ollege students sleeping with technology

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Journal of American College Health
ISSN: 0744-8481 (Print) 1940-3208 (Online) Journal homepage: https://www.tandfonline.com/loi/vach20
Interrupted sleep: College students sleeping with
Elizabeth B. Dowdell & Brianne Q. Clayton
To cite this article: Elizabeth B. Dowdell & Brianne Q. Clayton (2019) Interrupted sleep: College
students sleeping with technology, Journal of American College Health, 67:7, 640-646, DOI:
To link to this article: https://doi.org/10.1080/07448481.2018.1499655
Published online: 26 Oct 2018.
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Interrupted sleep: College students sleeping with technology
Elizabeth B. Dowdell, PhD, RN, FAAN, and Brianne Q. Clayton, MSN, RN
M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania, USA
Objective: To examine the influence of cell phones and sleep quality among college
students and the prevalence of sleep texting. Participants: Participants were 372 college students at two mid-size universities in 2013. Methods: A survey was used to ask about cell
phone use during sleep and sleep quality. Students were asked about hours of sleep, both
on a school night, and over the weekend in addition to location of cell phone. Results: A
quarter of the sample (25.6%) reported sleep texting behavior along with poor sleep quality
and the cell phone influencing their sleep (p < .05). Students that sleep text were more likely
to report sleep interruption (p < .000), to place their phone in bed with them (p < .000), have
no memory of texting (72%) or what they texted (25%). Conclusions: Sleep texting and its
influence on poor sleep habits is a growing trend in a college student population.
Received 25 March 2018
Revised 22 May 2018
Accepted 9 July 2018
College students; sleep
habits; sleep quality;
sleep texting
Sleep is a vital indicator of overall health and
well-being as well as an important component of individual wellness since it affects daily functioning as
well as physical, emotional, and mental health.1–3
Humans spend up to one-third of their lives asleep,
and the overall state of an individual’s sleep health
remains an essential question throughout our lifespan.
Sleep needs vary across ages and are especially
impacted by lifestyle and health.4,5 Most adults know
that getting a good night’s sleep is important, but too
few actually sleep for eight or more hours or make it
a priority behavior. In 2011 a national sleep survey
reported that, among 74,571 adult respondents, 35.3%
reported less than seven hours of sleep during a typical 24-hour period; 37.9% reported unintentionally
falling asleep during the day at least once in the
preceding month; and 4.7% reported nodding off or
falling asleep while driving at least once in the preceding month.3
When considering sleep loss, there is a distinction
made between total and partial sleep deprivation.
Total sleep deprivation occurs when a person is awake
for more than 24 hours at a time, with absolutely no
sleep. Partial sleep deprivation is different; when a
person is experiencing partial sleep deprivation, they
are sleeping every night but they are not getting
enough sleep.6 For example, if a person requires
8 hours of sleep but only gets six each night for a
week, they have entered into partial sleep deprivation.
This culminates in a “sleep debt”, the difference
between the hours you should be getting and the
hours you actually get. This debt can be difficult to
repay: instead of one extended sleep session, an hour
or two must be tacked on each night to catch up. As
this deficit increases, people begin to feel the consequences; sleep deprivation has an effect on both mental physical health.2
Young adults who are college students tend to sleep
less than other age groups with many reporting an
average of six to 6.9 hours of sleep per night.3,5
Having minimal adult supervision, erratic schedules,
academic pressure, and easy access to over-thecounter, prescription and recreational drugs, college
students can be a population particularly susceptible
to the deleterious effects of poor sleep. Insufficient
and irregular sleep has been well documented among
college students.4,6–10 Poor sleep quality, often caused
by college students’ self-imposed sleep deprivation8
and irregular sleep schedules3,7
, can lead to significant
emotional imbalance,10 fatigue,4,10,11 poor concentration,11 impaired memory,4,9–12 and generally lower life
The underlying causes for poor sleep among college
students may be complex and multi-factorial. College
students often report being sleep deprived, have poor
sleep habits, experience poor sleep quality3,7,8 often
CONTACT Elizabeth B. Dowdell. [email protected] M. Louise Fitzpatrick College of Nursing, Villanova University, 800 Lancaster
Avenue, Driscoll Hall #326, Villanova, 19085, PA, USA.
