Association between multidimensional sleep hygiene and sleep quality among university students

Abstract

Sleep hygiene is a key behavioural determinant of sleep quality, yet its multidimensional nature is often overlooked when relying on composite scores of the Sleep Hygiene Index (SHI). This study examined associations between distinct dimensions of sleep hygiene and sleep quality among university students in Malaysia. A cross-sectional sample of 203 university students completed the SHI and Pittsburgh Sleep Quality Index (PSQI). Exploratory factor analysis identified a three-factor structure comprising sleep routine and behavioural activation, sleep environment, and cognitive–emotional arousal. Multiple linear regression was conducted to examine the predictive value of these dimensions on sleep quality. The regression model was statistically significant, F(3,199) = 11.82, p < 0.001, explaining 15.1% of the variance in sleep quality (R² = 0.151, adjusted R² = 0.138). Cognitive–emotional arousal emerged as the strongest predictor (β = 0.256, p < 0.001), followed by sleep environment (β = 0.206, p = 0.003). However, sleep routine and behavioural activation did not significantly predict sleep quality after controlling for other dimensions (β = 0.083, t = 1.14, p = 0.254). Sleep hygiene is best conceptualised as a multidimensional construct. These findings align with hyperarousal models and the Theory of Planned Behaviour, highlighting cognitive–emotional arousal and environmental factors as empirically supported targets for improving sleep quality among university students. Factor-level analysis of Sleep Hygiene Index identifies three distinct dimensions in university students. Cognitive-emotional arousal is the strongest predictor of poor sleep quality. Sleep environment also significantly predicts sleep quality. Sleep routine and behavioural activation do not significantly predict sleep quality after controlling for proximal factors. Findings support targeted, multidimensional interventions integrating hyperarousal models and the Theory of Planned Behaviour. Factor-level analysis of Sleep Hygiene Index identifies three distinct dimensions in university students. Cognitive-emotional arousal is the strongest predictor of poor sleep quality. Sleep environment also significantly predicts sleep quality. Sleep routine and behavioural activation do not significantly predict sleep quality after controlling for proximal factors. Findings support targeted, multidimensional interventions integrating hyperarousal models and the Theory of Planned Behaviour.