{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:05:14Z","timestamp":1793379914110,"version":"4.5.0"},"reference-count":40,"publisher":"Royal College of Psychiatrists","issue":"6","license":[{"start":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T00:00:00Z","timestamp":1699315200000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["PJT 152976"],"award-info":[{"award-number":["PJT 152976"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["TG1 165597"],"award-info":[{"award-number":["TG1 165597"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:sec id=\"S2056472423005975_sec_a1\">\n\t    <jats:title>Background<\/jats:title>\n\t    <jats:p>Sleep problems associated with poor mental health and academic outcomes may have been exacerbated by the COVID-19 pandemic.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005975_sec_a2\">\n\t    <jats:title>Aims<\/jats:title>\n\t    <jats:p>To describe sleep in undergraduate students during the COVID-19 pandemic.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005975_sec_a3\" sec-type=\"methods\">\n\t    <jats:title>Method<\/jats:title>\n\t    <jats:p>This longitudinal analysis included data from 9523 students over 4 years (2018\u20132022), associated with different pandemic phases. Students completed a biannual survey assessing risk factors, mental health symptoms and lifestyle, using validated measures. Sleep was assessed with the Sleep Condition Indicator (SCI-8). Propensity weights and multivariable log-binomial regressions were used to compare sleep in four successive first-year cohorts. Linear mixed-effects models were used to examine changes in sleep over academic semesters and years.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005975_sec_a4\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>There was an overall decrease in average SCI-8 scores, indicating worsening sleep across academic years (average change \u22120.42 per year; <jats:italic>P<\/jats:italic>-trend &lt; 0.001), and an increase in probable insomnia at university entry (range 18.1\u201329.7%; <jats:italic>P<\/jats:italic>-trend &lt; 0.001) before and up to the peak of the pandemic. Sleep improved somewhat in autumn 2021, when restrictions loosened. Students commonly reported daytime sleep problems, including mood, energy, relationships (36\u201348%) and concentration, productivity, and daytime sleepiness (54\u201366%). There was a consistent pattern of worsening sleep over the academic year. Probable insomnia was associated with increased cannabis use and passive screen time, and reduced recreation and exercise.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S2056472423005975_sec_a5\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>Sleep difficulties are common and persistent in students, were amplified by the pandemic and worsen over the academic year. Given the importance of sleep for well-being and academic success, a preventive focus on sleep hygiene, healthy lifestyle and low-intensity sleep interventions seems justified.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1192\/bjo.2023.597","type":"journal-article","created":{"date-parts":[[2023,11,7]],"date-time":"2023-11-07T09:41:51Z","timestamp":1699350111000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":24,"title":["Changes in sleep and the prevalence of probable insomnia in undergraduate university students over the course of the COVID-19 pandemic: findings from the U-Flourish cohort study"],"prefix":"10.1192","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4664-5456","authenticated-orcid":false,"given":"Nathan","family":"King","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Pickett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles D. 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