2018 Taylor & Francis Group, LLC
2019, VOL. 67, NO. 7, 640–646
reporting that technology use and access has affected
their sleep habits.2 Utilization of cell phones and texting
have become the main means of personal communication
for many people. Texting is especially high in adolescents
and young adults, who are exchanging as many as
60–100 text messages a day.13 The “24/7,” “always on”
nature of society, compounded by easy access to cell
phone, Internet, television, and other media may have
significantly contributed to the sleep deprivation and
poor sleep experienced by young adults.14
In today’s world almost everyone has a cell phone
which can be used to call or text anyone, just about
anywhere. New technology has enabled phones to
become “smart” data devices used for online access,
music capability, photo sharing, video streaming, and
other applications that can be used in everyday life.
This ability to text does not stop at bedtime, and the
phenomenon known as “sleep texting” is emerging as
a growing technology trend among adolescents and
young adults. Sleep texting occurs when an individual
responds to or sends a text message electronically
while in a sleep state. The beep or buzz of the cell
phone indicating that a call has come in awakens the
sleeper, who instinctively reaches over and responds
to the message. This action can occur once or multiple times during the sleep cycle, adversely affecting
the quality and the duration of the individual’s sleep.
Anecdotally, college age students who sleep text
report that most of their messages are gibberish or
nonsensical responses to questions. This finding is
supported by an August 29, 2017 Google search of the
social media platforms Twitter and Tumblr which
indicated that users regularly recount the “ridiculous”
messages they’ve sent with the hashtag #sleeptexting.
Examples from this search include: “Lips I dripped it,”
“I legittt wish veggird were enough to fuelme,” and “It
means Girls tonight. It I 10.” Other social media sites
such as Twitpics and Instagram have photos showing
users’ unique or garbled messages, frequently containing more gibberish than actual words.
The action of sleep texting, viewed independently,
suggests that the messages being sent are more embarrassing than dangerous. It is important to note that
these postings are made by older adolescents or college students, almost all of whom are most likely not
currently members of the work world interacting with
clients, bosses, administration, or fellow employees.
Sleep texting amongst the working population may
result in a different experience and a different set of
consequences based on what was texted-and to whom
when viewed through a professional work lens.
To better understand technology via cell phone use
during sleep a study with young adult college students
was developed using a one-time anonymous survey to
identify cell phone use and sleep habits. College students were chosen because they have a well-earned
reputation for getting the least amount of quality sleep
when compared with other age groups. The goals of
this pilot study were to explore the frequency and
duration of cell phone use during sleep by asking what
is the influence of technology on the sleep patterns of
college students, what are the sleep texting experiences
of college students, and, if a college student is sleep
texting are there any differences between students who
sleep text and those who do not sleep text?
This study used a questionnaire to survey college
students about their cell phone during sleep and sleep
quality. The survey was administered in April 2013 at
two mid-size, private universities located in the
Northeastern United States. The study was approved
by the Institutional Review Board at both University
A and B. All surveys were given in-person, as paper
and pencil instruments, with the first page containing
informed consent. The anonymous 18- question survey was administered to three separate classes consisting of college students who were sophomores, juniors,
or seniors. The response rate for the sample was quite
high with class #1 at University A having 100%
response rate (184/184). At University B, class #2 had
a 96% response rate (100/104) and class #3, the senior
level class, had an 84% response rate (38/45). Students
were asked about hours of actual sleep, both on a
school night, and over the weekend. Descriptive and
correlational statistical analyses were used with this
study’s convenience sample. All variables were
screened for systematic and nonsystematic missing
data, outliers, and logistical inconsistencies with other
variables. When variables were examined by school
(University A versus University B) there were no significant differences noted between the two schools but
there were sex differences noted.
Sample demographics
The sample consisted of a total of 372 college
students, 75% female (n ¼ 282) and 25% male
(n ¼ 90), with the average respondent age being
19.7 years (range 19–21; SD ¼ .6). One hundred percent of the sample’s mobile or cell phone was
identified as being a “smart phone.” Questions about
specific phone brands or mobile operating systems
were not asked. Information regarding race/ethnicity
or grade point average was not gathered.
