1134 INSOMNIA AND DAYTIME TIREDNESS IN STUDENT ATHLETES ASSOCIATED WITH RISKY BEHAVIORS AND POOR DECISION MAKING WHEN UNDER THE INFLUENCE OF ALCOHOL

Abstract

Introduction: Insomnia and daytime tiredness are particularly common among student athletes who are balancing academics with athletics, are often over-scheduled, and frequently travel. Alcohol consumption is also high in this group. The present study examined whether athletes with sleep-related problems are more likely to engage in unhealthy behaviors when drinking. Methods: Data from the National College Health Assessment (an annual survey of US college/university students conducted by the American College Health Association) was used. Data encompassed survey years 2011-2014 and were restricted to varsity athletes (N=8,683). Participants reported the frequency over the past 7 days of: “had an extremely hard time falling asleep” (insomnia) and “felt tired, dragged out, or sleepy during the day” (tiredness). Responses were dichotomized around ≥3 days/week. Participants were asked whether, in the past 12 months when drinking alcohol, they did something they regretted, lost memory for the event, got in legal trouble, had sex without providing consent, had sex without others' consent, had unprotected sex, physically injured themselves, physically injured others, and/or seriously considered suicide. Logistic regressions restricted to the 73% who reported drinking examined likelihood of behaviors relative to insomnia and tiredness, adjusted for age, sex, and survey year. Results: Insomnia was associated with increased likelihood of doing something regretful (OR=1.32, p<0.0001), forgetting (OR=1.26, p<0.0001), legal trouble (OR=1.51, p=0.006), sex without providing consent (OR=1.75, p=0.002), sex without other's consent (OR=3.40, p<0.0001), unprotected sex (OR=1.33, p<0.0001), injuring self (OR=1.56, p<0.0001), injuring other (OR=1.70, p=0.003), and suicide ideation (OR=2.42, p<0.0001). Tiredness was associated with doing something regretful (OR=1.61, p<0.0001), forgetting (OR=1.46, p<0.0001), sex without providing consent (OR=1.50, p=0.03), unprotected sex (OR=1.32, p<0.0001), injuring self (OR=1.56, p<0.0001), and suicide ideation (OR=2.56, p<0.0001). All remained significant in a combined model with both sleep variables (neither mediated the other). These relationships were also not mediated by depression. Conclusion: Insomnia and daytime tiredness among student athletes both independently predict risky/dangerous behavior and poor decision- making when drinking alcohol. Alternatively, risky behavior may also lead to poor self-care and worse sleep.