Sex-specific associations between sleep and mental health in university students: a large cross-sectional study

Abstract

Objective: To examine the associations between sleep problems and mental health dimensions in university students, and the effect of sex on these associations. Participants: Self-reported survey data from 3,483 students aged 18–30 years was drawn from a larger web-based study (i-Share) conducted in France in the years 2013–2017. Methods: We performed logistic regression analyses stratified by sex using insufficient sleep duration, poor sleep quality, difficulty initiating sleep and excessive daytime sleepiness, in relation with stress, self-esteem, depression and anxiety. Results: All sleep problems were strongly associated with all mental health dimensions, particularly anxiety, in female students. Sleep and mental health problems were also associated in male students, with the exception of low self-esteem, but odds ratios were lower than for female students. Conclusions: Present findings warrant attention to propose early interventions targeting sleep and mental health in the university setting taking sex into account.

Keywords:

• Cohort study
• young adult
• mental health
• psychological measures
• sex

Acknowledgments

The authors are indebted to the participants of the i-Share project for their commitment and co-operation and to the entire i-Share team for their expert contribution and assistance. The authors would like to acknowledge Clément Gohers for his contribution to the first discussions and hypotheses concerning this study, and especially Professor Pierre Philip for his valuable and constructive suggestions concerning sleep measurement and data analysis.

Author contribution

IM, SQ, EP, and CT designed the study. SQ and EP analyzed the data and synthesized results. IM drafted the manuscript, PT contributed to the final writing, and CT supervised the entire study. All authors provided critical feedback and helped shape the research, analysis and manuscript.

Conflict of interests

All authors declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials. Raw data are available from the principle investigator of the i-Share study on request.

Ethics approval

The i-Share project was approved by the “Commission Nationale de l'Informatique et des Libertés” (CNIL – National Commission of Informatics and Liberties) [DR-2013-019] and every student signed an online informed consent form before completion of the baseline questionnaire.

Additional information

Funding

The i-Share research project has received funding from the French National Research Agency (Agence Nationale de la Recherche, ANR) via the program “Investissements d’Avenir,” reference ANR-10-COHO-05.