College students were first asked questions about
their sleep, eg, “What type of sleeper are you?” Over
half (56%) of the students identified themselves as
being a medium sleeper, 33% were heavy/deep
sleepers and 11% were light sleepers. Hours of sleep
on a school night ranged from two to 10 hours
(M ¼ 6.5) with the most common response (30%)
being seven hours of sleep (Table 1). Amount of
hours slept on a weekend night ranged from one to
12 hours (M ¼ 8.5), with the most common responses
indicating more sleep than on a school night. Some
70% of respondents indicated sleeping eight hours or
more on weekend nights. Students were also asked
about the quality of their sleep with the majority,
(65%) responding that their sleep was fairly good, 18%
had very good sleep, 16% had fairly bad sleep, and 1%
(n ¼ 5), had very bad sleep (Table 1).
The majority of students (93%) reported keeping
their cell phone with them at night. Questions asking
about cell phone use during sleep, “Have you ever
answered your cell phone in your sleep?” Found
approximately one- third of the total sample (30%)
answered “yes” with significantly more woman (90%
vs. 10%; X2 ¼ 19.971, p ¼ .000) reporting the behavior. Questioning about the location of the cell phone
during sleep garnered some interesting responses,
with the majority of students placing the phone either
next to the bed (67%) or in the bed (28%) with them.
Within the total sample the majority of male students
(80%) placed their phone next to the bed compared to
63% of the female students (X2 ¼ 8.724, p ¼ .003). In
contrast when asked “Do you put the cell phone in bed
with you?” there were significantly more woman than
mens who answered “yes” (52.6% vs. 47.4%;
X2 ¼ 9.136, p ¼ 0.002). Over half of the sample, 57%,
reported that they do not mute or place the cell phone
on vibrate or airplane mode at night, with more
woman (61.8%; p ¼ .001) keeping the ringer on. When
asked if they turn the phone off at night, the majority
of the total sample (67%; n ¼ 249) responded “no.”
The majority of these students (65%; n ¼ 242) also
responded “no” to the question Do you feel using a
cell phone at night influences your sleep?
Sleep texting
When asked “Have you ever texted in your sleep?”
over one-quarter of the total sample (25.6%)
responded that they had texted, with more female students (86% vs. 14% respectively) reporting the behavior. There were again sex differences, with over onequarter of the females (26.5%) sleep texting, compared
to only 13.3% of males who reported the behavior.
Sleep texting students, were asked “When did this
behavior begin?” The majority (62%) reported this as a
new behavior having only started in college, 30%
reported the behavior as occurring in both high
school and college, with the remaining 8% having
started in high school.
The majority of students (72%) who sleep text
reported not remembering the behavior. When asked
how the student discovered they had texted in their
sleep the overwhelming majority (95%) had read their
phone history upon waking up, the remaining five
percent were told by a friend about the text. Using
their phone history to see where the sleep text was
sent, the majority (65%) reported they had sleep text a
friend, while 35% texted to a boyfriend or girlfriend.
Table 1. Quality of sleep.
Type of sleeper Men Women Total
Light 5 (1.3%) 38 (10.2%) 43 (11.5%)
Medium 49 (13.2%) 155 (41.8%) 204 (55%)
Heavy 37 (9.0%) 88 (24.5%) 125 (33.5%)
Sleep quality Men Women Total
Very good sleep 14 (16.5%) 50 (18.3%) 64 (17.9%)
Fairly good 52 (61.2%) 180 (65.9%) 232 (64.8%)
Fairly bad sleep 16 (18.8%) 41 (15%) 57 (15.9%)
Very bad sleep 3 (3.5%) 2 (0.7%) 5 (1.4%)
Ever texted in your sleep? Men Women Total
Yes 12 (3.2%) 75 (20.2%) 90 (24.2%)
No 78 (21.0%) 207 (55.6%) 282 (75.8%)
Type of sleeper Yes Sleep Texting No Sleep Texting Total
Light 8 (9.1%) 35 (12.3%) 43 (11.6%)
Medium 47 (53.4%) 157 (55.3%) 204 (54.8%
Heavy 33 (37.5%) 92 (32.4%) 125 (33.6%)
Sleep texting students (72.6%) were more likely
than non-sleep texting students (17.2%) to report
having ever answered the phone in their sleep
(X2 ¼ 96.419, p ¼ .000; missing 10.2%), had lower
sleep quality ratings which may have been influenced
by their being more likely to have their phone next to
the bed (X2 ¼ 4.556, p ¼ .033). Compared to nonsleep texting students, those who reported sleep texting were more likely to put the phone in bed with
them (X2 ¼ 16.850, p ¼ .000). Students who sleep text
were also less likely to turn off their phone
(X2 ¼ 7.492, p ¼ .006) at night or to report feeling
that the cell phone influenced their sleep (X2 ¼ 3.981,
p ¼ .046). Interestingly, it appears that sleep texting
students are more likely to know other college students who share the same behavior of sleep texting
(52.3% vs.47.7%; X2 ¼ 10.956, p ¼ .001) than students
who do not sleep text.
