Prevalence and Correlates of Insomnia and Their Relationship With Quality of Life Among College Students in China: A Multi-Center Network Study

Abstract

Background:

Insomnia is a common sleep problem among college students. There is insufficient research on the inter-relationships between different insomnia symptoms and their associated factors and quality of life (QoL). This study examined the prevalence and correlates of insomnia symptoms (insomnia hereafter) among Chinese college students as well as their association with QoL from a network perspective.

Methods:

A multi-center, cross-sectional study was conducted between September and December 2023 in China. Insomnia symptoms were assessed using Insomnia Severity Index (ISI). The centrality index of “Expected influence” was applied to identify the most central symptoms in the network, and the “flow” function was used to identify specific symptoms that were directly related to QoL.

Results:

The prevalence of insomnia among the 6,514 college students was 26.42% (n = 1,721; 95% confidence interval [95% CI] [25.17, 27.67%]). The logistic regression analysis revealed that having a history of psychiatric problems (odds ratio [OR] = 1.316, p = .003), being quarantined during the COVID-19 pandemic (OR = 1.134, p = .035), and currently smoking (OR = 1.431, p = .005) and drinking (OR = 1.386, p < .001) were associated with an increased risk of insomnia. In contrast, being a freshman (OR = 0.782, p = .001), majoring in a health-related discipline (OR = 0.747, p < .001), and having good health status (OR = 0.415–0.594, p < .001) and good economy status (OR = 0.413, p < .001) were associated with a reduced risk of insomnia. The most central symptoms included ISI7 (“Distress caused by the sleep difficulties”), ISI2 (“Sleep maintenance”), and ISI1 (“Severity of sleep onset”), while ISI2 (“Sleep maintenance”), ISI7 (“Distress caused by the sleep difficulties”), and ISI5 (“Interference with daytime functioning”) had the strongest negative association with QoL.

Conclusion:

Among Chinese college students, insomnia was common and had a negative impact on QoL. Addressing these symptoms and implementing measures to improve insomnia could enhance students’ well-being and QoL.

Keywords

insomnia quality of life college students network analysis prevalence

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