Unhealthy sleep culture at Yale
In November 2015, Molly Montgomery ’19 slept an average of four hours a night. After two weeks of this routine, 20 minutes into a seminar, her body finally gave out. Fully conscious of what was happening, but unable to fight her exhaustion any longer, Montgomery fell asleep while sitting directly across from her professor.
Although she said the embarrassment of this incident prompted her to get more rest, Montgomery clocked an average of only six hours a night for the remainder of the semester — still lower than the medically recommended seven to nine nightly hours of sleep.
The National Sleep Foundation recommends that college-aged adults sleep between 49 and 63 hours a week. However, last semester, the Yale College Council Health Task Force reported that the average Yale student sleeps only 6.7 hours on a weekday night during the semester — a total of only 33.5 hours a week, excluding weekends. The report also found that more than one in 10 Yalies clock five hours or less on an average weekday night.
Yale is not alone. College students are one of the most sleep-deprived demographics in America, according to the National Institutes of Health. In a 2015 study published in the Sleep Health Journal — the official journal of the National Sleep Foundation — it was found that 70 to 96 percent of college students are sleeping less than eight hours a night.
And new studies have proven sleep deprivation to be even more dangerous than thought before. Sleep loss has been linked with obesity, abnormal blood lipids, cardiovascular disease, breast and prostate cancer, worsening of cognitive impairment, mood disorders and many other medical conditions.
But is it impossible to succeed at this institution without giving up sleep? Interviews with students and experts have found that the causes of Yale’s sleep deprivation problem lie not just in students’ full schedules and heavy course loads, but in a culture which glorifies sleep deprivation as an intrinsic and unavoidable component of the Yale experience — even in the absence of extreme academic or extracurricular pressure.
IS SNOOZING REALLY LOSING?
According to a 2000 study published in the “Journal of Occupational and Environmental Medicine,” staying awake for 17 hours — and leaving only seven hours for sleep — results in cognitive impairment equivalent to a blood alcohol content of 0.05 percent. After 21 hours awake, a person’s cognitive impairment can reach the equivalent of a 0.08 percent BAC — the legal driving limit in Connecticut.
Meir Kryger, director of the Yale Sleep Center, described the current level of sleep deprivation at Yale as a “serious health issue.” This fall semester Kryger is teaching a residential college seminar entitled “The Mystery of Sleep.”
According to Kryger, students’ lack of awareness regarding the effects of sleep deprivation is potentially as dangerous as the deprivation itself, because students who try to act normally following a period of insufficient sleep put themselves and others in danger.
Lack of sleep impairs fundamental bodily functions such as concentration, judgment and reaction time, Kryger said, endangering undergraduates even if they are not behind the wheel.
Yale School of Medicine professor Christine Won described sleep deprivation at Yale as a “rampant problem.” Won, who joined the Yale faculty in 2009, added that although it has always been an issue at the University, sleep deprivation has not been recognized or appreciated.
However, experts interviewed suggested that the chronic results of sleep deprivation can be just as dangerous as the short-term consequences. In particular, Kryger highlighted weight gain, cardiovascular disease, hypertension and psychological risks, including increased chances of developing a mood disorder.
Won said that those who routinely deprive themselves of sleep often have lower life expectancies than those who maintain healthier schedules, adding that sleep-deprived students also run the serious risk of sleep attacks: intermittent, uncontrollable episodes of falling asleep during the daytime. She added that because the longer-term effects of sleep deprivation often do not appear until later in life, it is easier for college-aged students to compensate for lack of sleep while they are young.
Rafael Pelayo, a Stanford University School of Medicine professor who co-teaches a popular undergraduate course titled “Sleep and Dreams” at the university in Palo Alto, said the mixture of sleep deprivation with other potentially dangerous activities on college campuses, such as alcohol and drug abuse, is a further cause for concern.
“When people are sleep deprived they are more prone to effects of alcohol,” Pelayo said. “Sleep deprivation will augment the effects of alcohol. So if [college students] have been staying up late during the week and want to celebrate at the weekend, then you’re compounding [the effects of] sleep deprivation and alcohol.”