Sleep is increasingly recognized as important to health
across the lifespan, with poor sleep quality being
linked to unintentional accidents, physical ailments,
psychological distress, and chronic health conditions.1,2 The current study supports findings in the literature and anecdotal evidence that technology, such
as smart phones and sleep texting is a growing trend
in a college age student population. Key findings from
this study are: (1) The majority of students are not
reporting quality or length of sleep during the week;
(2) Most students do not mute or turn off their cell
phone for sleep; (3) A third of the sample reported
answering their cell phone when asleep and a quarter
of the college students reported sleep texting; (4)
Students who sleep text were more likely to report
that the cell phone influenced their sleep as well as
sleep quality; and (5) The majority of the students
who sleep text reported not remembering the behavior
or context of the text.
Our findings confirm the typical sleep pattern
reported in college students who are partially sleep
deprived throughout the week5,6 and who use the
weekends for sleeping.8–11 Sleep is important at any
age, but in a college student population not getting
enough sleep may be linked to success in school as
sleep disturbance has been consistently rated as a top
impediment to academic performance in college.6,7
For college students who have sleep debt, research
suggests that the lack of sleep affects the memory ability needed in learning new material, studying for
exams, and test taking skills.5,6,10 Research on learning
suggests that sleep is critical at almost all stages of
memory formation, memory processing, and longterm memory retention, which are key aspects linked
to academic success.2,3 Without sleep an individual’s
brain becomes less effective at absorbing new information and the ability to retain recently learned information is impaired.1–3
Findings from the current study suggest that the
majority of the sleep texting students had no memory
of the texting behavior as well as who or what they
texted. The lack of memory is not surprising as sleep
research has found that people awakened after sleeping more than a few minutes are usually unable to
recall the last few minutes before they fell asleep. This
sleep-related form of amnesia is the reason people
often forget telephone calls or conversations they’ve
had in the middle of the night.14 It is interesting to
note that the majority of sleep texting students
reported having no memory of who or what they
sleep texted, but an overwhelming percentage (95%)
reported checking their phone histories every morning
suggesting that their sleep texting is not a
new behavior.
Technology use and the constant monitoring of
social media have altered sleep behaviors among traditional-age college students10 with the Pew Research
Center reporting that nearly 24% of teens are online
“almost constantly”.
15 To a college student whose cell
phone is also a data device connecting them to the
world, their school, their friends, their professors, as
well as family, placing the phone near them when
sleeping provides opportunities for technology to
interfere with quality sleep.10,15,16 In our study, onethird of the college students surveyed reported
answering their cell phone at night. Answering a call
at night is not an unusual occurrence, a recent study
reported that 47% of respondents described nighttime
waking to answer text messages and 40% to answer
phone calls.16 Communicating during sleep is not an
uncommon event. Many persons acknowledge that
they talk in their sleep, walk in their sleep, eat in their
sleep, or have answered phone calls on their landlines
in their sleep with little recollection of having done so
the following day. This type of behavior, frequently
referred to as the “on call effect,” derives from the
clinical response of physicians who, awakened by
pages, respond, often later having no recollection of
their conversations.14 Too little sleep over time leads
to individuals becoming drowsy, anxious, and often
unable to concentrate the next day in addition to
reports of impaired memory and physical performance.14 With the phone either in the bed or near the
bed, it is not surprising that being awoken by a phone
is another factor that is affecting student quality
of sleep.
