Psychometric Analysis Of The Sleep Hygiene Index And Correlation With Stress And Anxiety Among Saudi University Students

Mental health among college students a year after COVID-19 outbreak in Israel: The association between wellbeing and anxiety

Objective: To evaluate anxiety and well-being among college students. Participants: The sample comprised 366 college students who responded to an online survey In January 2021. Methods: An online survey included demographics, a 7-item Generalized Anxiety Disorder Scale (GAD-7), and a 14-item Mental Health Continuum-Short Form (MHC-SF) measuring well-being. Results: Findings revealed low self-rated well-being compared to the general population. The mean anxiety level was 8.89, and 39% of respondents showed moderate to severe anxiety. Negative correlations were found between well-being and anxiety. A regression model showed that students who live with their parents, had been diagnosed with COVID-19, and have low emotional well-being scores, are at risk of suffering from anxiety (R2=0.32, F = 53, p < 0.001). Conclusions: Student mental health is significantly affected by the pandemic and should be carefully monitored. It is crucial to provide timely psychological support to prevent negative long-term implications of the crisis on student mental health.

Effects of Transition from Remote to In-Person Learning in University Students: A Longitudinal Study

Previous studies have shown that the transition from the University environment to remote learning impacted student mental health. Our study aimed to investigate the effects of university environment on anxiety and depressive symptoms in health sciences students. Students at the Technical University of Manabí, Ecuador, with 6-10 in-person semesters, who shifted to remote learning and then returned to face-to-face learning were selected. Students responded to the General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). In addition, questions regarding social interaction, physical exercise, mood and sleep habits were also asked. This longitudinal study tracked 323 students during the return to in-person classes and term end. The results showed similar rates of anxiety (GAD-7, p = 0.011-p = 0.002) and depression (PHQ-9 p = 0.001-p = 0.032) among students at week 1 and week 15. Previous diagnosis of depression (OR, 0.171; CI 0.050-0.579, p < 0.005) was shown to correlate with depression levels in week 1, with no changes seen at follow-up. Anxiety levels were shown to be associated with a previous diagnosis of the disorder at week 1, but not at follow-up (OR 0.233; CI 0.085-0.643, p < 0.005). The return to in-person learning among university students maintained levels of anxiety and depressive symptoms, underscoring ongoing vulnerabilities to mental health disorders in this group.

Validation of the Korean version of the Sleep Hygiene Practice Scale in a Non-Clinical Population

OBJECTIVES

This study aimed to validate the Korean version of the sleep hygiene practice scale (SHPS-K) and determine its effectiveness in screening poor sleepers with insomnia.

METHODS

Online survey was conducted using translated SHPS in Korean, the Korean versions of the Pittsburgh Sleep Quality Index (PSQI-K), Insomnia Severity Index (ISI-K), and Epworth Sleepiness Scale (KESS) in a non-clinical population. The internal consistency and test-retest reliability of the SHPS-K were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. Construct validity was evaluated using correlation analyses with other questionnaires and confirmatory factor analysis. We determined the cutoff values that could identify poor sleepers with insomnia symptoms (PSQI-K > 5 and ISI-K ≥ 15) using receiver operating characteristic analysis.

RESULTS

A total of 484 participants (242 women, mean age of 43.8 years) were enrolled. The average SHPS-K score was 71.2, with no significant sex differences. Women had poorer sleep scheduling and timing behaviors, and men had poorer eating and drinking behaviors. Good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (ICC = 0.80) were observed. The SHPS-K was positively correlated with the PSQI-K (r = 0.55), ISI-K (r = 0.54), and KESS (r = 0.42). A cutoff value of 73 identified poor sleepers with insomnia (area under the curve = 0.828).

CONCLUSIONS

The SHPS-K is a reliable instrument for evaluating sleep hygiene in non-clinical Korean populations.

The motivation behind better sleep: self-determination as a framework for examining sleep outcomes in college students

OBJECTIVE

To examine sleep health within a self-determination framework across a diverse college sample.

PARTICIPANTS

A nonclinical sample of undergraduate students (n = 399) from a large, urban, public university in the Mid-Atlantic United States in Spring 2020.

METHODS

Participants were recruited via an online research participation portal and received extra credit for participation. All measures were administered via an online survey.

RESULTS

Basic psychological need satisfaction was associated with sleep health. This association was partially mediated by sleep hygiene but not by regulatory style. There were no racial/ethnic differences in sleep health, sleep hygiene, basic need satisfaction, or regulatory style. Men reported more maladaptive motivational styles for sleep health, and non-binary/transgender students reported worse sleep hygiene.

