CORRELATIONS OF THE FEAR OF MISSING OUT & INTERPERSONAL STRESS WITH FEMALE COLLEGE STUDENTS ’ SLEEP

Insomnia has been correlated with several negative mental and physical health outcomes in female undergraduate students, a population with increasing interest when considering those suffering with insomnia. Considering the increased vulnerability reported by college students, and the poor outcomes of insomnia, it is important to determine correlates of insomnia and which factors differentially impact college students’ development of insomnia. This study examined whether interpersonal stress or the fear of missing out (i.e. FoMO) was more highly correlated with insomnia in a population of female undergraduate students at the University of Rhode Island. This study also examined whether levels of interpersonal stress, FoMO, and insomnia varied across students in different class years. Variables examined included levels of insomnia, FoMO, interpersonal stress, year in school, race, and age. An examination of the data using correlations and ANOVAs was utilized to determine if there were differences in students among the four class years in college and the correlations of insomnia with interpersonal stress and FoMO. It was hypothesized that FoMO would be more highly correlated to insomnia than interpersonal stress would be correlated to insomnia. It was also hypothesized that all three measures would be significantly higher for first year students and seniors than for juniors and sophomores. No significant differences were found in students on any measure among the four class years. It was found that interpersonal stress was more highly correlated with insomnia than FoMO was correlated with insomnia. However, both interpersonal stress and FoMO were more highly correlated with each other than either was to insomnia. Each of these correlation analyses showed statistical significance. Therefore, neither hypothesis proposed by the researcher was supported. This study contributes to the literature showing that interpersonal stress and FoMO are related and that this relationship should be studied further in order to help students identify healthy coping strategies to deal with each and have successful college careers.


ABSTRACT
Insomnia has been correlated with several negative mental and physical health outcomes in female undergraduate students, a population with increasing interest when considering those suffering with insomnia. Considering the increased vulnerability reported by college students, and the poor outcomes of insomnia, it is important to determine correlates of insomnia and which factors differentially impact college students' development of insomnia. This study examined whether interpersonal stress or the fear of missing out (i.e. FoMO) was more highly correlated with insomnia in a population of female undergraduate students at the University of Rhode Island. This study also examined whether levels of interpersonal stress, FoMO, and insomnia varied across students in different class years. Variables examined included levels of insomnia, FoMO, interpersonal stress, year in school, race, and age. An examination of the data using correlations and ANOVAs was utilized to determine if there were differences in students among the four class years in college and the correlations of insomnia with interpersonal stress and FoMO.
It was hypothesized that FoMO would be more highly correlated to insomnia than interpersonal stress would be correlated to insomnia. It was also hypothesized that all three measures would be significantly higher for first year students and seniors than for juniors and sophomores. No significant differences were found in students on any measure among the four class years. It was found that interpersonal stress was more highly correlated with insomnia than FoMO was correlated with insomnia. However, both interpersonal stress and FoMO were more highly correlated with each other than either was to insomnia. Each of these correlation analyses showed statistical significance. Therefore, neither hypothesis proposed by the researcher was supported.
This study contributes to the literature showing that interpersonal stress and FoMO are related and that this relationship should be studied further in order to help students identify healthy coping strategies to deal with each and have successful college careers.
iv ACKNOWLEDGMENTS I would like to acknowledge a number of individuals for contributing to and guiding the success of the current study. Each of these individuals has supported my personal growth over the course of my Master's degree as well as the growth of this thesis from the original proposal to the final manuscript.    al., 1996;Cernovsky, 1984;Galambos et al., 2013). College students in particular are exposed to a variety of new life circumstances that lead them to make choices that may have negative consequences, and must navigate this newfound autonomy to learn greater independence and less reliance on the opinions of others. This time of change and newfound autonomy leads students to make choices that impact their social and academic lives. These choices ultimately have impacts on students' well-being, including the potential to develop insomnia.
Many factors contribute to a college student developing insomnia, defined as the inability or difficulty of falling asleep or remaining asleep, including the fear of missing out (i.e. FoMO) and interpersonal stress (Adams et al., 2016). The experiences that students face throughout their college years have varying impacts on these constructs (Galambos et al., 2013). FoMO is described as the all-consuming feeling that others as having more rewarding experiences without you (Przybylski et al., 2013). This is considered a psychological factor of one's development. FoMO has dimensions relating to sense of self, social interactions, and social anxiety. FoMO is a reality that is increasingly occurring in college students. The daunting feeling of trying to fit in and managing relationships with many new individuals affects the student's daily decision making in terms of choosing between academic and social responsibilities (Alt, 2015;Przybylski et al., 2013;Riodian et al., 2015).
