Sleep Quality, Daytime Sleepiness and Sleep Hygiene Among Youth in a Rural District in South India: A Cross-Sectional Study

Abstract

Background Adequate sleep is crucial for youth cognitive function, academic performance, and mental health. However, various factors, including academic pressure, technology use, and socio-cultural norms can significantly impact sleep patterns, particularly in rural settings. This cross-sectional study assessed sleep quality, daytime sleepiness prevalence, and sleep hygiene practices among youth in a rural South Indian district. We also investigated factors associated with these sleep parameters in this understudied population Methods This was a cross-sectional study among 852 young subjects who were assessed with a self-reported proforma of socio-demographic details, behavioural factors, Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Regression model was created to analyse the predictor for sleep quality and daytime sleepiness with respect to sociodemographic variables, behavioural factors and sleep hygiene practices. Results Our study revealed that 49.4% (n=421) of participants exhibited poor sleep quality, while 29.5% (n=251) reported abnormal daytime sleepiness. The most prevalent sleep hygiene practices were reading in bed (68.5%, n=584) and pre-bedtime eating (56.22%, n=479). Multivariate analysis indicated that sleep quality was significantly associated with accommodation type, with increased odds for those in private accommodation (adjusted odds ratio (AOR) 1.29, 95% CI: 1.14-1.62) and hostels (AOR 3.79, 95% CI: 1.79-8.06). Additionally, eating in bed (AOR 1.42, 95% CI: 1.03-1.95) and pre-bedtime eating (AOR 1.41, 95% CI: 1.07-1.88) were also associated with poor sleep quality. Factors significantly associated with daytime sleepiness included younger age (AOR 0.84, 95% CI: 0.75-0.94), non-medical academic streams (AOR 1.94, 95% CI: 1.33-2.83), extensive internet usage (three or more hours) (AOR 1.87, 95% CI: 1.15-3.13), watching TV in bed (AOR 1.46, 95% CI: 1.06-1.99), writing (AOR 1.45, 95% CI: 1.02-2.06), and eating in bed (AOR 1.55, 95% CI: 1.09-2.21). Conclusion This study reveals a significant incidence of poor sleep quality and daytime drowsiness among young individuals residing in rural areas of South India. The results of our study emphasize significant connections between sleep disturbances and several modifiable aspects, such as the kind of accommodation, eating habits, and use of technology. The impact of eating behaviours, both in bed and before bedtime, on sleep quality and daytime sleepiness underscores the importance of proper sleep hygiene education. Furthermore, the relationship between extensive internet usage and daytime sleepiness points to the growing influence of digital technology on youth sleep patterns. These findings emphasize the need for comprehensive sleep health programs tailored to rural youth. Such initiatives should address environmental factors, promote healthy sleep hygiene practices, and provide guidance on balanced technology use. Additionally, the varying impact of academic streams on sleep parameters suggests that sleep health strategies may need to be customized for different educational contexts.

Keywords: daytime sleepiness; pittsburgh sleep quality index; quality of sleep; the epworth sleepiness scale; youth health.

Figure 1. Frequency (%) of subjects with the following sleep hygiene practices (n=852)

The figure shows the proportion of students who responded "Yes" to the following questions