CONCLUSION

Basic psychological need satisfaction and sleep hygiene are critical targets for intervention across diverse college student populations. Motivation may be less critical for nonclinical interventions.

Sleep hygiene strategies for individuals with chronic pain: a scoping review

OBJECTIVES

Up to a quarter of the world's population experience chronic pain, which, in addition to interfering with daily activities and waking function, is often associated with poor sleep. Individuals experiencing poor sleep are often encouraged to implement sleep hygiene strategies. However, current sleep hygiene strategies have not been developed considering the unique challenges faced by individuals with chronic pain and therefore they might not be as effective in this population. The aim of this scoping review is to map the state of the existing literature examining sleep hygiene strategies in individuals with chronic pain.

DESIGN

This scoping review included a search of four online databases (Medline, Embase, PsycINFO and CINAHL) to identify articles examining the use of sleep hygiene strategies in populations with chronic pain.

RESULTS

Thirty articles investigated at least one sleep hygiene strategy in individuals with chronic pain, with improvements to sleep reported for six sleep hygiene strategies (education, exercise, limiting alcohol use, limiting tobacco use, prebed state and sleep environment). However, the timing of these strategies was often not reported which limits the degree to which these strategies can be generalised for use as a presleep strategy.

CONCLUSION

This scoping review examined the existing literature focusing on sleep hygiene strategies for people with chronic pain. There are limitations to the methodology of the existing literature and gaps in our understanding of sleep hygiene strategies in some chronic pain conditions that must be addressed in future research before the effectiveness of these strategies can be understood.

Factors that protect against poor sleep quality in an adult lifespan sample of non-Hispanic Black and non-Hispanic White adults during COVID-19: A cross-sectional study

Introduction

Stress in relation to the Coronavirus disease 19 pandemic (i.e., COVID-19, COVID stress) may be linked with poor sleep quality. The association between stress that is specific to the COVID-19 pandemic and sleep quality has been understudied, particularly in racially diverse people across the adult lifespan. Here, we investigated self-reported sleep quality in relation to COVID stress and factors that may protect against experiencing poor sleep quality from high COVID stress, including social support and religiosity.

Method

We recruited non-Hispanic Black (n = 73) and non-Hispanic White (n = 178) participants across the adult lifespan (18-76 years) using an online, cross-sectional design during the COVID-19 pandemic (March 2021-June 2021). We asked participants to report information regarding demographics (age, race/ethnicity, years of education), sleep (sleep quality, sleep habits), and positive (social support, religious activities) and negative (events of discrimination, depression, general stress, COVID stress) psychosocial factors.

Results

Across age and racial groups, better sleep habits were associated with better sleep quality, and higher COVID stress was linked to poorer sleep quality. Black participants reported higher quality sleep than White participants (p = 0.006). They also endorsed greater private and internal religiosity (p's < 0.001). Across racial groups, moderation analyses revealed a protective effect of religiosity against poor sleep (p's < 0.006). Specifically, individuals with high religious activity and high COVID stress did not experience poor sleep quality, but individuals with low religious activity and high COVID stress demonstrated poor sleep quality. These results remained significant when controlling for general stress.

Discussion

Protective factors, such as religiosity, may mitigate the negative associations between high COVID stress and poor sleep quality.

Evaluation of Sleep Habits, Generalized Anxiety, Perceived Stress, and Research Outputs Among Postgraduate Research Students in Hong Kong During the Coronavirus (COVID-19) Pandemic

Purpose

The current study aimed to evaluate the impact of coronavirus (COVID-19) pandemic on sleep hygiene, anxiety levels, perceived stress, and research output among postgraduate research students in Hong Kong.

Methods

An online survey was developed and distributed to Hong Kong postgraduate research students. The sleep hygiene, anxiety levels, and perceived stress during the outbreak of COVID-19 were assessed. Questions about COVID-19’s impact on research outputs were asked.

Results

A total of 108 (response rate, 72%) full-time postgraduate students (PhD, 64%; M Phil, 8%; and Masters, 28%) participated. Approximately 83% of students reported poor sleep hygiene. Similarly, nearly 76% of students reported mild to severe levels of self-perceived anxiety levels. Most of the respondents (89%) expressed a moderate level of perceived stress. Sleep hygiene scores were moderately associated with anxiety levels (r = 0.384, p < 0.01) and perceived stress scores (r = 0.423, p < 0.01). Perceived stress was strongly correlated with anxiety levels (r = 0.601, p < 0.01). A hierarchical regression analysis revealed a significant association between respondents’ ethnicity (B = −0.923, p = 0.003), past medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.112, p = 0.005), or poor sleep hygiene (B = 0.259, p = 0.000) and high levels of perceived stress. Additionally, prior medical history (such as hypertension, diabetes, and musculoskeletal disorders) (B = 1.957, p = 0.001) and poor sleep hygiene (B = 0.312, p = 0.000) were found to be strongly related to anxiety levels among postgraduate research students.

