Prevalence and risk factors of sleep disorders among undergraduates in a Nigerian university: A clinical epidemiological framework

Background: Sleep disorders have been increasingly recognised as important public health problems among young adults, especially university students. Such disturbances may interfere with students’ concentration, sense of well-being and learning. Despite their public health significance, little is known about the prevalence and determinants in Rivers State, Nigeria. The study aimed to determine the prevalence and risk factors associated with sleep disorders among undergraduates at Rivers State University, Port Harcourt, using a clinical epidemiological framework.

Methods: An analytical cross-sectional study was conducted among 424 undergraduates for four months (February 20, 2025, to June 24, 2025). The students were selected using a multistage sampling technique. Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Perceived Stress Scale were used to collect the data. Descriptive statistics, bivariate, and multivariable logistic regression were used to compare prevalence and predictors of sleep disorders. The discriminatory power of the model was assessed using the receiver operating characteristic curve.

Results: The mean age was 21.3 ± 2.6 years, with the majority, 206 (48.6%), falling within the 21–25 years age range. The prevalence of sleep disorders was 155 (36.5%). Depressive symptoms increased the odds of poor sleep quality by threefold, making it the most significant predictor (AOR: 3.01; 95% CI: 1.74-5.21; p<0.001). Stress doubled the odds (AOR: 2.04; 95% CI: 1.27-3.27; p=0.003), while excessive screen time also emerged as an independent risk factor (AOR: 1.79; 95% CI: 1.12-2.85; p=0.015). The final model showed good fit (Hosmer–Lemeshow p = 0.62) and excellent discrimination (AUC = 0.91).

Conclusion: Sleep disturbances are prevalent among undergraduates in Port Harcourt and are highly associated with modifiable lifestyle factors. University-based health promotion programmes targeting stress management, responsible screen use, and substance avoidance are urgently needed.