Association between nonmedical use of prescription drugs and sleep quality in a large college student sample.

Objective/Background: Poor sleep and nonmedical use (NMU) of prescription drugs (NMUPD) are both common among college students. Since lack of sleep adversely influences academic performance, this study examined the association between NMUPD and subjective sleep quality among college students. Participants: Students who completed the American College Health Association-National College Health Assessment data (Fall 2010, Spring 2011; N = 135,874). Methods: Associations were examined between NMUPD in four classes over the past 12 months (antidepressant, painkillers, sedatives, and stimulants), and five aspects of sleep quality (Enough Sleep, Early Awakening, Daytime Sleepiness, Difficulty Falling Asleep, and Problem With Daytime Sleepiness) in the past seven days. Results: Any NMUPD (at least one class), NMU of stimulants specifically, and NMU of painkillers specifically were associated with getting fewer days of Enough Sleep (OR: 0.86, 0.93, and 0.84 respectively), more days of Early Awakening (OR: 1.28, 1.10, and 1.28 respectively), Daytime Sleepiness (OR: 1.23, 1.13, and 1.16 respectively), and Difficulty Falling Asleep (OR:1.32, 1.10, and 1.27 respectively; p < .0001, each). NMU of sedatives was significantly associated with having Problem With Daytime Sleepiness (OR: 1.10), more days of Early Awakening (OR: 1.12), and Difficulty Falling Asleep (OR: 1.17; p < .0001). Conclusions: NMUPD is associated with poor sleep among college students. Therefore, behavioral medicine screening and treatment of this vulnerable population should consider sleep health, NMUPD, and the potential that these problems may be comorbid.