The interplay between sleep and mood in predicting academic functioning, physical health and psychological health: A longitudinal study

Mark Lawrence WONG, Esther Yuet Ying LAU, Jacky Ho Yin WAN, Shu Fai CHEUNG, C. Harry HUI, Doris Shui Ying MOK

Research output: Contribution to journalArticle

79 Citations (Scopus)


Objectives: 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. 

Conclusion: 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. Copyright © 2012 Elsevier Inc. All rights reserved.

Original languageEnglish
Pages (from-to)271-277
JournalJournal of Psychosomatic Research
Issue number4
Early online date25 Sep 2012
Publication statusPublished - Apr 2013



Wong, M. L., Lau, E. Y. Y., Wan, J. H. Y., Cheung, S. F., Hui, C. H., & Mok, D. S. Y. (2013). The interplay between sleep and mood in predicting academic functioning, physical health and psychological health: A longitudinal study. Journal of Psychosomatic Research, 74(4), 271-277. doi: 10.1016/j.jpsychores.2012.08.014


  • Negative affect
  • Well‐being
  • School grades
  • Sleep–wake schedule
  • Structural equation modeling
  • Post-sleep functioning