Sleep quality, sleep hygiene practices and their influencing factors among Malaysian university students: A cross-sectional study.

Introduction: Sleep quality refers to the subjective experience of sleep, encompassing aspects such as duration, depth and continuity. In contrast, sleep hygiene practices involve behaviours and habits conducive to healthy sleep patterns. This study aimed to explore the prevalence of good sleep quality and hygiene and the factors that affect good sleep hygiene and quality. Methods: A cross-sectional study was conducted among 384 Malaysian university students sampled from October to December 2023 using a validated self-administered questionnaire that included the Pittsburgh Sleep Quality Index (PSQI) and Sleep Hygiene Index (SHI). The PSQI and SHI were used to measure sleep quality and hygiene, respectively. Data was analysed using SPSS v26. Results: Approximately 94.0% (95% Confidence Interval (CI)=91.0-96.1) of the participants had good/normal sleep hygiene, while 60.2% (95% CI=55.1-65.1) had poor sleep quality. The multivariate binary logistic regression analysis showed that the participants who had good sleep hygiene had a 4.36-fold (95% CI=1.26-15.17, P=0.02) higher odds of having good sleep quality. Conversely, ethnicity (high odds ratio, P<0.001) and sleep hygiene were associated with a 4.22-fold (95% CI=1.19-14.95, P=0.03) higher odds of good sleep quality. Conclusion: Malaysian university students have a high prevalence of good sleep hygiene, but many have poor sleep quality. Although sleep hygiene may be directly affected by sleep quality, sleep quality can be affected by sleep hygiene and ethnicity.