/10.1186/1471-244X-12-237

Li, L., Wang, Y., Wang, S., Li L., Lu, L., Ng, C. H., Ungvari, G. S., Chiu, H. F. K, Hou, C., Jia, F. & Xiang, Y. (2017). Sleep Duration and Sleep Patterns in Chinese University Students: A Comprehensive Meta-Analysis. Journal of Clinical Sleep Medicine, 13(10), 1153-1162. https://doi.org/10.5664/jcsm.6760

Lopes, E., Milheiro, I., & Maia, A. (2013). Sleep quality in college students: a study about the contribution of lifestyle, academic performance and general well-being. Sleep Medicine, 14(1). https://doi.org/10.1016/j.sleep.2013.11.437

Lund, H. G., Reider, B. D., Whiting, A. B., & Prichard, J. R. (2010). Sleep patterns and predictors of disturbed sleep in a large population of college students. Journal of Adolescent Health, 46(2), 124-132. https://doi.org/10.1016/j.jadohealth.2009.06.016

Madras, B. & Kuhar, M. (Eds.). (2013). The effects of drug abuse on the human nervous system. Elsevier.

Mariño, M. C., González-Forteza, C., Andrade, P., & Medina-Mora, M. E. (1998). Validación de un cuestionario para detectar adolescentes con problemas por el uso de drogas. Salud mental, 21(1), 27-36.

Marôco, J. & Garcia-Marques, T. (2006). Qual a fiabilidade do alfa de Cronbach? Questões antigas e soluções modernas? Laboratório de psicologia, 4(1), 65-90. https://doi.org/10.14417/lp.763

Massud, M., Barbosa, G. A., & Gouveia, V. V. (2007). Indicadores de saúde mental. Em G. A. Barbosa (Coord.), A saúde dos médicos no Brasil (pp. 143-157). Conselho Federal de Medicina.

Mendes, J., Sousa, M., Leite, V. M., Belchior, N., & Medeiros, T. (2019). Qualidade do sono e sonolência em estudantes do ensino superior. Revista Portuguesa de Investigação Comportamental e Social, 5(2), 38-48. https://doi.org/10.31211/rpics.2019.5.2.150

Mendlewicz, J. (2009). Sleep disturbances: core symptoms of major depressive disorder rather than associated or comorbid disorders. The World Journal of Biological Psychiatry, 10(4), 269-275. https://doi.org/10.3109/15622970802503086

Michielsen, H. J., De Vries, J., Van Heck, G. L., Van de Vijver, F. J., & Sijtsma, K. (2004). Examination of the dimensionality of fatigue. The construction of the Fatigue Assessment Scale (FAS). European Journal of Psychological Assessment, 20(1), 39-48. https://doi.org/10.1027/1015-5759.20.1.39

Milojevich, H. M. & Lukowski, A. F. (2016). Sleep and mental health in undergraduate students with generally healthy sleep habits. PloS one, 11(6), 1-14. http://doi.org/10.1371/journal.pone.0156372

Morphy, H., Dunn, K. M., Lewis, M., Boardman, H. F., & Croft, P. R. (2007). Epidemiology of insomnia: a longitudinal study in a UK population. Sleep, 30(3), 274-280. https://doi.org/10.1093/sleep/30.3.274

Müller, M. R. & Guimarães, S. S. (2007). Sleep disorders impact on daily functioning and life quality. Estudos de Psicologia, 24(4), 519-528. https://doi.org/10.1590/S0103-166X2007000400011

Najafi Kalyani, M., Jamshidi, N., Salami, J., & Pourjam, E. (2017). Investigation of the relationship between psychological variables and sleep quality in students of medical sciences. Depression Research and Treatment, 2017, 1-6. https://doi.org/10.1155/2017/7143547

Nordt, S. P., Vilke, G. M., Clark, R. F., Cantrell, F. L., Chan, T. C., Galinato, M., Nguyen, V. & Castillo, E. M. (2012). Energy drink use and adverse effects among emergency department patients. Journal of community health, 37(5), 976-981. https://doi.org/10.1007/s10900-012-9549-9

Panjwani, U., Wadhwa, M., Ray, K., & Kishore, K. (2019). Sleep deprivation, cognitive functions, and countermeasures. Em S. K. Jha & V. M. Jha (Eds.), Sleep, memory and synaptic plasticity (pp. 41-56). Springer.

