Skip to main content
SpringerLink
Log in

Test Anxiety and Poor Sleep: A Vicious Cycle

  • Special Issue: Sleep Science
  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Test anxiety may be better thought of as a biopsychosocial process affecting academic performance during the days leading up to an exam, rather than a static appraisal of attitudes related to test taking. This was a passive observational study following students 2 days before a midterm exam and was designed to test the Sleep Anxiety Performance Process (SAPP) model in the context of a psychology statistics exam.

Methods

Undergraduates (N = 167) enrolled in a statistics class, January–November 2015. Participants completed an electronic battery of measures and Sleep Mood Study Diaries (SMS) during the mornings, 2 days before a statistics exam. Instructors confirmed exam scores.

Results

A path model showed a reciprocal bi-directional relationship between Sleep Quality and restfulness (Q&R) and test anxiety 2 days before a scheduled exam, with test anxiety measured in the morning, before the exam predicting exam performance. Prior exam performance, being a non-native English speaker (ESL), and class performance motivation also predicted exam performance.

Conclusions

These data support the SAPP model’s premise that that sleep and anxiety feed one another, as a reciprocal process, that collectively impairs academic performance, with direct effects on academic performance, but with implications for overall student health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. It should be noted that race/ethnicity was a significant predictor of exam score. However, the effect was entirely dependent upon a single student’s outlier (poor) test score. Because of the low probability for replication, this effect is not pictured in the model or reported in Table 2.

References

  1. Zeidner M. Does test anxiety bias scholastic aptitude test performance by gender and sociocultural group? J Pers Assess. 1990;55:145–60.

    Article  CAS  Google Scholar 

  2. Gregor A. Examination anxiety: live with It, control it or make it work for you? Sch Psychol Int. 2005;26(5):617–35.

    Article  Google Scholar 

  3. Oaten M, Cheng K. Academic examination stress impairs self-control. Journal of social and clinical psychology. J Soc Clin Psychol. 2005;24(2):254–70.

  4. Gillespie NA, Gehrman P, Byrne EM, Kendler KS, Heath AC, Martin NG. Modeling the direction of causation between cross-sectional measures of disrupted sleep, anxiety and depression in a sample of male and female Australian twins. J Sleep Res. 2012;21(6):675–83.

    Article  Google Scholar 

  5. Chapell MS, Blanding ZB, Silverstein ME, Takahashi M, Newman B, Gubi A, McCann N. Test anxiety and academic performance in undergraduate and graduate students. J Educ Psychol. 2005;97:268–74.

    Article  Google Scholar 

  6. Macher D, Paechter M, Papousek I, Ruggeri K, Freudenthaler HH, Arendasy M. Statistics anxiety, state anxiety during an examination, and academic achievement. Br J Educ Psychol. 2013;83:535–49.

    Article  Google Scholar 

  7. Hunsley J. Test anxiety, academic performance, and cognitive appraisals. J Educ Psychol. 1985;77(6):678–82. https://doi.org/10.1037/0022-0663.77.6.678

  8. Onwuegbuzie AJ, Wilson VA. Statistics anxiety: nature, etiology, antecedents, effects, and treatments—a comprehensive review of the literature. Teach High Educ. 2003:195–209.

  9. Onwuegbuze AJ. Satistics test anxiety and female students. Psychol Women Q. 1995;19:413–8.

    Article  Google Scholar 

  10. Kopasz M, Loessl B, Hornyak, M, et al. Sleep and memory in healthy children and adolescents—a critical review. Sleep Med Rev. 2010;14:167–77.

  11. Dimitriou D, Knight FLC, Milton P. The role of environmental factors on sleep patterns and school performance in adolescents. Front Psychol. 2015;6.

  12. Trockel MT, Barnes MD, Egget DL. Health-related variables and academic performance among first year college students: implications for sleep and other behaviors. J Am Coll Health. 2000;49:125–31.

    Article  CAS  Google Scholar 

  13. Borisenkov MF, Perminova EV, Kosova AL. Chronotype, sleep length, and school achievement of 11-to 23-year-old students in northern European Russia. Chronobiol Int. 2010;27(6):1259–70.

    Article  Google Scholar 

  14. Taylor DJ, Vatthauer KE, Bramoweth AD, Roggero C, Roane B. The role of sleep in predicting college academic performance: is it a unique preictor? Behav Sleep Med. 2013;11(3):159–72.

    Article  Google Scholar 

  15. Genzel L, Ahrberg K, Roselli C, al. e. Sleep timing is more important than sleep length or quality for medical school performance. Chronobiol Int. 2013;30(6):766–71.

  16. Gomes AA, Tavares J, de Azevedo MH. Sleep and academic performance in undergraduates: a multi-measure, multi-predictor approach. Chronobio Int. 2011;28(9):786–801.

    Article  Google Scholar 

  17. Uhde TW, Cortese BM, Vedeniapin A. Anxiety and sleep problems: emerging concepts and theoretical treatment implications. Curr Psychiatry Rep. 2009;11(4):269–76.