Interpersonal stress is described as stress that arises from conflict with others. This is considered a social factor to one's development. College student stress has been related to many changes in the lives of students when first arriving to a college campus. These changes include decreased communication with friends and family from home, living in a new environment, decreased academic supervision and increased academic demands, managing increased autonomy, and opportunities for students to experience novel situations (Adams et al., 2016). While the prevalence of students experiencing negative outcomes due to stress has been widely studied and supported, and great efforts have been made to make services available and known to students, many students do not reach out for help (Coiro et al., 2017).
Reflecting impacts of the biopsychosocial model (Engel, 1977) (used in this study as insomnia being biological, FoMO being psychological, and interpersonal stress being social), negative outcomes associated with these issues include poor academic performance, increased college dropout, immune system deficits and higher frequency of illness, increased suicidal thoughts, decreased stress management, and substantial decrements in the quality of life (Adams et al., 2016;Lund et al., 2010;Wallace et al., 2017;Wilson et al., 2017). Previous research on college students has shown differences in men and women's responses to these stressors, including women being more likely to report stress and use maladaptive coping strategies (Hudd et al., 2000;Dyson & Renk, 2006;Piercall & Keim, 2007). Also, insomnia has been correlated with several negative health outcomes in female undergraduate students (Breslau et al., 1996;Cernovsky, 1984;Galambos et al., 2013). FoMO, and also that both FoMO and interpersonal stress were more highly correlated with each other than either was correlated to insomnia. All of these correlation analyses were statistically significant. Also, the findings indicate that there were no differences in levels of FoMO, interpersonal stress, or insomnia across students in different years in their college careers. Future research should utilize a broader population of students in order to increase generalizability of results, consider other correlates of FoMO and interpersonal stress, and implement a longitudinal study design in order to determine causality and directionality of how FoMO, interpersonal stress, and insomnia interact with one another.

REVIEW OF LITERATURE
Insomnia has been correlated with several negative mental and physical health outcomes in female undergraduate students, a population with increasing interest when considering those suffering with insomnia (Breslau et al., 1996;Cernovsky, 1984, Galambos et al., 2013. Many factors contribute to a college student developing insomnia, including the fear of missing out (i.e. FoMO) and interpersonal stress (Adams et al., 2016). The experiences that students face throughout their college years have varying impacts on these constructs (Galambos et al., 2013).

Insomnia
Considering the increased vulnerability reported by college students, and the poor outcomes of insomnia, defined as the inability or difficulty of falling asleep or remaining asleep, it is important to determine correlates of insomnia and which factors differentially impact college students' development of insomnia (Breslau et al., 1996;Cernovsky, 1984;Galambos et al., 2013). College students in particular are exposed to a variety of new life circumstance that lead them to make choices that may have negative consequences, and must navigate this newfound autonomy to learn greater independence and less reliance on the opinions of others. One health issue that has been shown in previous literature to affect students is insomnia (Katz & McHorney, 2002). Insomnia is not only an individual concern, but has major implications for public health, with studies showing that driving sleepy is equally as dangerous as driving under the influence of alcohol, which would also increase traffic and workrelated accidents (Katz & McHorney, 2002). Insomnia has many poor health outcomes, including greater fatigue, irritability, anxiety, depression, difficulty completing tasks, impairment in cognitive functioning, work absenteeism, poor quality of life, developing substance abuse, impaired immune functioning, and development of cardiovascular disease (Taylor et al., 2013). Taylor and colleagues (2013), using self-reported sleep data of college students, found a prevalence of 9.5% of students with insomnia using the more stringent DSM-5 criteria. However, they found a prevalence of 27% of students showing symptoms of insomnia without complaint (part of the DSM-5 criteria), meaning that these students do not consider their sleep deficits a problem, but still would be able to be diagnosed with insomnia if they did have complaints about it. Therefore, while insomnia has been extensively studied in this population and the negative consequences of it are well known, this study demonstrates that students continue to experience insomnia while believing it to be part of the normal college experience.
In another study conducted by Nardoff and colleagues (2010), insomnia was reported to be significantly associated with suicidal ideation, even after controlling for mental health disorders containing insomnia as a diagnostic criterion. In this study of an undergraduate student population, both insomnia and nightmares were related to suicide ideation independent of one another. When controlling for symptoms of depression, anxiety, and PTSD, only nightmares, and not insomnia, was related to suicidal ideation. Therefore, insomnia is both a symptom and a risk factor for onset and recurrence for mental health issues and should be considered with nightmares when researching suicide, which has been reported as one of the leading causes of death for the college student age population (Nadorff, Nazem, & Fiske, 2010). Buboltz and colleagues (2001) conducted a study of sleep patterns and habits in college students. They found that while 73% of their students reported occasional sleep problems, only 15% met the criteria to be considered to have low sleep quality.
