Abstract
BACKGROUND: Secondary school students experience notable physiological and psychological changes and academic stressors, rendering them prone to poor sleep quality. We aimed to investigate impact of perceived academic stress and mental stress on sleep quality among secondary school students. METHODS: We conducted a two-stage cluster sampling cross-sectional study among 634 secondary school students in eight schools in Triyuga municipality, Nepal, from February to March 2022. A self-administered on-site survey was conducted to assess sleep quality, perceived academic stress and mental stress symptoms. Generalized linear mixed-effects models were performed to determine associations of academic stress and mental stress symptoms with sleep quality. RESULTS: The prevalence of poor sleep quality was 27.6%. Regarding perceived academic stress, 56.1% of students reported neutral or affirmative responses, while 33.1% exhibited varying degrees of mental stress symptoms. Students with perceived academic stress (adjusted odds ratio [aOR] = 2.09, 95% CI: 1.35, 3.22) and those experiencing mental stress symptoms (aOR = 1.74, 95% CI: 1.18, 2.58) were more likely to have poor sleep quality compared to their counterparts without these stressors. Students who indicated even a modest degree of feeling touchy (aOR = 1.47, 95% CI: 1.01, 2.14), who faced difficulties in winding down (aOR = 1.79, 95% CI: 1.23, 2.62) and frequently experienced agitation (aOR = 1.94, 95% CI: 1.13, 2.86) were at higher risk of experiencing poor sleep quality compared to their counterparts. CONCLUSION: The study found a relatively high prevalence of poor sleep quality in secondary school students, attributed to perceived academic and mental stress. To mitigate stress and foster healthier sleep patterns, interventions aimed at addressing and reducing stress and promoting good sleep hygiene practices are recommended.