Prevalence of sleep disorders among university students and its impact on academic performance

Predictors of insomnia among undergraduate students at Hawassa University Sidama, Ethiopia, 2023: a facility-based cross-sectional study

Background

Insomnia is a sleep disorder characterized by difficulty falling asleep, staying asleep, or experiencing poor-quality sleep. People with this problem often have trouble falling asleep at night, wake up frequently during the night, and may wake up too early in the morning and feel tired and not refreshed. This can lead to daytime fatigue, irritability, difficulty concentrating, and impaired functioning in their day-to-day activities. Study is scarce in resource-limited countries such as Ethiopia, particularly concerning the study setting. As a result, this study aimed to assess the prevalence of insomnia and its associated factors among undergraduate students at Hawassa University.

Methods

An institution-based cross-sectional study design was used. A stratified simple random sampling method was used among 398 study participants. The data were collected using a structured self-administered questionnaire. The outcome variable was assessed by the insomnia severity index (ISI). The data were then gathered by using the Kobo toolbox online and then exported into the Statistical Package for Social Sciences version 27 to analyze the data. Data cleaning and screening were conducted exclusively by the investigators. Descriptive statistics like frequency, percentages, and mean were used. Bivariate and multivariate binary regression were performed. In multivariate binary logistic regression, a p-value of<0.05 was identified as a significantly associated factor with the dependent variable.

Results

Among 398 students who participated in the study, 81 (20.4%) experienced insomnia. Being female [adjusted odds ratio (AOR) = 2.98; 95% confidence interval (CI) 1.56-5.69], age (AOR = 3.06; 95% CI 1.11-8.45), mild anxiety symptom (AOR = 4.89; 95% CI 1.56-15.37), and mobile device use ≥30 min just before going to sleep (AOR = 7.81; 95% CI 2.34-26.12) were significantly associated with insomnia.

Conclusion

In this study, the prevalence of insomnia was one-fifth among university students, which is high when compared to another study at the national level. There were significant associations between being female, age, anxiety symptoms, and mobile device use before going to sleep with insomnia. This indicates that there is a need to treat and prevent insomnia in college students, emphasizing the necessity for mental healthcare and ethical technology use.

The Prevalence and Predictors of Sleep Disorders and Their Impact on Academic Performance Among Saudi University Students: A Cross-Sectional Study

BACKGROUND

University students encounter a variety of sleep problems that have an impact on their health and academic performance. Therefore, the aim of this study was to evaluate the prevalence of sleep disorders and their impact on academic performance among Saudi university students.

METHODS

This is an online cross-sectional study that involved university students and was conducted between November 2022 and February 2023 in Saudi Arabia. Sleep disorders were examined among undergraduate students through online screening surveys including the Epworth Sleepiness Scale (ESS) to assess excessive daytime sleepiness, the Insomnia Severity Index (ISI) to measure insomnia, and the Berlin questionnaire to examine obstructive sleep apnea (OSA). Restless leg syndrome (RLS) was measured using the RLS rating. SPSS version 29.0 (IBM Corp., Armonk, NY, USA) was used for all statistical analyses. Binary logistic regression analysis was used to identify predictors of having excessive daytime sleepiness, insomnia, sleep-disordered breathing, and RLS.

RESULTS

The sample included 449 participants. According to the ESS, 56.6% (n=254) of students reported excessive daytime sleepiness. Using the ISI, 78.4% (n=352) of students were found to have insomnia. The Berlin questionnaire indicated that 6.7% (n=30) of students had sleep-disordered breathing. Additionally, 13.6% (n=61) of students reported having RLS. Male students had higher odds of sleep-disordered breathing compared to females (p<0.01), while marital status showed that married students had higher odds of sleep-disordered breathing (p<0.05). Students who reported nighttime sleeping had lower odds of insomnia and restless leg syndrome (p<0.05). Having regular sleeping times was associated with higher odds of insomnia (p<0.05). Napping sometimes was associated with higher odds of excessive daytime sleepiness and sleep-disordered breathing (p<0.05). Students working day and night shifts had higher odds of sleep-disordered breathing (p<0.01). Interestingly, students with comorbidities had lower odds of RLS (p<0.01).

CONCLUSION

This study established that sleep disturbances among students significantly reduce grade point averages (GPAs), where the most affected were male students and those who were married. The government should implement sleep education programs, provide resources for the management of sleep, encourage consistent sleep schedules, and come up with targeted interventions for at-risk groups. More research is also recommended on effective sleep interventions.

