title: The interplay between sleep and mood in predicting academic functioning, physical health and psychological health: a longitudinal study.
abstract: OBJECTIVE
  Existing studies on sleep and behavioral outcomes are mostly correlational. Longitudinal data is limited. The current longitudinal study assessed how sleep duration and sleep quality may be causally linked to daytime functions, including physical health (physical well-being and daytime sleepiness), psychological health (mood and self-esteem) and academic functioning (school grades and study effort). The mediation role of mood in the relationship between sleep quality, sleep duration and these daytime functions is also assessed.
  
  
  METHODS
  A sample of 930 Chinese students (aged 18-25) from Hong Kong/Macau completed self-reported questionnaires online across three academic semesters. Sleep behaviors are assessed by the sleep timing questionnaire (for sleep duration and weekday/weekend sleep discrepancy) and the Pittsburgh sleep quality index (sleep quality); physical health by the World Health Organization quality of life scale-brief version (physical well-being) and Epworth Sleepiness Scale (daytime sleepiness); psychological health by the depression anxiety stress scale (mood) and Rosenberg Self-esteem Scale (self-esteem) and academic functioning by grade-point-average and the college student expectation questionnaire (study effort).
  
  
  RESULTS
  Structural equation modeling with a bootstrap resample of 5000 showed that after controlling for demographics and participants' daytime functions at baseline, academic functions, physical and psychological health were predicted by the duration and quality of sleep. While some sleep behaviors directly predicted daytime functions, others had an indirect effect on daytime functions through negative mood, such as anxiety.
  
  
  CONCLUSIONS
  Sleep duration and quality have direct and indirect (via mood) effects on college students' academic function, physical and psychological health. Our findings underscore the importance of healthy sleep patterns for better adjustment in college years.
authors.affiliation: Department of Psychology, University of Hong Kong, Hong Kong, China.
authors.forename: Mark Lawrence
authors.initials: ML
authors.lastname: Wong
authors.forename: Esther Yuet Ying
authors.initials: EY
authors.lastname: Lau
authors.forename: Jacky Ho Yin
authors.initials: JH
authors.lastname: Wan
authors.forename: Shu Fai
authors.initials: SF
authors.lastname: Cheung
authors.forename: C Harry
authors.initials: CH
authors.lastname: Hui
authors.forename: Doris Shui Ying
authors.initials: DS
authors.lastname: Mok
mesh_terms: D000124:Achievement; D000293:Adolescent; D000328:Adult; D000339:Affect; D001007:Anxiety / Q000523:psychology; D003863:Depression / Q000523:psychology; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D012890:Sleep; D013334:Students / Q000523:psychology*; D011795:Surveys and Questionnaires; D014495:Universities