Sleep Across the Pandemic in Norwegian University and College Students: A National Repeated Cross-Sectional Analysis (2010-2023).

Sleep problems are increasingly common among students in higher education, but long-term trajectories before, during and after the COVID-19 pandemic remain poorly described. We analysed population-level surveillance data from the Students' Health and Wellbeing Study conducted in Norway in 2010, 2014, 2018, 2021, 2022 and 2023, including nearly 200,000 participants. Difficulties initiating or maintaining sleep were assessed in all waves using a consistent survey item. In the 2018, 2021 and 2022 surveys, participants also reported bedtime, risetime, sleep onset latency, wake after sleep onset and total sleep duration. DSM-5-based insomnia disorder symptoms were identified using criteria based on symptom frequency, duration and daytime impairment. The prevalence of difficulties initiating or maintaining sleep increased steadily from 2010 to 2023, rising from 23.8% to 38.3% among women and from 20.3% to 32.2% among men. Symptom prevalence was higher in every survey wave compared with 2010, with the steepest increase occurring during the pandemic. Insomnia disorder symptoms increased markedly from 2018 to 2021 and declined only modestly in 2022. Sleep onset latency and wake after sleep onset increased during the pandemic, resulting in reduced sleep efficiency, whereas mean sleep duration remained stable at approximately seven and a half hours. Bedtime and risetime were delayed during the pandemic, with partial reversion in 2022. In conclusion, worsening sleep among students appears to represent a sustained trend rather than a transient pandemic-related disruption. These findings provide population-level surveillance of long-term sleep trends and underscore the need for systematic support for student sleep health within higher education.