Young adults are averaging 60–100 texts a day so
checking a cell phone multiple times a day has
become a common behavior. Thirty-nine percent of
individuals over 30 years of age report bringing their
cell phones or smart phones into their bedrooms at
night. This is in sharp contrast to the 72% of
13–18 year olds and the 67% of 19–29 year olds who
report not only having their cell phones in the bedroom but are using them to text in the hour prior to
trying to fall asleep.2,3 In a young adult group 21%
have reported that they are texting in the hour prior
to falling asleep which indicates that their cell phone
remains in the room, frequently in the bed with
them.2 The influence of having a cell phone that provides instant access to almost anyone, anything, and
everything has made this hand-held device an integral
part of everyday life. The attitude of college students
regarding their mobile phone has shifted; the use and
proximity of the phone has become habitual to the
point where some students seem to have developed a
hypervigilance toward their phones. This hypervigilance may be likened to that of a mother, who is able
to sleep through many disruptive or loud sounds, but
immediately awakens at the sound of her baby’s cry.
Just as the mother has developed a special sense to
hear her baby crying, college students may treat their
phone in the same manner.17 Keeping the phone at a
close proximity at all times, including during sleep,
and the hypervigilant attitude may cause students to
wake for the notifications while sleeping through
other stimuli. This hypervigilance is demonstrated
during the phenomenon of sleep texting, where the
phone notification disrupts sleep, and the student
replies, often with no memory of the interaction.
The sleep interruptions created by the hypervigilant
attitude toward the phone throughout the night may
affect the students sleep quality and length, each notification and response contributing to an overall sleep
debt that lengthens each night. This chronic partial
sleep deprivation caused by sleep texting contributes
to students’ fatigue, affecting their decision making as
well as their health. One study found that sleepdeprived college students performed significantly
worse than peers who had adequate sleep on the cognitive task work and that the sleep-deprived students
were not aware of the extent to which sleep deprivation negatively affects their ability to complete cognitive tasks.11 Sleep duration and obesity have been
linked in multiple studies, with greater sleep
deprivation associated with an increased obesity risk.
Several laboratory studies have shown that short sleep
durations over time can result in changes in the regulation of the hormones associated with appetite
and satiety.18
The effects of insufficient sleep or partial sleep
deprivation, are also associated with cognitive problems, mood alterations, reduced job performance,
reduced motivation, increased safety risks, and physiological changes.18 Our study’s sample was recruited
from two schools of nursing, a profession that carries
a high risk of inducing partial sleep deprivation. The
length of the shifts, rotating shifts, and working nights
all contribute to sleep loss as well as unhealthy sleep
patterns. Many American nurses have unusual sleep
patterns with some missing, on average, 84 minutes of
sleep on work days versus non-work days, and nightshift workers obtain 1–4 less hours when working
night shift.19 There is a growing body of literature
looking at understanding how nurse and provider
fatigue effects decision making and patient outcomes.
Healthcare worker fatigue increases the risk of adverse
events, compromises patient safety, and increases risk
to personal safety and well-being. For many the
missed sleep adds up and evidence suggests that the
long shifts, shift rotations between day and night, as
well as double shifts, are associated with multiple
short- and long- term health and safety risks.19
Nurses who are fatigued, tired, have a sleep debt, or a
lack of time to recover between shifts are more likely
than unimpaired nurses to regret clinical decisions.20
How our sample performed in the clinical settings
with patients or in the simulation lab during testing is
not known but encouraging the future nursing workforce to increase their understanding of healthy sleep
practices, adverse health consequences of impaired
sleep is important.
Cell phones are not the only piece of technology
that college students use. Attention to other devices
such as laptops, iPads, iPods, tablets, electronic book
readers, charging devices, and printers must also be
evaluated. When measuring amount of sleep during
the week compared to the weekend, students with
four or more technological devices in their bedroom
had significantly less sleep when compared to those
with three or fewer devices.3,10,16 Research has demonstrated that individuals who report excessive use of
computers and mobile devices in the bedroom have
later bedtimes and tend to sleep later in the morning.2,3,16 This supports the premise that the reliance
on technology, in a place that has been traditionally
reserved for sleep, is making it difficult for some
individuals to maintain a separation between their
waking and sleeping activities.
Clinical implications
The subject of sleep can be a gateway topic for nurses,
providers, health care professionals and educators to
address across the lifespan, but especially when working with a young adult, college student population.
