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INTRODUCTION
According to the National Sleep Foundation (2015), sleep is essential for a person’s
health and wellbeing. It is also a critical part of maintaining the overall health, especially to
college students as it plays an important role in the cognitive learning of the student. The
National Sleep Foundation convened experts from sleep, anatomy and physiology, as well as
paediatrics, neurology, gerontology and gynecology to reach a consensus from the broadest
range of scientific disciplines. The panel revised the recommended sleep ranges. The
recommended number of hours of sleep for ages 18-25 which are mostly young adults or college
students is at 8-9 hours (Czeisler, 2015). Most of the students tend to stay up late into the night to
accomplish their tasks, whereby prioritizing tasks, commonly academics, rather than personal
rest and sleep. Students from all year levels, most especially college students, experience sleep
deprivation. One of the most common problems of a nursing student will include sleep
deprivation. At an alarming rate, sleep deprivation among nursing students has also become a
major concern. Nursing is a demanding profession with occupational stress which involves
Good quality sleep and enough amount of sleep are very important in order to have better
psychiatric disorders. When students are sleep deprived, students are more prone to cognitive
problems and poor decision-making skills. A good quality sleep is one of the most important
things to become a good and active student nurse. Nowadays, student nurses face a lot of
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problems due to heavy school works and balancing their time as a student nurse and a normal
teenager. However, the most significant problem a student nurse faces is the sleep deprivation
they get due to demands by the academe, and community or hospital duty. This paper will focus
on the incidence of sleep deprivation among level IV nursing students of Ateneo de Zamboanga
University. This topic was chosen after careful decision and the fact that sleep deprivation has
become a major concern among students of this course. Studying this topic on incidence of sleep
deprivation, knowing the number of sleep deprived students, how often these students are
deprived of sleep, and even possible commonalities for coping mechanism, after accurate
interpretation, will help the researchers understand the incidence of sleep deprivation and
A research study conducted by Khin Thandar Aung, Mohammad Said Nurumal, and Siti
Nurhizwanybinti Zainal (2016) about sleep quality and performance of nursing students found
that the majority of college students experienced poor sleep quality. In addition, intense
academic demands among college students particularly nursing students because they had the
least amount of sleep. Another research study conducted by Cynthia Thomas, Constance
McIntosh, Ruth Ann Lamar, and Roberta Allen (2017) about Sleep Deprivation in nursing
students found that majority of the participants of the study needed 8 or more hours sleep to feel
rested. More alarming, more received 6 hours or less before a clinical experience. This
potentially places the students at risk for less than optimal learning in the classroom and more
Being deprived of sleep can become a cause for various types of sleeping disorders. A
study conducted by Jane F. Gaultney (2010), focused on the prevalence of sleep disorders in
college students, with sleep deprivation being the most common, and its impact on the academic
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performance. The results showed that twenty-seven percent of students were at risk for at least
one sleep disorder. African American and Asian students reported less risk for insomnia and
fewer poor sleep practices relative to white and Latino students. Students reported insufficient
sleep and a discrepancy between weekday and weekend amount of sleep. Students at risk for
sleep disorders were overrepresented among students in academic jeopardy. The data indicates
that a substantial number of college students may be at risk for sleep disorders or poor sleep
hygiene, and that sleep may impact academic success. Considering this, sleep deprivation is a
major concern among students, especially level IV nursing students of Ateneo de Zamboanga
University, knowing that this course demands both academic excellence, and related learning
experience duty.
Many people suffer from sleep deprivation especially the students who study every night,
long nights of not having sleeps because of requirements that need to be passed on the next day.
Students suffer a lot from sleep deprivation especially the one who is in college. Pressman, 1997
indicates that sleep deprivation has been shown to impact negatively on a wide range of
cognitive, behavioral, physiological, and emotional measures. For example, mood changes
memory alterations due to decreased attention, concentration lapses, and decreased motivation.
Illusions, hallucinations, visual misperceptions, and paranoid ideation are also observed with
sleep loss.
