***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Energy drink consumption has continued to gain in popularity since the 1997 debut of Red Bull , the current leader in the energy drink market . Although energy drinks are targeted to young adult consumers , there has been little research regarding energy drink consumption patterns among college students in the United States . The purpose of this study was to determine energy drink consumption patterns among college students , prevalence and frequency of energy drink use for six situations , namely for insufficient sleep , to increase energy ( in general ) , while study ing , driving long periods of time , drinking with alcohol while partying , and to treat a hangover , and prevalence of adverse side effects and energy drink use dose effects among college energy drink users . Methods Based on the responses from a 32 member college student focus group and a field test , a 19 item survey was used to assess energy drink consumption patterns of 496 r and omly surveyed college students attending a state university in the Central Atlantic region of the United States . Results Fifty one percent of participants ( n = 253 ) reported consuming greater than one  energy drink  each month in an average month for the current semester ( defined as energy drink user ) . The majority of users consumed energy drinks for insufficient sleep ( 67 % ) , to increase energy ( 65 % ) , and to drink with alcohol while partying ( 54 % ) . The majority of users consumed one energy drink to treat most situations although using three or more was a common practice to drink with alcohol while partying ( 49 % ) . Weekly jolt and crash episodes were experienced by 29 % of users , 22 % reported ever having headaches , and 19 % heart palpitations from consuming energy drinks . There was a significant dose effect only for jolt and crash episodes . Conclusion Using energy drinks is a popular practice among college students for a variety of situations . Although for the majority of situations assessed , users consumed one energy drink with a reported frequency of 1 – 4 days per month , many users consumed three or more when combining with alcohol while partying . Further , side effects from consuming energy drinks are fairly common , and a significant dose effect was found with jolt and crash episodes . Future research should identify if college students recognize the amounts of caffeine that are present in the wide variety of caffeine-containing products that they are consuming , the amounts of caffeine that they are consuming in various situations , and the physical side effects associated with caffeine consumption Objective : Several epidemiologic , longitudinal studies have reported that short sleep duration is a risk factor for the incidence of obesity . However , the vast majority of these studies used self-reported measures of sleep duration and did not examine the role of objective short sleep duration , subjective sleep disturbances and emotional stress . Design : Longitudinal , population -based study .Subjects : We studied a r and om sample of 815 non-obese adults from the Penn State Cohort in the sleep laboratory for one night using polysomnography ( PSG ) and followed them up for a mean of 7.5 years .  Subjective and objective measures of sleep  as well as emotional stress  were obtained at baseline . Obesity was defined as a body mass index ( BMI ) ⩾30 kg/ m-2 . Results : The incidence of obesity was 15 % and it was significantly higher in women and in individuals who reported sleep disturbances , shorter sleep duration and higher emotional stress . Significant mediating effects showed that individuals with subjective sleep disturbances who developed obesity reported the shortest sleep duration and the highest emotional stress , and that subjective sleep disturbances and emotional stress were independent predictors of incident obesity . Further analyses revealed that the association between short sleep duration , subjective sleep disturbances and emotional stress with incident obesity was stronger in young and middle-age adults . Objective short sleep duration was not associated with a significantly increased risk of incident obesity . Conclusion : Self-reported short sleep duration in non-obese individuals at risk of developing obesity is a surrogate marker of emotional stress and subjective sleep disturbances . Objective short sleep duration is not associated with a significant increased risk of incident obesity . The detection and treatment of sleep disturbances and emotional stress should become a target of our preventive strategies against obesity Objective : The authors ' purpose in this study was to determine the sleep patterns of college students to identify problem areas and potential solutions . Participants : A total of 313 students returned completed surveys . Methods : A sleep survey was