Nursing students’ Factors Affecting Sleep

Table 4 presents the factors affecting sleep in terms of internal factors. Individual quality
of life can be disrupted due to many different reasons, one of the important causes for that is
having a sleep loss. The phenomenon of sleeping pattern is common among students most
especially when their examination is fast approaching and accomplishing the overloaded school
works, at the same time feeling unexpected pain and occupied thoughts due to hectic schedules.
In relation to the study conducted, the researchers have found out that occupied thoughts is with
highest frequency with 63 (79.75%) and ranked first among all other factors under internal
factors. The result indicates that having occupied thoughts disrupts sleep for most of the students.
Worrying at bedtime and losing sleep to stress and anxiety is one of the most common sleep
concern. For the student nurses, anxiety increases which affects their seep relating to the other
factors presented.

Then followed by studying (for exam, lecture or advance reading) with frequency of 59
(74.68%). This result suggest that some of the student nurses’ problem is on time management as
to how they will be able to maximize and create time to study have other considering the
workload they have. But student nurses must be aware that terminating sleep to study can
precede undesired effects, sleep is important for cognitive restitution. It influences information
processing, learning and memory consolidation. According to the National Institute of
Neurological Disorders and Stroke, Sleep is an important part of the daily routine spend about
one-third of the time doing it, without sleep a person can’t form or maintain the pathways in the
brain that let learning and create new memories, and it’s harder to concentrate and respond
quickly. This is followed by finishing overloaded homework and projects with frequency of 57
(72.15%) from the respondents. Doing other tasks for school matters and sleeping late to
accomplish it causes them sleep deprivation. This is followed by preparing for a report on a
subject having frequency of 45 (56.96%) that ranked fourth out of five internal factors. Then
followed by experiencing pain with frequency of 20 (25.32%). The result implies that when
student nurses’ experiencing pain can disrupted their sleep due to uncomfortable feeling. It
greatly show how student nurses spend their time that makes them sleep deprived. According to
the National Sleep Foundation (NSF), Sleep is essential for a person’s health and wellbeing
especially to students. Adequate sleep will aid in making one’s tasks efficiently and effectively.
Terminating sleep has its undesired consequences which will lead to affecting one’s performance
at school.

Table 4

Internal Factors That Affect Sleep

INTERNAL FACTOR Frequency % Rank

Studying 59 74.68% 2

Finishing overloaded homework and projects 57 72.15% 3

Preparing for a report on a subject 45 56.96% 4

 Experiencing any pain 20 25.32% 5

Occupied thoughts 63 79.75% 1

Table present another factor of sleep and this is the external factors. Surfing the net
(facebook, instragam, twitter, youtube etc.) had the highest frequency of 74 with a percentage of
93.67. The result indicates that doing a leisure at night for relaxation due to the workload in
school works can also affect the sleeping pattern. This implies that a big number of student
nurses experiences sleep deprivation due to usage of this social media sites. According to an
expert in sleep patterns and body clocks, mostly nowadays students are hooked with use of
Facebook and other social media sites that leads them of being sleep deprived. This is not a good
at all as it’s having huge negative effect on their sleep.It is said that a lot of people think that
when they go to sleep their brain is turned off but that is not the case. The brain simply engages
in a different activity where it stores important memories and gets rid of information that is not
needed. The result implies that if student nurses aren’t getting enough sleep each night, their
long-term memory is the most definitely being affected and using social networking sites and
technology before they go to sleep is worsening this.