Indeed, while alcohol is well known to accelerate the onset of sleep, its metabolization by the body actually decreases sleep quality. Alcohol reduces cycles of deeper sleep and Rapid Eye Movement sleep, prolonging lighter sleep from which one can be easily woken. REM sleep has been shown to be important to memory consolidation and development.
In an April 2016 Huffington Post article, “To Sleep Or To Party? The College Conundrum,” Lucy Friedmann ’19 discussed the complicated relationship between sleep, stress and social life at Yale. Based on interviews with several Yalies, including student athletes, Friedmann highlighted that while for many students, partying is a necessary antidote to college stress, it too can result in fewer hours of sleep than recommended.
Jennifer Roxanne Prichard, scientific director of the Center for College Sleep at the University of St. Thomas, has researched college sleep for 11 years. She said that in her experience, many students coming to college absorb the idea that sleep deprivation is a prerequisite to performing academically, and that this misconception perpetuates unhealthy sleep cycles on campuses. She added that research has shown international students at U.S. universities to get healthier levels of sleep than their American peers.
According to Prichard, national data has shown that students who consistently sleep a healthy amount perform better academically than sleep-deprived students.
“What would be interesting to educators at Yale to do is to look at the relationship between grades and sleep hours, because national figures suggest that the students who are least sleepy have the highest GPAs,” Prichard said.
A survey distributed by the News this August found more ambiguous results. Of respondents who reported sleeping seven or more hours nightly, the average GPA was 3.68, while those who reported sleeping between six and seven hours had a slightly higher average of 3.72. The mean GPA of students who reported sleeping between five and six hours a night was 3.69.
Yale Student Wellness Health Educator Tracy George said that she was not surprised by the findings of last semester’s YCC report, noting that while some people can function normally on six hours of sleep or less, it is unlikely that the roughly 40 percent of Yale students who receive six hours or less are receiving the rest they need.
And it is only getting worse. Prichard said that according to research by the American College Health Association, the problem of sleep deprivation on college campuses is worsening, rather than improving.
According to the spring 2015 National College Health Assessment conducted by the ACHA, almost 12 percent of college students are not getting enough sleep to feel rested on six or more days per week. In 2011 and in 2008, this figure was around 10 percent.
“I’LL SLEEP WHEN I’M DEAD”: SLEEP CULTURE AT YALE
“Frankly, from people I know, if you’re sleeping normally, then you’re doing Yale ‘wrong,’”Albert Cao ’18 said.
Students and experts attributed the level of sleep deprivation at Yale and other colleges to a pervasive anti-sleep culture that exists independently of the demands of academics and extracurriculars.
Director of College Outreach for The Huffington Post Abigail Williams, who spent much of the past year travelling to colleges and speaking with students about their campus sleep culture, emphasized the prevalence of ingrained anti-sleep attitudes at colleges around the country.
“When you talk to college students, [sleep deprivation] is something they complain about and it’s also accepted as a feature of college life,” Williams said. “It doesn’t matter if you end up being sick or exhausted. You might even end up collapsing from exhaustion, but that’s just the price of business.”
Williams described the phrase “I’ll sleep when I’m dead” as the standard response of many of the college students in regards to sleep. She said it was used repeatedly at the universities she visited to sum up students’ attitudes.
She added that the cultural association among students between college life and lack of sleep was so strong that it allowed many students to justify staying up late, even when they were not under particular pressure from academic or extracurricular commitments. This most often comes in the form of browsing the internet or watching movies late at night, Williams said.
The majority of students interviewed characterized Yale’s culture as hostile to sleep. Many students, including Nicholas Dacosta ’18, said that sleep deprivation seemed to be accepted by the student body as the rule, rather than the exception.
