Sleep quality among Italian university students: the UnSleep multicenter study

Sleep quality among Italian university students: the UnSleep multicenter study

Authors

  • Francesca Gallè Department of Medical, Movement and Wellbeing Sciences, University of Naples “Parthenope”, Naples, Italy
  • Fabiano Grassi Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  • Federica Valeriani Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
  • Roberto Albertini Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Silvia Angelillo Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
  • Giuseppina Caggiano Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
  • Annalisa Bergellini Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
  • Aida Bianco Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
  • Lavinia Bianco Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  • Laura Dallolio Department of Biomedical and Neuromotor Science Alma Mater Studiorum, University of Bologna, Bologna, Italy
  • Giorgia Della Polla Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
  • Gabriele Di Giuseppe Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
  • Maria Eufemia Gioffrè Multispecialty Clinical Institute, Trauma Orthopedic Care, Messina, Italy
  • Pasqulina Laganà Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
  • Francesca Licata Department of Health Sciences, School of Medicine, University of Catanzaro “Magna Græcia”, Catanzaro, Italy
  • Fabrizio Liguori Department of Economics and Legal Studies, University of Naples “Parthenope”, Naples, Italy
  • Giuseppina Lo Moro Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
  • Isabella Marchesi Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
  • Manuela Martella Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
  • Alice Masini Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont and Ospedale Maggiore della Carità, Novara, Italy
  • Maria Teresa Montagna Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
  • Christian Napoli Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  • Stefania Oliva Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  • Giovanni Battista Orsi Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  • Stefania Paduano Department of Biomedical, Metabolic and Neural Sciences, Section of Public Health, University of Modena and Reggio Emilia, Modena, Italy
  • Cesira Pasquarella Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Concetta Paola Pelullo Department of Medical, Movement and Wellbeing Sciences, University of Naples “Parthenope”, Naples, Italy
  • Rossella Sacchetti Department of Education Studies “Giovanni Maria Bertin”, University of Bologna, Bologna, Italy
  • Roberta Siliquini Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy; Hospital Medical Direction, A.O.U. City of Health and Science of Torino, Turin, Italy
  • Francesco Triggiano Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
  • Licia Veronesi Department of Medicine and Surgery, University of Parma, Parma, Italy
  • Vincenzo Romano Spica Department of Movement, Human, and Health Sciences, University of Rome “Foro Italico”, Rome, Italy
  • Matteo Vitali Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
  • Carmela Protano Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy

Keywords:

Undergraduates; Electronic Devices; Lifestyles

Abstract

Background. Scientific evidence demonstrates that poor sleep quality can lead to various health problems. This study aimed to investigate sleep patterns among Italian university students and identify several factors that may contribute to its quality. Study design. Cross-sectional study. Methods. An electronic questionnaire regarding sociodemographic characteristics, lifestyle, and sleep-related habits, including the Pittsburgh Sleep Quality Index (PSQI) questionnaire, was distributed between January 2022 and July 2023 among students belonging to 12 universities located in Northern, Central, and Southern Italy.

References

1. Bin YS. Is Sleep Quality More Important Than Sleep Dura-

tion for Public Health?. Sleep. 2016 Sep;39(9):1629-1630.

https://doi.org/10.5665/sleep.6078. Epub 2016 Aug 19.

PMID: 27568809; PMCID: PMC4989250.

2. Krystal AD, Edinger JD. Measuring sleep quality. Sleep

Med. 2008 Sep;9(Suppl 1):S10-7. doi: 10.1016/S1389-

9457(08)70011-X. PMID: 18929313.

3. Ohayon M, Wickwire EM, Hirshkowitz M, Albert SM,

Avidan A, Daly FJ, et al. National Sleep Foundation’s sleep

quality recommendations: first report. Sleep Health. 2017

Feb;3(1):6-19. https://doi.org/10.1016/j.sleh.2016.11.006.

Epub 2016 Dec 23. PMID: 28346153.

4. Hertenstein E, Feige B, Gmeiner T, Kienzler C, Spiegelhal-

der K, Johann A, et al. Insomnia as a predictor of mental

152 F. Gallè et al.

disorders: A systematic review and meta-analysis. Sleep

Med Rev. 2019 Feb;43:96-105. https://doi.org/10.1016/j.

smrv.2018.10.006. Epub 2018 Nov 16. PMID: 30537570.

5. Sivertsen B, Hysing M, Harvey AG, Petrie KJ. The Epide-

miology of Insomnia and Sleep Duration Across Mental and

Physical Health: The SHoT Study. Front Psychol. 2021 Jun

14;12:662572. https://doi.org/10.3389/fpsyg.2021.662572.

PMID: 34194368; PMCID: PMC8236531.

