INTRODUCTION:

Sleep was instrumental in people’s physical health, cognitive functioning, and emotional well-being. Among university students, sleep took on even further importance since this population was characterized by unique demands of their academic work, irregular schedules, social commitments and lifestyle changes that often disrupted normal sleep habits [1]. The shift from being a student in school to going to the university was often a period during which students had to adapt to higher academic workloads, independent living, and changes to their daily routines. As a result, sleep disturbance and poor sleep quality had become more and more common in university students across the globe.

Not only the length of sleep was part of sleep quality but also the depth, continuity, and restorative character of sleep. Adequate sleep was critical for memory consolidation, attention, learning capacity and executive functioning – all processes that were directly tied to academic performance [2]. Neurocognitive research had shown that sleep helped people to consolidate newly acquired information and improve their problem-solving capabilities. Most opposite, a lack of adequate or continuous sleep had been linked with impaired concentration, reduced alertness, mood instability and decreased motivation, all of which could adversely affect the academic outcomes of the students [3].

Academic performance in academic settings was usually assessed in the form of grade point average (GPA), examination scores, class participation, and overall learning achievements. Multiple aspects had been demonstrated to affect academic performance, ranging from study habits to socioeconomic background, mental health status, teaching quality and lifestyle behaviors. Among these factors, sleep quality had been found as a potentially modifiable determinant capable of having a significant impact on the scholastic success of students [4]. Despite this recognition, many students tended to sacrifice sleep to the point of late night study, social media activity, part time employment or recreation time without a full appreciation for the consequences of sleep deprivation.

Previous studies had shown large rates of poor quality of sleep among university students, the most common problems being insomnia, delayed sleep phase, frequent arousals, and excessive sleepiness. The general tendency to use electronic devices before sleep had had an additional detrimental influence on sleeping problems by suppressing melatonin secretion and delaying onset of sleep [5]. In addition, stress and anxiety which were related to academic deadlines and examinations had been identified as major contributors to sleep problems in this population. Such sleep disruptions had previously been associated with a decrease in cognitive efficiency and poor school performance.

Furthermore, chronic sleep deprivation had been linked to long term health risks including obesity, hypertension, depression and poor immune system. From a public health standpoint, knowledge of the link between sleep quality and academic achievement was important since academic achievement may impact future career choices and quality of life [6]. Universities therefore had a responsibility to see sleep health as integral part of student well-being and academic success.

Although several international studies had been conducted on the link between sleep quality and academic performance, studies had been varied due to differences in study design, the cultures and the tools of measurement. In many developing countries with rapidly increasing higher education systems, little local data in this respect was available [7]. Therefore, further investigation had been needed in order to assess the degree of influence that the quality of sleep had on academic outcomes amongst university students.

In light of the above considerations the present study had been taken up to examine the relationship between sleep quality and the academic performance of students in the Universities. By determining possible associations, the study set out to prove evidence to back towards interventions that encourage healthy sleep habits and ultimately increase academic achievement and student health [8].

MATERIALS AND METHODS:

This descriptive cross-sectional study was performed from January 2024 to January 2026 at Fatima Memorial Hospital for the research of the relationship between the quality of sleep and the level of students at university. Ethical approval was obtained from the Institutional Review Board (IRB) of the Fatima Memorial Hospital before the study was started. Written informed consent was obtained from all participants; confidentiality of the data was ensured throughout the research process.

A total of 300 undergraduate and postgraduate students, aged between 18 and 25 years were recruited using Stratified random sampling technique. Stratification by year of study and faculty was done in order to ensure representation from a variety of academic disciplines. Students with diagnosed sleep disorders or psychiatric illnesses or who suffer from chronic medical conditions or who currently take medications that affect sleep patterns were excluded to minimize the effect of confounding factors.

Data collection was carried out by using structured, self-administered questionnaire. This questionnaire had three parts: demographic data, assessment of sleep quality and academic performance measures. Demographic variables were age, gender, year of study, faculty, and lifestyle variables such as caffeine intake, physical activity and screen time. Quality of sleep was determined with the Pittsburgh Sleep Quality Index (PSQI), a validated tool that determines quality of sleep over the past month, subjectively. The PSQI contained such components as sleep duration, sleep latency, sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. A global PSQI score > 5 was considered poor sleep quality and 5 or less was considered good sleep quality.

Academic performance was determined from the cumulative grade point average (CGPA) of the students, obtained from official records at the university. CGPA was divided into high performance (all above 3.5), moderate performance (2.5-3.49), and low performance (less than 2.5) to conduct statistical analysis. Students were asked for voluntary consent to access their academic records and anonymity was ensured through assignment of unique identification codes.

Data collection was carried out in quiet settings on the university campus in order to minimize distractions and make sure honest responses are obtained. Participants were administered the questionnaire under the supervision of trained research assistants who explained any doubt that may have arisen regarding questions. Data completeness and accuracy were checked on-site before handing in the different questionnaires.

The data collected were entered into the statistics package, version 26.0, of the software program, the Statistical Package for Statistical analysis (SPSS). The means, standard variabilities, frequencies, and percentages of demographic variables, PSQI, and academic performances were determined using descriptive statistics. The relationship between sleep quality and academic performance was analyzed using Pearson correlation coefficients and Chi square tests for categorical variables. A p value of < 0.05 was considered to be statistically significant. Multiple linear regression analysis was conducted on whether sleep quality was predictive of academic performance controlling for possible confounding factors, such as age, gender, caffeine intake and physical activity levels.

All the procedures were performed under the Declaration of Helsinki. The methodology ensured strict adherence of ethical standards, reliability, and validity of data, thus a strong framework to assess the impact of sleep quality on academic performance among university students.

RESULTS:

The study was carried out on 200 university students at Fatima memorial hospital between January 2024 to January 2026 to establish the relationship between sleep quality and academic performance. The subjects comprised 55 (50%) females and 95 (50%) males with age ranging from 18 to 25 years. Sleep quality was measured using Pittsburgh Sleep Quality Index (PSQI) and academic performances were measured based on GPA of the students.

Table 1 shows the distribution of the students based upon their sleep quality and demographic characteristics. In all the participants, 68 (34%) had poor sleep quality (PSQI > 5), and 132 (66%) reported good sleep quality (PSQI <= 5). Poor quality of sleep was found to be more common in female students (40%) than in male students (26.7%). The mean age of the students who had poor sleep quality was 21.1 +- 1.9 years and those with good sleep quality had a mean age of 20.8 +- 2.0 years.