Women reported sleep difficulty more often than men, especially in the areas of maintaining sleep, more morning tiredness, and more daytime napping. The students in this study believed they were getting less sleep than they actually reported during the week, and wished they had gotten more sleep on the weekends. This in turn makes them feel more tired than they actually are. In addition, college students have been found to suffer decreased sleep quality compared to the non-student adult population (Buboltz, Brown, & Soper, 2001). When students shift their sleep-wake times by 2 hours while maintaining the same amount of sleep, they experience feelings of depression, reduced affability, and difficulty concentrating. When they sleep later on the weekends than during the week, they develop chronic psychomotor slowing and concentration problems, irritability, and depression (Buboltz, Brown, & Soper, 2001).
Previous studies have shown that the rapid eye movement (REM) stage of sleep is associated with learning integration (De Koninck et al., 1989). Therefore, when sleep is interrupted and students do not get to enter into REM sleep, integration of new learning is limited.

Interpersonal Stress
The stress that undergraduate students experience has been associated with numerous negative outcomes. Interpersonal stress is the stress that is associated with conflict with others. This is particularly important for college students, as they are in a period of identity development and trying to find social groups in which they fit in (Torres et al., 2009). This type of stress is often related to trait anxiety, which is one's general disposition to become anxious and typical levels of anxiety (Alt, 2015).
It has been reported that between 20-50% of undergraduates have either reported a current or previous diagnosis of depression or symptoms of depression, anxiety, and low levels of mood and life satisfaction (Gress-Smith et al., 2015;Oberst, et al., 2017;Wallace et al., 2017;Wilson et al., 2014). Negative outcomes associated with these mental health issues include poor academic performance, increased college dropout, immune system deficits and higher frequency of illness, increased suicidal thoughts, more impaired memory, decreased stress management, increased levels of obesity and substantial decrements in the quality of life (Adams et al., 2016;Lund et al., 2010;Wallace et al., 2017;Wilson et al., 2017). College student stress has been related to many changes in the lives of students when first arriving to a college campus. These changes include decreased communication with friends and family from home, living in a new environment, decreased academic supervision and increased academic demands, managing increased autonomy, and opportunities for students to experience novel situations (Adams et al., 2016). While the prevalence of students experiencing negative outcomes due to stress has been widely studied and supported, and great efforts have been made to make services available and known to students, many students do not reach out for help (Corrio et al., 2017).
Coping strategies may differ by culture or generation. The current study sample included millennial students, defined as those born from 1981-1997 (Fry, 2016). Bland and colleagues (2012) discuss the specific characteristics of millennial college students that make them more susceptible to stress in the college years. For example, the millennial generation is larger than any since the Boomers. Millennials have habits of teamwork, achievement, modesty, and good conduct. They also are more diverse, better educated, more affluent, and have had more parental support throughout their upbringing than any generation before. This parental support has often led to millennials being over scheduled, heavily monitored, and pressured to excel academically. They have high achievement needs; going to college is now the norm, often an expectation, and academic standards are higher than ever before. Technology advancements in their lifetimes have made millennials constantly connected to one another and to the outside world in real time, including extensive trauma and mass casualties. Millennial students have generally very active "helicopter" parents on whom they rely for social support, even when these parents create stress for academic achievement (Bland et al., 2012). One study showed that the two greatest worries of current young adults are college acceptance and grades, compared to AIDS and violent crime in the early 2000s, and nuclear war in the 1980s (Howe & Strauss, 2000). When these students do move on to college, they are removed from their current support networks on which they relied for coping with all these stressors. In the Bland study (2012), levels of stress tolerance of college students were compared to types of coping strategies they utilized. Only one coping strategy was associated with high stress tolerance: social support, an approach-oriented strategy. On the other hand, low stress tolerance was associated with avoidance coping strategies, including cleaning their room, going on social media, and using substances. While college students are developing autonomy, a purpose, and their identity, many are unable to cope with stressors in the absence of their original support network. This research shows it is important to encourage students to find a good social support system in school and develop autonomy in creating that network while relying less on parents to solve problems for them, as many are used to with "helicopter" parenting (Bland et al., 2012). Cohen also found that social support buffers the negative effects from stress (Cohen, 2004).
