Louisiana Tech University Louisiana Tech Digital Commons Doctoral Dissertations Graduate School Fall 2002 Development and evaluation of the Sleep Treatment and Education Program for Students (STEPS) Franklin Christian Brown Follow this and additional works at: https://digitalcommons.latech.edu/dissertations Part of the Psychoanalysis and Psychotherapy Commons INFORMATION TO USERS This manuscript has been reproduced from the microfilm master. UMI films the text directly from the original or copy submitted. Thus, some thesis and dissertation copies are in typewriter face, while others may be from any type of computer printer. The quality of this reproduction is dependent upon the quality of the copy submitted.Broken or indistinct print, colored or poor quality illustrations and photographs, print bleedthrough, substandard margins, and improper alignment can adversely affect reproduction. 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Brown, M.A. College of Education Louisiana Tech University A Dissertation Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy November 2002 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. UMI Number 3066289 Copyright 2002 by Brown, Franklin Christian All rights reserved. UMI’ UMI Microform 3066289 Copyright 2002 by ProQuest Information and Learning Company. All rights reserved. This microform edition is protected against unauthorized copying under Title 17, United States Code. ProQuest Information and Learning Company 300 North Zeeb Road P.O. Box 1346 Ann Arbor, Ml 48106-1346 Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. LOUISIANA TECH UNIVERSITY THE GRADUATE SCHOOL July 2, 2002 ____________ Date We hereby recommend that the dissertation prepared under our supervision by _______ Franklin C. Brown__________________________________________ entitled Development and Evaluations of the Sleep Treatment and_____ Education Program for Students fSTEPS!__________________________ be accepted in partial fulfillment of the requirements for the Degree of Doctor of Philosophy Supepti sor of ^ksertation I ^search /r ^ 4 - 1 HeadI Psychology S Behavioral Sciences Department Recommendation concurred in: dvisory Committee Approved: Approved: Director of Gradu£e Studies Dean of the Graduate School i of the College GS Form 13 (1/0 0 ) Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. ABSTRACT Sleep difficulties are becoming progressively more common among university students and may be related to increased academic and emotional difficulties. Psychoeducational interventions are among the most effective methods for reducing sleep difficulties and are significantly better than pharmacological treatments. Attempts to demonstrate the effectiveness of such treatments among university students are not present in the literature. The purpose of this study was to develop the Sleep Treatment Education Program for Students (STEPS) and evaluate its effectiveness to improve sleep habits and reduce sleep complaints. The study used a double blind, experimental design. Participants in the treatment condition received Sleep Hygiene Guidelines, Stimulus Control Instructions, information about caffeine content, and a brief lecture describing the impact of poor sleep quality on university students. The control group students were informed about the scientific methods of behavioral sciences. Students in the treatment group reported significant improvements in their overall sleep quality and habits. Bedtime worries about sleep difficulties, inconsistent sleep times, nighttime thirst, and caffeine use accounted for the most variance in poor sleep quality. These results suggest that inception of an inexpensive student sleep awareness program such as STEPS may significantly reduce or prevent sleep difficulties in university students. Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. TABLE OF CONTENTS ABSTRACT...................................................................................................................... iii LIST OF TABLES .......................................................................... vii LIST OF FIG U R E S.......................................................................................................... viii CHAPTER 1 ......................................................................................................... 1 INTRODUCTION ........................................................................................ 1 Statement of the Problem .................................................................. 6 Statement of the Purpose .................................................................. 9 Literature Review .............................................................................. 10 Historical Foundations ......................................................... 10 Description of Sleep ............................................................... 14 Sleep Stages ............................................................ 16 Physiological Processes of the Sleep-Wake Cycle .... 20 Autonomic Nervous S y stem...................................... 20 Homeostatic Drive ................................................... 22 Circadian R h y th m ...................................................... 23 Sleep Disorders ..................................................................... 29 Dyssomnias ............................................................... 29 Primary Insomnia ...................................... 29 Primary Hypersomnia ................................... 30 Breathing Related Sleep Disorder .... 31 Narcolepsy ................................................ 33 Circadian Rhythm Disorders ...................... 34 Dyssomnias Not Otherwise Specified .... 36 Parasomnias ............................................................... 36 Nightmare Disorder ....................................... 37 Sleep Terror Disorder ................................... 37 Sleep Walking D iso rd e r ................................ 38 Parasomnias Not Otherwise Specified . 39 Sleep Habits and Difficulties in University Students .... 40 Importance of Sleep ............................................................ 44 Poor Sleep Quality and Subjective Complaints . 46 Inadequate Sleep Length .......................................... 47 Regular Sleep Habits ................................................ 49 REM Sleep and Learning ....................................... 53 Sleep Treatments .................................................................... 57 Psychoeducational Interventions ............................. 57 Sleep Hygiene ................................................ 58 Stimulus Control .......................................... 66 Sleep Restriction T h e ra p y............................. 67 Psychotherapeutic Interventions ................................. 67 Relaxation Training ....................................... 68 Cognitive Therapy ...................................... 68 Psychoeducational Treatments for Students .... 70 Hypotheses .......................................................................................... 71 iv Reproduced with permission of the copyright owner. Further reproduction prohibited without permission. Hypothesis One ..................................................................... 73 Hypothesis Two ..................................................................... 73 Hypothesis Three .................................................................. 73 Hypothesis Four .................................................................. 73 Hypothesis Five .................................................................. 74 Hypothesis Six ........................................................................ 74 Hypothesis Seven .................................................................. 74 Hypothesis Eight .................................................................. 74 Hypothesis Nine .................................................................. 74 Hypothesis Ten .................................................................. 74 Hypothesis Eleven .................................................................. 74 Hypothesis Twelve ............................................................... 75 Hypothesis Thirteen ............................................................... 75 CHAPTER 2 76 METHODS ................................................................................................. 76 Participants ....................................................................................