Then followed by went home late at night from duty (3-11 hours shift) with a frequency
of 46 (58.23%) and ranked second. The result implies that when the student nurses went home
late from RLE duty, considering that some of them is still from the area, they tend to sleep late
and this deprives them of sleep especially when they will have to wake up early for a class the
next day. Turned on lights when sleeping is another factor considered by the respondents having
a frequency of 39 (49.37%) and ranked third. Night-time light exposure suppresses the
production of melatonin, the major hormone secreted by the pineal gland that controls sleep and
wake cycles. Therefore, a reduction in melatonin at night is associated with subjective levels of
sleeplessness affecting sleep quality of the student nurses or other individuals. Then followed by
noisy environment with a frequency of 38 (48.10%) and ranked of fourth. It is said that
environmental noise is another significant factor when it comes to influencing sleep-wake
behavior and sleep quality. High sound levels during sleep whether from traffic, neighbors, or
disturbances in one’s own home can decrease sleep intensity that cause an individual to wake
more often during the night, and can even increase stress hormone secretion. Then followed by
the three factors under external in a ranked fifth and these are playing computer games (dota, FB
games and application), room temperature (too hot or too cold) and quality of bed with the
frequency of 35 (44.30%) from the respondents. Two factors with frequency of 16 (20.25%) are
in ranked sixth, and these are watching teleserye or evening show and listening to loud music.
Then followed by not comfortable sleeping alone with a frequency of 14 (17.72%). Sleeping
alone is one of the factor that affects sleep.
 Rotating shift while on duty with a frequency of 11 (13.92%) is ranked eighth in
external factor. However, despite that some of the respondents considered a noisy environment
as a factor affecting their sleep, a frequency of 8 (10.13%) considered a too silent as a factor.
Drinking alcohol and beverages with friends is also in ranked ninth with too silent environment.
Then followed by routine drinking of caffeine with a frequency of 7 (8.86%) from the
respondents. Drinking caffeine is one of the contributory factor that affect sleep. Some said that
they drink coffee hours before sleeping. Coffee which contains caffeine has a disruptive effects
on sleep especially if taken hours prior to sleep. Avoidance taking it before bed time help in
obtaining better sleep. Lights turned off with frequency of 6 (7.59) ranked eleventh is also one of
the factor of external that affect sleep. Followed by the two factors in ranked twelve; not
comfortable with other people in the room and medication taken. The sound of the thunder with
a frequency of 4 (5.06%) of the respondent is ranked thirteenth. Then followed by going to night
parties with frequency of 3 (3.8%). Ranked fifteenth has none respondent for smoking.

Table

External Factors That Affect Sleep

EXTERNAL FACTOR Frequency % Rank

Went home late at night from duty (3-11 shift/ 36 hours shift) 46 58.23% 2

Watching teleserye or evening shows 16 20.25% 6.1

Listening to loud music 16 20.25% 6.2

Playing computer games (dota, FB games and applications) 18 22.78% 5.1

Surfing the net (facebook, instagram, twitter, youtube, etc.) 74 93.67% 1

Room Temperature (too hot or too cold) 35 44.30% 5.2

Lights turned on 39 49.37% 3

Lights turned off 6 7.59% 11

Noisy environment 38 48.10% 4

Too silent environment 8 10.13% 9.1

Not comfortable sleeping alone 14 17.72% 7

The sound of a thunder 4 5.06% 13

Quality of bed 18 22.78% 5.3

Not comfortable with other people in the room 5 6.33% 12.1

Medications taken 5 6.33% 12.2

Routine drinking of caffeine 7 8.86% 10

Going to night parties 3 3.8% 14

Drinking alcohol beverage with friends 8 10.13% 9.2

Smoking 0 0 15

Rotating shift while on duty 11 13.92% 8

MEDICAL STUDENTS’ FACTORS AFFECTING SLEEP

Table presents the factors affecting sleep in terms of internal factors in medicine.
According to Harvey et al. (2008), good sleep quality is associated with a wide range of positive
outcomes such as better health, less daytime sleepiness, greater well-being and better
psychological functioning. But because of hectic schedule with overloaded school works, the
student can’t manage the time to do this works. In relation to the study conducted, the researcher
have found out that studying is with high frequency of 55 (91.67%) and ranked first among all
other factors under internal factors. The result indicates that most of the medical student has a
problem on time management. But medical student must be aware that terminating sleep to study
can precede undesired effects, sleep is important for cognitive restitution. Then followed by
occupied thoughts with a frequency of 40 (66.67%). The result indicates that worrying disrupts
sleep for most students. For medical students, anxiety increases which affect their sleep relating
to the other factors presented. Preparing for a report on a subject with a frequency of 25 (41.67%)
has a ranked third under internal factors. Then followed by finishing overload homework and
projects with a frequency of 20 (33.33%). Finishing school works and sleeping late due to
overloaded school works it causes them sleep deprivation. Then the last is ranked fifth with a
frequency of 5 (8.33%) of the respondents experiencing any pain.It greatly show how medical
student spend their time to complete the task that makes them sleep deprived. According to
Jordan, sleeping pattern is the cornerstone on getting great sleep. A messed up sleep pattern is one
of the main causes of insomnia. The key on getting it right is to choose a sleep pattern and stick to
it.
 INTERNAL FACTOR Frequency % Rank
Studying 55 91.67% 1
Finishing overloaded homework and projects 20 33.33% 4