More importantly, stress and insomnia are very difficult to separate. Researchers examining this topic have supported the idea that there is a bidirectional relationship between stress (depression and anxiety) and insomnia. While stress could lead to having difficulty falling asleep or staying asleep, these experiences could also cause further stress within the individual. Most of the previous literature has been cross sectional on this topic, so it is impossible to determine causality in these constructs.
Taylor and colleagues (2011) discuss this difficulty in their study of undergraduate students, stating it is often difficult to determine symptoms and comorbidities of insomnia as studies use varying degrees of specificity when defining insomnia and insomnia is a diagnostic criterion for many mental health disorders. Using a very strict definition of insomnia, they were able to determine that those with insomnia showed more obsessive-compulsive symptoms, but no other mental health symptoms. They also could not determine if insomnia symptoms resulted in increased mental health symptoms or if mental health symptoms lead to insomnia symptoms (Taylor et al., 2011). Etindele Sosso reports, "Insomnia is a consequence of slight damage of brain structure or a symptom indicating the necessity to evaluate mental health," (Etindele Sosso, 2017, p. 32). Even at the brain chemistry level, these ideas are intertwined. The current study adds to the literature by studying insomnia, FoMO, and interpersonal stress separately in an attempt to separate them.
Amaral and colleagues (2018) examined stress in college students related to insomnia and differences in men and women students. In their study, they discuss the difficulty in the transition to college resulting in increased stress to undergraduates.
Sleep deprivation, homesickness, and stress all negatively impact academic success (Amaral et al., 2018). They report that women tend to report more sleep problems and more emotional distress, more rumination and repetitive negative thinking, and more depressive symptoms than men, all of which are related to more sleep problems. Using an 80% female undergraduate sample, they found that the women reported more sleep problems, negative affect, perceived stress, and repetitive negative thinking than the men. Pre-sleep rumination and repetitive negative thinking in "individuals with insomnia is excessive, uncontrollable, negatively toned, and covers a broad range of topics," (Amaral et al., 2018, p. 336). This impact of stress on sleep is mediated by the amount of repetitive negative thinking and negative affect prior to sleep onset; this means stress itself does not necessarily cause sleep problems if not obsessively thought about prior to falling asleep (Amaral et al., 2018). The current study adds to the previous literature by focusing on the women student population in order to further understand their needs and characteristics, which have been shown to be different than those of men.
Additionally, Brougham and colleagues (2009) aimed to find differences in stressors and coping mechanisms between men and women in an undergraduate student population, citing significance of transition to college leaving students vulnerable to stress when exploring identity. Common stressors included academics, social relationships, finances, daily hassles, and family relationships. Previous research has shown differences in men and women's responses to these stressors (Hudd et al., 2000;Dyson & Renk, 2006;Pierceall & Keim, 2007). This study (Brougham et al., 2009) found that women experienced more stress from family relationships, finances, daily hassles, and social relationships at school than men.
Social relationships were the most significant stressor for women. Women were also found to use more self-help, approach, and self-punishment coping strategies than men. These findings support women's overall greater reports of stress and greater use of emotion focused strategies (Brougham et al., 2009). The men in this sample were found to use both maladaptive and adaptive emotion focused coping while women used only maladaptive emotion focused coping along with adaptive problem focused coping. Both men and women used emotion focused coping more than problem focused coping (Brougham et al., 2009 (Przybylski et al., 2013;Riodian et al., 2015). FoMO is defined as the all-consuming sense that others are having rewarding experiences that the individual is not a part of. FoMO has roots in self-determination theory (SDT), which states that "effective self-regulation and psychological health are based on the satisfaction of three basic psychological needs: competencethe capacity to effectively act on the world, autonomyself-authorship or personal initiative, and relatedness -closeness or connectedness with others," (Przybylski et al., 2013(Przybylski et al., , p. 1841. FoMO is often referred to as a trait anxiety, similarly to interpersonal stress. It has dimensions relating to sense of self, social interactions, and social anxiety (Alt, 2015).
FoMO is a reality that is increasingly occurring in college students. These students are navigating the newfound autonomy of the college experience. The daunting feeling of trying to fit in and managing relationships with many new individuals affects the student's daily decision making in terms of choosing between academic and social responsibilities (Oberst et al., 2017;Riodian et al., 2015). Feeling as if you are missing out on activities or social engagement with peers due to easy access to social media may increase feelings of interpersonal stress. Those high in FoMO have been found to be more likely to engage in social media during risky times, such as while driving or during a lecture (Riodan et al., 2015). FoMO has been determined to be a mediating factor in the use of social media engagement and the negative effects it has on individuals with existing mental health issues and low self-esteem (Oberst et al., 2017). It also has been correlated with a decline in subjective wellbeing, both in how people feel moment to moment and how satisfied they are with life overall.