The National Sleep Foundation (NSF), along with a multi-disciplinary expert panel,
issued its new recommendations for appropriate sleep durations. The report recommends wider
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appropriate sleep ranges for most age groups. The results are published in Sleep Health: The
Journal of the National Sleep Foundation. The National Sleep Foundation convened experts from
sleep, anatomy and physiology, as well as pediatrics, neurology, gerontology and gynecology to
reach a consensus from the broadest range of scientific disciplines. The panel revised the
recommended sleep ranges for all six children and teen age groups. A summary of the new
recommendations includes: Newborns (0-3 months): Sleep range narrowed to 14-17 hours each
day (previously it was 12-18), Infants (4-11 months): Sleep range widened two hours to 12-15
hours (previously it was 14-15). Toddlers (1-2 years): Sleep range widened by one hour to 11-14
hours (previously it was 12-14). Preschoolers (3-5): Sleep range widened by one hour to 10-13
hours (previously it was 11-13). School age children (6-13): Sleep range widened by one hour to
9-11 hours (previously it was 10-11). Teenagers (14-17): Sleep range widened by one hour to 8-
10 hours (previously it was 8.5-9.5). Younger adults (18-25): Sleep range is 8-9 hours (new age
category). Adults (26-64): Sleep range did not change and remains 7-9 hours. Older adults (65+):
Sleep is a major aspect in our everyday lives; however, fewer people are getting enough
sleep each night and more are slowly becoming sleep deprived. Sleep deprivation is defined as a
condition that occurs when an individual does not get enough sleep each night (What Are Sleep
determine how to overcome sleep deprivation, but in order to surpass any issue, it is important to
know who is at risk of being afflicted by it. It is important to understand that people of all ages,
and ethnicities are at risk of becoming sleep deprived. More specifically, individuals who have
limited time for sleep, such as students, people who work a lot of hours either at either one or
more jobs, as well as caregivers. Also, those who have schedules that conflict with circadian
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rhythms such as; shift workers, first responders and individuals who travel for work can also be
at risk of suffering from sleep deprivation. Other individuals that could be included would be
those whose life style choices do not allow them to receive adequate amounts of sleep such as;
individuals who take medication to stay awake, those who abuse alcohol and or drugs, or those
who don’t place sleep high on their priority list. Individuals who suffer from various medical
conditions such as heart failure, heart disease, obesity, high blood pressure, diabetes, stroke,
transit ischemic attack (mini stroke), attention-deficit hyperactivity disorder, and depression can
So many people fail to maintain a proper sleep schedule, but sleep is one of the most
important aspects of mankind’s everyday life. There are several important aspects to maintaining
an adequate The Effects of Sleep Deprivation on Memory, Problem Solving, and Critical
Thinking 13 amount of sleep on a nightly basis. These would include: committing new
information to memory, maintaining normal body processes such as proper carbohydrate storage
and maintaining proper hormone levels, reduced tendency for day time sleepiness, thereby
reducing human errors such as medical mistakes and traffic accidents, reduction in irritability
and patience, improves concentration and reduces moodiness and laziness. Sleep disorders have
been linked with hypertension, irregular heartbeat, and increased cortisol levels, while an
adequate amount of sleep assists in maintaining proper immune system function (Benefits of
Sleep, 2015)
According to the National Heart, Lung and Blood Institute, Sleep Deprivation is defined
as a condition that occurs if you don't get enough sleep. Sleep deficiency is a broader concept. It
occurs if you have one or more of the following: You don't get enough sleep (sleep deprivation).
You sleep at the wrong time of day (that is, you're out of sync with your body's natural clock).
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You don't sleep well or get all of the different types of sleep that your body needs. You have a
sleep disorder that prevents you from getting enough sleep or causes poor quality sleep. Sleep
deficiency can lead to physical and mental health problems, injuries, loss of productivity, and
To understand sleep deficiency, it helps to understand how sleep works and why it's
important. The two basic types of sleep are rapid eye movement (REM) and non-REM. Non-
REM sleep includes what is commonly known as deep sleep or slow wave sleep. Dreaming
typically occurs during REM sleep. Generally, non-REM and REM sleep occur in a regular
pattern of 3–5 cycles each night. Your ability to function and feel well while you're awake
depends on whether you're getting enough total sleep and enough of each type of sleep. It also
depends on whether you're sleeping at a time when your body is prepared and ready to sleep.
You have an internal "body clock" that controls when you're awake and when your body is ready
for sleep. This clock typically follows a 24-hour repeating rhythm (called the circadian rhythm).
The rhythm affects every cell, tissue, and organ in your body and how they work. If you aren't
getting enough sleep, are sleeping at the wrong times, or have poor quality sleep, you'll likely
feel very tired during the day. You may not feel refreshed and alert when you wake up. Sleep
deficiency can interfere with work, school, driving, and social functioning. You might have
trouble learning, focusing, and reacting. Also, you might find it hard to judge other people's
emotions and reactions. Sleep deficiency also can make you feel frustrated, cranky, or worried in
social situations. The signs and symptoms of sleep deficiency may differ between children and
adults. Children who are sleep deficient might be overly active and have problems paying
attention. They also might misbehave, and their school performance can suffer.
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According to Hershner and Chervin (2014). College is a time of intellectual growth and
development as young adults’ transition from adolescence to adulthood. Although the worth of
college in terms of increased productivity and higher earning potential is rarely debated, there is
a significant personal and societal cost of college both in terms of time and money. For optimal
return on the investment of time, effort, and money, students need to maximize their learning,
academic, and personal growth. Sleepiness from any cause can compromise these goals, through
impact on learning, memory, grades, perception of effort, driving performance, and mood.