“I think Yale is unique in that there is almost a commoditization of exhaustion as an indicator of status,” Dacosta said. “There seems to be an implicit social script telling us that we should be tired and exhausted all the time and that if we aren’t — if we are well rested and not stretched overly thin between classes and extracurriculars and jobs and friends — that we’re doing something wrong, or at least not doing as much as we could or should be doing. There is definitely an understood pressure to always be doing as much as we can, and to choose to do otherwise is seen as lazy or falling short of potential or just generally condescended upon.”
Kryger attributed the high levels of sleep deprivation at American universities to a “macho” culture which wrongly romanticizes lack of sleep as a symbol of strength and control. He compared this attitude to historical perspectives on driving while intoxicated.
“[The sleep deprivation problem] ultimately has to be resolved with education — we went through the same thing 30 years ago with drunk driving,” Kryger said. “These things take time. There was a time 30 to 40 years ago when being drunk and driving was considered a macho thing. People finally learned it’s not so cool after all.”
Incidents of driving under the influence have decreased over decades, but it may still take years for awareness of the risks of sleep deprivation to reach the same level, Kryger added.
Won described the sleep culture at Yale as one in which sleep was “not important in terms of balancing what you’re trying to achieve.” She said that because students were incentivized by their peers to achieve highly, many students saw sleep as the most disposable element of each school day.
“I know that I don’t get enough sleep, and the vast majority of my friends get less sleep than I do,” Eli Daiute ’18 said. “A few of my friends have multiple all-nighters a week, every week. It’s ridiculous.”
But others pointed to the developing role of technology as an important factor in college sleep culture. In particular, the role played by social media in pressuring students into documenting potentially unhealthy levels of activity was cited.
Williams noted that in her interactions with students, many explained lack of sleep with reference to “FOMO,” or the fear of missing out — a phenomenon fostered by social media and pressure to compete with friends.
Friedmann said there was an acute awareness among Yale students of the fleeting nature of the college experience and its associated opportunities. She added that there was a desire among students to pack their schedules further in an effort to make the most out of their four years, even if this conflicted with overall well-being.
Kryger mentioned that the bright screens of electronic devices also interfere with sleep, and that this produced a particular problem for college students because of their dependence on smartphones and computers for academic reasons.
“A lot of students at Yale work until the minute they get into bed and they are at their computer screens and their phones and we know that this interferes with sleep,” he said. “This can lower the amount of melatonin that the body produces.”
The release of melatonin, a hormone that helps regulate circadian rhythm, is largely controlled by natural light. When humans are exposed to screens late at night, the artificial light can disrupt this cycle, according to the National Sleep Foundation.
According to Pelayo however, the increased reliance on smartphones and computers of recent years has been a “multiplier” rather than a root cause with regard to sleep deprivation on campuses. He noted that sleep deprivation has been a problem for students since the 1980s.
WAKING UP TO THE PROBLEM
Increasing awareness of the extent of the sleep deprivation problem among American college students has led to a variety of efforts aimed at improving sleep culture on campuses. While these have begun to turn the tide on college sleep, leaders of these initiatives said that long-term reform must come from more gradual cultural change.
Last spring, Arianna Huffington, co-founder and editor-in-chief of the Huffington Post, visited Yale to promote her book “The Sleep Revolution,” which deals with the consequences of sleep deprivation. At the event, students were encouraged to reflect on their own sleep habits and the campus sleep culture.
Kryger, who spoke at the event, said that in spite of the problems with sleep at Yale, he was pleasantly surprised at the hundreds of students who attended the event, and that he felt this showed an interest within the student body to address the current situation.
Williams said The Sleep Revolution tour, which visited universities nationwide, was designed to engage with millennials and to rephrase the typical college sleep conversation into one that prioritized sleep. She added that framing sleep as a health issue proved an effective way to do this.
“Drawing a comparison between mental health, alcohol and sleep training — that is what we found would be an effective way to counter the prevalence of sleep deprivation on college campuses,” Williams said. “We found that counseling centers were aware of the issue and wanted to get people interested because they found that people seeking their services were not sleeping because of mental health problems or depression after they had not gotten a lot of sleep.”
