title: Effects of an irregular bedtime schedule on sleep quality, daytime sleepiness, and fatigue among university students in Taiwan.
abstract: BACKGROUND
  An irregular bedtime schedule is a prevalent problem in young adults, and could be a factor detrimentally affecting sleep quality. The goal of the present study was to explore the association between an irregular bedtime schedule and sleep quality, daytime sleepiness, and fatigue among undergraduate students in Taiwan.
  
  
  METHODS
  A total of 160 students underwent a semi-structured interview and completed a survey comprising 4 parts: Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Fatigue Severity Scale (FSS), and a rating of irregular bedtime frequency. Participants were grouped into 3 groups in terms of irregular bedtime frequency: low, intermediate, or high according to their 2-week sleep log. To screen for psychological disorders or distress that may have affected responses on the sleep assessment measures, the Chinese health questionnaire-12 (CHQ-12) was also administered.
  
  
  RESULTS
  We found an increase in bedtime schedule irregularity to be significantly associated with a decrease in average sleep time per day (Spearman r = -0.22, p = 0.05). Multivariate regression analysis revealed that irregular bedtime frequency and average sleep time per day were correlated with PSQI scores, but not with ESS or FSS scores. A significant positive correlation between irregular bedtime frequency and PSQI scores was evident in the intermediate (partial r = 0.18, p = 0.02) and high (partial r = 0.15, p = 0.05) frequency groups as compared to low frequency group.
  
  
  CONCLUSIONS
  The results of our study suggest a high prevalence of both an irregular bedtime schedule and insufficient sleep among university students in Taiwan. Students with an irregular bedtime schedule may experience poor sleep quality. We suggest further research that explores the mechanisms involved in an irregular bedtime schedule and the effectiveness of interventions for improving this condition.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, No. 252 Wu-Xing Street, Taipei 110, Taiwan, Republic of China. jhk@tmu.edu.tw
authors.forename: Jiunn-Horng
authors.initials: JH
authors.lastname: Kang
authors.forename: Shih-Ching
authors.initials: SC
authors.lastname: Chen
mesh_terms: D000328:Adult; D004282:Documentation; D005221:Fatigue; D005260:Female; D006801:Humans; D008297:Male; D012890:Sleep; D013334:Students; D011795:Surveys and Questionnaires; D013624:Taiwan; D014495:Universities