The simple access to others' social lives via technology and social media has increased feelings of irritability, anxiety, and inadequacy (Alt, 2015). This has been particularly seen in younger students and in women. For example, Beyens, Frison, and Eggermont (2016) (Gradisar et al., 2013), this study (Rosen et al, 2016) also measured students' response to placing the phone away from the bed while sleeping.
This recommendation comes from research showing that blue light omitted by devices, such as laptops, smart phones, and tablet, limits the production of melatonin, which delays sleep onset. Blue light also increases cortisol, which interferes with falling asleep. However, Rosen and colleagues found that placing the phone away from the bed at sleep onset predicted more sleep problems, leading to anxiety about missing out on phone calls, messages, and notifications (i.e. FoMO) (Rosen et al., 2016).
Another study (Alt, 2015) assessed FoMO related to social media use during class time and its correlates with learning motivations. While she hypothesized that college students who are extrinsically motivated or do not have motivation to learn would be more likely to use social media in the classroom, it was actually found that FoMO is more directly related to social media use in the classroom regardless of motivation type (Alt, 2015). Ko and colleagues (2008) report on the topic of risky behaviors in their study of Chinese college students in which they tested decision making characteristics of college students with internet addiction, which has been seen in those experiencing high levels of FoMO. In this study, extreme uses of the internet were seen to change brain structure, producing lesions on the amygdala. This impacted the students' decision making, novelty seeking, and risk taking behaviors (Ko et al., 2008).
Another study by Stead and Bibby (2017) found that FoMO is both a variable that heightens social media use and a factor in unhealthy obsessive behaviors. FoMO was also negatively correlated with subjective wellbeing in their study. This means that those higher in FoMO were less likely to report their own wellbeing as being healthy.
Stead and Bibby claim that these are the result of feelings of social envy and social exclusion with heightened social media use, as well as believing other people's lives are better than their own. Those high in FoMO tend to overestimate the positive emotional experiences and underestimate the negative emotional experiences of others seen on social media.
An additional study that considers the use of late night social media use and sleep was conducted by Scott and Woods (2018). In this study, they evaluated a model in which FoMO predicts nighttime social media use through behavioral and cognitive means which should affect sleep. Their research shows that those high in FoMO were more likely to engage in more social media behavior at night and feel more alert in the bed. They reported that 95% of the sample reports social media usage at night, suggesting a high prevalence of pre-sleep cognitive arousal that stems not just from social media behavior itself, but from the fear of missing out. Therefore, both presleep cognitive arousal and nighttime social media use were shown to be the path by which FoMO predicts shortened sleep duration. (Scott & Woods, 2018). This relates to decreased levels of melatonin and increased levels of cortisol induced by blue light emitted by electronic devices, suggesting an increased flight or fight response when lying in bed by those engaging in social media or other device usage (Gradisar et al., 2013). This appears to be the mechanism by which FoMO affects biological processes of the body impacting sleep.
One study in particular investigated the relationship between FoMO and college student sleep behaviors, noting that many would rather delay onset of sleep for simply the possibility of friends deciding to spend time together in the dorm or of going out with friends late at night (Adams et al., 2016). This is related to the idea that those high in FoMO are more likely to participate in risky behaviors, as many of the students in this study reported delaying the onset of sleep created a cycle of restlessness, waking late, napping in the afternoon, and trying to find time to prioritize both socializing and academic responsibilities. Socializing for the undergraduate is a very important responsibility in order to participate in the full college experience. This can also be a source for stress on these students, as many put off academic duties and self-care tasks in order to engage with peers.
However, it is again difficult to separate these two constructs, as interpersonal stress is interwoven throughout the literature regarding FoMO. Those high in FoMO would tend to be those who are more affected by the feeling of not fitting in, use of maladaptive strategies for coping with interpersonal stress, and have a diminished sense of self-worth, which further triggers the rumination and guilt leading to feelings of FoMO. This is why it is hypothesized that FoMO will more strongly predict insomnia rather than interpersonal stress. Again, a bidirectional relationship was identified between interpersonal stress and FoMO, which also has a bidirectional relationship with insomnia (Oberst et al., 2017).

