Sleep quality and its association with substance abuse among university students

Clin Neurol Neurosurg. 2020 Jan;188:105591. doi: 10.1016/j.clineuro.2019.105591. Epub 2019 Nov 7.


Objective: Poor sleep is one of the greatest health problems with social significance whose prevalence started early in adolescence. The relationship between poor sleep quality and the use of alcohol and illicit substances among university students has not been studied. Our study aimed to determine these relationships and the factors influencing the risk of poor sleep in students from health sciences degrees which are the future healthcare providers.

Patients and methods: A cross-sectional study performed in European university students (n = 676). Sleep quality was assessed by measuring insomnia symptoms with the Athens insomnia scale (AIS). The CRAFFT screening test and AUDIT test were used to measure the use of substances of abuse.

Results: Insomnia symptoms were highly prevalent (40.2%) and more common among the youngest students (p = 0.012), who had been studying at the university for less time (p = 0.018), and had high levels of illicit drug use (p = 0.037). Good sleep quality represented a significant protective factor for problematic drug use, with an OR of 0.8 (CI95%: 0.76-0.99). In contrast, the category "not having a job" represents risk 1.2 times higher (CI95%: 1.025-1.557) for problematic drug use. The CRAFFT score significantly predicted higher insomnia symptoms (AIS ≥ 6), yielding an OR of 1.2 (CI95%:1.10-1.32, p < 0.001).

Conclusions: Poor sleep quality is common in university students. There is an inverse association between higher insomnia symptoms and illicit drug abuse being a good sleep qualitya protective factor against problematic use of illicit drugs. Several personal and social consequences of illicit drug use are related to poor sleep in this population and it deserves future studies and interventions in order to improve both problems.

Keywords: Alcohol abuse; Cannabis; Insomnia; Sleep; University students.

MeSH terms

  • Adolescent
  • Adult
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Protective Factors
  • Risk Factors
  • Sleep
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Students / statistics & numerical data*
  • Substance-Related Disorders / epidemiology*
  • Unemployment
  • Universities
  • Young Adult