College Students Seek Sleep Solutions Beyond Medication

At midnight, Guo Tongshun, 19, a second-year student from Hong Kong Baptist University, found himself exhausted but unable to sleep. After an hour of tossing and turning, his anxiety about getting up early made him more restless.

In desperation, he gave up on sleeping and picked up his phone to watch videos. But the light of the phone and the fast-swiping videos made him more and more excited.

At 3 am, he felt anxious but was no longer sleepy. He then took a melatonin tablet to try to sleep again.

“It works well, but I am afraid to take more,” Guo said. “I hate the feeling of being weak and fuzzy after taking it, and I am worried that it would cause hormonal disruption.”

Many university students in Hong Kong are overwhelmed by the problem of sleep disorders and sleep anxiety, caused by excessive screen time, heavy academic pressure and mental stress. Some of them take medication to combat sleep disorders, but they are also trying to explore other solutions.

Sleep disorders can have multiple psychological and physical effects. People who suffer from it often do not have good sleep quality and sufficient sleep time, which may lead to function impairment and fatigue during the day, thus increasing the risk of anxiety, depression, high blood pressure, diabetes, and heart attack, according to the National Library of Medicine in the US.

According to a "White Paper on the Sleep Health of Chinese Residents 2024" published by the Chinese Association for Sleep Research, more and more young people in China suffer from sleep disorders. 

According to the Paper, people aged between 14 and 34 are troubled by sleep difficulties, falling asleep after midnight on average, more than an hour later than those aged above 34.

In Hong Kong, nearly 70% of local people suffer from insomnia, and about 40% of the respondents suffer from insomnia due to work or academic pressure, according to the Hong Kong Sleeping Quality Association

The average sleep time of Hong Kong people is less than seven hours, ranking 16th from the bottom among 50 countries in the world, according to the World Population Review. 

Li Shanwen, 18, a freshman at Hong Kong Baptist University, said he hasn't had a good night’s rest since he came to Hong Kong this year because of academic pressure.

“I usually take melatonins to help me fall asleep faster, but I found that long-term use can lead to drug dependence and causes dizziness and poor concentration the following day,” Li said.

Beyond melatonins and sleeping pills, the most effective treatment for insomnia is cognitive behavioral therapy which does not have side effects, according to Chan Ngan-yin, an Assistant Professor in the Department of Psychiatry at Chinese University of Hong Kong. 

70 to 80% of insomniacs show significant improvement during treatment, according to the National Library of Medicine.

“Insomnia is related to a person's poor sleeping habits, including irregular sleep schedules, excessive screen time before sleeping, and lack of exercise,” Chan said. “And many insomniacs like to stay in bed all the time, even when they cannot fall asleep, which can worsen the problem.”

“Cognitive behavioral therapy for insomnia can help patients set a regular sleep plan and change their misperceptions,” said Chan.

“Focusing too much on sleep or worrying about the negative consequences of insomnia can make it harder to sleep,” Chan added. 

Chan said that one of her patients was very anxious that insomnia would affect his health and lead to a bad situation the next day.

 “I had discussions with him about his excessive worries, providing him with adequate information and helping him replace some of his catastrophic thoughts with positive ones,” said Chan. “After about four sessions of discussion, his restlessness and panic about difficulty falling asleep were reduced, and the time it took him to fall asleep was halved.”

“A lot of people have insomnia not because of a physical problem, but because they can't control their subconscious emotions because of anxiety and depression,” said Catman Chung, the founder of Hong Kong Hypnotherapy Centre.

“Hypnotherapy takes people from the surface consciousness to the subconscious mind and stimulates them to discover the source events which make them feel nervous, panicky and unhappy, and help them release these pressures by breathing practice and picture imagery, which put you into a deep sleep,” Chung said.

But for college students living in dormitories, self-hypnosis or meditation is a more practical approach.

“They can listen to guided hypnosis audios and make sure there are no distractions, perform breathing exercises and learn to relax,” said Chan Kai-ho, 31, the founder of VOID, a community that offers hypnosis and meditation service.

Chan said that when you want to go to bed, you should not go to bed right away.

“It means giving yourself five to 15 minutes to relax your brain before going to bed, like warming up before exercise,” he said.“You can take deep breaths while doing and thinking about nothing, which can effectively improve your sleep quality.”

Chan said some people will find this process hard, with thoughts constantly flooding their minds, but it takes practice, just like anything else we learn.

“Following the hypnosis blogger's guidance for half an hour, I slowly pulled away from the tense state, feeling the exhaustion of the body and the peace of mind, allowing me to fall asleep faster,” Guo said.

“Although sometimes it may have the opposite effect, like feeling more sober, most of the time it works for me,” Guo added.

Yoga is another form of relaxation that can help people fall asleep, especially women. 

About 50% of yoga practitioners find that it improves sleep and reduces stress, according to the National health statistics report in the US.

Zhang Zixuan, 19, a student at the Hong Kong Baptist University, who has experienced the side effects of taking melatonin and cannot endure the bad taste of traditional Chinese medicine, began to practice yoga before bed to improve her sleep quality.

“I often do stretches like putting my hands against a wall and slowly pressing my back down and pulling my upper body like a leather band,” Zhang said. “I also balance my breathing in a smoother way while doing stretches,” she added. 

Lau Tin-ming, a yoga instructor from a fitness platform, Pure Yoga, said yoga is a practice that combines both mind and body in order to allow more restful sleep.

“When your breathing rhythm and movements of the body are on the same frequency, the human spirit will slowly relax,” said Lau. “And many yoga poses can improve the blood circulation of your brain or other organs,  helping you to relieve physical fatigue and get better sleep.”

One of the yoga poses, a child's pose, stretches the thighs and ankles and provides deep relaxation for the back.

“The pose requires you to sit on your heels, bend your body forward and gently rest your forehead on the floor,”  he said. “Like a baby in its mother's womb, this pose along with deep breathing is an effective way to affect the secretion of melatonin and make you feel a deeply calming mind.”

“If your brain is very tense and tired, consider placing a pillow under your spine or your hips for a change in blood circulation when you sleep,” he added.

Traditional Chinese medicine also offers some methods to improve sleep such as acupuncture, ear acupressure, and head massage. 

“Acupuncture regulates blood circulation by stimulating specific points, achieving a calming effect without side effects,” said Zhou Keyi, 29, a TCM practitioner. “Some acupoints, including Shenmen, Baihui, Neiguan and Anmian, have remarkable effects on insomnia.” 

Zhou said massaging these points is convenient for college students.

“For example, you can massage the Neiguan point, which is three fingers away from the wrist, for 2-3 minutes before going to bed, and massage the Taichong point between the big toe and the second toe to relax the liver, which helps you have a better sleep,” Zhou said.

“Ear massages are also effective for helping you fall asleep more quickly, including massaging the lobes, tips and rubbing the front and back of the ears,” Zhou added.

Zhang has benefited from massaging his ear lobes and pressure points such as the anmian before bed. 

“I feel hot with my year and yawn, but also sleepy after messaging them for several minutes,” she said. “It is amazing.”

“Work at sunrise and rest at sunset,” Zhou said. “College students should do more exercise, avoid sitting for a long time during the day to study, and avoid strenuous exercise and watching exciting videos at night in order to keep you calm before sleep.”