6. Scott AJ, Webb TL, Martyn-St James M, Rowse G,

Weich S. Improving sleep quality leads to better mental

health: A meta-analysis of randomised controlled trials.

Sleep Med Rev. 2021 Dec;60:101556. doi: 10.1016/j.

smrv.2021.101556. Epub 2021 Sep 23. PMID: 34607184;

PMCID: PMC8651630.

7. Huang T, Mariani S, Redline S. Sleep Irregularity and

Risk of Cardiovascular Events: The Multi-Ethnic Study of

Atherosclerosis. J Am Coll Cardiol. 2020 Mar 10;75(9):991-

999. https://doi.org/10.1016/j.jacc.2019.12.054. PMID:

32138974; PMCID: PMC7237955.

8. Knutson KL, Van Cauter E. Associations between

sleep loss and increased risk of obesity and diabetes.

Ann N Y Acad Sci. 2008;1129:287-304. https://doi.

org/10.1196/annals.1417.033. PMID: 18591489; PMCID:

PMC4394987.

9. Fang H, Tu S, Sheng J, Shao A. Depression in sleep distur-

bance: A review on a bidirectional relationship, mechanisms

and treatment. J Cell Mol Med. 2019 Apr;23(4):2324-2332.

https://doi.org/10.1111/jcmm.14170. Epub 2019 Feb 7.

PMID: 30734486; PMCID: PMC6433686.

10. Léger D, Bayon V, Ohayon MM, Philip P, Ement P, Met-

laine A, et al. Insomnia and accidents: cross-sectional study

(EQUINOX) on sleep-related home, work and car accidents

in 5293 subjects with insomnia from 10 countries. J Sleep

Res. 2014 Apr;23(2):143-152. https://doi.org/10.1111/

jsr.12104. Epub 2013 Nov 15. PMID: 24237855.

11. Morin CM, Drake CL, Harvey AG, Krystal AD, Manber R,

Riemann D, et al. Insomnia disorder. Nat Rev Dis Primers

2015 Sep 3;1:15026. https://doi.org/10.1038/nrdp.2015.26.

PMID: 27189779.

12. Baranwal N, Yu PK, Siegel NS. Sleep physiology,

pathophysiology, and sleep hygiene. Prog Cardiovasc

Dis. 2023 Mar-Apr;77:59-69. https://doi.org/10.1016/j.

pcad.2023.02.005. Epub 2023 Feb 24. PMID: 36841492.

13. Becker SP, Jarrett MA, Luebbe AM, Garner AA, Burns GL,

Kofler MJ. Sleep in a large, multi-university sample of col-

lege students: sleep problem prevalence, sex differences, and

mental health correlates. Sleep Health. 2018 Apr;4(2):174-

181. https://doi.org/10.1016/j.sleh.2018.01.001. Epub 2018

Feb 21. PMID: 29555131; PMCID: PMC5863586.

14. Lemma S, Gelaye B, Berhane Y, Worku A, Williams MA.

Sleep quality and its psychological correlates among univer-

sity students in Ethiopia: a cross-sectional study. BMC Psy-

chiatry. 2012 Dec 28;12:237. https://doi.org/10.1186/1471-

244X-12-237. PMID: 23270533; PMCID: PMC3554495.

15. Li W, Yin J, Cai X, Cheng X, Wang Y. Association between

sleep duration and quality and depressive symptoms among

university students: A cross-sectional study. PloS One. 2020

Sep 11;15(9):e0238811. https://doi.org/10.1371/journal.

pone.0238811. PMID: 32915844; PMCID: PMC7485879.

16. Jahrami H, Dewald-Kaufmann J, Faris MAI, AlAnsari

AMS, Taha M, AlAnsari N. Prevalence of sleep problems

among medical students: a systematic review and meta-

analysis. J Public Health (Berl.). 2020;28:605-622. https://

doi.org/10.1007/s10389-019-01064-6.

17. Wang L, Qin P, Zhao Y, Duan S, Zhang Q, Liu Y, et al.

Prevalence and risk factors of poor sleep quality among In-

ner Mongolia Medical University students: A cross-sectional

survey. Psychiatry Res. 2016 Oct 30;244:243-248. https://

doi.org/10.1016/j.psychres.2016.04.011. Epub 2016 Jul 19.

PMID: 27500455.

18. Zhang L, Zheng H, Yi M, Zhang Y, Cai G, Li C, et al.

Prediction of sleep quality among university students af-

ter analyzing lifestyles, sports habits, and mental health.

Front Psychiatry. 2022 Aug 4;13:927619. https://doi.

org/10.3389/fpsyt.2022.927619. PMID: 35990068; PMCID:

PMC9385968.

19. Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni

O, DonCarlos L, et al. National Sleep Foundation’s sleep

time duration recommendations: methodology and results

summary. Sleep Health. 2015 Mar;1(1):40-43. https://doi.

org/10.1016/j.sleh.2014.12.010. Epub 2015 Jan 8. PMID:

29073412.

20. McMahon DM, Burch JB, Youngstedt SD, Wirth MD, Har- Wirth MD, Har-

din JW, Hurley TG, et al. Relationships between chronotype,

social jetlag, sleep, obesity and blood pressure in healthy

young adults. Chronobiol Int. 2019 Apr;36(4):493-509.

https://doi.org/10.1080/07420528.2018.1563094. Epub

2019 Jan 21. PMID: 30663440.

21. Cappuccio FP, D’Elia L, Strazzullo P, Miller MA. Quan-

tity and quality of sleep and incidence of type 2 diabetes:

a systematic review and meta-analysis. Diabetes Care.

2010 Feb;33(2):414-420. https://doi.org/10.2337/dc09-

1124. Epub 2009 Nov 12. PMID: 19910503; PMCID:

PMC2809295.

22. Zou P, Wang X, Sun L, Liu K, Hou G, Yang W, et al. Poorer

sleep quality correlated with mental health problems in

college students: A longitudinal observational study among

686 males. J Psychosom Res. 2020 Sep;136:110177. https://

doi.org/10.1016/j.jpsychores.2020.110177. Epub 2020 Jun

27. PMID: 32623194.

23. Valenzuela RLG, Velasco RIB, Jorge MPPC, 2nd. Impact

of COVID-19 pandemic on sleep of undergraduate stu-

dents: A systematic literature review. Stress Health. 2023

Feb;39(1):4–34. https://doi.org/10.1002/smi.3171. Epub

2022 Jun 24. PMID: 35699687.

24. Franceschini C, Musetti A, Zenesini C, Palagini L, Scarpelli

S, Quattropani MC, et al. Poor Sleep Quality and Its Conse- Poor Sleep Quality and Its Conse-

quences on Mental Health During the COVID-19 Lockdown

in Italy. Front Psychology 2020 Nov 9;11:574475. https://

doi.org/10.3389/fpsyg.2020.574475. PMID: 33304294;

PMCID: PMC7693628.

25. Gualano MR, Lo Moro G, Voglino G, Bert F, Siliquini R.

Effects of Covid-19 Lockdown on Mental Health and Sleep

Disturbances in Italy. Int J Environ Res Public Health. 2020

Sleep quality among Italian university students

153

Jul 2;17(13):4779. https://doi.org/10.3390/ijerph17134779.

in university students: A systematic review and meta-

PMID: 32630821; PMCID: PMC7369943.

analysis. Sleep Med Rev. 2021 Aug;58:101482. https://

26. Alghwiri AA, Almomani F, Alghwiri AA, Whitney SL.

doi.org/10.1016/j.smrv.2021.101482. Epub 2021 Mar 20.

Predictors of sleep quality among university students: the

PMID: 33864990.

use of advanced machine learning techniques. Sleep Breath.

35. Meers JM, Nowakowski S. Sleep, premenstrual mood disor-

2021 Jun;25(2):1119-1126. https://doi.org/10.1007/s11325-

der, and women’s health. Curr Opin Psychol. 2020 Aug;34:43-

020-02150-w. Epub 2020 Jul 23. PMID: 32700289.

49. https://doi.org/10.1016/j.copsyc.2019.09.003. Epub

27. Schmickler JM, Blaschkr S, Robbins R, Mess F. Deter-

2019 Sep 23. PMID: 31610482.

minants of Sleep Quality: A Cross-Sectional Study in

36. Breda M, Belli A, Esposito D, Di Pilla A, Melegari MG,

University Students. Int J Environ Res Public Health. 2023

DelRosso L, et al. Sleep habits and sleep disorders in Ital- Sleep habits and sleep disorders in Ital-

Jan 23;20(3):2019. https://doi.org/10.3390/ijerph20032019.

ian children and adolescents: a cross-sectional survey. J

PMID: 36767422; PMCID: PMC9915447.

Clin Sleep Med. 2023 Apr 1;19(4):659-672. https://doi.

28. Carpi M, Cianfarani C, Vestri A. Sleep Quality and Its As-

org/10.5664/jcsm.10400. PMID: 36661089; PMCID:

sociations with Physical and Mental Health-Related Quality

PMC10071380.

of Life among University Students: A Cross-Sectional Study.

37. S caioli G, Squillacioti G, Bersia M, Bellisario V, Borraccino

Int J Environ Res Public Health 2022 Mar 1;19(5):2874.

A, Bono R, et al. The wellbeing of adolescents and the role

https://doi.org/10.3390/ijerph19052874. PMID: 35270566;

of greenness: A cross-sectional study among Italian students.