e-mailed to a r and om sample of students at a North Central university . Questions included individual sleep patterns , problems , and possible influencing factors . Results : Most students reported later bedtimes and rise times on weekends than they did on weekdays . More than 33 % of the students took longer than 30 minutes to fall asleep , and 43 % woke more than once nightly . More than 33 % reported being tired during the day . The authors found no differences between freshmen , sophomores , juniors , seniors , and graduate students for time to fall asleep , number of night wakings , or total time slept each night . Conclusions : Many students have sleep problems that may interfere with daily performance , such as driving and academics . Circadian rhythm management , sleep hygiene , and white noise could ameliorate sleep difficulties STUDY OBJECTIVES To describe the technology use and sleep quality of Americans , and the unique association between technology use and sleep disturbances . METHODS Interviews were conducted via r and om digit dialing ( N = 750 ) or the Internet ( N = 758 ) . 1,508 Americans ( 13 - 64 years old , 50 % males ) matched to 2009 U.S. Census data provided complete interviews . The sample was further divided into adolescents ( 13 - 18 years , N = 171 ) , young adults ( 19 - 29 years , N = 293 ) , middle-aged adults ( 30 - 45 years , N = 469 ) , and older adults ( 46 - 64 years , N = 565 ) to contrast different generations ' technology use . Participants answered a 47-item semi-structured survey , including questions about their sleep habits , and the presence and use of technology in the hour before bed in the past 2 weeks . RESULTS Nine of 10 Americans reported using a technological device in the hour before bed ( e.g. , TVs the most popular ; 60 % ) . However , those under 30 years of age were more likely to use cell phones ( 72 % of adolescents , 67 % of young adults ) than those over 30 years ( 36 % of middle-aged , and 16 % of older adults ) . Young adults ' sleep patterns were significantly later than other age groups on both weekdays and weekend nights . Unlike passive technological devices ( e.g. , TV , mp3 music players ) , the more interactive technological devices ( i.e. , computers/laptops , cell phones , video game consoles ) used in the hour before bed , the more likely difficulties falling asleep ( β = 9.4 , p < 0.0001 ) and unrefreshing sleep ( β = 6.4 , p < 0.04 ) were reported . CONCLUSIONS Technology use near bedtime is extremely prevalent in the United States . Among a range of technologies , interactive technological devices are most strongly associated with sleep complaints Objective : To examine the relationship between body mass index class , presenteeism , and prospect i ve registered sickness absence . Methods : Data were collected from 2983 Belgian workers . Presenteeism was assessed by a single question , evaluating the frequency of being at work , despite illness , during the preceding year . Sickness absence data were registered during 12 months ' follow-up . Multiple logistic regression analysis was conducted . Results : Body mass index class was positively and significantly associated with presenteeism ( at least two occasions of working despite illness ) in the male employees and was a significant predictor of high sickness absence ( at least 10 sick leave days ) in the female population . A final multivariate model demonstrated that these relations were only partly mediated by self-rated health . Conclusion : The results of this study suggest a gender difference concerning absenteeism and presenteeism in overweight and obese employees Background Young adults are at risk for  weight gain . Little is known about how to design weight control programs to meet the needs of young adults and few theory-based interventions have been evaluated in a r and omized control trial . The Choosing Healthy Options in College Environments and Setting s ( CHOICES ) study was funded to create a technology-based program for 2-year community college students to help prevent unhealthy weight gain . The purpose of this article is to ( 1 ) provide a brief background on  weight-related interventions in young adults ; ( 2 ) describe the study design for the CHOICES study , the conceptual model guiding the research and the CHOICES intervention ; and ( 3 ) discuss implication s of this research for health educators . Translation to Health Education Practice Our experiences from the CHOICES study will be useful in suggesting other theory-based models and intervention strategies that might be helpful in programs attempting to prevent unhealthy weight gain in young adults . In addition , this article discusses important considerations for working with 2-year colleges on this type of health promotion work Context Studies in animals and humans suggest that sleep duration is an important regulator of