Although sleep deprivation has effects on many aspects of health, this article will focus on areas
According to Hershner and Chervin (2014). Students with sleep disorders probably do
not achieve optimal academic performance, and up to 27% of students may be at risk for at least
one sleep disorder.57 Students at risk for academic failure (GPA <2.0) were at a
disproportionately high risk for sleep disorders. Among those who screened positive for
obstructive sleep apnea, 30% were at risk for academic failure. Medical students classified as
frequent snorers more frequently failed their Internal Medicine examination (47%) than did
occasional snorers (22.2%) or non-snorers (12.8%). After adjustment for age, BMI, and sex, the
relative risk for snorers to fail the examination was 1.26 (95% confidence interval: 1.01–1.57).65
Obstructive sleep apnea is suspected to have cognitive effects in both children and adults.66 A
higher percentage of students at risk for academic failure screened positive for other sleep
disorders including: periodic limb movement disorder/restless legs syndrome (21%),67 insomnia
(22%), circadian rhythm sleep disorders (26%), and hypersomnia (21%).57 As nearly one in four
students is at risk for a sleep disorder, screening for sleep disorders among students with poor
Many people suffering from routine sleep loss are not even aware of it, and many who do
realize they are not getting enough sleep are not aware of what it is costing them. Sleep loss
creates sleepiness, which can be associated with decrements in vigilance, reaction time, memory,
sleepiness, individuals demonstrate poorer performance despite increased effort, and they may
report indifference regarding the outcome of their performance (Behavioral Medicine, 1996).
Behavior Medicine illustrates that not getting enough sleep affects the person in several ways:
1. Problem solving skills are impaired. Sleep loss noticeably impairs our ability to
comprehend rapidly changing situations, increases the likelihood of distraction, 8 makes us think
more rigidly and less flexibly, and reduces our ability to produce innovative solutions to
problems.
2. Communication skills suffer. Sleep loss reduces the words in vocabulary both verbally
and in writing.
3. Learning and memory suffer. Sleep loss diminishes scores on tests of memory, verbal
4. Motor skills are impaired. Studies show there is a direct connection between sleepiness
and impaired hand-eye coordination. The degree of impairment has led researchers to compare it
in severity to drunkenness.
One thing is for certain, that chronic sleep loss may lead to deterioration of mood and
irritability, tension, anxiety, and depression. Individuals suffering from sleep deprivation may
irregularities, headaches, and increased muscle tension (National Sleep Foundation, 1999). Any
one of these consequences of sleep deprivation can seriously affect productivity and
performance.
Just like other problems that humanity faces, there is not a single cause for sleep
deprivation. If a person suffers from a sleep disorder, it is very likely that the individual will
become sleep deprived, the issue is determining which disorder the person suffers from so that
help can be sought after to assist in receiving enough sleep. People have been known to suffer
from insomnia, sleep terror disorder, narcolepsy, sleep walking, and sleep apnea; these are just a
few of the many disorders that individuals can suffer from, which can prevent them from
achieving an optimum sleep regimen each night as witnessed by researchers Murphy and
Along with officially diagnosable sleep disorders, it has been observed through empirical
studies such as Hershner and Chervin’s Causes and Consequences of Sleepiness Among College
Students that schedules set by colleges and public schools are partially responsible for students
being afflicted with sleep deprivation. With class times being set early in the morning and late in
the evening as well as work-loads being increased outside of the class room, individuals’
circadian rhythms can become discombobulated, causing them to have an inadequate sleep cycle
The third major factor that can lead to an insufficient amount of sleep is when an
individual makes personal and professional commitments beyond that of what is reasonably
accomplished. Different careers can lead individuals to go extended periods of time without
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adequate amounts of sleep each night, for example; medical professionals and shift workers.
When said individuals do finally have the opportunity to go home and rest, they still have to deal
with the demands of their socioeconomic factors such as raising a family and environmental
possibility of there being one or more adverse effects on the individual’s cognitive capabilities.
The actual ability to store information is not completely hindered when a person is suffering
from total sleep deprivation; however, when a person is suffering from a lack of sleep, they may
tend to lose the ability to filter information; therefore, storing more irrelevant information into
their working memory, leaving less room for that which is relevant, making it appear that the
memory itself is being hindered. This was clearly observed through the empirical research study
titled: The Effects of Two Types of Sleep Deprivation on Visual Working Memory Capacity and
Filtering Efficiency, which was conducted by researchers Drummond, Anderson, Straus, Vogel,
Sleep loss has been shown to be inversely proportional to academic performance; when
one fails to receive an adequate amount of sleep on a nightly basis, the literature states that an
individual’s skills in learning capacity, such as memory, attention and problem solving skills are
effected the most. Sleep deprivation can also lead to daytime sleepiness. When these factors are
all being faced, students are likely to achieve lower test scores and lower grade point averages;
however, it has been shown that cognitive function is not hindered as drastically when the
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individuals are working in groups as when working alone (Chiang, Arendt, Zheng, & Hanisch,
2014)
An individual’s physical and mental health and abilities have been shown to have direct
correlation with sleep deprivation. Research has shown that people who suffer from sleep
deprivation, are more likely to have issues with their cognitive abilities, such as memory and
problem solving skills when the individual also suffers from hypertension, but the relationship
does not end there. The empirical research study Decreased Cognitive/CNS Function in Young
Adults at Risk for Hypertension: Effects of Sleep Deprivation, which was conducted by
researchers; McCubbin, Peach, Moore & Pilcher have also shown that individuals who do not
have hypertension are more likely to develop this issue when constantly depriving themselves of
sleep (McCubbin, Peach, Moore, & Pilcher, 2012). The brain is most effectively influenced by
the different chemicals that are naturally released by the body, but it is very possible to disorient
the brain by not releasing, or releasing too much of, a certain chemical. The empirical research
study Neurophysiological Effects of Sleep Deprivation in Healthy Adults, has shown that people
suffering from total sleep deprivation have an increase in dopamine output and a decrease in
cortisol, thereby requiring an increase in a combined effort of production from the prefrontal and
limbic cortical regions. Despite the increase of activity in the brain, individuals still suffer from
decreased cognitive performance (Klumpers, Veltman, van Tol, Kloet, Boellaard, Lammerrtsma,
A review of the relevant literature over the past 15 years reveals that insufficient sleep (or
partial sleep deprivation) has a variety of adverse effects. Despite the wide range of research
methodologies (e.g., qualitative studies, surveys and clinical trials, instruments) and settings
(e.g., field studies, and time-isolation laboratories, and sample sizes), the results are quite
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similar: insufficient sleep has been associated with cognitive problems, mood alterations,
reduced job performance, reduced motivation, increased safety risks, and physiological changes.