Preparing for a report on a subject 25 41.67% 3

Experiencing any pain 5 8.33% 5

Occupied thoughts 40 66.67% 2

Table _ present the factors affecting sleep in terms of external factors.Surfing the net
(facebook, instragam, twitter, YouTube, etc.) had a highest frequency of 45 (75%) among all
other external factors and ranked first. It showed that doing leisure at night for relaxation and
stress-free due to hectic schedules and overloaded school works can also affect the sleeping
pattern. It implies that a big number of medical students sleep deprivation because of using social
media sites.It is bad at all because it has a negative effect on their sleep. Most people don’t realize
what impact using computer, mobile phones and other gadgets before falling sleep is having on
their night’s sleep. Being exposed to bright light from computer and mobile phone screens while
in bed completely delays the brain and body’s ability to get sleep. As a result, people are not able
get sleep as quickly as they should and aren’t getting the required amount of sleep they need each
night.
Then followed by went home late at night from duty (3-11 shift/36 hours duty) with
frequency of 30 (50%) and second ranked under external factors. It showed that, when a medical
student went home late at night from RLE duty, they tend to sleep late and deprive especially
when they have a class next day. Rotating shift while duty with a frequency of 30 (50%) is also
ranked second in external factors that affect sleep. Then followed by room temperature with a
frequency of 25 (41.67%) of the respondents. This implies that temperature in the environment
where an individual sleeps also would affect their sleep quality. Two factors are ranked fourth
with a frequency of 20 (33.33%) and this are the lights turned on and routine drinking of caffeine.
Then followed by the two factors in ranked fifth, and this are playing computer games and noisy
environment with a frequency of 15 (25%). Watching teleserye or evening show with a frequency
of 10 (16.67%) is ranked sixth. Then followed by lights turned off, quality of bed, not
comfortable sleeping alone and not comfortable with other people in the room with frequency of
5 (8.33%) are ranked seventh on factors affect sleep. None of the respondent vote in listening to
loud music, too silent environment, the sound of thunder and medication taken.
 EXTERNAL FACTOR Frequency % Rank

Went home late at night from duty (3-11 shift/ 36 hours 30 50% 2.1
shift)
Watching teleserye or evening shows 10 16.67% 6

Listening to loud music 0 0 0

Playing computer games (dota, FB games and 15 25% 5.1

applications)
Surfing the net (facebook, instagram, twitter, youtube, 45 75 % 1
etc.)
Room Temperature (too hot or too cold) 25 41.67% 3

Lights turned on 20 33.33% 4.1

Lights turned off 5 8.33% 7.1

Noisy environment 15 25% 5.2

Too silent environment 0 0 0

Not comfortable sleeping alone 5 8.33% 7.2

The sound of a thunder 0 0 0

Quality of bed 5 8.33% 7.3

Not comfortable with other people in the room 5 8.33% 7.4

Medications taken 0 0 0

Routine drinking of caffeine 20 33.33% 4.2

Going to night parties 0 0 0

Drinking alcohol beverage with friends 0 0 0

Smoking 0 0 0

Rotating shift while on duty 30 50% 2.2

Respondent’s Sleeping Pattern

Table 3 contains the usual sleeping pattern of the nursing respondents. The variables
included are the respondent’s average hours of sleep, usual time of sleep, usual time of waking
up when there is no duty/classes, usual time of waking up when there is duty/classes, quality of
sleep during 3-11 shift/from duty, difficulty of falling asleep, waking up often at night.

Respondent’s average hours of sleep.

This is one important data from the respondents of this study. There are many factors
as to why student nurses are experiencing sleep deprivation, lies with this concern are the effects
of sleep deprivation or its implications to academic performance and health aspects. As it is
stated in the theoretical framework, the researchers have used the Maslow’s hierarchy of needs
as the basis, and part of the basic needs that a man should be able to meet is the physiologic
needs. Part of the physiologic need is sleep. According to his theory, for one to be able to meet
other needs, one should be able to meet first the basic needs and before advancing to other needs
and to function in other aspects that includes the physical, social, mental/emotional aspects of
life.

