ASSESMENT OF SLEEP PATTERNS AMONG UNDERGRADUATE IN

A TERTIARY EDUCATIONAL INSTITUTION IN EDO STATE

BY

EJIGUE TAMARANIMIEBI

EXAMINATION NUMBER

N/23/07057

IN PARTIAL FULFILLMENT OF THE REQUIREMENTS OF NURSING AND

MIDWIFERY COUNCIL OF NIGERIA FOR THE AWARD OF

“REGISTERED NURSE” CERTIFICATE

NOVEMBER, 2023

DECLARATION

This is to declare that this research project titled ASSESMENT OF SLEEP

PATTERNS AMONG UNDERGRADUATE IN A TERTIARY

EDUCATIONAL INSTITUTION IN EDO STATE was carried out by EJIGUE

TAMARANIMIEBI. It is solely the result of my work except where acknowledged as

being derived from other person (s) or resources.

EXAMINATION NUMBER: N/23/07057

DEPARTMENT/SCHOOL: NURSING SCIENCE, SCHOOL OF BASIC MEDICAL

SCIENCES, UNIVERSITY OF BENIN, BENIN CITY.

Signature: …………………….

Date: ………………….

CERTIFICATION/APPROVAL

This is to certify that this research project by EJIGUE TAMARANIMIEBI with

Examination Number N/23/07057 has been examined and approved for the award of

Registered Nurse in the Department of Nursing Science, School of Basic Medical

Sciences, University of Benin, Benin City.

______________________________

_______________________________

PROF. F.U OKAFOR DATE

Supervisor
______________________________

_______________________________

DR. (MRS).R.E. ESEWE DATE

Head of Department

______________________________

_______________________________

External Examiner DATE

 ABSTRACT

Sleep patterns play a crucial role in the overall health and well-being of individuals,
particularly among undergraduate students who face unique academic, social, and
lifestyle challenges. This study aimed to assess the sleep patterns of undergraduate
students attending tertiary institutions in Edo State, Nigeria. The research was conducted
to better understand the prevalence of sleep-related issues, their contributing factors, and
potential implications for academic performance and student well-being. The research had
a target population of undergraduate nursing students of the University of Benin. Two
hundred and fifty three (253) samples were randomly collected using both the accidental
non-probability and the simple random sampling methods. A self structured questionnaire
using 28 open ended questions was developed, distributed, retrieved and analyzed using
the simple percentage and presented in tables. Findings revealed that all 100%
undergraduate nursing students of the University of Benin never received formal education
or training on sleep quality in their study, sleep quality of students is affected by sleep
environment, such as noise levels or room lighting, affects their sleep quality, 98.8%, and
undergraduate students experience inadequate sleep duration and poor sleep quality due
to academic pressures (97.9%). The results of this study suggest the need for targeted
interventions and awareness campaigns in Edo State's tertiary institutions to improve
undergraduate students' sleep patterns. Implementing policies and programs that
emphasize the importance of sleep hygiene, time management, and stress reduction may
positively impact both academic performance and overall student well-being. Students
must cultivate the habit of having sufficient daily sleep and to be supported by the
department, fixed bed time and waking time to improve their sleep pattern and the
establishment of a sleep unit and other sleep-related issues. In conclusion, this study sheds
light on the sleep patterns of undergraduate students in Edo State, emphasizing the
importance of addressing sleep-related issues to enhance their academic success and
overall quality of life

.
 DEDICATION

This research project work is dedicated to Almighty God for His grace,favour and

guidance through the period of this research, to my parents Mr. And Mrs. Ejigue
for their support and love during this period to enable me to carry out and
complete this research work.
 ACKNOWLEDGEMENTS

My profound gratitude goes to Almighty God for his grace, strength, mercy, love and

kindness upon my life throughout the period of my study and for making this research

work a success. I am glad to acknowledge and appreciate my project supervisor Prof.

F.U Okafor for the support, guidance and patience throughout this research study, I

pray that the Almighty God continue to bless you and your family. Special thanks to

the Head of Department, Nursing Sciences Dr. (Mrs).R.E. Esewe and my course

adviser, Mrs. C. C. Edo-Osagie as well as all my lecturers; Dr. J. N. Oko-Ose,, Dr. J.

A. Afemike, Dr. C. E. Omorogbe , Dr. C. A. Enuku, Dr. T. A. Ehwarieme, Sr. J. N.

Chukwurah, Mrs. M. A. Iniomor, Dr. (Mrs). F. Amiegheme, Mrs. S.O. Bolaji-Osagie,

Mrs. Elusoji, Mrs. Usoh, Mrs. E. N. Oyana, Mrs. Lawal, as well as non-academic staff

and technologists and all other lecturers for their immense contribution, dedication

and commitment to the success of this research work. I am glad to be under your

guidance. Thank you for all your tremendous advice and for the knowledge you have

instilled in me.

Special appreciation goes to my father, Mr. Lewis Ejigue and my dear mother, Mrs.
Amayerinbo Ejigue, and the family i was blessed with, The Ojo’s, my brothers Mr.
Ejigue Tamaraekiolemo, Ojo Precious, Ofeimu Gabriel, my sisters Veno and Ejiro and
also to my friends Moses, Favour, Daniel, Excel, Samuel for their prayers, support
and understanding throughout the period of this academic pursuit, also to my friends
and fellow course mates for their encouragements at one time or the other and for
their support in the pursuit of my career
 TABLE OF CONTENTS

PA

GE

Title Page i
Declaration ii
Certification/Approval iii
Abstract iv
Dedication v
Acknowledgement vi
Table of Contents vii
List of Tables x

CHAPTER ONE: INTRODUCTION

1.1 Background of the Study 1
1.2 Statement of the Problem 2
1.3 Objectives of the Study 4
1.4 Research Questions 4
1.5 Hypothesis 5
1.6 Significance of the Study 5
1.7 Scope of the Study 7
1.8 Operational Definition of Terms 7

CHAPTER TWO: LITERATURE REVIEW

2.1 Conceptual Clarification 9
2.1.1 Concept of Sleep 9
2.1.2 Classification of sleep 10

2.1.3 Stages of Sleep 12

2..2 Sleep Patterns 13

2.2.1 Effect of Quality Sleep Patterns

2.3 Sleep Deprivation 14

2.3.1 Effects of Sleep Deprivation 16

2.3.2 Factors Contributing To Sleep Deprivation

2.4 Knowledge level of the Undergraduate Nursing Students About Sleep Quality

18

2.5 The Average Sleep Duration of Undergradate Nursing Students 20

2.6 Factors That Affect Undergraduate Students Sleep In Tertiary Institutions 26

2.7 What Relationship Exists Between Sleep Patterns and Academic Performance 27

2.8 Theoretical Framework 29

2.8.1 Application to the Study

2.9 Empirical Review 29

2.9.1 Knowledge of Sleep 29

2.9.2 Average Sleep Duration 31

2.9.3 Factors Influencing Sleep Quality 33

2.9.4 Perceived Relationship between sleep Patterns and Academic Performance

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Research Design 35
3.2 Research Setting 35
3.3 Target Population 36
3.4 Sampling Size 36
3.5 Sampling Technique 37
3.6 Instrument for Data Collection 37
3.7 Validity of the Instrument 38
3.8 Reliability of the Instrument 38
3.9 Method of Data Collection 38
3.10 Method of Data Analysis 39
3.11Ethical Consideration 39

CHAPTER FOUR: RESULTS

4.0 Results 41
4.1 ANSWERING RESEARCH QUESTION

CHAPTER FIVE: DISCUSSION OF FINDINGS

5.1 Discussion of Major Findings 52
5.2 Implications of Findings with Literature Support and Aligning Findings of
Previous
5.3 Implication of Findings to Nursing 53
5.4 Limitation of the Study 54
5.5 Summary of the Study 55
5.5 Conclusion 56
5.6 Recommendations 57
5.7 Suggestion for Further Studies 58

REFERENCE 59
APPENDICES 68
 LIST OF TABLES

PAGES

Table 4.1: Demographic Data of Respondents 41

Table 4.2: Shows the knowledge level of the Undergraduate Nursing Students About

Sleep Quality 44

Table 4.3: Average Sleep Duration of Undergraduate Students . 46

Table 4.4: Factors Influencing Sleep Quality And Patterns of Undergraduate Students

Table 4.5: Perceived Relationship Between Sleep Patterns and Academic Performance

of Undergraduate Students
 CHAPTER ONE

INTRODUCTION
1.1 Background of the Study
Sleep is a natural phenomenon that every human being desire to have for a refreshing mental and physical
stability. Sleep is seen as an inactive, or passive, state in which both the body and the brain “turned off” to rest and
recuperate from the day’s working activities (Healthy Sleep). Sleep is a vital activity of daily living as it restores
and refreshes an individual.
Sleep is a state that is relatively easy to reverse. This has distinguishes sleep from other states of induced
consciousness such as hibernation and coma (Wikipedia). Sleep also result in a decreased responsiveness to
external stimuli. According to Ahmed, et al (2020) sleep is a naturally recurring state of mind and body, which is
identified by periodically altered consciousness, relatively inhibited sensory activity, reduced muscle activity and
inhibition of nearly all voluntary muscles. It is important for maintaining good health and insufficient sleep can
affect our mood and wellbeing.
 Sleep is associated with a typical posture such as lying down with eyes closed in humans. Scientists have
since found that the brain goes through characteristic patterns of activity throughout each period of sleep and that it
is some times more active when we’re asleep than we’re awake.
Understanding these patterns and the factors that affect them may help in making choices that will lead to
better quality sleep. Our bodies require sleep in order to maintain proper function and health. In fact, we are
programmed to sleep each night as a means of restoring our bodies and minds. Prior to the era of modern sleep
research in the early 1920s, scientists regarded sleep as an inactive brain state. It was generally accepted that as
night fell and sensory inputs from the environment diminished so too did brain function (Healthy Sleep)
Sleep patterns can be affected by many factors, including age, the amount of recent sleep or wakefulness,
the time of the day or night relative to an individual’s internal clock, other behavior prior to sleep such as exercise,
stress, illness, environmental conditions such as temperature and light, the sleep place (bed), and various chemical,
noise (equipment, conversations of people, cell phone, etc), physical factors like visitation, medication and
nutrition.
Hormonal factors such as estrogen and progesterone degeneration in menopausal women can cause sleep
deprivation (SD). Psychological factors, examples are anxiety, pain, etc. Light exposure can cause our biological
clock to advance or delay, which affect our sleep and wake cycle. Light is one of the most important external
factors that can affect sleep. It does so both directly, by making it difficult for people to fall asleep, and indirectly,
by influencing the timing of our internal clock and thereby affecting our preferred time to sleep.
In a study conducted by Zager et al (2007), rats were deprived of sleep for 24 hours. When compared with a
control group, the sleep deprived rat’s blood tests indicated a 20% decrease in white blood cell count, a significant
change in the immune system. It is now possible to state that sleep loss impairs immune function and immune
challenge alters sleep, and it has been suggested that mammalian species which invest in longer sleep time have
higher white blood cell counts.
From the foregoing, it is evidence that adequate sleep is needed for all humans, especially for students who are
faced with the need to always study day and night in order to acquire knowledge, develop their intellectual abilities
and ultimately pass their examinations. This study, therefore, is to assess the sleep patterns among undergraduate
students in a tertiary educational institution in Edo state.
1.2 Statement of Problem
Sleeplessness has been one of the factors that students` of tertiary institutions has to contend with. Sleeping
adequately at least 2-3 hours during the day, and 7-8 hours at night is necessary for an average human to perform
to his full potentials.
Undergraduate students many at times do all within their power and ability to murder sleep in other to
cover the huge assignments they need to carry out within a limited time. The average higher institution student that
runs a degree awarding course has an average of 5 hours of lectures to take daily, assignments to research some
topics, submit term papers, usually on each course offered, and prepare for test and examinations for proper
evaluation of performance.
It is, therefore, very obvious that most students of tertiary educational institutions do not understand that
lack of comprehensive understanding of sleep patterns could cause negative impact on their academic performance
and to their overall health conditions. Put succinctly, despite the acknowledged importance of healthy sleep
patterns for overall well-being and academic success, there exists a significant gap in our understanding of the
sleep patterns among undergraduate students within tertiary institutions in Edo state. This knowledge gap hinders
the institutions` ability to implement effective interventions to promote optimal sleep habits and subsequently
impacts students' academic performance, mental health, and overall quality of life.
 Therefore, a comprehensive assessment of sleep patterns, their influencing factors, and their implications is
essential to inform targeted strategies that enhance the sleep health of undergraduate students and contribute to
their holistic development during their academic journey.
1.3 Objectives of the Study
The main objective of this study is: To assess the sleep patterns of undergraduate in a Tertiary Educational
Institution in Edo state.