Results from laboratory studies of total sleep deprivation (one or more nights without sleep) were
not included in this review, since the focus of this section is on insufficient sleep (partial sleep
It is important to note that none of the several hundred studies reviewed for this paper
showed any positive effects from sleep restriction in healthy adults. While it is true that one night
of sleep deprivation can temporarily elevate mood in depressed patients, it has adverse effects on
mood in healthy individuals of all ages, including nurses. Depression increases, irritability
increases, and people report feeling more stressed when sleep is restricted. Extended sleep times,
however, are not associated with improved mood or health and may be associated with poor
health. Mortality rates were highest among subjects ages 30 to 100 years who slept 8 or more
hours, and lowest among those who slept 7 hours sleep, findings that were identical to those
obtained a year later from a prospective study of 82,975 registered nurses (Nurses Health Study).
Students think that when they purposely lose sleep by pulling all-nighters, that they are
preparing themselves for more success. This is far from the truth, and students are not
performing better. Doing all-nighters and losing sleep is not worth beneficial. A study by Curcio,
Otenyo- 12 Ferrara, and De Gennaro (2006) explored the idea that sleep plays an essential role in
learning and memory. The study observed that there is a corresponding relationship between
sleep and memory and synaptic plasticity (Curcio, Ferrara, and De Gennaro, 2006). To test the
ideas behind memory retention and sleep loss, researchers Pilcher and Walters (1997) conducted
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a series of cognitive tasks that had participants complete 2 questionnaires that mainly tested
concentration and estimated performance. Students were also able to self-report on the amount of
effort they perceived to use on the tests. As anticipated, sleep deprived participants performed
tasks significantly worse than non-sleep deprived participants on cognitive tasks (Pilcher and
Walters, 1997). Surprisingly, participants who were sleep deprived rated their concentration and
effort level higher than non-deprived participants (Pilcher and Walters, 1997). Students who
were sleep deprived also rated their estimated performance significantly higher than non-
deprived participants (Pilcher and Walters, 1997). Although sleep deprived students had the
selfperceived notion that they were more concentrated and more likely to perform well compared
to non-deprived students, these finding are contrary to the actual facts which show that sleep
deprived students will perform worse. The Pilcher and Walters (1997) study shows that college
students are unaware to what extent their sleep deprivation has on their ability to complete
There are multiple ways in which individuals can work to overcome their sleep
deprivation and return to functioning at an appropriate efficiency. Insomnia has been shown to
be a lead cause in sleep deprivation, causing individuals to lie awake at night, unable to achieve
sleep, or constantly waking throughout the night, there are multiple treatments that have been
tested and of these, one seems to stand out. With all the different drugs being used to aid with
sleep, acupuncture is actually proving to be an effective aid and more research is going into
discovering the true potential of this treatment (YuanFang, Jian-Hua, Neng-Gui, Zhao-Hui,
Another aid in the fight against sleep deprivation is natural sleep aids. It is remarkable
how many natural aids there are, most of which come from leaves, roots and tree bark. Some of
these aids include: kava-kava, which is an herbal remedy that relaxes the body and enhances
dreaming. Valerian root, which eases nerve and muscle tension as well as relieves anxiety and
chamomile, which is a flower that is most often drunk as a tea, aids in reducing restlessness and
digestion. There are a plethora of natural remedies that help with releasing Melatonin and
Tryptophan, which are natural chemicals in the body that aid in healthy sleep. One should always
choose a natural remedy over its synthetic counterpart when available (Kopparapu, Puranik,
A full night of sleep is not always an option with people’s nonstop lives, so the majority
of people turn to different stimulants in order to keep them going during the day. Studies have
shown that when 20mg of d-amphetamines are ingested orally, the individual returns to a
cognitive state that was present prior to being sleep deprived, allowing for an improvement in
addition and subtraction as well as logical reasoning tasks. Amphetamines also reduce a person’s
response bias by increasing their confidence in their actions and decisions. It has long been
believed that nicotine has the ability to aid in the retention and enhancement of cognitive
functions, when the individual is sleep deprived, due to the fact that it is a stimulant, but research
has actually shown it has no positive effect on the brain’s cognitive capabilities, due to its
inability to improve sleep latency. L-deprenyl, like nicotine, fails to improve sleep latency in
the sleep deprivation period. These findings were discovered in the empirical research of
Stimulant Drug Effects on Performance and Behavior After Prolonged Sleep Deprivation: A
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Comparison of Amphetamine, Nicotine, and Deprenyl (Newhouse, Penetar, Fertig, Thorne, Sing,
Poor sleep hygiene is a common factor that increases sleep loss. Sleep hygiene is the
promotion of regular sleep (CDC, 2012). Without adequate sleep hygiene, students may find
themselves with worse health consequences that encourage sleep deprivation. A study
implemented with college students showed that 33% of sleep deprived students took longer than
30 minutes to fall asleep, and 43% of the students studied also reported prematurely waking up
more than once on a nightly basis (Forquer et al, 2008). Some people may have the belief that
college students have different sleep hygiene depending on their class standing and majors.