    Article  Google Scholar 

  18. Blankstein KR, Flett GL, Watson MS, Koledin S. Test anxiety, self-evaluative worry, and sleep disturbance in college students. Anxiety Res. 1990;3(3):193–204.

    Article  Google Scholar 

  19. Rosa RR, Bonnet MH. Reported chronic insomnia is independent of poor sleep as measured by electroencephalography. Psychosom Med. 1983;62:474–82.

    Article  Google Scholar 

  20. Tsypes A, Aldao A, Mennin DS. Emotion dysregulation and sleep difficulties in generalized anxiety disorder. J Anxiety Dis. 2013;27(2):197–203.

    Article  Google Scholar 

  21. Campbell R, Soenens B, Beyers W, Vansteenkiste M. University students’ sleep during an exam period: the role of basic psychological dneeds and stress. Motiv Emot. 2018;42(5):671–81.

    Article  Google Scholar 

  22. Ahrberg K, Dresler M, Niedermaier S, Steiger A, Genzel L. The interaction between sleep quality and academic performance. J Psychiatry Res. 2012;46(12):1618–22.

    Article  CAS  Google Scholar 

  23. Alsaggaf MA, Wali SO, Merdad RA, Merdad LA. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years: relationship with stress and academic performance. Saudi Med J. 2016;37(2):173–80.

    Article  Google Scholar 

  24. Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193–213.

    Article  CAS  Google Scholar 

  25. Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. Int J Chronobiol. 1976;4(2):97–110.

    CAS  Google Scholar 

  26. Morin CM, Belleville G, Bélanger L, Ivers H. The Insomnia Severity Index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34(5):601–8.

    Article  Google Scholar 

  27. Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory: twenty-five years of evaluation. Clin Psychol Rev. 1988;8:77–100.

    Article  Google Scholar 

  28. Spielberger CA, Gorsuch RL, Lushene RE. Manuel for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press; 1970.

    Google Scholar 

  29. Trautwein U, Köller O. The relationship between homework and achievement—still much of a mystery. Educ Psychol Rev. 2003;15(2):115–45.

    Article  Google Scholar 

  30. Sadigh MR, Himmanen SA, Scepansky JA. An investigation of the prevalence of insomnia in college students and its relationship to trait anxiety. Coll Stud J. 2014;48:397–406.

    Google Scholar 

  31. Center NSCR. Snapshot report: Persistence: National Research Center 2016.

  32. Carney C, E., Edinger JD, Manber R, Garson C, Segal ZV. Beliefs about sleep in disorders characterized by sleep and mood disturbance. J Psychosomatic Res. 2007;62:179–88.

  33. Wolf EJ, Harrington KM, Clark SL, Miller MW. Sample size requirements for structural equation models: an evaluation of power. Bias Solut Propriety Educ Psychol Meas. 2013;76(6):913–34. https://doi.org/10.1177/0013164413495237.

    Article  Google Scholar 

  34. Enders CK, Bandalos DL. The relative performance of full information maximum likelihood estimation for missing data structural equation models. Struct Equ Modeling. 2001;8(3):430–57.

    Article  Google Scholar 

  35. Lindsey C. Trait anxiety in college students: the role of the approval seeking schema and separation individuation. Coll Stud J. 2014;48:407–18.

    Google Scholar 

  36. Clements AD, Bailey BA. The relationship between temperament and anxiety. J Health Psychol. 2010;15:515–25.

    Article  Google Scholar 

  37. Matthews KA, Patel SJ, Pantesco EJ, et al. Similarities and differences in estimates of sleep duration by polysomnography, actigraphy, and self-reported habitual sleep in a community sample. Sleep Health. 2018;4(1):96–103.

    Article  Google Scholar 

  38. Bernstein JPK, DeVito A, Calamia M. Subjectively and objectively measured sleep predict differing aspects of cognitive functioning in adults. Arch Clin Neuropsychol. 2019;34:1127–37.

    Article  Google Scholar 

  39. Bower GH. Mood and memory. Am Psychol. 1981;36:129–48.

    Article  CAS  Google Scholar 

  40. Grassgreen A. Students rate mental health services. Inside High Educ 2012.

  41. Ergene T. Effective interventions on test anxiety reduction. Sch Psychol Int. 2003(24):313 28.

  42. Park CL, Cohen LH, Murch RL. Assessment and prediction of stress-related growth. J Personal. 1996;64:71–105.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, University of Kansas, KS, 66044, Lawrence, USA

    Nancy Hamilton, Ronald Freche, Yichi Zhang, Gabriella Zeller & Ian Carroll

Authors
  1. Nancy Hamilton
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ronald Freche
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yichi Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gabriella Zeller
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ian Carroll
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nancy Hamilton.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hamilton, N., Freche, R., Zhang, Y. et al. Test Anxiety and Poor Sleep: A Vicious Cycle. Int.J. Behav. Med. 28, 250–258 (2021). https://doi.org/10.1007/s12529-021-09973-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-021-09973-1

Keywords

Search

Navigation