The sub-objectives for this study are stated below.

1. To know the knowledge level of the undergraduate nursing students about sleep quality in university of
Benin.
2. To determine the average sleep duration of undergraduate students.

3. To identify the factors influencing sleep quality and patterns.

4. To examine the perceived relationship between sleep patterns and academic performance.

1.4 Research Questions

1. What is the knowledge level of the undergraduate nursing students about sleep quality in university of
Benin?
2. What is the average sleep duration of undergraduate students?
3. What factors influence sleep quality and patterns of undergraduate students?
4. What is the perceived relationship between sleep patterns and academic performance of undergraduate
students?

1.5 HYPOTHESIS OF THE STUDY

To aid the completion of the study, the following research hypothesis will be formulated
H0: There is no significant relationship between the knowledge of sleep pattern and how it affect their academic
performance among undergraduates in a tertiary institution in Edo state
H1: There is no significant knowledge about the factors that affect sleep pattern among undergraduates in a tertiary
institution in Edo state

1.6 Significant of the Study

Contribution to Individuals
The significant of the study to undergraduate seeks to enlighten them on ways they can improve their sleep
patterns which in turn impact greatly on life’s quality and specifically the academic performance
Contribution to Profession and Health Providers
This study when concluded, and critically review by all stakeholders in the health sector, will immensely
contribute in expanding the horizon of the health care givers in attending to students who suffer health challenges
resulting from sleep deprivation. The nursing profession will also be enriched in terms of engaging in continuous
education in strategies of enhancing healthy sleep.
Contribution to Society
The society in general will benefits from the results of data information given because after the completion
of this study ways to improve sleep quality will be devised and hopefully implemented.
1.7 Scope of Study
This study is primarily to assess the sleep patterns among undergraduate students in a tertiary educational
institution in Edo state, with particular reference to the University of Benin, Benin City, Nigeria.
The study will cover the Department of Nursing Sciences under the School of Basic Medical Sciences of
the University of Benin.

1.8 Operational Definition of Terms

SLEEP: A period of rest for the body and mind. A state of recuperation of the body whole physiological process,
INSOMNIA: Inability to sleep or difficulty in sleeping.
FACTOR: A circumstance that contributes towards a result.

CHAPTER TWO
 LITERATURE REVIEW

Conceptual clarification, Classification of sleep, Stages of sleep, Sleep patterns, Effect of quality sleep
patterns, sleep deprivation, effects of sleep deprivation, Average sleep duration of Undergraduate Students,
Factors contributing to sleep deprivation, Factors that affect undergraduate sleep pattern In Tertiary
Instruction, What relationship exist between sleep patterns and academic performance, Empirical

2.1 CONCEPTUAL CLARIFICATION

2.1.1 Concept of Sleep
Sleep is a stage of natural unconsciousness. During sleep time the brain’s activity is not apparent (apart
from the continued maintenance of basic bodily functions such as breathing) but can be detected by means of an
electroencephalogram (EEG). Sleep is further defined as a universal phenomenon of natural repose found across
the animal realm, spanning mammals, birds, and a multitude of reptiles, amphibians, and fish. Among beings like
humans, fellow mammals, and various other scrutinized creatures such as fish, birds, ants, and fruit-flies,
consistent slumber emerges as an essential requisite for existence. The ability to awaken from slumber serves as a
safeguarding mechanism, vital not only for overall well-being but also for the continuation of life itself.
Sleep according to the Wikipedia, is a “heightened anabolic state, accentuating the growth and rejuvenation
of the immune, nervous, skeletal and muscular systems”, and that it is observed in all mammals, all birds, and
many reptiles, amphibians, and fish.
There are various causes and processes postulated by various authors on sleep. The oldest theories about the
causes of sleep postulated that there is the congestion or anemia of the brain (International Encyclopedia). More
recent hypotheses have attributed sleep to arterial anoxemia, endocrine periodicities, functional neural blocks, or
the accumulation of fatigue products. International Encyclopedia, reviewing the work of Pieron (1913) stressed
that the idea of a “hypnotoxin” that accumulates during waking and is metabolized away during sleep is one of the
best-known explanations.
2.1.2 Classification Of Sleep
Sleep is a fascinating and intricate physiological phenomenon that is intricately divided into two distinct
phases known as non-rapid eye movement (NREM) and rapid eye movement (REM). These phases represent the
intricacies of our slumbering experience, unveiling a captivating dance between different states of consciousness.
Non-rapid eye movement (NREM) sleep encapsulates the initial stages of our restorative journey. During
this phase, our minds venture into a realm of tranquility, characterized by slower brainwave patterns and reduced
muscle activity of the eye. It is as though our bodies embark on a profound voyage of rejuvenation, engaging in
reparative processes that contribute to physical renewal and vitality.
Rapid eye movement (REM) sleep, on the other hand, unfolds as a surreal exploration of the subconscious.
While our bodies remain mostly immobilized, our minds awaken to a world of vivid dreams and heightened
cognitive activity. REM sleep is thought to play a pivotal role in memory consolidation and emotional processing,
allowing us to delve into the depths of our psyche and gain insights into our innermost thoughts.
In this interplay between NREM and REM sleep, our nights are transformed into a symphony of bodily
restoration and mental voyage. These distinct phases, though seemingly contrasting, collaborate harmoniously to
weave the intricate tapestry of our slumber, offering us glimpses into the profound mechanisms that underlie our
most vulnerable yet profound state of being.
2.1.3 STAGES OF SLEEP
The NREM sleep is characterized into four stages. They are:
1.) STAGE ONE
This stage encompasses the lightest level of slumber; this stage endures only for a brief span of minutes. As
physiological activity takes a gradual descent, marked by diminishing vital signs and metabolic activity, the
sleeper's susceptibility to sensory stimuli such as noise heightens, promptly arousing them. Should one be
awakened during this phase, the sensation often mirrors that of having drifted through a daydream . In this stage
there is general slowing of the electroencephalogram (EEG) frequently the eye tend to roll slowly from side to
side, the muscles tension remains absences in the face and the neck. This stage last for only 10 minutes and in this
stage a sleeper can easily awaken.
2.) STAGE TWO
This stage is describe s still fairly light sleep with further flowing of encephalogram (EEG) pattern and roll
of slowly eye movement. The person involves experience loss of awareness outside world and it last for about 20
minutes and about 50% of normal adult sleep may occur in stage two. During this phase, a period of robust sleep
sets in as relaxation deepens. The ease of arousal continues, and this stage extends its presence for approximately
10 to 20 minutes. While bodily functions continue their gradual deceleration, brain waves adopt a mixed pattern of
low voltage, occasionally punctuated by bursts of activity recognized as sleep spindles, as well as substantial
amplitude waves termed K complexes.
3.) STAGE THREE
Initiating the onset of profound slumber, this stage proves resistant to awakening and is marked by minimal
physical movement. Oxygen consumption diminishes, and the muscles recline into a state of complete relaxation.
While vital signs experience a decline, their regularity remains intact. This stage spans roughly 15 to 30 minutes.
4.) STAGE FOUR
Diving into the deepest realm of sleep, this stage presents an exceptional challenge to arouse the sleeper. If sleep
deprivation has occurred, a significant portion of the night is devoted to this stage. Vital signs notably drop below
waking levels, and the stage persists for about 15 to 30 minutes. Occasional instances of sleepwalking and enuresis
may manifest within this phase.
Stage 3 and 4, collectively referred to as slow wave sleep; derive their name from the distinctive high
voltage and low-frequency delta waves that hallmark their presence. Sleep walking, sleep talking, enuresis (bed
wetting) and night tremor occur in this stage three and four. Sleep is an essential part of the normal human life. It is
essential for maintenance of physical, sexual and mental functions of the body. Due to some factors undergraduate
students in tertiary institutions experiences sleep deprivation.
2.2 SLEEP PATTERNS
Establishing a healthy sleep pattern serves as the fundamental bedrock for achieving optimal sleep quality.
Conversely, a disrupted sleep pattern stands as a chief catalyst for the onset of insomnia. The crux of mastering this
lies in consciously selecting a sleep pattern that resonates and adhering to it with unwavering dedication.
Yet, the notion of being confined to a single sleep and wake schedule is far from restrictive. Armed with an
insightful comprehension of the intricacies inherent to the stages of sleep and the sleep cycle, one can harness the
ability to engage in multiple sleep sessions throughout the day, thereby harnessing the potential to feel invigorated
on as little as three hours of sleep within a twenty-four hour span. However, this pursuit demands resolute
determination, as it is by no means a venture for the faint-hearted. Success in this endeavor hinges upon a profound
understanding of the theoretical underpinnings that govern such an unconventional approach.
Having delved into the intricacies of conventional sleep patterns, which harmonize with the natural day-
night rhythm, it is pertinent to state that each undergraduate student will be free to chart his own unique sleep
regimen. Adopting unconventional and alternative sleep pattern presents a myriad of potential advantages,
accompanied by an equal share of potential pitfalls. Undertaking such an endeavour demands meticulous
forethought and unwavering dedication. Its imperative too for students to approach this with caution and
comprehensive understanding, lest finds themselves grappling with a profoundly disrupted sleep routine that
proves to be an arduous challenge to rectify.
The different sleep patterns that exist include the monophasic, biphasic and polyphasic. They are discussed
below:

Monophasic Sleep Pattern:

The monophasic sleep pattern is widely regarded as the standard and traditional sleep schedule that most people
follow. Typically, individuals set aside around 8 hours each night for their sleep, although this duration can vary
from person to person based on their specific needs and lifestyle. This pattern is the dominant and universally
accepted way of organizing sleep in most societies, and it is marked by its ordinary and unexceptional nature.
Monophasic sleep involves a single continuous period of sleep, usually during the night, followed by a full day of
wakefulness. This pattern has become deeply ingrained in our societal norms and is often influenced by factors like
work schedules, social obligations, and cultural norms.
One of the key features of monophasic sleep is its consistency, as individuals strive to maintain a regular
bedtime and wake-up time. This predictability aligns with the demands of modern life, making it easier to
synchronize with daily routines and responsibilities.
However, it's important to note that while monophasic sleep is the most common pattern, it may not be suitable for
everyone. Some individuals may naturally gravitate towards different sleep patterns, such as biphasic or polyphasic
sleep, depending on their lifestyle and personal preferences.
In summary, monophasic sleep is the standard and widely accepted sleep pattern characterized by a single,
continuous period of nighttime sleep. While it is the norm for most people, it's essential to recognize that different
sleep patterns exist and may be better suited to some individuals depending on their unique circumstances and
preferences.
Biphasic Sleep Pattern:
The biphasic sleep pattern involves splitting sleep into two distinct phases throughout a day. Commonly, it
involves a substantial sleep period during the night, coupled with a briefer period of rest during daylight hours.
While not extensively practiced in regions such as Britain or America, the concept of siestas, brief afternoon naps
taken after lunch, finds prevalence in Spain and numerous Latin American countries. Siestas strategically capitalize
on the "post-lunch dip," a phase in the early afternoon following lunch when the body experiences heightened
drowsiness, rendering it more amenable to nodding off. Siestas typically span around 30 minutes, as a longer
duration could lead to deeper sleep stages that prove challenging to emerge from. Executed adeptly, a brief
afternoon nap can yield profound rejuvenation and simulate the effects of additional hours of sleep.
Alternatively, some individuals adopt a biphasic sleep pattern by indulging in an extended nap lasting
approximately 90 minutes. This duration permits completion of a full sleep cycle, likely concluding within REM or
NREM stage 1. Thus, upon waking, a natural sense of alertness and renewal is experienced. The brief afternoon
naps is popular in tertiary institutions in Edo state as it acts as a means to the rejuvenation for students` and
preparing them to have hitch free night studying.
Polyphasic Sleep Pattern:
Exploring the fascinating realm of alternative sleep patterns, the polyphasic sleep schedule represents a
departure from the conventional monophasic approach. In this intriguing pattern, sleep is fragmented into multiple
episodes, distributed throughout the day and night. Typically, polyphasic sleep involves breaking up the sleep into
4 to 6 segments, creating a diverse range of potential configurations. This non-traditional approach to sleep has
gained attention for its potential benefits and unconventional nature, with notable variations such as the Everyman,
Uberman, and Dymaxion schedules capturing the imagination of those who seek a different way of structuring
their rest.
The Everyman schedule is one of the more popular variations of polyphasic sleep. It features a core sleep
period, usually lasting around 3-4 hours at night, supplemented by several shorter naps during the day, each lasting
approximately 20-30 minutes. This approach aims to maximize the benefits of both deep and REM (rapid eye
movement) sleep while reducing the total time spent sleeping.
On the other hand, the Uberman schedule takes the concept of polyphasic sleep to an extreme by dividing
sleep into 6 or more 20-30 minute naps spaced evenly throughout the day. This ambitious approach drastically
reduces the total sleep time, allowing individuals to maintain a high level of wakefulness and productivity.
However, it requires strict adherence and may not be sustainable for everyone due to its demanding nature.
The Dymaxion schedule, conceived by renowned inventor and visionary Buckminster Fuller, is perhaps the
most radical form of polyphasic sleep. It involves four 30-minute naps spread evenly throughout the day, totaling
just 2 hours of sleep. This schedule, although intriguing in its potential for increased waking hours, can be
extremely challenging to adapt to and maintain.
Polyphasic sleep enthusiasts argue that these alternative patterns can lead to increased productivity and
more efficient use of time. However, it's essential to approach polyphasic sleep with caution, as it can be physically
and mentally demanding, requiring a significant adjustment period. Not everyone may find these schedules
suitable, and it's important to consult with a healthcare professional before attempting such a drastic change in
sleep patterns.
In conclusion, the polyphasic sleep pattern is a captivating departure from the traditional monophasic
approach, featuring multiple sleep episodes spread throughout the day and night. Variations like the Everyman,
Uberman, and Dymaxion schedules offer intriguing possibilities for those seeking to maximize their time awake,
but they require careful consideration and adaptation due to their unconventional nature.
2.2.1 EFFECT OF QUALITY SLEEP PATTERN
Sleep patterns offer a multitude of advantages, and when we delve into both biphasic and polyphasic sleep
patterns, we discover several key benefits and this include:
i. Decreasing the daily sleep duration: One of the most appealing aspects of both biphasic and polyphasic sleep
patterns is the potential to reduce the total amount of time spent sleeping each day. By strategically breaking up
sleep into multiple segments or consolidating it into a shorter duration, individuals can free up more time for their
waking activities. This flexibility in sleep scheduling can be particularly advantageous for those with busy
lifestyles or demanding schedules.
ii. Enhancing sleep quality by allocating more time to NREM sleep: Non-rapid eye movement (NREM) sleep
is a crucial component of the sleep cycle, encompassing stages that are associated with physical restoration and
growth. Biphasic and polyphasic sleep patterns often allow for increased NREM sleep by optimizing the timing of
sleep segments. This can result in a more restorative and refreshing sleep experience, leading to improved overall
sleep quality.
iii. Amplifying the capacity for recalling dreams:Dreams play a significant role in our sleep experiences,
offering insights into our subconscious and providing a unique avenue for creativity and self-discovery. Some
individuals find that breaking their sleep into distinct segments in biphasic or polyphasic patterns can enhance their
dream recall. This heightened awareness of dream content can be personally enriching and even contribute to
improved problem-solving and emotional processing.
iv. Elevating overall daytime energy levels: Perhaps one of the most noticeable advantages of optimized sleep
patterns is the boost in daytime energy levels. Biphasic and polyphasic sleep schedules aim to align sleep phases
with the body's natural circadian rhythms, which can result in increased wakefulness and alertness during waking
hours. This heightened daytime energy can lead to improved productivity, concentration, and overall well-being.
In exploring alternative sleep patterns, such as biphasic and polyphasic sleep, can offer several noteworthy
advantages. These include the potential to reduce daily sleep duration, enhance sleep quality by prioritizing NREM
sleep, increase dream recall, and elevate daytime energy levels. While these benefits are intriguing, it's important
to remember that the suitability of these patterns can vary from person to person, and consulting with a healthcare
professional is advisable when considering a significant change in sleep habits.
Now, the question arises; should individuals universally transition to polyphasic sleep patterns to seize the
additional time gained? Potentially in the future, but currently, grappling with the complexities of maintaining even
one consistent sleep-wake schedule presents enough challenges, let alone attempting to manage six!
Undertaking a shift in one's sleep pattern necessitates a formidable reservoir of self-discipline. During the
initial weeks of adaptation, it's probable that you'll confront acute sleep deprivation. Furthermore, there will be
instances where your wakefulness coincides with the night and slumber with the day, intensifying the difficulties
posed by the body's melatonin regulation.
The primary adversary of unconventional sleep patterns is societal norms. A significant portion of societies
is structured around the monophasic sleep framework, which consequently renders engaging in work, shopping, or
social interactions during non-conventional sleep hours socially acceptable. Moreover, the prospect of being awake
while the majority sleeps can yield a sense of isolation and detachment. Even in instances where societal factors
fail to dissuade one, the sheer effort required to align an entire day with an alternative sleep pattern can be
exhaustingly demanding.
A fundamental principle binding all sleep schedules together is rooted in predictability and consistency on a
daily basis. The delicate equilibrium can be easily disrupted by even a minor alteration, setting off a chain reaction
that could take days to rectify.
2.3 SLEEP DEPRIVATION
Sleep deprivation is simply a condition that occurs when an individual does not get enough sleep to meet their
body's physiological and cognitive needs. It can result from various factors, including inadequate sleep duration,
disrupted sleep patterns, or poor sleep quality. When a person consistently fails to get the recommended amount of
sleep for their age group, they may experience sleep deprivation.
There are records of some persons that have experienced sleep deprivation. For instance, Nikola Tesla, a prolific
inventor and an engineer claimed to have only two hours sleep per night for most of his life, Winston Churchill
was the prime minister of the United Kingdom during World War II and was known for his irregular sleep patterns
and frequent naps, Margaret Thatcher was the prime minister of the United Kingdom from 1979 to 1990 and was
famous for sleeping only four hours per night and working long hours, Leonardo Da Vinci was a renowned artist,
scientist, and inventor who allegedly followed a polyphasic sleep schedule, sleeping for 15 minutes every four
hours, Thomas Edison was a prolific inventor and businessman who claimed to sleep only three to four hours per
night and opposed the idea of sleeping more, Albert Einstein was a Nobel Prize-winning physicist who is widely
regarded as one of the greatest minds of the 20th century. He reportedly slept for about 10 hours per night, but also
suffered from insomnia and nightmares, Barrack Obama is the 44th president of the United States who is widely
praised for his leadership and charisma. He has admitted to struggling with sleep deprivation during his presidency
and often read and write late into the night, etc.
These men and woman mentioned above are in doubt successful in their various chosen professions and careers. It
should be noted that these persons represent on a fraction of the human population.
2.3.1 EFFECTS OF SLEEP DEPRIVATION
 It is natural that living beings, including the human being needs to sleep to constantly maintain a stable
physical and mental state. If therefore, patients who are sick do not have adequate sleep, what may be the effect?
Also, an undergraduate student who stayed awake to study may have negative impact on his academic
performance.
According to Bonnet (2000) sleep deprivations leads to decrease vigilance, impaired decision making,
reduced concentration, irritability, increase fatigue and difficulty in thinking clearly. The effects of sleep
deprivation can be both short-term and long-term, and they can vary in severity depending on the extent and
duration of sleep loss. Sleep deprivation is also recognized as a stress or affecting human health in many adverse
ways including memory impairment. Succinctly, the common consequences of sleep deprivation include:
1. Fatigue: The most immediate and noticeable effect of sleep deprivation is fatigue. Individuals may feel
extremely tired, lethargic, and mentally foggy, making it challenging to concentrate and perform daily tasks
effectively.
2. Cognitive Impairments: Sleep deprivation can impair cognitive functions such as memory, attention, problem-
solving, and decision-making. It can also lead to slower reaction times and reduced ability to think clearly.
3. Mood Changes: Sleep deprivation is associated with mood disturbances, including increased irritability, mood
swings, heightened stress levels, and a higher risk of developing mood disorders like depression and anxiety.
4. Physical Health Issues: Chronic sleep deprivation is linked to various physical health problems, including
obesity, diabetes, cardiovascular diseases, and a weakened immune system. It can also exacerbate pre-existing
medical conditions.
5. Accidents and Errors: Sleep-deprived individuals are more prone to accidents, including those related to motor
vehicles, workplace incidents, and other daily activities. They are also more likely to make errors in judgment and
performance.
6. Hallucinations and Delusions: Severe sleep deprivation, especially over an extended period, can lead to
hallucinations, delusions, and other psychiatric symptoms. These are typically observed in extreme cases.
7. Microsleeps: During periods of severe sleep deprivation, individuals may experience brief episodes of
"microsleeps," which are uncontrollable, very short bursts of sleep that can last for just a few seconds. These can
occur without the person realizing it, making them particularly dangerous, especially when driving or operating
machinery.
8. Hormonal Imbalances: Sleep deprivation can disrupt the balance of hormones in the body, including those that
regulate appetite and stress. This can contribute to weight gain and increased stress levels.
It's essential to note that the effects of sleep deprivation can accumulate over time, leading to chronic health
problems if trivialized While occasional short-term sleep deprivation may not have lasting consequences, chronic
sleep deprivation can significantly impact physical and mental well-being. To maintain good health and cognitive
function, it's crucial to prioritize regular, quality sleep and seek help if sleep deprivation becomes a persistent
issue.
According to the International Encyclopedia, several studies of animals showed that a prolonged loss of
sleep results in death. The study further stated that a number of human subjects have stayed awoke 200 hours or
more without sustaining serious physical damage, but after 120 hours without sleep, most subjects developed
reversible delirious or psychotic states characterized by visual hallucinations, delusions of persecution,
disorientation, and confusion.
Sleep deprivation is a commonplace occurrence in modern culture. Many individuals if possible will want
the time of work to be extended to allow them finish set goals and target for the day. While some people, according
to Serendip, may like to believe that they can train their bodies to not require as much sleep as they once did this
belief is false. Sleep is needed to regenerate certain parts of the body, especially the brain, so that it may continue
to function optimally. After periods of extended wakefulness or reduced sleep neurons may begin to malfunction,
visibly affecting a person's behavior. Some organs, such as muscles, are able to regenerate even when a person is
not sleeping so long as they are resting. This could involve lying awake but relaxed within a quite environment.
Even though cognitive functions might not seem necessary in this scenario the brain, especially the cerebral cortex,
is not able to rest but rather remains semi-alert in a state of "quiet readiness" (Serendip).