Although it may be true that some majors have different amount of work load, Forquer et al.
(2008) found that there is no differences between freshman, sophomores, juniors, seniors, and
graduate students for the time to fall asleep, number of premature waking per night, and total
Poor sleep hygiene is a common cause of sleep deprivation among college students;
however, other causes such as alcohol consumption also affect students. According to Hershner&
Chervin (2014), approximately four out of five college students drink alcohol. Alcohol is known
to shorten sleep latency; however, it promotes fragmented sleep in the latter half of the night
(Hershner& Chervin, 2014). A study conducted about sleep and alcohol consumption found that
11.6% of students who drank alcohol used it as a sleep aid (Hershner& Chervin, 2014). The use
of alcohol for sleep is a dangerous practice that has negative health consequences. In fact,
alcohol may increase the risk for obstructive sleep apnea (Hershner& Chervin, 2014). In addition
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to alcohol consumption, college students are also sleep deprived due to other drugs such as
preserving alertness and most importantly, preventing sleep in times when there is an urgency for
studying. Students depend on caffeine products such as coffee and energy drinks for their source
of caffeine. The body’s response to highly caffeinated drinks is detrimental to sleep hygiene; for
example, intake of 2 to 4 cups of coffee taken at night can increase sleep latency on average from
6.3 to 12.1 minutes, reduce sleepiness, and improve the ability to sustain wakefulness
(Hershner& Chervin, 2014). Students who plan to study for long periods of time seek caffeinated
dirnks because they are readily available products. Students gravitate to the effectiveness of
caffeine consumption, because the effects of caffeine can last 5.5–7.5 hours (Hershner& Chervin,
2014). This suggests that caffeine consumed in the afternoon could impair one’s ability to fall
asleep (Hershner& Chervin, 2014). Energy drinks are another form of caffeinated drinks that are
popular among college students. Approximately 34% of 18–24 year Otenyo- 8 olds consume
them regularly (Hershner& Chervin, 2014). In 2006, it was reported that Americans spent more
than $3.2 billion on energy drinks , and the majority (67%) of consumers bought energy drinks to
help alleviate the symptoms linked to insufficient sleep (Hershner& Chervin, 2014). Like coffee,
the main sources of stimulus in energy drinks is caffeine, which has similar effects on the body.
The amount of caffeine in energy drinks varies from 45–500 mg, which explains the potency of
these products (Hershner& Chervin, 2014). Students view the effect of caffeine as a benefit to
their health; nevertheless, many do not consider the dangerous side effects associated with
When students are pulling all fighters to study, and or using distracting technology prior to
themselves from performing in school to the best of their ability. As mentioned in the Pilcher and
Walters (1997) study, students are unaware that their choice to deprive themselves from sleep in
deterring them from academic achievement. People can improve sleep hygiene by following a
few strategies to increase sleep quality. The first strategy is to go to bed and wake up at the same
time each day (CDC, 2012). Notre Dame College (2007) suggests that getting on Otenyo- 14 a
schedule, will help the body get used to a regular sleep cycle. The second tip is to make sure the
one’s bedroom is conducive to a distraction free sleep by making sure the room is quiet, dark,
comfortable in temperature, and it is a general relaxing environment (CDC, 2012). The third
suggestion is to make sure that one’s bed is comfortable and is used only for sleeping and not for
other activities such as reading, or watching TV (CDC, 2012). It is highly recommended that
students use common areas and the library instead, because using the bed to complete stress
related activity such as schoolwork can be destructive to effective sleep (Notre Dame College,
2007).The fourth recommendation is to avoid large meals before bedtime (CDC, 2012). It is
suggested that if one plans to eat before bed to do it about 2 hours prior to bedtime (Notre Dame
College, 2007). These tips are based on the CDC’s general assessment of good sleep hygiene so
that people can avoid sleep deprivation or other disordered sleep patterns. Students can benefit
from these suggestions; however, the college student environment sometimes does not support
good sleep.
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THEORETICAL FRAMEWORK
Below is the theoretical framework of the study (refer to Figure 1). This research will
utilize the theory of Oswald which is the Restoration Theory, conceptualized in 1996, and the
theory of Nightingale which is the Environmental Theory, conceptualized during the 19th
Century.
