Background: Sleep is an indispensable necessity of humankind, imperative for sustaining the quality of life and well-being of all ages. Poor sleep is proven to have an impact on students’ academic endeavors and general health. Even though some university students are conversant with health repercussions associated with poor insomnia, a substantial proportion fail to prioritize sleep health over their academic tasks or deem their health to be at risk.

Objectives: To determine the prevalence of insomnia among undergraduate students at the College of Health Sciences, University of Rivers state.

Methodology: An institutional analytic cross-sectional study was carried out at the College of Health Sciences. A stratified random sampling technique was employed with strata being the schools. A Pittsburgh Insomnia Inventory was used to measure insomnia. Out of the 378 participants, 245 were interviewed through a tablet device-based questionnaire running on the Open Data Kit (ODK) application and the remaining 133 students completed an online questionnaire (SurveyMonkey). Descriptive statistics, correlations, bivariate, and multivariate binary logistic regression were performed using the IBM Statistical Package for the Social Sciences (SPSS) version 23 at p <0.20 and p <0.05 level of significance, and a 95% confidence interval.

Results: Out of the 378 participants the majority were females (57.1%) and 42.9% were males. The prevalence of poor insomnia (PSQI > 5) was 80% among undergraduate students, whereas good insomnia was 20%. In an adjusted multivariate analysis, factors that were significantly associated with poor insomnia were perceived stress [AOR:3.15; 95% Cl: (1.43, 6.91); p = 0.004], room air quality [AOR: 2.32; 95% Cl: (1.08, 5.01); p = 0.0031], and sleep hygiene [AOR:1.08; 95% Cl: (1.03, 1.14); p = 0.002].

Conclusion: Findings from this study demonstrated an alarming prevalence of poor insomnia (PSQI > 5) 80 percent among undergraduate students. This study has shown a significant correlation between perceived stress, sleep hygiene, and insomnia which suggests that sleep hygiene practices and stress coping strategies should be considered as a potential influence on enhancing good insomnia. The modifiable risk factors such as perceived stress, sleep hygiene, and room quality were considered potential risks for poor insomnia.

Recommendations: To improve insomnia among undergraduate students at the College of Health Sciences, the University should develop sleep hygiene education programs as an intervention and prevention strategy. To alleviate high stress, students should equip each other with better relaxation techniques such as Yoga, meditation, and extracurricular activities and manage their time properly to attain optimal insomnia and academic functioning.

• Background
Sleep is vital in life and is known to significantly contribute to the cognitive, emotional, physical, and overall health of human beings (Paterson, Nutt & Wilson, 2011). Sleep is termed as a repeated natural state of mind and body, that leads to reduced consciousness, diminished sensory activities of voluntary muscle, and rejuvenation of mental and physical functioning. The sleeping cycle is composed of roughly eight hours of night-time sleep and sixteen hours of wakefulness during the day time in humans and is regulated by opposing internal factors: circadian rhythms and homeostasis of sleep (Ohayon et al., 2017). It is acknowledged in the literature that adequate sleep is imperative to process information learned during a period of wakefulness and translate it into useful memory, to allow communication between several components of the brain (Sexton-Radek & Pichler-Mowry, 2011).

Recently, there has been widely epidemiological evidence indicating that sleep health is a public concern globally. It is projected that people who suffer from sleep disorders are approximately 150 million universally and virtually 17% of this population is in developing countries (Berhanu, Mossie, Tadesse & Geleta, 2018). The National Sleep Foundation (2018) depicted that American people who are affected by poor insomnia are approximately 50 to 70 million. In China, the likelihood of having poor sleep outcomes was reported to be 56.7% in adults with a higher proportion among males (Wu et al., 2018). Whereas, the prevalence of poor insomnia in Spain stood at 38.2%, as women were essentially twice as likely than men to have poor quality, suggesting sex to be linked with poor insomnia (Madrid-valero, Martínez-selva, Ribeiro, Sánchez-romera, & Ordo, 2017).

It is generally known that developing and low-income countries are faced with a vast demographic and epidemiological transition. A challenging problem arises in this domain as sleep health remains an unprioritized health issue with less emphasis on the worldwide dimension of this emergent public health concern (Stranger, Tigbe, Gomez-Oliv, Torogood & Kandala, 2012). The outcome from the WHO-SAGE study by Stranger et al., (2012) among average adults in South Africa exhibited that 27.2 % of men and 31.3% of women experienced poor insomnia. In more African countries such as Ghana, Nigeria, and Tanzania, poor insomnia overall rates ranged from 8.3 % to 12.7 % and it was more pervasive than cancer, HIV and AIDS, cardiovascular diseases, neurophysiological disease, and respiratory diseases (Stranger et al., 2012).