2.3.2 FACTORS CONTRIBUTING TO SLEEP DEPRIVATION

Several factors contribute to this widespread sleep deficiency among individuals ad it is subjective.
1.Environmental factors
Excessive noise is a significant problem affecting patient sleeping pattern in the hospital. According to
Biomed central limited (2009) noise is defined as unwanted sounds and could affect people both psychologically
and physiologically with reported negative effects including cardiovascular stimulation, hearing loss, increased
gastric secretion, pituitary and adrenal gland stimulation and others.
The World Health Organization (WHO, 2009) recommended that noise levels inside hospital wards should
not exceed 30 DBA at night in terms of sleep disturbance. The most effective technique for improving sleep is the
sound making. Noise has manifest not only from equipment and machines now, but from cell phones. This is why
some patients who need real time to rest are strongly advised to put off their cell phones.
Light is another environmental factor affecting the sleep of patients in the hospital. To be exposed to light at night
time can trigger a chemical process that can operate as a neutral switch that can switch the sleep/wake cycle is run
but the pineal gland. The pineal gland located in the brain secretes melatonin. The production of melatonin is at its
peak when a person sleeps turning on the light during sleep can cause the production of melatonin to turn on and
off thereby affecting sleep (Avery 2006).
According to Dijk and Archer (2009) humans are diurnal, meaning they sleep at night, because of this, light
exerts an acute alerting effect causing an alteration in sleep Light is one of the most important external factors that
can affect sleep. It does so both directly, by making it difficult for people to fall asleep and indirectly by
influencing the timing of ones internal clock and thereby affecting ones preferred time to sleep (Amira 2008).
Mosquito is also identified as one of most common factors that affect patient sleeping pattern in central
hospital, Warri, especially at night. At the time these mosquito starts disturbing, patient finds it difficult to sleep
because of their noise and not only that, the patient try to protect their body from mosquito bit in order not to be
infected with malaria.
According to health incorporated (2009), the female mosquito which is known as the anopheles mosquito is
responsible for the transfer of malaria infection. When non infected anopheles mosquito bites an infected person
with malaria it becomes infected by drawing blood that contains the parasite and when this infected mosquito bite
a non infected person, the person becomes infected with malaria imposing more expenses on the patient and
making patients uncomfortable in the hospital environment.
Therefore, the government can help to eradicate mosquito from the hospital environment by the provision
of treated mosquito nets for each bed in the ward, cutting down of bushes around the hospital buildings, proper
disposal of tins broken buckets and bottle around surrounding to prevent storing water and serving as a breeding
area for mosquito.
2. Disease Conditions
The disease condition of some patient makes sleep difficult for them unless they are placed on hypnotic
drugs to induce their sleep. Savard, Simards and Hervonest (2005), insomnia in men treated with radical
prostatectomy for prostrate cancer is increased because of a younger age, worse prognosis, pain, depression and
prolong use of some cancer drugs. The research, therefore, reveal that the treatment for this disease condition is by
eliminating the cancer and side effect of cancer treatment and then promoting rest and treat sleep by creating an
environment free from noise, dimming or turning off light.
Patients’ sleep is also disturbed when there is great worry about illness by the patients’. Some terminal
diseases have a way of causing worries among patients and thus caused insomnia. Physical discomfort resulting
from pain also cause sleep disturbance or deprivation to patients.
3. Age
This is one of the factors that affect the sleeping pattern of the older people. E-medical health staff (2007)
states that the older we get, the more likely we will suffer from some kind of sleep disorder due to hormonal and
physical changes that occur as we age especially in menopausal women the increase presence of other medical
conditions and disorders.
One of the biggest sleeping problems the elderly experience is the inability to get deep, restorative sleep because
they don’t get as much rapid eye movement (REM). According to Lal and Good (2005), the sleeping disorder
among the older people can be controlled with the use of cool music and ensuring a quiet environment. A hypnotic
can also be use to induce their sleep.
2.4 KNOWLEDGE LEVEL OF THE UNDERGRADUATE NURSING STUDENTS ABOUT SLEEP
QUALITY.
Sleep is a fundamental component of human health, and understanding sleep patterns and quality is crucial for
healthcare professionals, including undergraduate nursing students. The knowledge level of nursing students about
sleep patterns and quality is essential because it directly impacts their ability to assess, educate, and provide care to
patients with sleep-related issues. It also plays an important role in the learning process for the students.
Higher education has influenced students’ concepts of sleeping time leading to a deficit of sleep quality. Khin
Thandar, et al (2016) observed that besides students experienced sleep deprivation due to lack of sleep during the
night and poor sleep quality, most of the students tend to stay up late into the night to accomplish their tasks as
they did their best to prepare for the future and thus forgo getting enough sleep.
It is essential to state the fact that students understand the significance of sleep quality in the healthcare system.
Adequate and restful sleep is essential for the body's physical and cognitive functions. Poor sleep quality can lead
to various health issues, including cardiovascular diseases, obesity, diabetes, and mental health disorders. Sleep is
an important physiological process that is essential for human survival. Among the most important functions of
sleep is the enhancement of optimal cognitive functioning such as attention, insight, decision-making, speech, and
most notably learning and memory, factors which are very key for efficient academic performance of
undergraduate students (Seun-Fadipe and Kolawole 2017).
2.5 THE AVERAGE SLEEP DURATION OF UNDERGRADUATE STUDENTS.
Getting enough sleep is not a luxury, but a necessity (Maas et al., 1998). In fact, people typically spend one
third of their lives sleeping (Mireku et al., 2019). However, the “always on” nature of college life is a constant
pressure, often resulting in sleep deprivation and/or overall poor quality of sleep (Dowdell, 2019). The average
sleep duration among undergraduate students is a topic of considerable interest, as it sheds light on a critical aspect
of their overall well-being and academic performance. Sleep, a fundamental biological process, plays a pivotal role
in cognitive function, memory consolidation, emotional regulation, and physical health. However, the demands
and pressures of undergraduate life, including academic responsibilities, social engagements, extracurricular
activities, and part-time jobs, often intersect with sleep, resulting in diverse sleep patterns and durations. From
experience, some nursing students at the University of Benin are engaged in part-time jobs, usually operating night
swifts.
Numerous studies have examined the sleep habits of undergraduate students, revealing a striking trend of
insufficient sleep duration. The National Sleep Foundation recommends that young adults, including those in the
undergraduate age range, should ideally aim for 7-9 hours of sleep per night for optimal health and functioning.
However, research consistently demonstrates that many undergraduate students fall short of this recommendation,
with average sleep durations often hovering around 6 hours or even fewer.
The Foundation also stated the role of light as it affects sleep patterns. It stated that science has proven that
blue light keeps you up at night. Cell phones, computers, tablets, and televisions emit blue light from their screens.
Blue light has shorter wavelengths than other colors in the visible light spectrum and causes more alertness than
warmer light tones. Because blue light promotes wakefulness, it can have a powerful effect on the natural sleep-
wake cycle, which is one of the essential circadian rhythms governing our body processes.
Circadian rhythms are the 24-hour cycle of hormones and chemicals in the body that help dictate when you
sleep and when you’re awake. Circadian rhythms work together with natural daylight. When the sun rises in the
morning, the body produces cortisol to make you feel alert. When the sun goes down, the body produces
melatonin, which induces feelings of sleepiness.
Light exposure within two hours of bedtime can be disruptive to one’s sleep cycle. That’s because exposure to
blue light at night stimulates your brain into thinking it’s earlier in the day. Your brain slows or stops its release of
melatonin, making it harder to fall asleep
2.6 FACTORS THAT AFFECT UNDERGRADUATE STUDENTS` SLEEP PATTERN IN TERTIARY
INSTITUTIONS.
Numerous elements exert influence over the sleep patterns of undergraduate students within tertiary
educational institutions, both on a broader Nigerian scale and with specific relevance to Edo State. These factors
encompass a wide spectrum, including environmental factors such as noise disturbances, mosquito presence,
lighting conditions, temperature variations, and a host of others. Additionally, health-related aspects contribute to
this intricate web, encompassing concerns related to diseases, both real and imagined, as well as physical unease
and the impact of medications. The economic status and the chronological age of the students further emerge as
pivotal determinant within this multifaceted equation.
1. Academic Demands: Rigorous coursework, assignments, exams, and project deadlines often create a
demanding academic environment that compels students to sacrifice sleep in order to manage their responsibilities.
For instance, the writing of this particular project, is time consuming, and need to be submitted within a short time.
Students therefore, must sacrifice, including having sleep to meet up with submission time.
2. Social and Extracurricular Activities: College life is also characterized by a plethora of social and
extracurricular opportunities, which can lead students to stay up late engaging in social interactions, club meetings,
or other events.
3. Technology and Screen Time: The prevalence of smartphones, laptops, and other electronic devices has been
associated with extended screen time, especially before bedtime, potentially disrupting sleep patterns due to the
effects of blue light and engaging content. It is a common practice in Nigeria for students to stay awake to browse
online because data are cheaper between 11 pm and 6 am. This act disrupts students sleeping hours.
4. Irregular Schedule: Inconsistent class schedules, part-time jobs, and other commitments can lead to irregular
sleep patterns, making it challenging for students to establish a consistent sleep routine. Nigeria faced with
insistent strikes of our universities, brought about breakage in academic calendaring and thus demands collapsing
of study hours to cover course contents.
5. Stress and Mental Health: The pressures of academic and personal life can contribute to stress and affect
mental health, leading to difficulty falling asleep, staying asleep, or achieving restorative sleep. There are several
number of stressors that contribute to the stress experienced by students. According to David (2008) these stressors
include Stressors related to studying, Stressors related to examinations, Stressors related to the transition to
university, Stressors related to being in a different country, and Stressors related to financial issues.
 The latter is one critical issue in determining the academic performance of undergraduate students in tertiary
institution in Nigeria. Most Nigerians students find it difficult to cope with the fees and dues paid in the
universities. To combat the lack of money for undergraduate students, increasing numbers of students are now
taking part-time paid employment during their studies and even involve in cybercrimes.
6. Diet and Lifestyle: Unhealthy dietary habits, caffeine consumption, and lack of
physical activity can impact sleep quality and duration.
The consequences of inadequate sleep among undergraduate students are far-reaching. Sleep deprivation can
lead to impaired concentration, memory problems, decreased cognitive performance, mood disturbances, and
compromised physical health. These effects can have a significant impact on academic achievement, overall well-
being, and the ability to effectively engage in extracurricular and social activities.
Efforts to address the issue of sleep duration among undergraduate students are essential. Universities and
colleges can play a role by promoting awareness about the importance of sleep, providing resources for stress
management, and encouraging healthy lifestyle habits. Students themselves can adopt strategies such as time
management, setting consistent sleep schedules, creating a conducive sleep environment, and limiting screen time
before bedtime.
In conclusion, the average sleep duration of undergraduate students often falls short of recommended
guidelines, influenced by a complex interplay of academic, social, technological, and lifestyle factors. Recognizing
the significance of sleep for both academic success and overall well-being, proactive measures at the institutional
and individual levels are crucial to promoting healthier sleep habits among undergraduate students.