Sleep Disorders' Prevalence and Impact on Academic Performance among Undergraduate Nursing Students in a Selected University, United Arab Emirates

Introduction

Throughout their academic pursuits, students may encounter various sleep-related issues, including insomnia, sleep apnea, hypersomnia, or sleep terror disorder. These disorders can profoundly impact their well-being, emotional state, and academic achievements.

Objective

This study, of significant relevance to the field of nursing and sleep disorders, aimed to investigate the prevalence of sleep disorders and their impact on academic performance among undergraduate nursing students in the United Arab Emirates.

Methods

A cross-sectional research method was implemented among 177 undergraduate nursing students. Two tools were used: Too I consisted of two parts: sociodemographic and academic performance classifications, whereas Tool II comprised the SLEEP-50 questionnaire.

Results

Our findings revealed that 30.6% of nursing students had one or more sleep disorders. Insomnia was the most prevalent among the nursing students (37.5%), followed by circadian rhythm (33.3%), narcolepsy (26.6%), sleep apnea and restless leg syndrome (25%), nightmares (22.2%), and sleepwalking (11.11%). There was a significant relation between restless leg syndrome and academic performance, while in linear regression analysis, it was found that the variable that most affects sleep is gender.

Conclusion

The implications of this study's findings are clear-nursing schools must intensify their efforts to raise awareness about the detrimental effects of sleep problems on academic performance. Furthermore, subsequent research is crucial to evaluate the execution of interventions aimed at preventing such disorders.

Nasal Blockage and Academic Performance Among Medical College Students in the Kingdom of Saudi Arabia

Objectives The most frequent otolaryngological complaint is nasal obstruction. We aimed to determine if there is a relationship between nasal blockage and academic performance among medical college students in Saudi Arabia. Methods This cross-sectional survey carried out from August to December 2022, included 860 medical students determining the risk of obstructive sleep apnea (OSA) on the participants using the Berlin Sleep Questionnaire Risk Probability, then comparing it to their socio-demographic characteristics, while the Chi-square test was used for the comparison of categorical variables. Result The average age of the participants in our study was 21.52 years; 60% were females and 40% were males. The risk of obstructive sleep apnea was found to be two times higher in females than in males (95% CI: 1.195- 3.345; p-value 0.008). The hypertensive participants had a 27-fold increased risk of OSA compared to non-hypertensives. Grade Point Average (GPA) and snoring had a statistically significant relationship, however, a fifth of the participants reported snoring (79.8% reported not snoring). We also found that 14.8% of the participants with snoring had a GPA between 2-4.49 compared to 44.6% of participants without snoring. Conclusion Female students had a two-fold higher chance of developing OSA than males. While a GPA of 4.5 and above was more often associated with participants without snoring, the number of individuals with a GPA of 2-4.49 was greater among participants with snoring. To aid in the prevention of illness complications and the management of risk factors, additional efforts should be made to increase disease knowledge among students, primary healthcare practitioners, and specialty doctors.

Assessment of the Psychometric Properties of the Holland Sleep Disorders Questionnaire in the Iranian Population

Background

Assessing sleep disorders and understanding their causes are essential for the proper treatment and management of the disorders. The Holland Sleep Disorders Questionnaire (HSDQ) is a self-assessment questionnaire that measures sleep problems and symptoms based on the six categories of sleep disorders described in the International Classification of Sleep Disorders-2 (ICSD-2). The aim of this study was at validating and assessing the psychometric properties of the HSDQ in Iranian adults.

Method

The study was carried out as a methodological and validation work. The guidelines for translation and cultural adaptation of patient-reported outcome measures were followed for the translation and the cultural validation of the tool. To examine construct validity, exploratory factor analysis (EFA) with 216 participants and confirmatory factor analysis (CFA) with 355 participants were used. As to the reliability, the test-retest method and, as to internal consistency, Cronbach's alpha were employed. Data analyses were done in SPSS-25 and LISREL-8.

Results

The CFA and EFA results confirmed the tool with six factors and 31 items. The R² index of the model was 0.99, which indicated that 99% of changes in the dependent variable (adults' sleep problem) were attributed to the independent variable (the 31 items). In other words, 0.99 of the changes in the dependent variable were due to the independent variables. The main indices of CFA (χ²/DF = 2.65, CFI = 0.91NNFI/TLI = 0.92GFI = 0.81, REMSEA = 0.043, R² = 0.99) were acceptable. In addition, a correlation coefficient below 0.05 was considered as significant. Reliability of the tool based on internal correlation (Cronbach's alpha) was in the 0.701–0.924 range for the subscales and equal to 0.789 for the whole tool.