Biopsychosocial Model and Developmental Perspective
The biopsychosocial conceptual framework, developed by Engel (1977), proposes that health and development of an individual must be considered within the context of biological, psychological, and social factors (Doherty & Campbell, 1988  In addition to the biopsychosocial model, developmental perspectives are considered due to the specific population of college students. The transition to college is known to be a particularly stressful, challenging, and exploratory time for young adults (Adams et al., 2016;Alt, 2015;Brougham et al., 2009;Torres et al., 2009).
Specifically, in college student development, Torres and colleagues (2009)  Previous studies have linked emerging adulthood with increased vulnerability to stress during identity exploration due to new environments, new responsibilities and expectations, modification of existing identities and roles, and adapting new roles (Brougham et al., 2009). Reconstruction of identity is consistent throughout the college experience, especially during the beginning of enrollment. This is due to exposure to new college experiences and increasingly diverse campus communities (Torres et al., 2009). Torres and colleagues (2009) discuss the importance of identities being fluid, flexible, and multidimensional. Identities also need to be recognized within the greater societal contexts of race, gender, class, and systems of power that marginalize certain identities.
Healthy identity development promotes self-esteem and a sense of belonging, which both contribute to wellbeing. On the other hand, feelings of inadequacy and stress related to not finding a peer group are related to poor health behaviors, such as poor eating habits, excessive time on social media, and decreased sleep quality (Beyens, Frison, & Eggermont, 2016;Nardorff, Nazem, & Fiske, 2010). Current college students have more opportunities than ever before to explore their identities, due to both increasingly diverse campus communities for face to face exploration and online communities (Torres et al., 2009).
While identity is constructed and reconstructed throughout the college years and the lifespan, times of transition leave college students most vulnerable to the biological, psychological, and social impacts the process can have on their development. According to Etindele Sosso (2017), the brain is influenced by social and psychological interactions of the body and its environment throughout the lifespan. These interactions particularly affect the central nervous system, where the majority of brain and mood disorders originate. Changes to these systems increase the risk of developing neurodegenerative diseases, mood disorders, and insomnia. This makes college age students most susceptible to these changes and developing these disorders, especially for those under 30 years old (Etindele Sosso, 2017).
The current study aims to evaluate levels of interpersonal stress (social), FoMO (psychological), and insomnia (biological) in a sample of female university students who attended the University of Rhode Island in 2014. Specifically, it is hypothesized that FoMO will be more highly correlated to insomnia than interpersonal stress will be for this population. Also, it is hypothesized that the women who are first year students and seniors will experience higher levels of FoMO, interpersonal stress, and insomnia than the sophomore and junior women. CHAPTER

Study Measures.
The Fear of Missing Out (FoMO), the pervasive apprehension that others might be having rewarding experiences from which one is absent, was measured in this survey by using a modified version of the ten item Fear of Missing Out scale developed by Przybylski et al. (2013). When administered to a large, nationally representative sample, young adults, especially young men, were found to have the "not at all" to "very." The items on the SSQ are as follows: "Being around other people who are inconsiderate or offensive," "Having problems with a friend," "Not having as many friends of your gender as you would like," "Having problems with people you live with," "Being rejected by an organization for a leadership position," "Seeking friendship or romantic relationship with someone who isn't interested," "Turbulence in a romantic relationship," "Feeling pressured by others to do something that makes you uncomfortable," "Not having a significant other," "Not having as many friends of the opposite sex as you would like," "Feeling pressured to live up to friends' or family members' expectations," "Not having time to maintain friendships," "Having issues with an authority figure (e.g. professor, coach, advisor, administrator, etc.)," "Having different drinking or partying patterns than your friends," "Being concerned about the behavior of a friend but not knowing how best to help," "Feeling like you are different from everyone else or you can't identify with anyone else," "Not having a date to a date function," "Balancing contact with your parents," "Feeling left out of social gatherings," "Worrying about the wellbeing of a friend or family member," "Stresses, tensions, or changes in your family," "Feeling disconnected or isolated from others," "Dealing with demandingness on the part of a family member or friend," "Feeling like you are putting a strain on your family," and, "Awkwardness in face to face interactions with a friend or acquaintance with whom you have been communicating with electronically." Insomnia, the inability or difficulty of falling asleep or remaining asleep, was measured using the Insomnia Severity Index (ISI). This is a 7 item, self-report questionnaire to assess the nature, severity, and impact of insomnia over the past As previously stated, the data has already been collected on these measures with no identifying information about participants. Data analysis was conducted using IBM SPSS Statistics 24 to run descriptive univariate and bivariate analysis.
Correlation analyses were used the test the hypothesis that FoMO will be more strongly correlated with higher levels of insomnia, rather than interpersonal stress.
