Sleep disorder, Mediterranean Diet and learning performance among nursing students: inSOMNIA, a cross-sectional study

Ann Ig. 2018 Nov-Dec;30(6):470-481. doi: 10.7416/ai.2018.2247.


Background: The International Classification of Sleep disorders, the International Classification of Diseases and the Diagnostic and Statistical manual of Mental Disorders defines insomnia as an experience of insufficient or poor sleep quality, characterized by at least one of the following symptoms: difficulty in initiating or maintaining sleep, early awakenings and poor restorative sleep. In Italy, the Morfeo 1 study detects a prevalence of 20% of insomnia and a 40% of cases with day-time symptoms. The chronic sleep deprivation is responsible for cognitive disorders with effects on social life. Being common knowledge, lifestyle can also influence sleep. Some of the "sleep hygiene rules" involve a control on smoking, coffee consumption and diet. The Mediterranean Diet (MD), thanks to its high level of tryptophan, has a positive influence on sleep and can protect against stress and anxiety.

Study design: The aim of InSOMNIA study was to determine the prevalence of sleep disorders among nursing students of the University of Perugia and, therefore, to evaluate how lifestyle, eating habits, health status and academics performance are linked to night-time and daytime symptoms of the interrupted sleep.

Methods: We adopted a cross sectional survey, collecting data from "Sleep and Daytime Habits Questionnaire" to evaluate the sleep disorders and from PREDIMED questionnaire to assess the adherence to MD.

Results: We found a statistical significant association between PREDIMED score and BMI (p-value=0.0127), smoking habit (p-value = 0.0125), quality of life (p-value = 0.0480) and academic progress (p-value = 0.0092).

Conclusions: We found a high prevalence of sleep disturbances statistically associated with diet and poor academic progress.

Keywords: Learning Performance; Mediterranean Diet; Nursing students; Sleep Disorder.

MeSH terms

  • Academic Performance*
  • Adult
  • Age Distribution
  • Alcohol Drinking
  • Body Height
  • Body Weight
  • Coffee
  • Cross-Sectional Studies
  • Diet, Mediterranean*
  • Employment / statistics & numerical data
  • Exercise
  • Female
  • Health Status
  • Humans
  • Italy / epidemiology
  • Learning
  • Life Style
  • Male
  • Prevalence
  • Quality of Life*
  • Regression Analysis
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / etiology
  • Sleep Initiation and Maintenance Disorders / prevention & control
  • Smoking / adverse effects
  • Students, Nursing / statistics & numerical data*
  • Surveys and Questionnaires
  • Tryptophan / administration & dosage
  • Young Adult


  • Coffee
  • Tryptophan