PMCID: PMC8910365.

Front Public Health. 2023 Jan 18;10:1050533. https://doi.

29. Li Y, Bai W, Zhu B, Duan R, Yu X, Xu W, et al. Prevalence

org/10.3389/fpubh.2022.1050533. PMID: 36743191; PM- PMID: 36743191; PM-

and correlates of poor sleep quality among college students:

CID: PMC9889974.

a cross-sectional survey. Health Qual Life Outcomes.

38. Otsuka Y, Itani O, Nakajima S, Kaneko Y, Suzuki M,

2020 Jul 1;18(1):210. https://doi.org/10.1186/s12955-020-

Kaneita Y. Impact of chronotype, insomnia symptoms,

01465-2. PMID: 32611434; PMCID: PMC7329462.

sleep duration, and electronic devices on nonrestorative

30. Peltzer K, Pengpid S. Nocturnal sleep problems among

sleep and daytime sleepiness among Japanese adolescents.

university students from 26 countries. Sleep Breath. 2015

Sleep Med 2023 Oct;110:36-43. https://doi.org/10.1016/j.

May;19(2):499-508. https://doi.org/10.1007/s11325-014-

sleep.2023.07.030. Epub 2023 Jul 29. PMID: 37531897.

1036-3. Epub 2014 Jul 14. PMID: 25017741.

39. Peltz JS, Bodenlos JS, Kingery JN, Rogge RD. The role of

31. Curcio G, Tempesta D, Scarlata S, Marzano C, Moroni

financial strain in college students’ work hours, sleep, and

F, Rossini PM, et al. Validity of the Italian version of the

mental health. J Am Coll Health 2019 Aug-Sep;69(6):577-

Pittsburgh Sleep Quality Index (PSQI). Neurol Sci. 2013

584. https://doi.org/10.1080/07448481.2019.1705306. Epub

Apr;34(4):511-519. https://doi.org/10.1007/s10072-012-

2020 Jan 15. PMID: 31940259.

1085-y. Epub 2012 Apr 13. PMID: 22526760.

40. Li TMH, Chan NY, Li CT, Chen J, Chan JWY, Liu Y, et

32. Foulkes L, McMillan D, Gregory AM. A bad night’s sleep on

al. The Associations of Electronic Media Use with Sleep

campus: an interview study of first-year university students

and Circadian Problems, Social, Emotional and Behav-

with poor sleep quality. Sleep Health. 2019 Jun;5(3):280-

ioral Difficulties in Adolescents. Front Psychiatry 2022 Jun

287. https://doi.org/10.1016/j.sleh.2019.01.003. Epub 2019

9;13:892583. https://doi.org/10.3389/fpsyt.2022.892583.

Mar 1. PMID: 31208711.

PMID: 35757219; PMCID: PMC9218337.

33. Deforche B, Van Dyck D, Deliens T, De Bourdeaudhuij I.

41. Gallè F, Sabella EA, Bianco L, Maninchedda M, Barchielli

Changes in weight, physical activity, sedentary behaviour

B, Liguori F, et al. How the COVID-19 Pandemic Has Im- How the COVID-19 Pandemic Has Im-

and dietary intake during the transition to higher educa-

pacted Daily Life? Assessing the Use of Web Resources for

tion: a prospective study. Int J Behav Nutr Phys Act. 2015

Recreational Activities in the Italian Adult Population. Int

Feb 15;12:16. https://doi.org/10.1186/s12966-015-0173-9.

J Environ Rese Public Health. 2022 Nov 16;19(22):15136.

PMID: 25881147; PMCID: PMC4332914.

https://doi.org/10.3390/ijerph192215136. PMID: 36429855;

34. Memon AR, Gupta CC, Crowther ME, Ferguson SA,

PMCID: PMC9690348.

Tuckwell GA, Vincent GE. Sleep and physical activity

Downloads

Published

2025-05-07

Issue

Vol. 37 No. 1 (2025)

Section

Original research

License

Copyright (c) 2025 Francesca Gallè, Fabiano Grassi, Federica Valeriani, Silvia Angelillo, Giuseppina Caggiano, Annalisa Bergellini, Aida Bianco, Lavinia Bianco, Laura Dallolio, Giorgia Della Polla, Gabriele Di Giuseppe, Maria Eufemia Gioffrè, Pasqulina L Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Transfer of Copyright and Permission to Reproduce Parts of Published Papers. 
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.

How to Cite

1.
Gallè F, Grassi F, Valeriani F, et al. Sleep quality among Italian university students: the UnSleep multicenter study. Ann Ig. 2025;37(1):141-153. doi:10.7416/ai.2024.2655