2.7 WHAT RELATIONSHIP EXISTS BETWEEN SLEEP PATTERNS AND ACADEMIC

PERFORMANCE?
The primary goal for students in attending and studying in the university is to acquire knowledge and skills that
could help them to survive life difficulties and challenges. Students learning effects are measured by the teachers
who guide them through the learning process and thus the students’ academic performance is measured in grades,
cumulative grade point average (CGPA).
It is a known fact that the human body normally requires seven hours of night sleep and eight to nine hours
of daily sleep. Sleepiness is inversely proportional to hours of sleep, and it may have a substantial adverse effect
on general health and quality of life. Conversely, adequate sleep can lead to a better quality of life, physical and
social health, life satisfaction, performance, and longevity (2016). Sleep problems are common and are likely to
increase, especially amongst undergraduate students because of increasing complexities in societies.
The medical student population is one of the populations that appear to be at increased risk for sleep
deprivation (Veldi M, et al (2005) and Loayza H, et al (2001)). This is because they need to be awake to do their
duty in the hospital or are under constant stress because of their examinations.
Academic performance is a multifaceted concept that encompasses a wide range of variables and influences.
According to Academic performance have been defined and explained by several authors. According to Narad and
Abdullah (2016) academic performance is the knowledge gained which is assessed by marks by a teacher and/or
educational goals set by students and teachers to be achieved over a specific period of time.
Academic performance refers to an individual's or a group's achievement and success in an educational
context. It is also view as a critical measure of a student's success in an educational environment. It serves as an
indicator of a student's grasp of academic material and skills, and it can significantly affect future educational and
career opportunities.
 Academic performance can be evaluated through various means, including grades, standardized test scores,
class participation, attendance, research outcomes, and other educational assessments. Numerous factors can
influence academic performance, making it a subject of extensive research and analysis in the field of education.
These factors include internal and external – motivation, intelligence and cognitive abilities, study habits and time
management, peer influence, family support, school quality, socioeconomic status, sleep quality and patterns, etc.
Several studies have identified some relationships between sleep patterns and academic performance. Here
are some key relationships that exist between sleep patterns and academic performance:
1. Sleep Duration and Academic Performance: One of the most well-established relationships is the
impact of sleep duration on academic performance. Research has consistently shown that students who
consistently get an adequate amount of sleep (typically 7-9 hours for young adults) tend to perform better
academically. Lack of sleep, on the other hand, can lead to difficulties in concentration, memory retention,
and overall cognitive function, which can negatively affect academic performance.
2. Sleep Quality and Academic Performance: The quality of sleep is equally important. Poor sleep
quality, which can result from factors like sleep disturbances, sleep disorders, or irregular sleep patterns,
can impair a student's ability to focus and learn effectively. This can, in turn, have a negative impact on
academic performance.
3. Chronotype and Class Timing: Individual differences in chronotype (whether a person is a morning or
evening person) can influence how well students adapt to class schedules. For instance, some students
perform better when classes align with their natural sleep-wake patterns. Early morning classes may be
challenging for night owls, potentially affecting their academic performance.
4. Sleep Hygiene and Study Habits: Students with good sleep hygiene practices, such as establishing
regular sleep schedules, avoiding excessive screen time before bedtime, and creating a conducive sleep
environment, are more likely to have better sleep patterns. These practices can positively influence
academic performance indirectly by promoting better sleep.
5. Stress and Mental Health: High levels of stress and poor mental health can disrupt sleep patterns.
Academic stress, as well as personal and financial stressors, are common among undergraduate students.
Poor sleep can exacerbate stress and negatively affect mental health, which in turn can impact academic
performance.
6. Daytime Sleepiness and Class Attendance: Insufficient sleep can lead to daytime sleepiness, which
may cause students to miss classes or struggle to stay engaged during lectures. Frequent class absenteeism
and reduced attentiveness can hinder academic performance.
7. Circadian Rhythms and Cognitive Function: Sleep patterns are closely tied to circadian rhythms,
which can influence cognitive function and alertness at different times of the day. Understanding these
rhythms can help students optimize their study and exam preparation schedules to align with their peak
cognitive performance periods.
It's important to note that individual variations exist, and not all students will be affected in the same way
by their sleep patterns. Additionally, various cultural, social, and environmental factors unique to the University of
Benin may influence sleep patterns and academic performance.

2.8 THEORECTICAL FRAMEWORK

This is based on Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is a combination of behavioral and

cognitive techniques, targeting emotions and dysfunctional behaviors through

behavior and cognition modification (Manea, 2013). Cognitive behavioral therapy

(CBT) is a form of psychological treatment that has been demonstrated to be effective

for a range of problems including depression, anxiety disorders, alcohol and drug use

problems, some sleep disorders, marital problems, eating disorders, and severe mental

illness (APA, 2017).

Cognitive Behavioral Therapy (CBT) is not authored by a single individual;

rather, it is a therapeutic approach that has evolved over time through the

contributions of numerous psychologists and clinicians. CBT has its roots in several

key figures and their work, including:

1. Aaron T. Beck: Often referred to as the "father of cognitive therapy," Aaron T.

Beck played a significant role in developing CBT. He developed cognitive

therapy in the 1960s, which later evolved into cognitive-behavioral therapy.

2. Albert Ellis: Albert Ellis is known for Rational Emotive Behavior Therapy

(REBT), which is another precursor to CBT. His work emphasized the role of

irrational beliefs in causing emotional distress.

3. Donald Meichenbaum: Meichenbaum contributed to the development of

CBT through his work on cognitive-behavioral techniques and stress

inoculation training.
 Figure 2.1; Abalance Client Centered Counseling (Cognitive Behavioral

Therapy)

1. Cognition (Thoughts):

- Cognitive Distortions: CBT identifies cognitive distortions, which are

irrational or negative thought patterns that contribute to emotional distress. Common

distortions include all-or-nothing thinking, catastrophizing, and mind reading.

- Automatic Thoughts: CBT emphasizes the importance of recognizing and

challenging automatic thoughts, which are thoughts that occur spontaneously in

response to events or situations.

 - Core Beliefs: Underlying a person's automatic thoughts are core beliefs,

which are deeply held, fundamental beliefs about oneself, the world, and the future.

These beliefs can be positive or negative and influence one's perception of reality.

2. Emotion:

- Emotional Regulation: CBT helps individuals identify and manage their

emotions, especially negative ones. It recognizes that emotions are influenced by

thoughts and can be altered by changing thought patterns.

- Emotional Resilience: CBT aims to enhance emotional resilience by

teaching coping strategies to manage distress and reduce emotional reactivity.

3. Behavior:

- Behavioral Activation: CBT encourages individuals to engage in activities

that promote well-being and a sense of accomplishment. This can help counteract

depression and lethargy.

- Exposure: In cases of anxiety disorders and phobias, CBT employs

exposure therapy to gradually confront feared situations or objects, thereby reducing

avoidance behaviors.

- Behavioral Experiments: Individuals are encouraged to test the accuracy

of their beliefs and assumptions through behavioral experiments, which help

challenge and modify thought patterns.

 4. ABC Model:

- The ABC model (Activating event, Beliefs, Consequences) is a

foundational concept. It illustrates how an external event or situation (A) triggers

specific beliefs and thoughts (B), leading to emotional and behavioral consequences

(C). CBT aims to modify the B component to change the C component.

5. Collaboration:

- CBT is a collaborative approach between the therapist and the individual

seeking help. Both parties work together to set goals, develop strategies, and monitor

progress.

6. Homework and Practice:

- CBT often involves homework assignments, where individuals practice

new skills and thought patterns between therapy sessions. This reinforces what is

learned in therapy and encourages self-sufficiency.

7. Empirical Support:

- CBT is an evidence-based therapy, which means it is supported by

numerous studies and research that have shown its effectiveness in treating various

mental health conditions.

8. Time-Limited and Goal-Oriented:

- CBT is typically a time-limited therapy, often spanning 10-20 sessions. It

focuses on specific, achievable goals that the individual sets with the therapist.
 9. Adaptability:

- CBT is adaptable and can be applied to a wide range of psychological and

emotional issues, making it one of the most versatile forms of therapy.

2.9 EMPIRICAL REVIEW

2.9.1 Knowledge of sleep Pattern

According to Urponen, H.et. al. (1991). .. Sleep disturbances are rather common and they reflect
various somatic and psychic diseases. Sleep length is associated with mortality. According to
several epidemiological surveys short sleepers and long sleepers seem to have poorer life
expectancy than those sleeping 7–8h/night [2, 4, 8]. Also myocardial infarctions are more common
among those sleeping more than 10 h or less than 6h/night than among those sleeping 7–8h [5].

2.9.2 Average sleep duration

According to Liguori, G. et. al (2011). This study was intended to assess changes in nightly sleep
duration over the course of one semester based on gender, residency, and year in school among
college students. In addition, issues related to short sleep, factors affecting sleep, and perceived
restfulness were assessed. Methods: 820 students from a Midwest university completed four
separate monthly e-survey's assessing sleep duration, including time to bed, time to wake, types
of sleep disturbance, and perceived restfulness. All data were analyzed with SPSS (V.17.0).
Results: Sleep duration ranged from 7:30 to 7:58 throughout, with freshmen sleeping 20 min
longer than upper division students (p = .006). The overall prevalence of short sleep ranged from
23% to 30%, and students reported a mean of 3.39 (SD = 1.48) days per week where they awoke
feeling rested. Females reported significantly longer sleep durations in November and December
compared to September (p=.005 and p= .003, respectively), and the entire sample showed a
change in sleep duration over time (p=.035). The most common reasons listed for sleep
inadequacy were studying/school-related work, socializing with friends, leisure activities, and
stress. Conclusions: Sleep duration appears to increase over the course of a semester, especially
in female students. Less than half of all students reporting feeling rested upon waking, yet the
mean sleep duration appears sufficient (~7h 45m). This study points out the importance of
sequential data collection regarding sleep duration and also that inferring good sleep habits based
solely on duration may not be appropriate. Semester long changes in sleep duration for college
students Sleep and sleep habits have been studied across many population segments. For adults,
literature supports 7-8 hr of sleep each night as optimal (Chaput, Despres, Bouchard, & Tremblay,
2008; Hublin, Partinen, & Koskenvuo, 2007), while it is suggested that children need even more
sleep, or as much as 10-14 hr per night (National Sleep Foundation, 2008). Mounting evidence
also suggests less than optimal amounts of sleep may be associated with a number of health
problems, including increased risk for obesity, coronary heart disease, type 2 diabetes, and
hypertension (Ayas et al., 2003; Beihl, Liese, & Haffner, 2009; Gangwisch et al., 2006; Hasler et
al., 2004; Lumeng et al., 2007; Taheri, Lin, Austin, Young, & Mignot, 2004). College students, a
much narrower but equally important population, have also been studied in regard to sleep
patterns and habits, including sleep deprivation, perceived quality of sleep, and mean sleep
duration. Varying reports on sleep duration in college students exist. Hicks, Fernandez, and
Pellegrini (2001) sampled three separate large cohorts of students over three consecutive decades
and reported a median sleep duration of 6.65 hr in 2000, or one full hour less than reported in the
late 1970s. However, subsequent research has been unable to show the same degree of short
sleep duration. Forquer, Camden, Gabriau, and Johnson (2008) sampled 313 students and
reported a mean sleep duration of 7.2 hr (SD = 1.2 hr) on weekdays and 8.6 hr (SD = 1.5 hr) on
weekends, while Hosek, Phelps, and Jensen (2004) examined sleeping patterns among a sample
of 996 students and found a mean sleep duration of 7.69 hr (SD = .99 hr). In addition, Forquer and
colleagues (2008) noted gender differences in sleep duration with a significantly greater mean
value among females; however, prior research has demonstrated conflicting results with regards to
gender differences in sleep duration (Ban & Lee, 2001; Jean-Louis, von Gizycki, Zizi, & Nunes,
1998). In addition to sleep duration, personal perceptions of sleep quality and habits (e.g., nightly
awakenings, sleep disturbances) have been explored in college students (Forquer et al., 2008;
Buboltz, Brown, & Soper, 2001). Findings from a sample of 191 students by Buboltz et al

2.9.3 Factors Influencing Sleep Quality

According to D.Spero (2005) Poor Sleep Habits, irregular bedtime, frequent naps, late-night
activities, or weekend sleeping-in can scramble your body’s normal sleep/wake schedules.
Insufficient and poor quality sleep often becomes a mosaic of cause and effect cemented by habit.
He studied that Emotional stress accounts for more than 50% of chronic sleep problems. Early
morning wake-up is typical of depression, while feelings of anxiety strike at bedtime. Major stress
can start insomnia or cause excessive fatigue. And sleep difficulties that begin with a single
incident may linger long after the stress is resolved. Physical Illness Physical disorders are also
important to consider as sources of sleep difficulties. Illness and accompanying symptoms such as
pain, nausea, and shortness of breath often disturb sleep patterns. Diet and Exercise Habits
Alcohol or caffeine near bedtime can have negative effects on one’s sleeping patterns. A large
meal or strenuous exercise close to bedtime can temporarily boost the body’s metabolism, chasing
away sleep.

According to Shochat.T. (2012) Although the physiological and psychological mechanisms

involved in the development of sleep disorders remain similar throughout history, factors that
potentiate these mechanisms are closely related to the “zeitgeist”, ie, the sociocultural,
technological and lifestyle trends which characterize an era. Technological advancements have
afforded modern society with 24-hour work operations, transmeridian travel and exposure to a
myriad of electronic devices such as televisions, computers and cellular phones. Growing
evidence suggests that these advancements take their toll on human functioning and health via
their damaging effects on sleep quality, quantity and timing. Additional behavioral lifestyle factors
associated with poor sleep include weight gain, insufficient physical exercise and consumption of
substances such as caffeine, alcohol and nicotine. Some of these factors have been implicated as
self-help aids used to combat daytime sleepiness and impaired daytime functioning. This review
aims to highlight current lifestyle trends that have been shown in scientific investigations to be
associated with sleep patterns, sleep duration and sleep quality. Current understanding of the
underlying mechanisms of these associations will be presented, as well as some of the reported
consequences. Available therapies used to treat some lifestyle related sleep disorders will be
discussed. Perspectives will be provided for further investigation of lifestyle factors that are
associated with poor sleep, including developing theoretical frameworks, identifying underlying
mechanisms, and establishing appropriate therapies and public health interventions aimed to
improve sleep behaviors in order to enhance functioning and health in modern society.