The average hours of sleep that had the highest frequency was sleep four to six hours a day, with
a frequency of 53 respondents with a percentage of (67.09%). This implies that most of the
student nurses of Bicol University experiences sleep deprivation as the average hours of sleep
they obtain is less than eight hours per day and this is below the given normal value. According
to Jordan, sleeping pattern is the cornerstone on getting great sleep. A messed up sleep pattern is
one of the main causes of insomnia. The key on getting it right is to choose a sleep pattern and
stick to it. Monophasic sleep is essentially what most people would call a normal sleeping
pattern. A person sleeps for around 8 hours per night, variable per person. It’s the most common
sleeping pattern and the one most societies have adopted. A frequency of 23 with seven to nine
hours a day and ranked second among the presented average hours of sleep per day. This result
implies that among 79 nursing students, only 23 obtains eight hours of sleep per day that is
within the normal value. Followed by less than three hours a day with a frequency of 2 (2.53%)
and ranked third. This is then followed by sleeps ten to twelve hours a day with a frequency of
one respondents with a percentage of (1.27%). The result suggests that student nurses are
obtaining less than normal value of sleeping hours compared with obtaining sleep within normal
value. This implies that this is a common concern for majority of the student nurses due to the
different effects in terms of academic performance and health.

Usual time of sleep.

In the study conducted it shows that had a highest frequency was usually sleeps at eleven to
twelve o’clock in the evening with a frequency of 42 (53.16%) of a total population. It implies
that most of the nurse’s student in Bicol University slept at below the right normal value of sleep.
According to Healthy sleep, most people don’t get enough sleep. A nation where people stay up
all night to study, work, or have fun. However, going without adequate sleep carries with it both
short- and long-term consequences. In the short term, a lack of adequate sleep can affect
judgment, mood, ability to learn and retain information, and may increase the risk of serious
accidents and injury. In the long term, chronic sleep deprivation may lead to a host of health
problems including obesity, diabetes, cardiovascular disease, and even early mortality. It also
drains a person’s mental abilities and puts physical health at real risk. Then followed by second
highest frequency of 31 respondents with a percentage of (39.24%) slept at nine to the o’clock in
the evening. The result shows

, with a frequency of 1 (1.27%) less than six hours. none sleeps at seven to eight o’clock in the
evening, 31 (39.24%) of the respondents sleeps at nine to ten o’clock in the evening, 42
(53.16%) sleeps at eleven to twelve o’clock in the evening, and 5 (6.33%) respondents sleep one
o’clock onwards. Most of the respondents usually sleep at eleven to twelve o’clock in the
evening.

Usual time of waking up when there is no duty/classes. The result showed that there
are no respondent who wakes up less than three o’clock in the morning, 2 (2.53%) of the
respondents wakes up at four to five o’clock in the morning, 15 (18.99%) of the respondents
wakes up at six to seven o’clock in the morning, 40 (50.63%) of the respondents wakes up at
eight to nine o’clock in the morning, 20 (25.32%) of the respondents wakes up at ten to eleven
o’clock in the morning, 2 (2.53%) of the respondents wakes up at twelve noon onwards. Most
respondents wake up at eight to nine in the morning when there is no duty/classes.

Usual time of waking up when there is duty/classes. The result showed that there are
no respondent who wakes up less than three o’clock in the morning, 56 (70.89%) of the
respondents wakes up at four to five o’clock in the morning, 23 (29.11%) of the respondents
wakes up at six to seven o’clock in the morning, none of the respondentswakes up at eight to
nine o’clock in the morning, none of the respondents wakes up at ten to eleven o’clock in the
morning, and none of the respondents wakes up at twelve noon onwards. Most respondents wake
up at four to five in the morning when there is duty/classes.

Quality of sleep during 3-11 shift/from duty. In the study conducted 56 (70.89%)
experienced short time of sleep during the 3-11 shift, none of the respondents experienced too
much sleep, 23 (29.11%) of the respondents experienced enough sleep, and none of the
respondents experienced no sleep at all. Majority of the respondents experienced short time of
sleep during the 3-11 shift duty.

Difficulty of falling asleep. Based on the result, 40 (53.16%) of the respondents had
difficulty falling asleep while 39 (49.37%) do not have difficulty falling asleep. Most of the
respondents have difficulty falling asleep.

Waking up often at night. The result showed that 20 (25.32%) of the respondents wake
up two to three times often at night due to frequent urination, however 59 (74.68%) of the
respondents do not experienced waking up at night. In conclusion, most of the respondents do
not experienced waking up at night.