metabolism . Contribution In this study , 12 young , healthy , normal-weight men exhibited reductions in the satiety hormone leptin , increases in the hunger hormone ghrelin , and increases in hunger after 2 nights of only 4 hours of sleep compared with after 2 nights of 10 hours of sleep . Implication s Inadequate sleep seems to influence the hormones that regulate satiety and hunger in a way that could promote excess eating . The Editors Sleep plays an important role in energy balance . In rodents , food shortage or starvation results in decreased sleep ( 1 ) , and , conversely , total sleep deprivation leads to marked hyperphagia ( 2 ) . Leptin and ghrelin are peripheral signals that contribute to the central regulation of food intake . Leptin , a hormone released by the adipocytes , provides information about energy status to hypothalamic regulatory centers ( 3 ) . In humans , circulating leptin levels rapidly decrease or increase in response to acute caloric shortage or surplus , respectively ( 4 ) . These changes in leptin levels have been associated with reciprocal changes in hunger ( 4 ) . Ghrelin , a peptide produced predominantly by the stomach , is also involved in energy balance regulation , but , in contrast to the anorexigenic effects of leptin , ghrelin stimulates appetite ( 5 ) . It has been proposed that leptin and ghrelin represent the yinyang of one regulatory system that has developed to inform the brain about the current energy balance state ( 6 ) . Over the past 40 years ,  sleep duration in the U.S. population has decreased by 1 to 2 hours ( 7 - 10 ) . The proportion of young  adults sleeping fewer than 7 hours per night has more than doubled between 1960 and 20012002 ( from 15.6 % to 37.1 % ) ( 7 - 10 ) . The effect of sleep curtailment on the control of appetite and food intake is not known . Because of the well-documented associations between sleep and food intake ( 1 , 2 ) , we sought to determine whether sleep duration influences the daytime profiles of leptin and ghrelin . Methods Participants Twelve healthy men(mean age [ SD ] , 22 2 years ] ; mean body mass index [ SD ] , 23.6 2.0 kg/m2 ) who did not smoke or take any medications participated in the study . All of the men were within 10 % of ideal body weight and had regular nocturnal time in bed of 7 to 9 hours . We excluded persons who had traveled across time zones less than 4 weeks before the study . Experimental Protocol The Institutional Review Board of the University of Chicago approved the protocol , and we obtained written informed consent from all participants . During the week preceding each study , we asked participants not to deviate from a fixed time in bed ( 11:00 p.m. to 7:00 a.m. ) by more than 30 minutes . Naps were not allowed . The men participated in 2 studies that were conducted in a r and omized order , were spaced at least 6 weeks apart , and were performed in the Clinical Research Center at the University of Chicago , Chicago , Illinois . Six of the 12 men first performed the study with  restricted time in bed , and the remaining 6 men first performed the study  with extended time in bed .  Average weight did not change over the time period separating the 2 study conditions ( 75.2 kg in the sleep restriction condition vs. 75.4 kg in the sleep extension condition ; P > 0.2 ) . We obtained blood sample s at 20-minute intervals from 8:00 a.m. to 9:00 p.m. after 2 consecutive nights of 10 hours in bed ( 10:00 p.m. to 8:00 a.m. ; sleep extension ) and after 2 consecutive nights of 4 hours in bed ( 1:00 a.m. to 5:00 a.m. ; sleep restriction ) . Sleep was recorded every night . For both extension and restriction conditions , each overnight stay began at 7:00 p.m. with a st and ard hospital dinner , and the first overnight stay ended after breakfast , which was served at 8:00 a.m. We instructed the participants not to deviate from their usual eating habits between breakfast and dinner , but caloric intake was not otherwise monitored . Participants were readmitted in the early evening and , after receiving a st and ard hospital dinner at 7:00 p.m. , remained at bed rest . At 8:00 a.m. after the second night , the participants ' caloric intake was kept constant to avoid meal-related fluctuations of hunger and satiety and consisted of an intravenous glucose infusion at a constant rate of 5 g/kg of body weight every 24 hours . There was no other source of calories . Every hour from 9:00 a.m. to 9:00 p.m. , the men completed vali date d visual analogue scales ( 0 to 10 cm ) for hunger ( 11 ) 
    Output:
    
The circadian clock is reset in traditional-age college students leading to delayed sleep times .
Newly realized autonomy and increased use of technology also prevent traditional-age college students from obtaining sufficient sleep .
Insufficient sleep may result in poor academic performance influencing subsequent health outcomes .