Epidemiological evidence established associations between poor sleep health with premature morbidity and mortality (Adriansen, Childers, Yoder, & Abraham, 2017; Ferrie, Kumari, Salo, Singh-Manoux & Kivimäki, 2011). The aforementioned is as well linked with numerous chronic morbidities such as cardiovascular disease, hypertension, Obesity, Diabetes, and attention-deficit hyperactivity disorder, and Psychiatric conditions (Adriansen et al., 2017; Ferrie et al., 2011).

In educational institutions, university students sacrifice their sleep to pursue good grades in their academic endeavors. Students in the Health fraternity are particularly faced with extensive theoretical and clinical content which leads to long study hours and attending clinical practice. The literature proved that poor sleep health influences academic performance and findings were found to be consistent globally (Ahrberg, Dresler, Niedermaier, Steiger & Genzel, 2012; Al-Kandari et al., 2017; Wang et al., 2016). According to Schlarb & Friedrich (2017), 60% of university students are subjected to poor insomnia and 7.7% are estimated to meet the eligibility criteria of sleep disorders including Insomnia. The university students who experienced poor sleep were compelled to report physical ailments, high perception of stress, and utilization of drugs to help them stay awake (Lund, Reider, Whiting & Prichard, 2010; Sahraian & Javadpour, 2010).

A series of recent studies that focused on university students have also revealed that poor insomnia leads to reduced learning capacity (Ahrberg et al., 2012; Perez-Olmos & Ibanez-Pinilla, 2014; Al-Kandari et al., 2017). Research infers that poor sleep leads to depression (Adams & Kisler, 2013) with detrimental sleep problems in the first semester of studies (Doane, Gress- Smith, & Breitenstein, 2015). Psychological imbalances like reduced alertness, mood variations, performance faults, reduced punctuality for lectures, and grade point average (GPA) has been pointed towards sleep deprivation (Amin et al., 2016). Disturbances in the sleep-wake cycle are associated with severe negative outcomes on mental and physical wellbeing (American Academy of Sleep Medicine, 2015).

Over time, some researchers constructed the Pittsburgh Insomnia Inventory (PSQI) that has become a frequently used gold standard and validated standardized self-report measure of insomnia that determines if an individual is a good or poor sleeper (Buysse, Reynolds, Monk, Berman, & Kupfer, 1988). The basis for constructing the index was on the high occurrence of sleep problems, in addition to the relation of poor insomnia with medical disorders (Buysse et al., 1988). Insomnia is an approved clinical construct that is utilized in clinical and non-clinical settings (Almojali, Almalki, Alothman, Masuadi, & Alaqeel, 2017). In particularly Nigeria, there are few studies published on sleep health, and these studies rarely examined factors related to insomnia amongst university students.

• Problem statement
Studies indicate that students lack knowledge of sleep health and the repercussions it has on individuals’ well-being (Ahrberg et al., 2012; Perry, Patil & Presley-Cantrell, 2013). This is not an exception for university students as studies indicate a high poor insomnia prevalence of about 60% higher than any other demographic (Alimirzae, Azzizadeh Forouzi, Abazari & Haghdoost, 2014). Students in the Health fraternity are faced with a greater academic load which could potentially arise to deprivation of sleep. Hence, it is imperative to know the extent of the problem and factors affecting their insomnia, and if disturbances in their sleep pattern impact their overall well-being and academic life.

Findings from various literature depict that students are less knowledgeable on the health effects derived from sleep deprivation and the impacts on the quality of care and safety rendered to patients (Agarwal, Eryuzlu & Chawla 2015; Thomas, McIntosh, Lamar & Allen, 2017). This negatively impacts the safety of the patients and it could affect proficiency in clinical practice (Agarwal et al., 2015; Thomas et al., 2017). Predisposing factors such as stress and alcohol misuse are regularly tackled in healthcare in isolation despite the negative consequences it has on insomnia.

Sleep is an understudied health concern (Knowlden, Sharma, & Bernard, 2012a). There are dearth and paucity of data on insomnia among university students in Nigeria, whose study program and culture may differ from other university students. The current study will address this research gap by determining the prevalence and underlying factors of insomnia among undergraduate students at the College of Health Sciences, University of Rivers state.

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Item Type: Project Material  |  Size: 93 pages  |  Chapters: 1-5
Format: MS Word  |  Delivery: Within 30Mins.


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