The Environment Theory of nursing is a patient-care theory. That is, it focuses on the
care of the patient rather than the nursing process, the relationship between patient and nurse, or
the individual nurse. In this way, the model must be adapted to fit the needs of individual
patients. The environmental factors affect different patients unique to their situations and
illnesses, and the nurse must address these factors on a case-by-case basis in order to make sure
the factors are altered in a way that best cares for an individual patient and his or her
The focus Environmental theory is to alter the patient's environment in order to affect
change in his or her health. The environmental factors that affect health, as identified in the
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theory, are: fresh air, pure water, sufficient food supplies, efficient drainage, cleanliness of the
patient and environment, and light (particularly direct sunlight). If any of these areas is lacking,
the patient may experience diminished health. A nurse's role in a patient's recovery is to alter the
environment in order to gradually create the optimal conditions for the patient's body to heal
itself. In some cases, this would mean minimal noise and in other cases could mean a specific
diet. All of these areas can be manipulated to help the patient meet his or her health goals and get
healthy. (Petepirin,2016)
assist him in his recovery. In this study, the researchers aims to know the different
environmental, external, and internal factors that causes the nursing students of Ateneo de
Zamboanga University to be sleep deprived. Knowing the different causes is not only the goal of
the researchers to find out but also the incidence of sleep deprivation among nursing students.
Some environmental factors and different causes of sleep deprivation also affects the rate of
occurrence of sleep deprivation among nursing students and in this study what the researchers
want to know is not the environmental factors that affects the incidence of sleep deprivation but
According to Oswald, the function of sleep is to restore the body during periods of inactivity so
that adequate biological functioning is ensured. The tissues of the brain and body are repaired
and the chemicals needed for proper functioning are replenished. Specifically, Oswald claims
that Non Rapid Eye Movement (NREM) sleep restores biological processes that have
deteriorated during the day. Rapid Eye Movement (REM) sleep replenishes and renews brain
processes through the process of protein synthesis. A student nurse is expected to function well
20
in classroom our in the clinical areas when amount of sleep is sufficient. Sleep is really important
and is essential to everyone, but when one is studying occurrence of sleep deprivation cannot
really be avoided and this increases the incidence as to why almost all college student are sleep
deprived. The restoration theory is necessary for this research because this study involves sleep
deprivation.
The Environmental theory by Nightingale and Restoration theory by Oswald were chosen
to provide knowledge on the possible causes for sleep deprivation of nursing students. These
causes will lead to the goal of the study: to identify the incidence of sleep deprivation among
level IV nursing students. The correlation of the restoration theory of Oswald and the
Environmental theory of Nightingale is a useful theory to find out the different causes of sleep
deprivation which would affect the incidence of sleep deprivation among level IV nursing
what causes the students to be sleep deprived and also this theoretical framework also serves as a
guide to formulate the conceptual framework needed in order to gather variables that can be
tested to determine the incidence of sleep deprivation among nursing students of Ateneo de
Zamboanga University.
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CONCEPTUAL FRAMEWORK
The following diagram is the Conceptual Framework of the study (refer to Figure 2).
Sleep Deprivation
Level IV BSN
student nurses of
ADZU
The conceptual framework of the study will mainly focus on the Incidence of sleep
deprivation and also how students handle sleep deprivation will also be included in this research
study in order for the researchers to know the commonalities of the causes why a student
becomes sleep deprived and how does these causes affect the incidence of sleep deprivation.
Coping with sleep deprivation and knowing how sleep deprivation affects the level IV nursing
students personally was also included in the study in order for the researchers to know on how
they overcome sleep deprivation in order for them to make it through the day of tiring school
There are five variables in the study; First variable is the sleep deprivation, second
variable is the causes of sleep deprivation, third variable is the incidence of sleep deprivation
fourth variable is to how nursing students cope with sleep deprivation, and lastly the level IV
nursing students of Ateneo de Zamboanga University. Sleep deprivation which is the first
variable happens when a certain person did not complete the number of hours sleep needed.
Sleep deprivation is on the top of the conceptual framework since sleep deprivation is the main
reason why this study is created, sleep deprivation is also the main reason why some incidences
of sleep deprivation happen, why causes of sleep deprivation arises, and lastly, why most of the
students are able to handle or overcome sleep deprivation. Sleep deprivation is further extended
into the three branches of variables, these are the, causes of sleep deprivation, incidence of sleep
deprivation, and coping with sleep deprivation. All of these variable comes down to the last
variable of the study which is the Level IV nursing students of Ateneo de Zamboanga University.
The last variable is intentionally placed in the bottom of conceptual framework because it is the
students who are greatly affected by sleep deprivation, it is through the students why causes and
incidence of sleep deprivation happens, and it is the duty of the students to handle sleep
deprivation in order for them to make it through the day of loads of requirements, quizzes, duties
and etc.
This research study aims to determine the Incidence of sleep deprivation among nursing
students of Ateneo de Zamboanga University. Specifically, the study aims to answer the
following questions:
1. What are the number of hours of sleep of the level IV nursing students on a regular day?
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2. What is the incidence of sleep deprivation among the level IV nursing students?
