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From Shots to Sleep: Staying Healthy in the Year Ahead

Well, you're off to college and on your own — paving your own path without parents to watch over you on a daily basis. In fact, this may be the first time there's no one around to monitor your eating and sleeping habits, immunization records and general well being. That's right, it's up to you now! And you need to know how to best handle the realities of campus life — crowded living quarters, late nights, different food choices and increasing social pressures and responsibilities. Your college years will likely be some of the best of your life, but you need to make your health a priority.

So, what contributes to good health at college? There are a lot of things you can do to stay healthy. For starters:

• Make sure you are up-to-date on recommended immunizations.
• Eat well.
• Get enough sleep.
• Stay active.
• Be aware of your surroundings to stay safe.
• Manage the stress that comes with juggling multiple exams and paper deadlines.
• Keep up with preventive health exams.

Although you may have thought the days of vaccinations were over, think again. College students are at greater risk for a number of infectious diseases, including meningococcal disease and hepatitis B. Some states and colleges require immunizations as part of enrollment if you're going to live on campus.

Meningococcal disease, although rare, can be debilitating and even fatal. College students are at increased risk of infection due to lifestyle factors, such as crowded living and social situations, active or passive smoking and variable sleep patterns. Bacteria are transmitted rapidly through the exchange of respiratory droplets, usually through close personal contact (e.g., coughing, sneezing, kissing or sharing a drinking glass, utensils or cigarettes). For this reason, the nation's leading health experts urge incoming freshman living in dorms to be vaccinated against meningococcal disease.

Adolescents and young adults account for one-third of cases. Symptoms such as fever, headache and a stiff neck are often mistaken for influenza (the flu). Other signs may include nausea, vomiting, confusion, sleepiness, sensitivity to light and a rash. If you or one of your friends notice these symptoms, it is important to seek medical evaluation immediately.

The best thing to do is to check with your university student health service to find out which immunizations you need. These might include:

• Meningococcal disease
• Measles — Many students never received the required second dose after their first birthday, so now's the time.
• Chicken Pox (Varicella) — If you've never had chicken pox or never received the vaccine, you should ask about this vaccine.
• Hepatits A — Recommended for all children older than six months to prevent this viral infection that can cause acute liver inflammation; immunization involves a series of two shots given six months apart. The immunization can be given at later ages if the first series was missed.
• Hepatitis B — Immunization involves a series of three shots to protect you against this type of serious liver disease, which disproportionately affects adolescents and young adults. An immunization series is typically given to children at one month of age; the immunization is recommended at later ages if the first series was missed. If you are 12-years-old or older you only need to get two shots four to six months apart.
• Influenza — It's not just a concern for the elderly. Influenza is a serious, highly contagious respiratory infection, so consider getting a "flu shot" starting in October or into the winter months to help prevent infection. This is especially important if you have an existing medical condition like asthma or diabetes, which places you at greater risk for complications and hospitalization from influenza. A nasal flu vaccine also is available.
• HPV (Human Papillomavirus) — This is a very common sexually transmitted infection (STI), which is the leading cause of cervical cancer. The newly available vaccine prevents the likelihood of becoming infected; however, it does not protect against other STIs or pregnancy.
• Tetanus — You should receive a booster every 10 years, so be sure you're current.

Vaccination is one of the most effective tools we have to prevent the spread of infectious diseases. Don't take chances with your health, get vaccinated.

Now is the time to develop good eating habits. You may have heard about the Freshman 15. While recent research finds students may only gain more like five to six pounds on average in their first year, it can still creep up on you if you're not careful. Changes in food choices and the convenience of high-fat fast foods on or around campus can lead you to pack on the pounds, especially if you don't make time for routine exercise. Variable loads of coursework, part-time jobs and irregular class schedules can make it difficult to find time to eat well. And while it may be easier to grab a snack or skip meals altogether, don't! Instead, try to:

• Eat at least five servings of fruits and vegetables each day.
• Look for foods that are rich in fiber.
• Don't skip meals; you'll only end up splurging later.
• Watch your portion sizes.
• Try food at different eating venues on campus to scope out which has the most healthful options.
• Don't fall into the trap of eating pizzas and other foods late at night.
• Drink plenty of water and low-fat milk.

