Associations between lifestyle behaviors and sleep problems in university students: a cross-sectional analysis

Abstract

ABSTRACT Introduction: Lifestyle behaviors such as nutrition, substance use, physical activity and stress management are independently associated with less risk of sleep problems, but there few evidence evaluating whether the combination of lifestyle behaviors associates with sleep problems. The aim of this study was to evaluate the associations between lifestyle behaviors and sleep problems in university students. Methods: The study had cross-sectional design. Data was gathered using an online survey (RedCap) enrolling university student from 11 universities in Brazil. The Short Multidimensional Inventory Lifestyle Evaluation (U-SMILE) was used to assess six lifestyle behaviors (diet, substance use, physical activity, stress management, social relationships, and environment exposure), while the DSM-5-TR self-rated level 1 cross-cutting symptom measure and the Pittsburgh Sleep Quality Index (PSQI) were used to assess sleep problems. Poisson regression was used to assess the associations between lifestyle and sleep problems. Results: A total of 747 participants (56.1% women, 42.6% ≤20 years old) participated the study. Participants with an overall healthier lifestyle, accounting six behaviors, had a lower prevalence of sleep problems compared to those with an unhealthier lifestyle (RP=0.59; 95%CI=0.48–0.72; p<0.001). Diet (RP=0.74; 95%CI=0.60–0.92; p=0.006), social support (RP=0.71; 95%CI=0.57–0.88; p=0.002), and environmental exposure (RP=0.80; 95%CI=0.64–0.99; p=0.044) were independently associated with a higher prevalence of sleep problems. Conclusion: A healthy lifestyle was associated with a lower prevalence of sleep problems, with diet, social support, and environmental exposure being the key contributing factors.