Thapa Bipin, Chaudhary Sandeep, Karki Rojeena, Karki Anita, Sapkota Suman, Li Menglong, Hu Yifei
Department of Research and Development, Dhulikhel Hospital-Kathmandu University Hospital, Kavre, Nepal.
Central Department of Public Health, Institute of Medicine, Maharajgunj, Kathmandu, Nepal.
BMC Public Health. 2025 Apr 14;25(1):1397. doi: 10.1186/s12889-025-22652-0.
Secondary school students experience notable physiological and psychological changes and academic stressors, rendering them prone to poor sleep quality. We aimed to investigate impact of perceived academic stress and mental stress on sleep quality among secondary school students.
We conducted a two-stage cluster sampling cross-sectional study among 634 secondary school students in eight schools in Triyuga municipality, Nepal, from February to March 2022. A self-administered on-site survey was conducted to assess sleep quality, perceived academic stress and mental stress symptoms. Generalized linear mixed-effects models were performed to determine associations of academic stress and mental stress symptoms with sleep quality.
The prevalence of poor sleep quality was 27.6%. Regarding perceived academic stress, 56.1% of students reported neutral or affirmative responses, while 33.1% exhibited varying degrees of mental stress symptoms. Students with perceived academic stress (adjusted odds ratio [aOR] = 2.09, 95% CI: 1.35, 3.22) and those experiencing mental stress symptoms (aOR = 1.74, 95% CI: 1.18, 2.58) were more likely to have poor sleep quality compared to their counterparts without these stressors. Students who indicated even a modest degree of feeling touchy (aOR = 1.47, 95% CI: 1.01, 2.14), who faced difficulties in winding down (aOR = 1.79, 95% CI: 1.23, 2.62) and frequently experienced agitation (aOR = 1.94, 95% CI: 1.13, 2.86) were at higher risk of experiencing poor sleep quality compared to their counterparts.
The study found a relatively high prevalence of poor sleep quality in secondary school students, attributed to perceived academic and mental stress. To mitigate stress and foster healthier sleep patterns, interventions aimed at addressing and reducing stress and promoting good sleep hygiene practices are recommended.
中学生经历显著的生理和心理变化以及学业压力源，使他们容易出现睡眠质量差的问题。我们旨在调查感知到的学业压力和心理压力对中学生睡眠质量的影响。
2022年2月至3月，我们在尼泊尔特里尤加市八所学校的634名中学生中进行了两阶段整群抽样横断面研究。进行了一项现场自填式调查，以评估睡眠质量、感知到的学业压力和心理压力症状。采用广义线性混合效应模型来确定学业压力和心理压力症状与睡眠质量之间的关联。
睡眠质量差的患病率为27.6%。关于感知到的学业压力，56.1%的学生报告了中性或肯定的回答，而33.1%的学生表现出不同程度的心理压力症状。与没有这些压力源的学生相比，感知到学业压力的学生（调整后的优势比[aOR]=2.09，95%置信区间：1.35，3.22）和经历心理压力症状的学生（aOR=1.74，95%置信区间：1.18，2.58）更有可能睡眠质量差。与同龄人相比，那些表示哪怕有适度易怒情绪的学生（aOR=1.47，95%置信区间：1.01，2.14）、难以放松的学生（aOR=1.79，95%置信区间：1.23，2.62）以及经常感到烦躁的学生（aOR=1.94，95%置信区间：1.13，2.86）睡眠质量差的风险更高。
该研究发现中学生睡眠质量差的患病率相对较高，这归因于感知到的学业和心理压力。为了减轻压力并培养更健康的睡眠模式，建议采取旨在解决和减轻压力以及促进良好睡眠卫生习惯的干预措施。