3. What are the common causes of sleep deprivation among level IV nursing students?
4. How often are the level IV nursing students sleep deprived on a regular week?
This study can be a learning paradigm for the college of nursing to enhance the students’
knowledge about the sleep deprivation. The researcher will focus on the incidence rate of sleep
deprivation among the nursing students thus this paper will give a more or less accurate number
of students who are sleep deprived. Included in this research is the quantitative value of sleep
Since sleep plays an important role in memory and learning process this study will be a
significant endeavour in promoting normal sleep pattern. This paper will promote awareness to
the nursing students that sleep deprivation very is detrimental to health; this would decrease their
ability to concentrate and complete complex task especially in the area of duty and in the
classroom as well.
and though it remains a struggle to find the motivation to modify the behaviours; this study can
be a wake-up call for the college of nursing clinical instructors and administrative staff in terms
of strategic management for the nursing students who are sleep deprived.
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Sleep deprivation is and largely under-recognized health issue which may require a multi-
dimensional approach to be able to transform previous behaviour. This study will therefore pave
the way for other researchers to investigate deeply about the causes and effects and other factors
The problem of this study will solely focus only in the Incidence rate of sleep deprivation
among level IV nursing students of Ateneo de Zamboanga University. The goal of the study is to
determine the incidence level of sleep deprived level IV nursing students and also to determine
what are the commonalities that causes them to be sleep deprived and how does the level IV
nursing students handle sleep deprivation. The scope area of the study will include the premises
The study participants for this research study will be chosen from the fourth year college,
nursing students from both groups A and B. The reason for the selection of this group is due to
the fact that the level IV nursing are considered to have stressful RLE duties and also the level
IV nursing students have lots of quizzes, requirements, and Sunday Review examination, by this
the researchers are expecting a great number of incidence of sleep deprivation among the level
IV nursing students. By using the Total Enumeration as for gather the study participants, an
estimate of 102 (excluding the researchers) or the total population of level IV nursing students
DEFINITION OF TERMS
Sleep Deprivation. This refers to the condition of not having enough sleep
translating enough sleep into numbers, it means the college students ages 18-25 years old
cannot complete the recommended sleeping hours which is 8-9 hours per night.
Student Nurses. The nurses from this study are the level IV student nurses
currently enrolled to the program Bachelor of Science in Nursing (BSN) S.Y. 2018-2019.
Quality of Sleep This refers to the amount of sleep that the students nurses can
have while juggling academic requirements as well as the student nurses related learning
RESEARCH METHOD
This chapter will be discussing the Research Design, Research Locale, Participants of the
Study, Instrument of the Study, Data Gathering Procedure, Plan of Analysis, and Ethical
RESEARCH DESIGN
This research study will be using a descriptive research design with quantitative
using computational techniques. This research study will seek to find out Incidence of Sleep
University. Descriptive research design with quantitative measures will be used to describe
and interpret the number of hours of sleep of the level IV nursing students on a regular day,
the incidence of sleep deprivation among level IV nursing students, the common causes of
sleep deprivation among level IV nursing students, and lastly how students cope with sleep
deprivation.
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RESEARCH LOCALE
Zamboanga University is the only school Jesuit school that exists in Western Mindanao. The
school was founded in the year 1912 as Escuela Catolica and the second oldest Jesuit school
The study participants of this research will be select nursing students of Ateneo de
Zamboanga University. Participants for this study will be chosen from the Level IV nursing
students. The reason for the selection of this group is due to the fact that the level IV nursing
students are those who have accumulated the most exposure to Related Learning Experience
(RLE), whether in a hospital or community set-up. The population of the study will be 102
The sample for this research study will be taken from all the 102 level IV nursing students
using the total population sampling by studying and examining the entire population to get
the most accurate findings for the study of incidence of sleep deprivation.
Inclusion Criteria:
The study participants for this research will be chosen based on the following
Science in Nursing student, c) having Related Learning Experience (RLE) duty, d) been
to a health center or hospital duty, & e) those who are sleep deprived.
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Exclusion Criteria:
Those who are not chosen for this study will be chosen based on the following
criteria: either, a) not bona fide student of Ateneo de Zamboanga University, b) not a
Experience (RLE) duty, d) never been to a health center or hospital duty, & e) those who
This study will utilize a research instrument in order to obtain the needed data for this
researchers. Prior to conduction the gathering of the data, a consent will be given to the study
participants as an approval sheet and making sure that all data gathered will be highly
confidential. The draft of the questionnaire will be drawn out based on the researcher’s readings,
previous studies, literature published and unpublished thesis relevant to the study.