Getting plenty of restful sleep, like maintaining a healthful diet and exercise routine, is critical. It is important for good health, learning, productivity and safety. Yet, most college students don't get enough. In fact, they have twice as many sleep problems as the general public, and women are more prone to difficulties sleeping.

You may find yourself burning the midnight oil in an attempt to balance a budding social life, part-time work and accumulating coursework. Some of your classmates may pull "all-nighters" to cram for exams. But sacrificing a good night's sleep can take its toll. Trying to function on limited sleep can result in lower grades, difficulties concentrating and increased irritability and anxiety. Being persistently tired can take away your enjoyment of college, too.

To stay rested and at your best, aim to get at least eight hours of sleep a night and try not to vary sleep times by more than two hours. Contrary to popular belief, sleeping late on the weekends won't make up for lost sleep during the week.

Here are some helpful tips to help you get the ZZZs you need:

• Stay away from caffeine within four to five hours before going to bed.
• Avoid alcohol, which can reduce the quality of sleep.
• Don't take naps that last more than an hour or occur after 3:00 p.m.
• Don't eat heavy or spicy meals before going to bed.
• Maintain regular sleep and wake times.
• Exercise regularly, but not less than three hours before going to sleep.
• Keep your dorm room quiet, dark and cool. If your hall mates are too loud, use a fan to create white noise.

Another word on sleep…if you are ever extremely exhausted for no particular reason, it may be mononucleosis, popularly called the "kissing disease," or "mono." Mono affects many college students. You don't have to kiss someone to become infected. Simply sharing a straw or being close to someone when they cough or sneeze without covering their mouth also exposes you to possible infection. The classic symptom of mono is enlarged glands or lymph nodes. Getting mono is the pits! It can put your life on hold for several weeks at a time while you recuperate with lots of bed rest. There is no vaccine available to prevent mono, but once you've had it, you can't get it again.

Physical assaults and rapes occur on some college campuses. While you might not think this could happen to you, you need to take the appropriate precautions to stay safe. Try your best to avoid compromising positions. Listen to your instincts and leave any situation in which you feel uncomfortable.

• Make sure to go out with a group of friends, especially at night. If you find yourself alone, be aware of those around you, walk in well-lit areas and hold your cell phone and either talk, or act as if you are talking, to someone.
• Going on a date? Meet in a public place. Let your roommate or a friend know when to expect you back.
• Be smart about getting money out. When you need money, look for ATMs inside convenience stores, rather than those on the street. Better yet, pay with your bank card the next time you go to the grocery store or pharmacy and ask for cash back.
• Pick up the phone. Many colleges have lighted security phones placed on poles around campus to connect directly with university police. Use these phones to get help quickly.
• Avoid alcohol. Alcohol can interfere with your judgment of people and situations. Never drink anything you haven't opened or poured yourself.
• Keep your dorm room locked. Even though you may trust your hall mates, other people can get into the building, too.

• What vaccinations do I need?
• I've heard the HPV vaccine was recently approved and recommended for college-aged women. Is this something I should receive?
• What is my ideal weight given my age and height?
• I'm having trouble sleeping. What can I do to improve sleep quality?
• If I or a friend is ever assaulted or raped, what are the appropriate steps to take?

American College Health Association. "Meningitis on Campus." Archived Webcast April 27, 2006. www.acha.org.

Cornell University. "Have You Considered These Vaccinations?" http://www.gannett.cornell.edu/medical/recommendedImmunizations.html.

Advisory Committee on Immunization Practices (ACIP). Recommended Vaccination Schedule. www.immunizationed.org.

Tufts E-news. University Freshman 15 a Myth?

Brown, FC. Applying sleep research to university students: Recommendations for developing a student sleep education program. Journal of College Student Development 2002 May/Jun.

National Heart, Lung, and Blood Institute. "In Brief: Your Guide to Healthy Sleep." http://www.nhlbi.nih.gov/health/public/sleep/healthysleepfs.pdf. Copyright April 2006.

American Academy of Pediatrics. "Common Health Problems in College Students." www.aap.org. Last updated 2000.