ANOVA tests were used in order to determine if levels of interpersonal stress, FoMO, and insomnia vary across the years in college. It is hypothesized that women will show higher levels on all three measures of insomnia, interpersonal stress, and FoMO in their first and fourth years of college than their second and third years of college, due to the onset or impending onset of new life experiences and transitions.

FINDINGS
Internal consistency estimates of reliability were computed for each of the three measures used in the current study expressed as Cronbach's coefficient alphas, and each indicated satisfactory reliability. The alpha for the modified FoMO scale created for this study was determined to be (α=.918). The alpha for the SSQ used in this study was determined to be (α=.937). Finally, the alpha for the ISI measure used in this study was determined to be (α=.885).
Pearson correlation coefficients were computed among the three focus variables of study (Insomnia, FoMO, and Interpersonal Stress). Using the Bonferroni approach to control for Type I error across the three non-redundant correlations, a p value of less than .008 (.05/6 = .008) was required for significance. The results of the correlational analyses presented in Table 1 show that all correlations were statistically significant. The correlation of Insomnia with Interpersonal stress (.413) was higher than the correlation of Insomnia with FoMO (.341), which was counter to the original hypothesis. However, these correlations are very close together, both showing moderate to weak strength. The reliability of the strengths of the correlations was not tested. The results also show that FoMO and Interpersonal stress were more highly correlated with each other (.597) than either was with insomnia. See Table 2 for the correlations discussed here. Three one-way analyses of variance tests were conducted to evaluate the hypothesis that women will experience more insomnia, FoMO, and interpersonal for the Interpersonal Stress score again was not significant at the .05 level, F(2, 250) = 2.41, p = .09. Therefore, the null hypothesis that students would not have any differences in insomnia, FoMO, or interpersonal stress throughout the college years could not be rejected. See Table 3 for the means of each measure across class years of this sample.
While the means for insomnia and FoMO scores are similar to previously recorded samples, the mean for interpersonal stress for this sample is larger than the mean of previous samples. See Table 4 to compare the means of this sample to previous samples. would be more highly correlated to insomnia than interpersonal stress would be correlated to insomnia, and that all three measures would be higher for first year students and seniors than they would be for juniors and sophomores. Analyses did not allow the null hypothesis for either research question to be rejected.
Correlation analyses showed that interpersonal stress was more highly correlated to insomnia than FoMO was correlated to insomnia; however, both interpersonal stress and FoMO were more highly correlated with each other than either was to insomnia. This finding supports previous literature reporting that stress and insomnia are highly related for the young adult population (Bernert et al., 2007;Brisette & Cohen, 2002;Hall et al., 2000;Hicks et al., 2001;Sadeh et al., 2004).
These studies show that, for young adults, conflict and stress within relationships both at home and in social circles can lead to a higher risk of showing symptoms of insomnia. Often, healthy coping skills act as a moderator for students not to suffer from insomnia (Sadeh et al., 2004). Since both interpersonal stress and FoMO are defined as types of trait anxiety (Alt, 2015), the results of this study extend the literature showing that each has a pervasive effect on one's well-being measured by insomnia symptoms. Williams and colleagues (1988) describe how state and trait anxiety differ: state anxiety increases the value of a threat assigned to a specific stimulus or situation, while trait anxiety creates a tendency to constantly direct attention to the source of a threat (Pacheco-Unguetti et al., 2010;Williams et al., 1988). That is, suffering from each interpersonal stress or FoMO is more likely to have a more disruptive effect on one's life because they are related to one's general disposition to become anxious and their typical levels of anxiety.
The high correlation between FoMO and interpersonal stress shown by the results means that there is multicollinearity between these two constructs, due to the overlap in predictability of each other (Grewal, 2004 Additionally, no differences were found on any of the measures of insomnia, FoMO, and interpersonal stress among any of the students of varying years in college.
ANOVA analyses on these variables were conducted showing no differences across the four class years. This finding is not supported in previous literature. Research shows that the many different and new experiences of students throughout their college careers creates significant changes in their identities (Torres et al., 2009) as well as their continued development (Adams et al, 2016;Galambos et al., 2013). Sleep patterns and insomnia symptoms have been shown to differ for first year students than other grades (Tsai & Li, 2004), and students report similarly high levels of stress in their first year students and senior years compared to their sophomore and junior years (Kreig, 2013).
Due to the frequently cited differences of students across the college years, it is most probable that differences were not seen in this study due to the limited sample size.  (Bland et al., 2012).
Sample characteristics continue to be a limitation in this study, discussed below.
The results of the current study should be interpreted in light of its limitations.
