Abstract
Background/Objectives: University students in health sciences are particularly vulnerable to poor sleep quality and elevated stress due to academic and clinical demands. This follow-up study aimed to compare sleep quality and perceived stress levels among health science students during online and frontal (in-person) education periods and to examine the influence of behavioral and demographic factors. Methods: A prospective, follow-up design was applied involving students from the University of Pécs, Faculty of Health Sciences, across nursing, radiography, laboratory analytics, paramedicine, and physiotherapy programs. Data were collected via anonymous online questionnaires during two intervals: February-March 2023 (online education) and April-May 2023 (frontal education). The Athens Insomnia Scale (AIS) and Perceived Stress Scale (PSS-10) were used to assess sleep quality and stress, respectively. Internal consistency was evaluated using Cronbach's alpha (AIS: α = 0.81-0.84; PSS: α = 0.87-0.90). Data were analyzed using descriptive statistics and paired sampled t-tests (p < 0.05). Results: AIS scores were significantly higher during online learning compared to in-person (5.47 ± 2.67 vs. 4.25 ± 2.48; p = 0.001), indicating poorer sleep quality. In contrast, PSS scores were higher during the frontal period (29.48 ± 8.67 vs. 24.31 ± 7.15; p < 0.05). Increased screen time, irregular routines, and lack of physical activity were associated with poorer outcomes. Conclusions: Online education may compromise sleep quality, while in-person learning appears to increase perceived stress. These findings highlight the need for targeted health promotion strategies adapted to different educational modalities.