Conclusion

This is the first study that highlights poor sleep hygiene, moderate-to-severe levels of anxiety, and perceived stress during the COVID-19 pandemic in postgraduate research students in Hong Kong. These findings will help educators to prepare strategies to alleviate the stress and psychological problems in postgraduate students.

The Impact of the COVID-19 Pandemic on Students' Mental Health and Sleep in Saudi Arabia

Background: Mental health problems are prevalent among university students in Saudi Arabia. This study aimed to investigate the impact of the COVID-19 pandemic on university students’ mental health and sleep in Saudi Arabia. Method: A total of 582 undergraduate students from Saudi Arabia aged between 18 and 45 years old (M = 20.91, SD = 3.17) completed a cross-sectional online questionnaire measuring depression, anxiety, stress, resilience, and insomnia during the COVID-19 pandemic (2020). Analysis included an independent samples t-test, one-way ANOVA, and Hierarchical regression analysis. Results: Undergraduate students reported high levels of depression, anxiety, and perceived stress and low levels of resilience (p < 0.001) during the pandemic. In addition, students reported experiencing insomnia. A hierarchical regression analysis indicated that lower resilience, high levels of insomnia, having a pre-existing mental health condition, and learning difficulties (such as dyslexia, dyspraxia, or dyscalculia) were significantly associated with high levels of depression and stress. In addition, lower resilience, a high level of insomnia, and pre-existing mental health conditions were significantly associated with high levels of anxiety. Finally, a lower level of psychological resilience and a high level of insomnia were significantly associated with increased levels of depression, anxiety and stress within university students. Conclusion: This study has provided evidence that a lower level of psychological resilience and insomnia were associated with mental health problems among undergraduate students in Saudi Arabia, thus enhancing psychological resilience and interventions to support sleep and mental health are vital to support student well-being outcomes throughout the pandemic.

Psychometric analysis of a Chinese version of the Sleep Hygiene Index in nursing students in China: a cross-sectional study

OBJECTIVE

The aim of the study had two stages. One was to examine the psychometric quality of the Sleep Hygiene Index (SHI) in Chinese version and its predicted function for the prevalence of insomnia. The other was to describe the prevalence of poor sleep hygiene habits and associated factors of sleep hygiene habits in Chinese nursing students.

METHOD

According to Brislin translation model, the English version of SHI was translated into Chinese. And a pilot-survey was carried out to measure psychometric quality of the Chinese version of SHI with 260 nursing students by convenient sampling. Then a cross-sectional survey was conducted. 659 undergraduates were recruited by simple random sampling in a medical university in China. Data collection instruments consisted of a demographic questionnaire, the Sleep Hygiene Index (SHI), the Insomnia Severity Index (ISI) and the Brief Insomnia Questionnaire (BIQ). Data were analyzed by SPSS 24.0 and Amos 24.0 with P = 0.05 as the significant test value.

RESULTS

The internal consistency reliability of SHI in Chinese version was more than 0.60 (α = 0.62, ω = 0.63). The concurrent validity presented significantly (r = 0.25, P < 0.001). Exploratory factor analysis found that a six component model explained 63.06% of total variance and confirmatory factor analysis showed good fitness (χ²/df=2.14, RMSEA = 0.04). ROC analysis showed that the cut-off value predicting for insomnia was 5.50 (52.90% sensitivity and 75.80% specificity). The area under the ROC curve was 0.66 (95% confidence interval = 0.61-0.71). 199 (30.20%) participant had poor sleep hygiene habits, especially in the aspects of staying too longer in bed (65.25%) and irregular sleep schedule. Multiple linear regression analysis showed health condition, academic difficulties and gender were more common associated factors of sleep hygiene.

CONCLUSIONS

The Chinese version of the Sleep Hygiene Index demonstrates satisfactory psychometric qualities and has higher sensitivity and specificity to predict for insomnia. So SHI could be used in Chinese nursing students and detect high levels of insomnia. The status of sleep hygiene of nursing students in China should be concerned. Sleep hygiene education should be carried out in nursing students with different gender, health condition, and academic performance.