The self-administered questionnaire will contain four (4) parts. The first part of the
instrument talks about the demographic data. This part of the instrument will solicit the study
participant's name, age, year and section. A follow up question will be asked whether the
participant has been sleep deprived for the past few weeks. If the participant answered “yes, I
have been sleep deprived then he or she can proceed in answering the rest of the instrument and
if the study participant, he or she will be asked to return the questionnaire. The second part of the
questionnaire talks about the incidence of sleep deprivation, this part of the instrument will
solicit the number of nights in which they are deprived of sleep in a week. In those nights of
being sleep deprived, the study participants will be asked as to how many hours they sleep
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during those nights including power naps in the afternoon. The third part of the questionnaire
talks about the causes of why nursing students are sleep deprived, a select that all apply (close
ended) type of questionnaire will be utilized. The researchers will give 10 different options
regarding the causes of why nursing students are sleep deprived. The study participants will be
given a chance to specify what causes him or her to be sleep deprived if the given options did not
match their idea. This part of the instrument will answer the question “What are the common
causes of sleep deprivation among level IV nursing students?” The last part of the questionnaire
aims to determine as to how the level IV nursing students cope with sleep deprivation. this part
of questionnaire will be answerable by the use of a 4 point Likert Scale in which the participant
has to agree, very much agree, disagree, or very much disagree to the given statement. The likert
questionnaire will have a total number of 10 items that is focused as to how do level IV nursing
Reliability Test
To fully know the incidence of sleep deprivation among level IV nursing students, a test
retest reliability will be used. It will measure the reliability obtained by administering the same
test twice over a period of time (one to two months) to the group of individuals. In order to
measure the test retest reliability, the researchers will give the same test to same respondents on
two separate occasions. The first test given can be referred as T1 and the second test can be
referred as the T2 known as the test retest reliability coefficient. The closer each study
participant’s scores are on T1 and T2, the more reliable the test measure.
Validity Test
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The different instrument of the study used in this research were referred to the adviser for the
face validity for assessments of the appropriateness and suitability of the instruments. The face
validity is the degree to which a procedure appears effective in terms of its stated aims. With the
recommendation of the adviser or to the experts in the research field, the research instruments
will be then subjected to a validity testing in order to modify or improve testing items that
The data gathering will begin with a letter made by the researchers for the dean of the
college of nursing to allow the researcher to conduct a study. Indicated in the letter is to ask
permission to invite the 102 level IV nursing students excluding the researhcers to be the
participants of the study entitled Incidence of Sleep Deprivation among Level IV Nursing
After the researchers are done choosing their study participants, a letter will then be handed
informing the participants of what the focus, significance, and goals of the study are. This letter
will also ask for their consent to answer a self-administered questionnaire prepared by the
researchers which contains 4 parts. A specific date and time will be announced to the study
participants for them to answer the questionnaires. The study participants must answer the
questions truthfully, independently and without the help of others in order to obtain the desired
result. When they are done answering the researchers will immediately collect the questionnaires
and check it and tally the results. The data obtained will be analysed using the frequency table
and the central tendency mode. The test will took place at the Nutrition Lab and Amphitheater,
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minutes
PLAN OF ANALYSIS
The gathered data obtained from the participants will undergo a process which utilized a
descriptive quantitative statistics. The obtained data will be interpreted by the use of the different
statistical tools. The statistical tool that will be utilized in this study will be the frequency
distribution table and central tendency mode. The central tendency “mode” or the most
frequently occurring number found in a set of numbers will be identified. The results will be
tabulated in a frequency table to help identify the mode in each of the different options provided
To answer the question “What are the number of hours of sleep of the level IV nursing
students on a regular day?” the researchers will utilize the central tendency “mode” in order to
identify the most occurring hour in which the study participants are sleep deprived on a regular
day. The data obtained will be interpreted by the use of a pie chart in order to classify the
different hours of sleeps the study participants had. The use of the pie chart will also aid the
researchers on discussing the most significant and the least significant data obtained.
To answer the question “What is the incidence of sleep deprivation among the level IV
nursing students?” it will be analysed by the use of the central tendency “mode” or the most
frequently occurring number found in a set of numbers. The results will be tabulated in a
frequency table and will be interpreted by the use of a bar graph presenting the different days in
which the study participants became sleep deprived and the different number of hours of sleep in
which the study participants had during the days of July 08, 2018 to July 14, 2018. The use of the
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bar graph will also aid the researchers in identifying and discussing the most and the least
To answer the question “How often are the level IV nursing students sleep deprived on a
regular week?” the researchers will utilize the central tendency “mode” in order to identify the
days in which most of the study participants are sleep deprived on a regular week. The data
obtained will be interpreted by the use of a bar graph in order to classify the different days in
which the study participants became sleep deprived. The use of the bar graph will also aid the
researchers on discussing the most significant and the least significant data obtained.
To answer the question “What are the common causes of sleep deprivation among level
IV nursing students and “How do level IV nursing cope with handle sleep deprivation” the data
obtained will again be analysed by the use of the central tendency mode. The results obtained
will be tabulated on a frequency table in order to identify the mode and will then be interpreted
by the use of a tabular form. For the common causes of sleep deprivation, the use of a tabular
form will rank the questions or set of choices from most agreed question or choice from the least
agreed question or choice. For the question “How do level IV nursing students cope with sleep
deprivation?” since the data obtained for this question is a likert type scale, each question will be
ranked as to whether the study participants strongly agree, agree, disagree, and strongly disagree.
The use of the tabular form will also aid the researchers in identifying and discussing the most
ETHICAL CONSIDERATIONS
The ethical consideration is to ensure the safety of the students in research and who assist in
making sure that human rights are not violated. The research also helps to protect the institution
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and the researchers against potential legal implications from any behavior that may be deemed
unethical.
The first ethical consideration is the approval of the dean of College of Nursing. Second, the
student should voluntary participate in the research, they can withdraw from the research
anytime. Third, the students must be properly informed regarding the purpose of the consent of
the study and that there will be no harm for them. Lastly, Ethical standards also protect the