COVID-19 Pandemic and Sleep Health in Polish Female Students.

: Insomnia and excessive sleepiness are significant health problems with a complex etiology, increasingly affecting young people, especially students. This study aimed to assess the prevalence of sleep disturbances and patterns of psychoactive drug use among female Polish students. We also explored the potential impact of the COVID-19 pandemic on sleep behaviors. We hypothesized that sleep disorders are common in this group, that medical students are more likely to experience insomnia and excessive sleepiness, and that the pandemic has exacerbated both sleep disturbances and substance use. : This cross-sectional study utilized a custom survey designed using standardized questionnaires-the Athens Insomnia Scale and Epworth Sleepiness Scale-that was distributed online using the Computer-Assisted Web Interviewing method. A total of 11,988 responses were collected from 31 January 2016 to 1 January 2021. Inclusion criteria were being female, having a college student status, and giving informed consent. : Among the 11,988 participants, alcohol use declined after the pandemic began ( = 0.001), while sedative use increased ( < 0.001). Insomnia (AIS) was associated with study year, university profile, and field of study ( < 0.001), with the highest rates in first-year and non-medical students. It was more common among users of sedatives, psychostimulants, and multiple substances. No significant change in insomnia was found before and after the pandemic. Excessive sleepiness (ESS) peaked in first-year and medical students. It decreased during the pandemic ( < 0.001) and was linked to the use of alcohol, psychostimulants, cannabinoids, and multiple substances. : These findings highlight that female students are particularly vulnerable to sleep disorders. The influence of the COVID-19 pandemic on sleep disturbances remains inconclusive. Given the varied results in the existing literature, further research is needed.