Conclusion

In general, the results showed that the Farsi version of HSDQ (six factors and 31 items) had acceptable and applicable indices and it can be used as a valid tool in the Iranian society. The tool can be used as a reliable tool in different fields of medical sciences.

Factors associated with the perception of fear of COVID-19 in university students

OBJECTIVE

to analyze the factors associated with the perception of fear of COVID-19 in Brazilian university students.

METHODS

this is an online, cross-sectional analytical study conducted at a Brazilian public university with 1,437 undergraduate students between September and November 2020. The Fear of COVID-19 Scale was used to measure the main construct. Data analysis was performed using Mann-Whitney U test, Cohen's r test and multiple linear regression analysis.

RESULTS

factors associated with fear of COVID-19 in university students were the variables biological sex, perception of good sleep quality, many days of access to information, not complying with social distancing, reporting sufficient hours of sleep, not having a partner, guidance sexual non-heterosexual, being in the risk group for COVID-19 and tobacco consumption.

CONCLUSIONS

the study findings can contribute to the discussion about the weaknesses that the university population is experiencing in this pandemic period.

The impact of COVID-19 pandemic on medical students’ mental health and sleep quality in Jordan: a nationwide cross-sectional study

Background

COVID-19 pandemic is expected to affect the mental health, especially among medical students. Data from the literature in Jordan are scarce, especially during the second wave of the pandemic. We aimed to assess medical students’ level of fear, prevalence of depressive and anxiety symptoms—represented in psychological distress (PD)—and sleep quality (SQ) amid the current pandemic of COVID-19. A total of 2104 students were included through convenient sampling from the six schools of Medicine in Jordan. Online-based questionnaire using Patient Health Questionnaire-4 (PHQ-4) scale, Fear of COVID-19 scale (FCV-19S), and Sleep Quality Scale (SQS) was used to collect the data. Chi-square, t-tests, and ANOVA were used to establish the associations.

Results

88.4% and 47.4% of the students were found to have PD and poor or just fair sleep quality on SQS, respectively, with PD ranging from mild (18.6%) to severe (42.1%). Calculated FCV-19S score was 14.62 (SD=5.38), indicating high level of fear. Students with excellent SQ had significantly lower rates of depression, anxiety, and PD as compared to those with good, fair, and poor SQ (P < 0.001 for all).

Conclusion

Jordanian medical students appear to be especially susceptible to COVID-19 pandemic impact on mental health and reported high rates of PD. While rates of COVID-19 fear are still considered high, they are remarkably lower than that reported in early studies. We strongly recommend providing resources and access to professional mental health care to students reporting poor SQ and/or symptoms of anxiety and depression.

Limitations

Using a cross-sectional design, online-based survey, convenient sampling, and scarcity of local literature are among the inevitable limitations caused by the pandemic that have prevented us from drawing cause-effect associations.

ANALYSIS OF PHOTOPLETHYSMOGRAPHIC MORPHOLOGY IN SLEEP APNEA SYNDROME PATIENTS USING CURVE FITTING AND SUPPORT VECTOR MACHINE

This paper develops a time-saving, simple, and comfortable method for detecting Sleep Apnea Syndrome (SAS). Seventy SAS patients and 17 healthy persons were randomly selected in this study, and nine analytical parameters (i.e., [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], [Formula: see text], and [Formula: see text] of healthy persons and SAS patients during five sleep stages (i.e., W, R, N1, N2, and N3) were obtained to construct a SAS classification model based on logarithmic normal analytical parameters using the Support Vector Machine (SVM) method to fit Photoplethysmographic (PPG) signals. The results show that there were no statistical differences among the five sleep stages for either the healthy or SAS patients. However, there were significant differences in the measured logarithmic normal analytical parameters between the healthy persons and the SAS patients in each of the five sleep stages. The accuracies of the SAS classification model were 95.00%, 90.00%, 84.00%, 94.67%, and 90.77%, corresponding to the five sleep stages, respectively. The SAS classification model based on the SVM method of logarithmic normal analysis parameters can achieve higher classification accuracy for each of the five sleep stages. It can be considered to collect the patient’s pulse wave during the awake period, but not necessarily during the sleep period to classify and identify the SAS; it provides an idea for a convenient and comfortable SAS detection.