Evidence map›Paper›PMID 40859219›Full record

ArticleBMC public health2025

Sleep quality among university students in Lebanon during war conflicts: a cross-sectional study.

Hanna El Haddad, Magalie Estanom, Michel Gergi, Christelle Khalil, Maria Angela Labaki, Rita Youssef, Shafika Assaad

Abstract read
In one paragraph

Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Sleeping under attack: Sleep disruption and next-day emotions during active wartime.International journal of clinical and health psychology : IJCHP
    Article
4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Hanna El HaddadSchool of Medicine and Medical Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
Magalie EstanomSchool of Medicine and Medical Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
Michel GergiSchool of Medicine and Medical Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
Christelle KhalilSchool of Medicine and Medical Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
Maria Angela LabakiSchool of Medicine and Medical Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon. mariaangela.g.labaki@net.usek.edu.lb.
Rita YoussefSchool of Medicine and Medical Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.
Shafika AssaadSchool of Medicine and Medical Sciences, Holy Spirit University of Kaslik, 446 Jounieh, Mount Lebanon, Lebanon.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSleep is a vital component for cognitive function, emotional well-being, and overall health, yet it is frequently disrupted by external stressors, such as war and conflict. University students, particularly those in conflict zones, face increased risks of poor sleep quality due to academic pressure, psychological stress, and trauma exposure.

objectivesThis study aims to assess the prevalence of poor sleep quality, sleep latency, and sleep efficiency among university students in Lebanon during the 2023-2024 war conflicts, and the direct and indirect effects of war exposure. MATERIALS AND

methodsA cross-sectional study was conducted on 631 university students in Lebanon using the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Sociodemographic characteristics and the type of war exposure (direct or indirect) were also assessed. Inferential statistical tests were performed to identify correlations between sleep quality and sociodemographic factors, as well as sleep quality and war exposure. The Prevalence Rate Ratio (PRR) was calculated to identify risk and protective factors for poor sleep quality in each socio demographic group. A binary regression model was applied to predict the most significant risk factors for compromised sleep quality.

results73.5% of Lebanese university students had poor sleep quality (PSQI > 5), with a mean Global PSQI score of 8.20 (± 3.95). Students with direct war exposure had the highest mean score of 10.57 (p < 0.001), compared to 8.04 for those with indirect exposure. The average sleep latency PSQI score was 1.46 ± 1.04, and the average sleep efficiency PSQI score was 1.00 ± 1.00. Compared to no exposure, indirect exposure resulted in a 22% higher prevalence (PRR = 1.22) of poor sleep, while direct exposure showed a 60% higher prevalence (PRR = 1.60). The binary exposure showed that female gender increased the odds of poor sleep by 2.71 (p = 0.035), and direct war exposure increased the odds by 19.76 times (p = 0.001).

conclusionThis study highlights the profound impact of war exposure on sleep quality among Lebanese university students, with direct exposure having the greatest risk. Poor sleep quality in war-affected zones can lead to severe disruptions in academic performance, cognitive function, and overall mental and physical health. The findings underscore the need for targeted interventions, including mental health support and stress management programs, to limit sleep disturbances in conflict-affected populations. Further research is warranted to explore effective coping mechanisms and long-term sleep health in similar contexts.

Indexed as

Armed ConflictsSleep QualityStudentsWarfareAdolescentAdultCross-Sectional StudiesFemaleHumansLebanonMalePrevalenceRisk FactorsSurveys and QuestionnairesUniversitiesYoung AdultLebanonMental healthPSQIPsychological stressSleepSleep disturbancesSleep qualityUniversity studentsWar conflict

Identifiers

PMID40859219
PMCPMC12379325

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.