Paschoal, T. & Tamayo, Á. (2004). Validação da escala de estresse no trabalho. Estudos de Psicologia, 9(1), 45-52. https://doi.org/10.1590/S1413-294X2004000100006

Phillips, A. J. K., Clerx, W. M., O’Brien, C. S., Sano, A., Barger, L. K., Picard, R. W., Lockley, S. W., Klerman, E. B. & Czeisler, C. A. (2017). Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing. Scientific Reports, 7(1), 1-13. https://doi.org/10.1038/s41598-017-03171-4

R Development Core Team. (2015). R: A language and environment for statistical computing (Version 4.3.1). https://cran.r-project.org/doc/manuals/fullrefman.pdf

Rasch, B. & Born, J. (2015). In search of a role of REM sleep in memory formation [Editorial]. Neurobiology of Learning and Memory, 122, 1-3. https://doi.org/10.1016/j.nlm.2015.04.012

Roberts, R. E., Shema, S. J., Kaplan, G. A., & Strawbridge, W. J. (2000). Sleep complaints and depression in an aging cohort: a prospective perspective. American Journal of Psychiatry, 157(1), 81-88. https://doi.org/10.1176/ajp.157.1.81

Rosseel, Y. (2012). Lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48(2), 1-36. http://doi.org/10.18637/jss.v048.i02

Sajadi, A., Farsi, Z., & Rajai, N. (2014). The relationship between sleep quality with fatigue severity and academic performance of nursing students. Nursing Practice Today, 1(4), 213-220.

Schreiber, J. B., Nora, A., Stage, F. K., Barlow, E. A., & King, J. (2006). Reporting structural equation modeling and confirmatory factor analysis results: A review. The Journal of Educational Research, 99(6), 323-338. https://doi.org/10.3200/JOER.99.6.323-338

Shilo, L., Sabbah, H., Hadari, R., Kovatz, S., Weinberg, U., Dolev, S., Dagan, Y. & Shenkman, L. (2002). The effects of coffee consumption on sleep and melatonin secretion. Sleep Medicine, 3(3), 271-273. https://doi.org/10.1016/S1389-9457(02)00015-1

Shrout, P. E. & Bolger, N. (2002). Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychological Methods, 7(4), 422. https://doi.org/10.1037/1082-989X.7.4.422

Sin, C. W., Ho, J. S., & Chung, J. W. (2009). Systematic review on the effectiveness of caffeine abstinence on the quality of sleep. Journal of Clinical Nursing, 18(1), 13-21. https://doi.org/10.1111/j.1365-2702.2008.02375.x

Soares, A. M., Pereira, M., & Canavarro, J. P. (2014). Saúde e qualidade de vid ana transição para o Ensino Superior. Psicologia, Saúde & Doenças, 15(2), 356-379. http://dx.doi.org/10.15309/14psd150204

Suzuki, H., Kaneita, Y., Osaki, Y., Minowa, M., Kanda, H., Suzuki, K., Wada, K., Hayashi, K., Tanihata, T & Ohida, T. (2011). Clarification of the factor structure of the 12-item General Health Questionnaire among Japanese adolescents and associated sleep status. Psychiatry research, 188(1), 138-146. https://doi.org/10.1016/j.psychres.2010.10.025

Thorpy, M. J. & Billiard, M. (Eds.). (2011). Sleepiness: causes, consequences and treatment. Cambridge University Press.

Tomfohr, L. M., Edwards, K. M., & Dimsdale, J. E. (2012). Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence. Sleep Medicine Reviews, 16(3), 243-249. https://doi.org/10.1016/j.smrv.2011.05.003

Tsai, S. C. & Lee-Chiong, T. (2013). Sleep disorders and fatigue. Sleep Medicine Clinics, 8(2), 235-239. https://doi.org/10.1016/j.jsmc.2013.02.003

Wang, F. & Bíró, É. (2021). Determinants of sleep quality in college students: a literature review. Explore, 17(2), 170-177. https://doi.org/10.1016/j.explore.2020.11.003

Wang, K., Xue, Y., Fan, X., Huang, T., & Chen, Z. (2019). Sedentary behaviors, psychological status, and sleep quality in Chinese university students. Social Behavior and Personality, 47(1), 1-10. https://doi.org/10.2224/sbp.7446

Wylie, G. R., Pra Sisto, A. J., Genova, H. M., & DeLuca, J. (2022). Fatigue across the lifespan in men and women: State vs. trait. Frontiers in Human Neuroscience, 16, 790006. https://doi.org/10.3389/fnhum.2022.790006

Yan, Y., Lin, R., & Su, Y. (2018). The relationship between adolescent academic stress and sleep quality: a multiple mediation model. Social Behavior and Personality, 46(1), 63-78. https://doi.org/10.2224/sbp.6530

Yusuf, J. E., Saitgalina, M., & Chapman, D. W. (2020). Work-life balance and well-being of graduate students. Journal of Public Affairs Education, 26(4), 458-483. https://doi.org/10.1080/15236803.2020.1771990

Zakeri, M., Shaban, M., Kazemnezhad, A., & Tavassoli, K. (2006). Effect of exercise utilizing the rate of respiratory on fatigue in patient with chronic obstructive pulmonary disease. Hayat, 3(30), 17-25.

Zhabenko, O., Austic, E., Conroy, D. A., Ehrlich, P., Singh, V., Epstein-Ngo, Q., Cunningham, R. M. & Walton, M. A. (2016). Substance use as a risk factor for sleep problems among adolescents presenting to the emergency department. Journal of Addiction Medicine, 10(5), 331. http://doi.org/10.1097/ADM.0000000000000243