Anxiety Symptoms Are Associated With Higher Psychological Stress, Poor Sleep, and Inadequate Sleep Hygiene in Collegiate Young Adults-A Cross-Sectional Study

Background: Anxiety symptoms, stress, poor sleep, and inadequate sleep hygiene are common in university students and these affect their learning and increase attrition. However, limited knowledge exists about the inter-relationship between these factors among university students in low-middle income countries. Therefore, this study aimed to investigate the prevalence of anxiety symptoms and their relationship with sleep quality, sleep hygiene practices, and psychological stress. Materials and Methods: A cross-sectional study was conducted with a randomly selected sample of students in Mizan-Aman, Ethiopia. Participants completed a self-administered questionnaire, which included questions about socio-demographics, socio-economic factors, the Leeds Sleep Evaluation Questionnaire-Mizan, Sleep hygiene index, Perceived stress scale-10 (PSS-10), and Generalized anxiety disorder-7 scale (GAD-7). Results: The prevalence of anxiety symptoms was about 22%. Multivariate regression analysis showed that both anxiety status χ²[(13, N = 480) = 82.68, p < 0.001], and increasing levels of anxiety (model adjusted R2 = 0.204, p < 0.001) were associated with greater psychological stress, inadequate sleep hygiene practices, and poor sleep quality scores after adjusting for age, gender, attendance, substance use, years of university education, time spent in athletic activity every day, and frequency of tea/coffee consumption. Conclusion: There was a high prevalence of anxiety symptoms in this study population, and this condition was associated with psychological stress, poor sleep, and inadequate sleep hygiene parameters. These results suggest a need to address the various aspects of mental health and its diverse sleep correlates in university students.

Swiss University Students' Risk Perception and General Anxiety during the COVID-19 Pandemic

University students were confronted with abrupt changes to their daily lives by the COVID-19 lock-down. We investigated Generalized Anxiety Disorder Scale-7 (GAD-7) and anxiety levels, and the association between perceived impact on well-being, studies, and daily lives and anxiety levels, adjusted for gender, age, social class and affiliation. Early in the lock-down all students of the Zurich University of Applied Sciences (N = 12,429) were invited to a voluntary longitudinal health survey. Participation rate was 20% (n = 2437): 70% females, median age 25 yrs. (IQR 23-28). A total of 10% reported a deterioration of well-being compared to pre-Corona. LCA yielded three classes varying in perceived COVID-19 impact: 1 (low, n = 675), 2 (moderate, n = 1098), and 3 (strong, n = 656). Adjusted proportion of moderate to severe anxiety by class were 45% (95% CI: 28.0-62.0), 15.5% (95% CI: 13.1-17.9), and 5.1% (95% CI: 4.7-5.6), respectively. Multivariate regression analyses yielded an OR for moderate to severe anxiety of 3.88 (95% CI: 2.5-6.0, class 2) and 22.43 (95% CI: 14.5-34.6, class 3) compared to class-1. The investigated association implies that containment measures have a selective effect on anxiety in students. The diversity of students' perception and associated anxiety should be monitored and considered in future response to pandemics.

Psychometric Analysis of the Perceived Stress Scale Among Healthy University Students

BACKGROUND

There is a gradual increase in the prevalence of stress during professional courses. Previous studies reported a high incidence of stress among university students. The psychometric properties of the perceived stress scale-10 (PSS-10) have been established in different populations. The current study aimed to assess psychometric properties of the PSS-10 in Saudi university students.

METHODS

Healthy university students (n= 192) participated in this cross-sectional study. All the participants were explained about the aim and procedures of the study. Participants were requested to complete the English version of the PSS, the generalized anxiety disorder-7 (GAD-7), the sleep hygiene index (SHI), and demographic details.

RESULTS

The range of the PSS-10 total score was 0-35; 1% reported minimum score of 0, but none reported maximum score of 40. Therefore, there was no issue of ceiling or floor effect in the PSS-10 total score. Positive and significant correlations of the PSS total and the PSS Factor-1 (distress perception) with the GAD-7 total score, SHI item-8 and SHI item-13 score support its convergent validity. Negative or no correlation of the PSS Factor-2 score (coping perception) with the GAD-7 total score, SHI item-8 and SHI item-13 scores demonstrate its divergent validity. The internal homogeneity test indicated moderate to strong positive correlations (r=0.60-0.82) between the PSS Factors and the items loading on them. The internal consistency test showed a good agreement for the PSS Factor-1 and the PSS Factor-2 scores (Cronbach's alpha 0.78 and 0.71, respectively), suggesting an acceptable level of consistency. Factor analysis favored a 2-Factor model of the PSS in the Saudi students.

CONCLUSION

The current study supported the use of the PSS-10 to assess the perceived stress among Saudi university students.