Factors Affecting University Students' Sleep Quality during the Normalisation of COVID-19 Epidemic Prevention and Control in China: A Cross-Sectional Study

ABSTRACT

Background: Insufficient and poor-quality sleep have significant negative health consequences for university students in China. In this study, we aimed to assess the subjective sleep quality of university students during the normalisation of COVID-19 epidemic prevention and control in China and to identify key factors affecting their sleep quality. Materials and Methods: A cross-sectional survey was conducted among 1326 university students from Hubei Province, China. Latent profile analysis was conducted on the results of class-difference tests of sleep patterns. Multinomial logistic regression was used to explore the relationship between the influencing factors and three classes of sleep quality. Results: The overall score of sleep quality (9.18 ±3.22) among university students was assessed by using the PSQI scale, and 427 (32.20%) students reported poor sleep quality. Three distinct classes of sleep patterns were identified, namely, good sleepers (Class 1, 70.44%), poor sleep quality with less medication use (Class 2, 26.55%) and poor sleepers (Class 3, 3.01%). Conclusions: Compared with 'good sleepers', students having 'poor sleep quality with less hypnotic drug use' were influenced by their education stage, smoking habits, physical activity, depression and anxiety. Meanwhile, 'poor sleepers' may be affected by their age, origins, smoking habits, mental stress, depression and anxiety. Significant heterogeneity was confirmed in the sleep patterns of university students. Their behavioural lifestyles and mental health-related factors demonstrated different relationship patterns with sleep quality. Multiple sleep promotion interventions, including moderate aerobic exercises, psychological counselling and mindfulness training, should be regularly performed in groups to improve their sleep quality.