2.9.4 Perceived relationship between sleep patterns and academic performance

According to Rostam at et (2020) in studying the effect of sleep quality on students academic performance
indicated that 34 cases (33.3%) of the subjects were male. The mean age of the sample 23.10 ± 3.25, where the
mean age for females was 22.46± 2.44 and for males was 24.38± 4.19. The participants in the study came from
various disciplines including laboratory science, medicine, pharmacology, emergency medicine, obstetrics,
radiology, operating room, health technology, and nursing. Most students lived in dormitories (50%) and 46.1% at
home, with 3.9% living in rental houses. The students' educational level ranged between the third semester and
twelfth semester.
They further stated that among those participating in the study, 67 patients (65.7%) consumed coffee, 90 cases
(88.2%) used tea, and 1 (1%) took a drug. For comparing the mean scores of students and the component of sleep,
Spearman test (non-normal data) was employed, where a significant correlation was observed between GPA and
hours taking to fall asleep. Similarly, there was a relationship between sleep components and tea, coffee, hypnotic
drugs, and drug. On the other hand, independent t-test between Pittsburgh scores in the two groups did not show
any significant differences. Nevertheless, impaired sleep quality was moderate to severe in both groups. The results
of the study indicated that impaired sleep quality between the two groups was not statistically significant. Although
the relationship between sleeping and academic success has been introduced in medical literature since a long
time, there still no definitive answer in this case.
Ganpat and Frizan (2019) Impact of Poor Sleep Quality on the Academic Performance of Medical Students in
Pakistan, clearly showed that they have poor sleep quality which has a negative impact on their academic
performance. A high propensity has been seen in young students attending medical schools. The study depicted
that the various studies that have been conducted to assess sleep disturbances and their results vary based on their
years of education and their lass daytime sleepiness and the percentage was 35.5% for Malaysian students which
were more common in clinical students. In Hong Kong, medical students had a mean night-time sleep duration of
6.6 ± 1.2 h; 70% of them complained of sleep deprivation. Poor sleep quality has been reported in 16% of
Malaysian medical students, 40.6% of Iranian medical students-with highest prevalence in their interns, 62.6% of
Indian students, and 77% of Pakistani medical students.
The study also revealed that out of the 791 students, 531 (66.62%) were females and 266 (33.37%) was
males. Mean GPA was 3.08 ± 1.12 for the entire study sample. There were 241 (30.23%) students with GPA less
than 2.71, 312 (39.14%) students with GPA 2.71-3.40 and 244 (30.61%) with GPA 3.41-4.00. Poor sleep quality
was witnessed in 512 (64.24%) students. Their mean GPA was 2.92 ± 1.09. There were 285 (35.76%) students who
were not poor sleepers and their PSQI score was <5. Their mean GPA was 3.31 ± 1.49. Poor sleepers had
significantly lower mean GPA (p < 0.0001).
All seven components of PSQI were compared with the average GPA of the students. Most of the students
with lower GPA (2.0-2.7) had very bad subjective sleep quality (28.2%), sleep latency of 16-30 min (29.05%),
sleep duration of <5-7 h (29.4%), and sleep efficiency of 75%-84% (27.8%). Most of these students experienced
sleep disturbances once or twice a week (29.8%), had not used sleep medication in the past one month (87.14%),
but experienced daytime dysfunction almost every day (37.7%). The comparison of their sleep quality parameters
to groups with higher GPAs is shown in Table 1.
In another study carried out in 2017 by Seun-Fadipe and Kolawole, at the Obafemi Awolowo University
Teaching Hospitals, Ile-Ife, Osun State, Nigeria it was observed that academic performance was assessed by asking
participants about their Cumulative Grade Point Average (CGPA). Participants provided their CGPA for the last
semester prior to the study period. In the University studied, the CGPA ranged from 1.00 to 5.00 points. The points
between 4.50-5.00 are categorized as First Class, 3.50-4.49 as Second Class Upper, 2.50-3.49 as Second Class
Lower and 1.50-2.49 as Third Class. Grade points lower than 1.50 is categorized as Pass.
Rasekhi, et al (2016) conducted a research to determine the effect of sleep quality on the scores of
undergraduate medical students of Bandar Abbas Medical School in Iran. While examining the Effects of Sleep
Quality on the Academic Performance of Undergraduate Medical Students, result shows that a total of 177
responses were obtained from the 240 students, thus giving a response rate of 74%. Among all the participants,
66.66% were considered poor sleepers. The mean age of the participants, which ranged from 17 to 31 years, was
20.99 ± 2.14. The finding further shows that among the population under study, 83 (46.9%) were male and 94
(53.1%) were female. When school performance was stratified into high (3.5 or higher), good (3 - 3.49), normal (2
- 2.99), and low (less than 2), 26 students (14.7%) had “high” scores, 78 students (44.06%) had “good” scores, 65
students (36.72%) had “normal” scores, and 8 students (4.52%) had “low” scores. The students were distributed
almost equally among the three academic years. Daily sleeping hours of 4 - 6 hours were reported by 110 (62.1%)
of the participants and 7 - 10 hours by 45 (25.4%). A small numbers of students slept less than 4 hours or more
than 10 hours (12.5%). Among the students, 59 (33.34%) had normal PSQI scores and 118 (66.66%) had abnormal
PSQI scores.
In another study, Williams and Aderanti (2014) carried out a study on, sleep as a determinant of academic
performance of university students in Ogun state, south west, Nigeria. The results show using the positive Pearson
correlation of 0.769 between adequate sleep and academic performance, reveals that the more students had
adequate sleep the better is their academic performance while the negative correlation value of – 0.518 indicates
that the more student had inadequate sleep the poorer they tend to perform academically. This result implies that
both lack of sleep and adequate sleep can affect students’ academic performance. The study specifically looked at
how adequate/inadequate sleeps contribute to the academic performance based on the students’ CGPA.

CHAPTER THREE
METHODOLOGY
This chapter will be discussed under the following subheadings: Research design, Research setting, Target
population, Sample size determination, Sampling technique, Instrument for data collection, Validity of
instruments, Reliability of instruments, Ethical consideration, Method of data collection and Method
of data analysis.
3.1 Research Design
The survey research design will be employ for this study. It will rely heavily on the use of the instruments
of questionnaire and interview to seek answers to the research questions. It is a form of survey method.
3.2 Research Setting
The researcher conducted the study in the main campus, Ugbowo of the University of Benin, Benin City, Edo
State, Nigeria which is located in Ovia North-East Local Government Area of Edo State. It is one of the foremost
federal government owed university in Nigeria.
 It is located along the Benin-Lagos road with the presence of commercial and social activities. There is also
a Teaching hospital for the university called the University of Benin Teaching Hospital (UBTH).
3.3 Target Population
The target population for this study is the nursing students. The total population for this study is 538 with
population of the students’ of 200 level (141), 300 level (160), 400 level (148) and 500 level (89). The population
consists of students in the Nursing Department of the University of Benin, Benin City.
3.4 Sample Size Determination
The size of sample for the study is 538 undergraduate nursing students who are in their 200, 300, 400 and
500 levels respectively.
The size was estimated from a population of 538 respondents using Taro Yamane (1967) formula.
n=N/ [1+ N (e)^2]

Where;

n= sample size

N= the number of Nursing students in University Of Benin

e= the level of precision which is 0.05

Therefore the sample size n is;

n= /[1+538(0.05)^2]

n= 538/[1+1.44]

n=538/2.72

n=229

10% attrition = 23

Therefore the sample size is 252.

3.5 Sampling Technique

A study population of 538 will be sampled using proportionate sampling technique. That is, 538 students
will be sampled from 200 level (141 )from 300 level, (160) from 400 level and (148) from 500 level(89) given a
sampled population of 538 students respectively.
3.6 Instruments for Data Collection
The instrument that will be used for data collection will be self structured questionnaire, requiring YES or
NO answers. The questions will be constructed in simple English language. It is designed to convince and motivate
respondents (subjects) and give the respondent a clear instruction which will enable him or her to make the
accurate response.
3.7 Validity of Instrument
The validity of the instrument will be ascertained by study objectives and will be determined by the Ethical
Committee of the department nursing sciences and my project supervisor.
3.8 Reliability of Instrument
In ascertaining reliability of the questionnaire, the Spearman Rank Order Correlation Coefficient (r) (a pre-
test/retest) will be used to determine the reliability and if the value is above 0.50 the questionnaire will judged to
be stable and thus reliable for use. Furthermore, the reliability will be determined by test-retest involving 20%
equivalent of the total students in a different institution, Igbinedion University, Okada with similar characteristics
of nursing department.

3.9 Method of Data Collection

A cross-sectional study will be conducted with undergraduate students in the Department of Nursing,
Faculty of Medical Sciences, University of Benin. The structured questionnaire will be administered.
3.10 Method of Data Analysis

The simple percentage tool was used in analyzing the data collected for the study.

Any item or response that has a percentage of 50 and above is judged to be accepted,

while that scores less than 50 is rejected and considered weak. Data will present in

frequency tables before analyses.

3.11 Ethical Consideration

Ethical approval was gotten from the ethics and research committee of
College of Medical Sciences, University of Benin. Due permission was
gotten from the Head of Department, Department of Nursing Science,
University of Benin, to go on with the research. Before data collection
commenced, careful explanation of the purpose, content and implication was
made known to the participants. The participants were given assurance of
confidentiality, by so doing, there will be no disclosure of information as the
information obtained will be personal and private.
The research will be conducted in accordance with the guidelines of
research. The following ethical considerations will be maintained during the
research exercise;

Confidentiality: The information provided by respondents were treated with

utmost confidentiality, no name or addresses was requested for in the
questionnaire. Respondents were made to understand that their responses in
the questionnaire will remain completely confidential and that the
observations were intended to be used only for specific research purposes.
To maintain this confidentiality and anonymity, no personal identifier was
used or indicated on any document or questionnaire.
Self-determination/voluntary participation: The respondents were
informed that they have the right to voluntarily decide whether to participate
in the study or not without the risk of incurring any penalty or prejudicial
treatment. They were given the right to decide at any point during the study
to withdraw their participation or refuse to provide any information on any
point that is not clear to them.
Avoidance of Plagiarism: All authors used in this study were appropriately
cited both in the body of the work and at the reference page.
The study also apprehended ethical considerations such as debriefing,
informed consent, and privacy.
 CHAPTER FOUR

RESULTS

This chapter deals on analysis and interpretation of data collected. The questionnaire

was designed and approved, and then distributed with only 97% were properly filled

as requested. The remaining 3% though recovered were disregarded as they were not

properly filled. This accounted for 245 properly filled questionnaires that were

analyzed for this study.

Table 1: Demographic data of respondents (n=245)

OPTIONS FREQUENCY (N) PERCENTAGE (%)
GENDER
Female 215 87.8
Male 28 11.4
Prefer not to say 2 0.8
Total 245 100
AGE (YEARS)
16 – 20 160 65.3
21 – 25 74 30.2
26 – 30 9 3.7
31 and above 2 .8
Total 245 100
MARITAL STATUS
Single 233 95.1
Married 12 4.9
Separated/Divorced - -
 Total 245 100
YEAR OF STUDY (LEVEL)
200 58 23.7
300 79 32.3
400 66 26.9
500 42 17.1
Total 245 100
Table 1 above shows that, 215 (87.8%) of the respondents were female, 28 (11.4%) were male

and 2 (0.8%) prefer not to say. The table also shows that 160 (65.3%) of the respondents were

within the age bracket of 16 – 20years, 74 (30.2%) were within 21 – 25years, 9 (3.7%) were within

age 26 – 30 years and only 2 (.8%) of them were 31 years and above. Marital status reveals that, a

large number of the respondents, 233 (95.1%) are single, 12 (4.9%) are married and 0 (0%) are

separated/divorced. On years of study (level) of the 245 respondents, 58 (23.7%. of them were

200, 79 (32.3%) are 300 level, 66 (26.9%) are 400 level while 42 (17.1%) of the respondents 500

level.