Providers are in a unique position capable of screening as well as assessing sleep and sleep quality by
asking questions directly related to amount of daily
sleep, quality of sleep, type of sleeper, any sleep
concerns, and the use of technology before or during
sleep. By asking questions about sleep, providers and
other health professionals can detect poor sleep quality as well as behaviors or problems associated with
lack of sleep much in the way that providers screen
for health risk behaviors (eg, alcohol use, smoking).
During the history taking or interview phase of the
assessment questions focused on sleep behaviors can
be asked directly. Answers to these questions can
provide insight into health promotion, plans of care,
and sleep interventions that can be tailored to fit the
individual. Teaching young adults and college students
how to effectively manage sleep can improve their
Individuals who report that their sleep quality is
directly affected by the cell phone may have difficulty
with limits due to a heavy reliance on their phones
which may be leading them to not be able to form
appropriate boundaries around usage.3,13,16 Ideally,
cell phones should not be in the bed, but on a table,
desk, or bureau placed in the room. During sleep time
phones can and should be turned to mute, programed
to not receive calls, or turned off. If this is not possible, students should be strongly encouraged to use
existing phone sleep settings or applications to
minimize sound disruption from the phone. They
should be reminded that applications, as well as
programs, can be useful in helping obtain quality
sleep. Healthy sleep habits such as regular bedtimes
and wake times, in addition to avoidance of screenrelated media in the bedroom should be discussed
with young adults. As our understanding of sleep
texting behavior increases, health providers can play a
supportive-educative role in promoting normal sleep
patterns in college students.
Our findings offer empirical support for the association between the sleep texting and sleep quality. On
the study’s survey multiple students wrote in response
to the one open-ended question their views of sleep
texting as well as some unique strategies to prevent
sleep texting. For example, one student shared her
creative solution to sleep texting was to wear mittens
to bed every night to prevent the texting since moving
“the phone from being in my bed to next to the bed
is not an option, I have to keep my phone with me.”
Another student shared, “I do sleep text sometimes,
but I also dream about sleep texting and that’s when I
check my history. But, it’s weird to dream of it and
not do it and then not dream of sleep texting only to
find out I did do it.” One senior wrote, “it surprised
me that this (sleep texting) is something you want to
study since everyone does it and I guess since it is
something we all do why should it be studied … .”
Further qualitative inquiry of sleep texting can facilitate the understanding of this behavior from the
student’s perspective and inform the strategies to discourage this behavior among college students.
The study findings should be viewed in light of the
study limitations. One limitation of the present study
is the reliance on retrospective subjective reports as
measures of sleep patterns and the behavior of sleep
texting. Sleep-wake diaries or sleep study tests measurements such as polysomnography or actigraphy,
could possibly provide more valid assessments of sleep
than asking a college student to recall their sleep patterns. Although a quarter of the college students
reported sleep texting in our sample, this behavior
may have been under-estimated as the students may
not have been aware of having engaged in this behavior. In addition, there were no data collected specifying the frequency of sleep texting during a night
session or when the text(s) occurred during the
student’s sleep pattern. Also, sleep texting was asked
as an overarching question without being specific to
nighttime sleeping versus napping, a trait common to
college students. Nonetheless, the study’s data were
well-suited to this initial examination of sleep texting
in a young adult, college student sample.
Future research
Our initial investigation of the impact of technology
and the phenomenon of sleep texting in college
students has suggested this to be a trending practice
in this population and provided support for the
perceived negative impact of sleep texting on sleep
quality. We will continue to investigate this interesting
phenomenon. The objective monitoring of polysomnographic changes during sleep together with a
continuous recording of nocturnal behavior via
camera in a lab setting may contribute to our understanding of the mechanism of how sleep texting
causes arousals from sleep. Qualitative inquiry may
facilitate our understanding of social factors contributing to this phenomenon, how students justify or
“make sense” of sleep texting, and the perceived
benefits of and barriers to discontinuing this behavior.
Conflict of interest disclosure
The authors have no conflicts of interest to report. The
authors confirm that the research presented in this article
met the ethical guidelines, including adherence to the legal
requirements, of the United States and received approval
from the Institutional Review Board of Villanova University.
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