The table 3 presents the usual sleeping pattern of the nursing respondents which include
the respondent’s average hours of sleep, usual time of sleep, usual time of waking up when there
is no duty/classes, usual time of waking up when there is duty/classes, quality of sleep during 3-
11 shift/from duty, difficulty of falling asleep, waking up often at night. The average hours of
sleep of the level IV nursing students is four to six hours a day. Nursing students usually sleeps
11-12 o’clock in the evening due to overloaded school works. The respondents usually wakes up
8-9 o’clock in the morning when there is no duty/classes to regain their energy. However, the
respondents usually wake up at 4-5 o’clock in the morning when there is duty/classes. Based on
the result, majority experienced short time quality of sleep during their 3-11 shift. Most of the
respondents have difficulty falling asleep and most of the respondents do not often wake up at
night.

NURSING TABULATED RESULT

 How many hours do you sleep?

Hours Frequency %

>3 hrs 2 2.53%

4-6 hrs 53 67.09%

7-9 hrs 23 29.11%

10-12 hrs 1 1.27%

 What time do you usually sleep?

Time Frequency %

<6 pm 1 1.27%

7-8 pm 0 0

9-10 pm 31 39.24%
 11-12 pm 42 53.16%

1 onwards 5 6.33%

 What time do you usually wake up when there is no duty/classes?

Time Frequency %

<3 am 0 0

4-5 am 2 2.53%

6-7 am 15 18.99%

8-9 am 40 50.63%

10-11 am 20 25.32%

12 onwards 2 2.53%

 What time do you usually wake up if there is duty/classes?

Time Frequency %

<3 am 0 0

4-5 am 56 70.89%

6-7 am 23 29.11%

8-9 am 0 0

10-11 am 0 0

12 onwards 0 0

 In your 3-11 shift or from duty, what quality of sleep do you get?
Frequency %

Short time of sleep 56 70.89%

Too much sleep 0 0

Enough sleep 23 29.11%

No sleep at all 0 0

 Do you have difficulty falling asleep?

 Frequency %

Yes 40 53.16%

No 39 49.37%

 Do you wake up often at night?

Frequency %

Yes 20 25.32%

No 59 74.68%

MEDICINE TABULATED RESULT

 How many hours do you sleep?

Hours Frequency
>3 hrs 35

4-6 hrs 25

7-9 hrs 0

10-12 hrs 0

 What time do you usualy sleep?

Time Frequency
<6 pm 35
7-8 pm 0

9-10 pm 10

11-12 pm 15
1 onwards 0

 What time do you usually wake up when there is no duty/classes?

 Time Frequency
<3 am 0
4-5 am 5

6-7 am 10

8-9 am 30
10-11 am 15

12 onwards 0

 What time do you usually wake up if there is duty/classes?

Time Frequency
<3 am 0

4-5 am 35

6-7 am 25

8-9 am 0
10-11 am 0

12 onwards 0

 In your 3-11 shift or from duty, what quality of sleep do you get?
Frequency
Short time of sleep 25

Too much sleep 10

Enough sleep 20

No sleep at all 5

 Do you have difficulty falling asleep?

Frequency

Yes 15

No 45
CONCLUSION

Based on the findings, the researchers can therefore conclude that:

1. The nursing and medical students’ sleeping pattern are varying. They have different duration of
sleep.
2. There are different factors affecting sleep among nursing and medical students.
3. Sleeping pattern affects the nursing and medical students in terms of academic performances
and health.
4. There are different recommendations that can utilize by the medical and nursing student to
address the problem.

RECOMMENDATIONS
As the result of the foregoing studies, findings and conclusion, the researchers have the following
recommendations:
1. The school administration must provide healthy school scheduling by considering the loads of
the students in their academic requirements.
2. Parents must take responsibility in monitoring the activities of their children. They should
provide more guidance and support to promote the well-being of their children
3. Medical and nursing students should utilize measures that were proposed to address the
problem. They should choose the ones that can help make it easier for them to do things, in
such a way that sleep will not be compromised.
4. Students should improve their study habits to avoid procrastination. Procrastination eventually
leads to cramming which is common among students who are carefree and take their studies for
granted
5. Students must be aware of the things should be avoided such as occupied thoughts that ranked
first in factors affecting sleep both internal and external factors before going to sleep to prevent
having a hard time getting to sleep.
6. Computer/ internet café owners should not allow student customers to stay very late just to
play computer games.
7. Students make good choices with time commitment