Table 2: KNOWLEDGE LEVEL OF THE UNDERGRADUATE NURSING STUDENTS ABOUT SLEEP

QUALITY (n=245)

VARIABLES FREQUENCY (N) PERCENTAGE (%)

Have you ever received formal education or training on sleep

quality during your undergraduate studies?
Yes - -
No 245 100
Total 245 100
Have you actively sought information or education about
sleep quality during your time as an undergraduate nursing
student?
 Yes - -
No 245 100
Total 245 100
Do you believe that your knowledge about sleep quality has
a direct impact on your overall health and well-being?
Yes 230 93.8
No 15 6.2
Total 245 100
Have you actively sought strategies or resources to improve
your sleep quality during your academic journey
Yes 200 81.6
No 45 18.4
Total 245 100
Do you think there is enough awareness and support for
sleep-related issues among undergraduate nursing students?
Yes 7 2.9
No 238 97.1
Total 245 100

Table 2 above reveals that all 245 (100%) of the respondents have never received formal

education or training on sleep quality during their undergraduate studies. On the question

whether the respondents have actively sought information or education about sleep quality

during their time as an undergraduate nursing student, all 245 (100%) answer to the contrary.

Majority of the respondents, 230 (93.8%) believe that knowledge about sleep quality has a direct

impact on your overall health and well-being, 15 (6.2%) do not believe that knowledge about

sleep quality has a direct impact on the overall health and well-being. While 200 (81.6%) of the

respondents have actively sought strategies or resources to improve their sleep quality during

their academic journey, 45 (18.4%) of them have not. Majority of the respondents 238 (97.1%)
did not think that there is enough awareness and support for sleep-related issues among

undergraduate students. 7 (2.9%) however, think there is enough awareness and support for

sleep-related issues among undergraduate students.

Table 3: AVERAGE SLEEP DURATION OF UNDERGRADUATE STUDENTS

(n=245)

VARIABLES FREQUENCY (N) PERCENTAGE (%)

Do you regularly monitor your own
sleep duration to ensure it meets
recommended guidelines?
Yes 5 2.1
No 240 97.9
Total 245 100
Do you have regular sleep hours up
to 8 hours?
Yes 55 22.4
No 190 77.6
Total 245 100
Do you feel 8 hours of sleep is
enough for a whole day?
Yes 195 79.6
No 50 20.4
Total 245 100
Do you believe that having a
consistent sleep schedule
contributes to better sleep quality?
Yes 242 98.8

No 3 1.2

Total 245 100

 Do you sleep for 8 hours in a day
during academic session?
Yes 10 4.1

No 235 95.9

Total 245 100

Table 3 above shows that a good number of the respondents, 240 (97.9%) do not regularly

monitor their own sleep duration to ensure it meets recommended guidelines. 5 (2.1%) do have

regular monitoring of their own sleep duration to ensure it meets recommended guidelines. The

table above also reveals that 190 (77.6%) of the respondents do not have regular sleep hours of

up to 8 hours. 55 (22.4%) do have regular sleep hours of up to 8 hours. While the table shows

that 195 (79.6%) of the respondents feel that 8 hours of sleep is enough for a whole day, 50

(20.4%) of them do not feel so. All most all the respondents, 242 (98.8%) of the respondents do

believe that having a consistent sleep schedule contributes to better sleep quality, 3 (1.2%) of

them do not feel that 8 hours of sleep is enough for a whole day. Majority of the respondents,

235 (95.9%) do not sleep for 8 hours in a day during academic session, 10 (4.1%) sleep for 8 hours

in a day during academic session.

Table 4: FACTORS INFLUENCING SLEEP QUALITY AND PATTERNS OF UNDERGRADUATE

STUDENTS (n=245)

VARIABLES FREQUENCY (N) PERCENTAGE (%)

Have you ever experienced sleep deprivation
due to academic responsibilities?
Yes 242 98.8
No 3 1.2
Total 245 100
Have you ever sought help or advice from
 campus resources regarding sleep-related
issues?
Yes - -
No 245 100
Total 245 100
Do you think there is enough awareness and
support for sleep-related issues among
undergraduate students?
Yes - -
No 245 100
Total 245 100
Do you think the sleep environment, such as
noise levels or room lighting, affects your sleep
quality?
Yes 242 98.8
No 3 1.2
Total 245 100
Have you ever used any drug or substance to
keep you awake?
Yes 200 81.6
No 45 18.4
Total 245 100
Have you ever used sleep aids or medications to
improve your sleep quality?
Yes 3 1.2
No 242 98.8
Total 245 100

Table 4 above reveals that, nearly all the respondents, 242 (98.8%) affirms that they had

experienced sleep deprivation due to academic responsibilities. Only 3 (1.2%) of the respondents

have not experienced sleep deprivation due to academic responsibilities. All 245 (100%) of the
undergraduate students, have never sought help or advice from campus resources regarding

sleep-related issues. Also from the table above, all 245 (100%) of the respondents do not think

that there is enough awareness and support for sleep-related issues among undergraduate

students. On the question whether the sleep environment, such as noise levels or room lighting,

affects their sleep quality, 245 (98.8%) of the respondents think the sleep environment, such as

noise levels or room lighting, affects your sleep quality. 3 (1.2%) think the contrary. Majority of

the respondents, 200 (81.6%) had been involved in the use of drugs or substances to keep them

awake. 45 (18.4%) do not use drugs or substances to keep them awake. The table above also

reveals that only 3 (1.2%) used sleep aids or medications to improve their sleep quality, while 242

(98.8%) do not use sleep aids or medications to improve their sleep quality.

Table 5: PERCEIVED RELATIONSHIP BETWEEN SLEEP PATTERNS AND ACADEMIC PERFORMANCE

OF UNDERGRADUATE STUDENTS (n=245)

VARIABLES FREQUENCY (N) PERCENTAGE (%)

Do you think the demands of your academic
workload have influenced your sleep duration?
Yes 245 100
No - -
Total 245 100
Do you think the sleep duration during
examinations affect your academic performance?
Yes 243 99.1
No 2 0.9
Total 245 100
Have you at anytime think that your sleep deficit
has been associated with lack of concentration
and attention during class?
Yes 241 98.4
No 4 1.6
Total 245 100
Have you attended examination without getting
enough sleep?
 Yes 245 100
No - -
Total 245 100
If yes, how was your performance in the last
session examination?
Very good 6 2.4
Good 239 97.6
Poor - -
Total 245 100

Do you perceive a correlation between the

quality of your sleep and your academic
performance?
Yes 242 98.8

No 3 1.2

Total 245 100

Do you perceive that the relationship between

sleep quality and academic performance is a
positive association?
Yes 240 97.9

No 5 2.1

Total 245 100

Table 5 above shows that, all the respondents, 245 (100%) do think the demands of academic

workload have influenced their sleep duration and none do not think the demands of academic

workload have influenced their sleep duration. The table also shows that 243 (99.1%) of the

respondents think that the sleep duration during examinations affect their academic

performance, 2 (0.9%) do not think the sleep duration during examinations affect their academic

performance. On whether the respondents had at anytime think that their sleep deficit has been

associated with lack of concentration and attention during class, 241 (98.4%) say yes to it and 4
(1.6%) did not at anytime think that their sleep deficit has been associated with lack of

concentration and attention during class. All the respondents, 245 (100%) attended examination

without getting enough sleep. Of the respondents, 245 (100) that attended examination without

getting enough sleep, shows that 6 (2.4%) performed very good, 239 (97.6%) performed well and

none performed poor. While 242 (98.8%) of respondents perceived a correlation between the

quality of sleep and academic performance, 3 (1.2%) do not accept it. Also, the table reveals that

240 (97.9%) of the respondents say yes that the perceived relationship between sleep quality and

academic performance is a positive association, and only 5 (2.1%) answer to the contrary.

4.2 Answering Research Questions

RESEARCH QUESTION 1 - What is the knowledge level of the undergraduate

nursing students about sleep quality in university of Benin?

The data from table 2 of the study shows that the undergraduate nursing students

never received formal education nor training on sleep quality in their study (100%),

the respondents had not also sought information or education about sleep quality as

nursing students (100%), they believe that their knowledge about sleep quality has a

direct impact on their overall health and well-being (93.8%), and that there have not

been enough awareness and support for sleep-related issues among undergraduate

nursing students of the University of Benin. In answering this research question, a

very high percentage (98%) of the students who do not have the knowledge of sleep

quality and so the knowledge level of sleep quality is low (12%).

RESEARCH QUESTION 2 - What is the average sleep duration of undergraduate

students?
Data analysis from table 3 shows 97.9% do not regularly monitor their own sleep duration to

ensure it meets recommended guidelines. 77.6% of the respondents do not have regular sleep

hours of up to 8 hours. 98.8% of the respondents do believe that having a consistent sleep

schedule contributes to better sleep quality. Majority of the respondents, 95.9% do not sleep for

8 hours in a day during academic session. The data shows that the average sleep duration is less

than the recommended 8 hours daily.

RESEARCH QUESTION 3 - What factors influence sleep quality and patterns of

undergraduate students?

The data analysis from table 4 indicates that 98.8% affirms that they had experienced

sleep deprivation due to academic responsibilities. 100% of the undergraduate

students have never sought help or advice from campus resources regarding sleep-

related issues. Also 100% of the respondents do not think that there is enough

awareness and support for sleep-related issues among undergraduate students. 98.8%

of the respondents think the sleep environment, such as noise levels or room lighting,

affects their sleep quality. 81.6% had been involved in the use of drugs or substances

to keep them awake. 45 (18.4%) do not use drugs or substances to keep them awake.

98.8% do not use sleep aids or medications to improve their sleep quality. It means

academic workload, lack of advice on sleep-related issues, environmental factors

(noise, room lighting, etc), the use of drugs, are amongst the factors that influence

sleep quality and patterns of undergraduate students.

RESEARCH QUESTION 4 - What is the perceived relationship between sleep

patterns and academic performance of undergraduate students?

Data analysis from table 5 above shows that, 100% do think the demands of academic workload

have influenced their sleep duration. 99.1% of the respondents think that the sleep duration

during examinations affect their academic performance. 98.4% perceived that sleep deficit has

been associated with lack of concentration and attention during class. All 100% attended

examination without getting enough sleep. 100% of the students performed well in their

examination. 97.9% of the respondents perceived that the relationship between sleep quality

and academic performance is a positive association. It means from the data gathered, there is no

direct perceived relationship of sleep quality and pattern, and academic performance.

CHAPTER FIVE

DISCUSSION OF FINDINGS
This chapter is mainly concerned with the results obtained from research exercise that

are analyzed in tables in their frequency and percentages. From the analysis of data in

chapter four one can make observations about assessing the sleep patterns among

undergraduate students in a tertiary educational institution in Edo state, with particular

reference to the University of Benin, Benin City, Nigeria. Identification of key

findings, implication of findings with literature support, aligning findings of previous

studies, implications of findings to nursing, limitations of the study, conclusion,

recommendations and suggestions for further studies are highlighted and discussed in

this chapter.

5.1 Major findings

1. All the 100% undergraduate nursing students of the University of Benin never

received formal education or training on sleep quality in their study.

2. The knowledge level of sleep quality is low (12%).

3. A very high 95.9% of undergraduate nursing students sleep duration is less

than the recommended 8 hourly in the night.

4. The sleep quality of students is affected by sleep environment, such as noise

levels or room lighting, affects their sleep quality, 98.8%.

5. All 100% of students attended examination without getting enough sleep.

100% of the students performed well in their examination.

6. A very high 97.9% of the respondents perceived that there is direct

relationship between sleep quality and academic performance.

5.2 Implication of Findings with Literature Support and Aligning Findings of Previous Studies.

Sleep is a fundamental component of human health, and understanding sleep patterns

and quality is crucial for healthcare professionals, including undergraduate nursing

students. The knowledge level of nursing students about sleep patterns and quality is

essential because it directly impacts their ability to assess, educate, and provide care

to patients with sleep-related issues.

The role that sleeps plays in the general performance of students cannot be overstated.