A limited number of colleges around the country have also implemented sleep education programs for students, the majority of which are optional. At the University of Iowa, the Refresh Sleep program seeks to keep healthy sleeping at the forefront of students’ minds by sending a weekly email to students with sleep tips, including mindfulness training, relaxation training and cognitive strategies, according to the university’s website.
Rebecca Don, a behavioral health consultant at the University of Iowa, said that the program was first implemented in 2013, following a study which found that this method had improved the sleep habits of a group of freshmen at a large public university. The University of Chicago and Stanford University have implemented similar programs.
While George said that a large number of sleep-related resources are available on campus to Yale students, including individual consultations at Student Wellness and group Koru mindfulness courses, she acknowledged that more dialogue shift is necessary to create a fully sleep-friendly environment at Yale.
“I’ve heard of ‘napping zones’ at other universities that give students an opportunity to take a power nap during the day,” George said. “I highly support this, as a 10 to 20 minute nap can greatly improve energy, focus and feelings of well-being … Also, I’ve heard of ‘email dark hours’ where a company or school shuts down — or encourages people to turn off — email during late hours.”
Melissa Hsu, a student at the University of California, Berkeley, based her platform for student government on the provision of sleep facilities for students.
“The idea was to create REST Zones or Relaxation Enhancing Study and Tranquility Zones on campus so that students could maximize their time rejuvenating their bodies and re-energizing their brains,” Hsu said. “[For many Berkeley students,] walking to and from home takes a total of 40 minutes, which is the recommended number of minutes scientists recommend for naps. REST Zones aren’t limited to nap pods; they include anything that’s comfortable to nap on. Our REST Zones include lounge chairs, placentero chairs and energy pods.”
LEARNING TO SLEEP
In addition to administrative and research efforts, an increasing number of colleges around the country, including Yale, offer classes on sleep for credit, often with the partial aim of improving sleep culture through direct interaction with students in the classroom.
One such class is the psychology course “Sleep and Dreams,” which is one of the most popular undergraduate courses at Stanford. Created over 40 years ago by pioneering U.S. sleep researcher William Dement, the course is now jointly run by Pelayo.
Taught twice a year, the course typically attracts over 200 students each quarter, making it the largest course offered to undergraduates by the Stanford University School of Medicine.
“Students routinely tell us that the course changed their life, because once the students who have been sleeping poorly for years see the difference, they themselves feel better,” Pelayo said. “[During the class, students] have to monitor their own sleep. They see how the sleep hours have increased and how they themselves feel better, so it doesn’t just impact them individually but also their life and the lives of their families and classmates.”
Kryger said that over the past several years, he has led a series of symposiums for Yale graduate and law students, adding that sleep deprivation is also an issue among graduate students. Last semester, he led similar sessions with undergraduates at Davenport and Pierson colleges.
“The Mystery of Sleep” seminar is being taught for the first time this semester by Kryger and Suman Baddam, a clinical fellow at the Yale School of Medicine. According to Kryger, five times as many students applied for the course than could be offered places.
Although the majority of sleep professionals interviewed said that they would support mandatory sleep training for incoming Yale students as part of freshman orientation, George said that a more effective model is to spread points of entry of sleep resources across all levels, from freshman year to graduate and professional level.
But Noora Reffat ’19 said that the rigidity of deadlines set by professors and administrators would still represent a barrier to healthy sleep schedules at Yale, adding that students’ well-being must be seen as equal to their academic success.
“I think it all comes down to the administrators and professors being more understanding about when students are unable to meet deadlines,” Reffat said. “Though Dean’s Excuses are in place, they can be very difficult to get, and it’s sometimes intimidating for a student to ask their dean for an excuse, especially if they feel as though they don’t have a ‘valid’ reason to be asking for an extension. In my opinion, choosing sleep over finishing an assignment is a very valid reason to not complete work, but I don’t know how much weight this would carry with a professor or dean. Sleep deprivation needs to be seen in the same way that illnesses are viewed on campus, and I think that changing the rhetoric around sleep would be instrumental in helping students ensure they get more sleep.”