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University of Iowa Case Study: Helping Students Improve Their Sleep

Get a Better Night’s Rest

Sleep impacts academic performance and other areas of wellness. But despite sleep’s importance, it is not always the focus of the university’s wellness efforts. At the University of Iowa, we implement the Refresh Sleep Improvement Program, a sleep education program with an app and email versions.

Program evaluation has shown improvements in all sleep measures (reductions in difficulty falling asleep, difficulty staying asleep, waking too early, and worry about sleep; increases in satisfaction and quality of sleep).

Students and Sleep

Wellness centers on all universities and college campuses have a significant role in supporting the students’ adaptation to their life on campus, from academic and social activities to dealing with the pressing challenges posed by entering their adult life and building a safe structure for a good and productive life at both the personal and societal levels. The role of the wellness centers is primarily a source of knowledge and support for the students’ emotional and curricular challenges.

According to the 2019 NCHA data, students at the University of Iowa (UI) and nationwide report sleep difficulties as one of the top 3 impediments to learning.1-2 Over 40% of UI students report problems with sleepiness during daytime activities, a number which has been steadily increasing over the past decade. 1 Sleep issues have been linked to a variety of concerns, including irritability, depression, fatigue, attention and concentration difficulties, and poor academic performance. 3

Research is lacking on effective measures for improving sleep among college students. A study from 2011 assessed the Refresh Sleep Program, which was based on Cognitive Behavioral Therapy for Insomnia; it was found to be effective in improving sleep quality. 4 UI Student Wellness has offered sleep programs for students since 2013 based on this research. The UI Refresh Sleep Program has evolved over time, starting with an email version only, then an app option, and now with optional components like consultations and heart rate monitor checkout.

The Solution

In an observational study, presented by Trisha Welter, MPH, MCHES, and Becca Don, MA, CADC from the Student Wellness Center of The University of Iowa at the American College Health Association (ACHA), the impact of the Refresh Sleep Program powered by Sleeprate was presented.

The Refresh Sleep Program aims to help students at the University of Iowa increase the quality and quantity of their sleep and better understand how sleep impacts their overall success.

The goal of this assessment project was to analyze the effectiveness of this program for the 2019-2020 academic year.

The Outcomes

Paired sample t-tests were conducted among students who completed the evaluation results showed –

Significant* Reductions In:

»Difficulty falling asleep
»Difficulty staying asleep
»Problems waking too early
»Noticeability of sleep problem to other
»Interference with daily functioning
»Worry/distress about a sleep problem
»Problems with sleep
»Restless sleep
»Efforts to get to sleep
»Worry/distress about not being able to fall asleep

Significant* Increases In:

»Satisfaction with current sleep pattern
»Sleep quality
»Refreshing sleep

*Changes significantly at p<.001; combines data from both email and app participants who completed evaluation (n=302)

Increase In Student’s Satisfaction:

»8% reported learning more about their sleep
»3% agreed that the program motivated them to improve their sleeping habits
»2% would recommend the program to a friend

Student Reactions

Education and sleep deprivation tend to go hand in hand. The change in lifestyle can be difficult for college students as they have busy social lives and often pulling ‘all-nighters’, causing a deficiency. Between varying class times and demanding work schedules, sleep is all too often a low priority for students. Lifestyle and culture inevitably play a big role in this phenomenon, as the average college student is likely to cram late-night studying sessions in and around partying, other social activities, and pretty much anything else we’ve all done in college to put off something that’s of such ‘little importance’ as sleep. The refresh program powered by Sleeprate got the students of the University of Iowa to put sleep as a priority. Here are some of their reactions:

  • “It’s great that programs addressing sleep quality exist—it is such an important, and often overlooked topicThough I continue to struggle with sleep, this program and the app have helped, and I’ll continue to use what I’ve learned here. I really love the app and will continue to use it, because I find that I sleep better after tracking my sleep”
  • Love the app
  • “Thank you for offering this service”
  • “It helped me focus more on my sleep, which I have struggled with in the past”
  • I plan on keeping up with the app for as long as possible. It was a good program and I learned a lot about my sleeping habits and Love the app on how to improve them!”


The observational study results showed a substantial number of students engagement with the sleep program as well as improvement in their sleep quality and overall health:

  • The Refresh program was effective in improving sleep among students
  • Students reported great satisfaction with the program
  • Not surprisingly, students greatly prefer to enroll in the app version of the program
  • Programs like this are a great way to reach many students in an individualized way, while still maintaining fairly low cost
  • Sleep programs are an important addition to college wellness programs, given sleep’s impact on health and academic success.

Working with Sleeprate

Sleeprate’s SaaS sleep solutions platform supports sleep self-care and sleep telemedicine to provide good care for patients with sleep disorders. Sleeprate’s core technology utilizes behavioral sleep medicine practices developed and implemented at Stanford University’s Behavioral Sleep Division. Sleeprate’s comprehensive all-in-one solution helps students and others achieve a better sleep-life balance and improve mental and physical performance – allowing them to be more productive and lead a healthier lifestyle. Sleeprate provides world-class technologies that offer people anywhere and everywhere the most effective, reliable, and user-friendly sleep analysis, monitoring, assessment, and improvement.

Refresh Powered by Sleeprate

A couple of leading US universities and their student wellness departments, like the University of IowaMIT, and the University of Kentucky, have embraced the Refresh Sleep Program powered by Sleeprate. This program aims to provide students and staff with the skills, strategies, and support to achieve more restful nights. The Refresh Sleep Program powered by Sleeprate comprehensive all-in-one solution helps deliver a better sleep-life balance and improve mental and physical performance – allowing users to be more productive and lead a healthier lifestyle.



  1. Student Wellness The University of Iowa. UI health data. Retrieved from:
  1. American College Health Association. Publications and reports: ACHA-NCHA II. Retrieved from:
  1. Brown FC Jr., Buboltz WC, Soper B. Development and evaluation of the sleep treatment and education program for students (STEPS). J Am College Health. 2016;54(4):231-237.
  2.  Trockel M, Manber R, Chang V, Thurston A, Tailor CB. An e-mail delivered CBT for sleep-health program for college students: effects on sleep quality and depression symptoms. J Clin Sleep Med. 2011:276-281.