It is therefore pertinent for undergraduate nursing students to have thorough

knowledge and understanding of sleep and sleep patterns. It is essential to state the

fact that students understand the significance of sleep quality in the healthcare system.

Adequate and restful sleep is essential for the body's physical and cognitive functions.

Poor sleep quality can lead to various health issues, including cardiovascular diseases,

obesity, diabetes, and mental health disorders. Among the most important functions

of sleep is the enhancement of optimal cognitive functioning such as attention,

insight, decision-making, speech, and most notably learning and memory, factors

which are very key for efficient academic performance of undergraduate students

(Seun-Fadipe and Kolawole 2017).

Sleep is undeniably crucial for a multitude of essential brain functions, prominently

among them being the facilitation of communication between nerve cells, or neurons.

The significance of sleep goes beyond merely a state of rest, as it's increasingly

evident that during this seemingly dormant phase, both the brain and body remain
notably engaged. Recent scientific discoveries reinforce the pivotal role of sleep as a

diligent housekeeper for the brain, actively purging accumulated toxins that accrue

throughout wakefulness (Eugene and Masiak, 2015). This housekeeping function is

essential for maintaining optimal cognitive health and overall well-being

Li Chiu Kong Family Sleep Assessment Unit (2021) stated six functions of sleep as it

helps the individual to regain energy, helps in memory consolidation, support healthy

growth, improves immune function, removes metabolic waste and mood regulation.

It was noted that getting enough sleep is not a luxury, but a necessity (Maas et al., 1998). In fact,

people typically spend one third of their lives sleeping (Mireku et al., 2019). However, the “always

on” nature of college life is a constant pressure, often resulting in sleep deprivation and/or

overall poor quality of sleep (Dowdell, 2019). The average sleep duration among undergraduate

students is a topic of considerable interest, as it sheds light on a critical aspect of their overall

well-being and academic performance.

Ganpat and Frizan (2019) observed that n Hong Kong, medical students had mean night-time

sleep duration of 6.6 ± 1.2 h; 70% of them complained of sleep deprivation. The study reveals too

that poor sleep quality has been reported in 16% of Malaysian medical students, 40.6% of Iranian

medical students-with highest prevalence in their interns, 62.6% of Indian students, and 77% of

Pakistani medical students. This is also true for undergraduate nursing students of the University

of Benin as 95.5% of them sleep duration are less than the recommended 8 hourly in the night.

The sleep quality of students is affected by sleep environment, such as noise levels or room

lighting. Numerous elements exert influence over the sleep patterns of undergraduate students

within tertiary educational institutions, both on a broader Nigerian scale and with specific
relevance to Edo State. These factors encompass a wide spectrum, including environmental

factors such as noise disturbances, mosquito presence, lighting conditions, temperature

variations, and a host of others.

According to Biomed central limited (2009) noise is defined as unwanted sounds and

could affect people both psychologically and physiologically with reported negative

effects including cardiovascular stimulation, hearing loss, increased gastric secretion,

pituitary and adrenal gland stimulation and others. Noise has manifest not only from

equipment and machines now, but from cell phones. This is why some students who

need real time to rest are strongly advised to put off their cell phones during sleeping

times. Light is another environmental factor affecting the sleep of students. To be

exposed to light at night time can trigger a chemical process that can operate as a

neutral switch that can switch the sleep/wake cycle is run but the pineal gland. The

pineal gland located in the brain secretes melatonin. The production of melatonin is at

its peak when a person sleeps turning on the light during sleep can cause the

production of melatonin to turn on and off thereby affecting sleep (Avery 2006).

Since humans are diurnal, meaning they sleep at night, because of this, light exerts an

acute alerting effect causing an alteration in sleep (Dijk and Archer, 2009). Light is

one of the most important external factors that can affect sleep. Mosquito is a

prevalent factor disrupting the sleep patterns particularly during nighttime hours.
When these mosquitoes commence their disturbances, students encounter challenges

in their nocturnal reading and sleeping routines.

This not only hinders their capacity to study but also exposes them to the risk of

contracting malaria from mosquito bites. Therefore, the government can help to

eradicate mosquito from the hospital environment by the provision of treated

mosquito nets for each bed in the ward, cutting down of bushes around the hospital

buildings, proper disposal of tins broken buckets and bottle around surrounding to

prevent storing water and serving as a breeding area for mosquito.

The medical student population is one of the populations that appear to be at increased

risk for sleep deprivation (Veldi M, et al (2005) and Loayza H, et al (2001)). This is

because they need to be awake to do their duty in the hospital or are under constant

stress because of their examinations.

Several studies have identified some relationships between sleep patterns and

academic performance. Some of the key relationships that exist between sleep

patterns and academic performance include sleep duration, sleep quality, chronotype,

sleep hygiene and study habits, class timing, stress and mental health. Williams and

Aderanti (2014) study on sleep as a determinant of academic performance of

university students in Ogun state, south west, Nigeria shows a positive Pearson

correlation of 0.769 between adequate sleep and academic performance. Unlike this

study, the one by Williams and Aderanti (2014) shows that the more students had

adequate sleep the better is their academic performance while the negative correlation

value of – 0.518 indicates that the more student had inadequate sleep the poorer they
tend to perform academically. A very high 97.9% of the respondents perceived that

there is direct relationship between sleep quality and academic performance.

Higher education has influenced students’ concepts of sleeping time leading to a

deficit of sleep quality. Khin Thandar, et al (2016) observed that besides students

experienced sleep deprivation due to lack of sleep during the night and poor sleep

quality, most of the students tend to stay up late into the night to accomplish their

tasks as they did their best to prepare for the future and thus forgo getting enough

sleep.

5.3 Implications of Findings to Nursing

Nurses have the major role of increasing the awareness of sleep patterns and quality. It is the

roles of the nurse to provide positive perception to health educate clients to observe regular and

quality sleep.

5.4 Limitations of the Study

1. Difficultly in persuading the students nurse to answer the questionnaire.

2. Finance was a constraint as the money needed was huge.

3. Time constraint.

5.5 Summary of the Study

This study aimed to assess the sleep patterns of undergraduate students in tertiary

institutions in Edo state, Nigeria using the Department of Nursing of the University of

Benin. Four relevant objectives were highlighted and corresponding research

questions were raised to guide the study. In quest for achieving this, cross-sectional
descriptive survey design was adopted and a questionnaire was developed by the

researcher and administered to 253 respondents randomly sampled for 200, 300,

400 and 500 levels. Findings from the study revealed amongst others that all 100% of

students attended examination without getting enough sleep; all the 100%

undergraduate nursing students of the University of Benin never received formal

education or training on sleep quality in their study; a very high 97.9% of the

respondents perceived that there is direct relationship between sleep quality and

academic performance.

Strong recommendations including the establishment of sleep-related unit were made

and the study concluded relying on the findings that undergraduate nursing students

need special training in understanding sleep quality and patterns.

5.5 Conclusion

The application of sleep patterns and sleep quality lies largely on the students’ knowledge about

sleep and its functions to humans. This is evident in the findings of this study. All the students

have however sought strategies and resources to knowledge of immunization and vaccine

preventable diseases. Despite sleep deprivation, students are always determined to succeed in

their academics. Majority of them, from 200 to 500 levels are in grade bracket of very good and

good.

5.6. Recommendations

Based on conclusion, it is recommended that:

i. Students must cultivate the habit of having sufficient daily sleep and to be

supported by the department.

 ii. Fixed bed time and waking time to improve their sleep pattern.

iii. Establishment of a sleep unit and other sleep-related issues.

5.7 Suggestions for Further Studies

The researcher suggests that a similar study should be conducted in other tertiary institution in

Edo State to generalize the findings.

APPENDIX
QUESSTIONNAIRE ON ASSESSMENT OF SLEEP PATTERNS AMONG

UNDERGRADUATE STUDENTS IN A TERTIARY EDUCATIONAL

INSTITUTION IN EDO STATE”

Dear respondent,

I am a Bachelor of Nursing degree student of the University of Benin, Benin City

conducting a research on: “ASSESSMENT OF SLEEP PATTERNS AMONG

UNDERGRADUATE STUDENTS IN A TERTIARY EDUCATIONAL

INSTITUTION IN EDO STATE”

I hereby humbly request for your co-operation in responding to the questions below.

The information will be strictly for academic purpose and you are assured of optimal

confidentiality.

Yours faithfully,
EJIGUE, Tamaranimiebi

INSTRUCTIONS
 Please tick [ ] the number which you think is your best answer.
 Where applicable, state your best options.

Introduction:

Thank you for participating in this survey. The purpose of this questionnaire is to gather

information about your knowledge of sleep patterns and sleep quality. Your honest responses will

contribute to research on this topic. This survey is anonymous, and your responses will be kept

confidential.

SECTION A: DEMOGRAPHIC INFORMATION

1. Gender: Male [ ] Female [ ] Prefer not to say [ ]

2. Age: 15 – 19 years [ ] 20 – 24 years [ ] 25 – 29 years [ ] 30 and above [ ]

3. Marital status: Single [ ] Married [ ] Separated/divorce [ ]

4. Department or Course of Study: _______________

5. Year of Study (Level): 200 [ ] 300 [ ] 400 [ ] 500 [ ]

SECTION B: ASSESMENT OF SLEEP PATTERNS AMONG UNDERGRADUATE STUDENTS

6. Have you ever received formal education or training on sleep quality during

your undergraduate studies? Yes [ ] No [ ]

7. Have you actively sought information or education about sleep quality during

your time as an undergraduate nursing student? Yes [ ] No [ ]

8. Do you believe that your knowledge about sleep quality has a direct impact on

your overall health and well-being? Yes [ ] No [ ]

9. Have you actively sought strategies or resources to improve your sleep quality
 during your academic journey Yes [ ] No [ ]

10. Do you think there is enough awareness and support for sleep-related issues

among undergraduate students? Yes [ ] No [ ]

SECTION C: AVERAGE SLEEP DURATION OF UNDERGRADUATE STUDENTS

11. Do you regularly monitor your own sleep duration to ensure it meets

recommended guidelines? Yes [ ] No [ ]

12. Do you have regular sleep hours up to 8 hours? Yes [ ] No [ ]

13. Do you feel 8 hours of sleep is enough for a whole day? Yes [ ] No [ ]

14. Do you believe that having a consistent sleep schedule contributes to better

sleep quality? Yes [ ] No [ ]

15. Do you sleep for 8 hours in a day during academic session? Yes [ ] No [ ]

SECTION D: FACTORS INFLUENCING SLEEP QUALITY AND PATTERNS OF UNDERGRADUATE

STUDENTS

16. Have you ever experienced sleep deprivation due to academic responsibilities?

Yes [ ] No [ ]

17. Have you ever sought help or advice from campus resources regarding sleep-

related issues? Yes[ ] No[ ]

18. Do you think there is enough awareness and support for sleep-related issues

among undergraduate students? Yes [ ] No [ ]

19. Do you think the sleep environment, such as noise levels or room lighting,

affects your sleep quality? Yes [ ] No [ ]

20. Have you ever used any drug or substance to keep you awake? Yes [ ] No [ ]
 21. Have you ever used sleep aids or medications to improve your sleep quality?

Yes [ ] No [ ]

SECTION E: PERCEIVED RELATIONSHIP BETWEEN SLEEP PATTERNS AND ACADEMIC

PERFORMANCE OF UNDERGRADUATE STUDENTS

22. Do you think the demands of your academic workload have influenced your

sleep duration? Yes [ ] No [ ]

23. Do you think the sleep duration during examinations affect your academic

performance? Yes [ ] No [ ]

24. Have you at anytime think that your sleep deficit has been associated with lack

of concentration and attention during class? Yes [ ] No [ ]

25. Have you attended examination without getting enough sleep? Yes [ ] No [ ]

26. If yes, how was your performance in the last session examination? Very good [

] Good [ ] Poor [ ] No [ ]

27. Do you perceive a correlation between the quality of your sleep and your

academic performance? Yes [ ] No [ ]

28. Do you perceive that the relationship between sleep quality and academic

performance is a positive association? Yes [ ] No [ ]

Conclusion:

Thank you for taking the time to complete this survey. Your input is valuable to our research.
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