Circadian rhythms and sleep quality among undergraduate students in China: The mediating role of health-promoting lifestyle behaviours

Abstract

Background: Poor sleep quality have become one of the most pressing public health problems for undergraduate students. The aim of this cross-sectional study was to investigate the relationship between circadian rhythms and sleep quality and the meditating role of health-promoting lifestyles in the relationship of Chinese undergraduate students.

Methods: A total of 3423 students participated. The online survey consisted of the reduced Morningness-Evening Questionnaire (rMEQ), the Pittsburgh Sleep Quality Index (PSQI) and Health-Promoting Lifestyle Profile-II (HPLP-II). Logistic regression models were employed.

Results: The prevalence of poor sleep quality is 43.03 %. The total mean scores of HPLP - II, PSQI, and rMEQ are 96.94 ± 17.26, 5.20 ± 2.70 and 14.83 ± 2.10, respectively. A significant negative correlation exists between the rMEQ and PSQI scores (r = -0.262, p < 0.001), but a positive correlation exists between the rMEQ and HPLP scores (r = 0.232, p < 0.001). The total and sub-domain scores of HPLP are also negatively correlated with the PSQI scores (r = -[0.166, 0.291], p < 0.001). Mediation analysis demonstrates the mediation of HPLP (indirect effect = -0.036, p < 0.001) on the effect of the rMEQ on PSQI scores that accounts for 13.30 % of the total effect.

Limitations: Cross-sectional design and recall bias in data collection.

Conclusions: The effect of circadian rhythm on sleep quality is partially mediated by the health-promoting lifestyle. In addition to maintaining a normal circadian rhythm, helping undergraduate students develop a healthy lifestyle is also an effective measure to improve sleep quality.

Keywords: Circadian rhythm; Health promoting lifestyle; Mediation model; Sleep quality; Undergraduate students.