First, the characteristics of the sample must be considered, due to its impact on the generalizability of the findings. The study sample included mostly white, typical college-age women. While the interest of the researcher lied in women specifically, it does limit the ability to generalize the results to include men or women of other races.
Race was not even considered in this study due to the small amount of non-white participants. Also, original study participants falling outside the typical college age range were excluded from the study. These individuals' answers could have provided insight into the college experience for older students as well. Finally, participants with any missing data on any independent or dependent variables were excluded from the study. The study design poses a second limitation in which the results should be interpreted. The literature on these topics consistently uses cross-sectional study design to learn more about FoMO, interpersonal stress, and insomnia in the college student population. The current study also utilized a cross-sectional study design, which limits the ability of the researcher to determine causality or directionality of the results. Future research should consider longitudinal studies of college students in which their levels of insomnia, interpersonal stress, and FoMO can be measured throughout the college career. Also, this research should attempt to determine the pathways in which interpersonal stress and FoMO interact with insomnia and with one another. All of these considerations may better help students learn how to combat each interpersonal stress, FoMO, and insomnia in order to have a more successful college career.
The final limitation to consider is the use of insomnia as a measure for the college student population. Taylor and colleagues (2013), using self-reported sleep data of students, found a prevalence of 9.5% of students with insomnia using the more stringent DSM-5 criteria. However, they found a prevalence of 27% of students showing symptoms of insomnia without complaint (part of the DSM-5 criteria), meaning that these students do not consider their sleep deficits a problem, but still would be able to be diagnosed with insomnia if they did have complaints about it. So the question arises: is insomnia the most appropriate measure for college students? In a study conducted by Pilcher and colleagues (1997), they found that sleep quality was more predictive of measures of health, wellbeing, and sleepiness than sleep quantity for college students. Using several established measures of sleep quality, they found that questions relating to daytime sleepiness, which has been shown to relate to severity of sleep disturbance, was better at predicting measures of subjective wellbeing than questions relating to times falling asleep, hours spent asleep, and nighttime awakenings (Pilcher et al., 1997). In a similar study, Lund and colleagues (2010) found that measurements of daytime sleepiness and sleep quality were more predictive of sleep problems than measures of bedtimes and rise times. However, they also found that perceived stress was the most predictive of poor sleep when compared to sleep schedule regularity, alcohol or drug use, exercise frequency, or electronics usage (Lund et al., 2010). With so many students unable to be caught by insomnia diagnostic criteria, and research showing other more appropriate measures of sleep for college students, it is a limitation of the current study that insomnia was used as a measure as opposed to measures of daytime sleepiness and sleep quality. This does lead to a strength of the study, however, that social stressors were also considered along with insomnia. If insomnia is not the best measure to use, then this is another area in which the study did not fully incorporate the biopsychosocial model: the biological marker of wellbeing was misinterpreted.
The implications of this research lie in directions for future research as well as practice within the college environment. Future research should look deeper into social media and other device usage around sleep in attempt to explain causality of how FoMO or interpersonal stress impacts the biological processes impacting sleep, such as the study conducted by Scott and Woods (2018) that both pre-sleep cognitive arousal and nighttime social media use were shown to be the path by which FoMO predicts shortened sleep duration. This relates to decreased levels of melatonin and increased levels of cortisol induced by blue light emitted by electronic devices, suggesting an increased flight or fight response when lying in bed by those engaging in social media or other device usage (Gradisar et al., 2013). This appears to be the mechanism by which FoMO affects biological processes of the body impacting sleep.
Causality could not be determined through the current study design, but doing so would have implications in practice with college student populations.
Much research still needs to be done in order to determine the ways that FoMO and interpersonal stress work together, are related, and are different. Also, more The biological marker of wellbeing chosen for this study was insomnia, though some studies show that might not have been the best choice. The social maker chosen was interpersonal stress, and the psychological maker chosen was FoMO. These were shown to be highly correlated and may not expand the range of both psychological or social characteristics. When thinking about the biopsychosocial model, it appears that both FoMO and interpersonal stress have impacts on the psychological and social aspects of one's life. Originally it was believed that FoMO would be more psychological while interpersonal stress would be more social. Perhaps there is an argument to be made that both are more one or the other, instead of stating that both are psychological and social. More research will need to be done to make this determination.
While the current study has limitations, the results of will lead further research and intervention development to help college students cope better with these stressors, create healthy sleep and self-care habits, and know when and how to reach out for help when needed (Coiro et al., 2017). With so many students exhibiting sleep problems and social stressors, it is most important to direct policies and programs towards helping students cope with social stressors, which should in turn improve their sleep quality.