Association between Psychological Strain, Conflict and Sleep Quality among University Students at Al-Mashreq University
Hebatalrahman Ali Ahmed
Faculty of Medicine, Al-Mashreq University, Khartoum, Sudan.
Rayan Aboh Khedir
Faculty of Medicine, Al-Mashreq University, Khartoum, Sudan.
Rayan Abubaker Noureldaim
Faculty of Medicine, Al-Mashreq University, Khartoum, Sudan.
Elmoiz Babekir
Department of Emergency Medicine, Faculty of Medicine, Al-Mashreq University, Khartoum, Sudan and Department of Medicine and Adult Critical Care Medicine, Ibn Sina College for Medical Studies, Jeddah, Saudi Arabia.
Bashir A. Yousef
*
Department of Clinical Pharmacy and Pharmacology, Ibn Sina National College for Medical Studies, Al Mahjar Street, Jeddah 22421, Saudi Arabia and Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan.
*Author to whom correspondence should be addressed.
Abstract
Background: Delayed bedtime is increasingly common among university students and is linked to psychological distress and somatic complaints. Data from Sudanese students, whose education has been disrupted by armed conflict and displacement, are almost non-existent. Thus, this study aimed to analyse the association of late sleep with the psychological and physical health of university students.
Methods: We conducted a cross-sectional survey of undergraduate students at Mashreq University, Jeddah Centre, Saudi Arabia, between January and June 2025. Students in medical and non-medical faculties aged 18–26 years completed a structured 15-item online questionnaire covering demographics, sleep timing, duration, and quality, pre-sleep electronic device use, daytime fatigue, mood disturbance, and concentration. Chi-square tests assessed the association between bedtime and daytime fatigue and the association between sleep duration and age. Statistical significance was set at p<0.05.
Results: Of 294 respondents (74.5% male; 53.1% aged < 20 years), 64.3% went to bed after midnight, 43.9% slept < 6 hours per night, and 80.6% used electronic devices before sleep. Difficulty initiating sleep was reported by 48.6% (a further 31.0% "sometimes") and nocturnal awakening by 58.2%. Daytime fatigue (63.3%), mood swings or psychological tension (63.6%), and impaired concentration or memory (51.0%) were highly prevalent. Fatigue was more common among students retiring after midnight than before (66.7% vs 57.1%; OR 1.50, 95% CI 0.92–2.45; p = 0.105).
Conclusions: Late bedtimes, short sleep, and screen exposure before bed were common in this displaced student population, and roughly two-thirds reported fatigue and psychological strain. Universities supporting displaced students should integrate sleep-health education, early identification of sleep and psychological difficulties, and appropriate referral pathways into student-support services. Longitudinal studies using validated instruments are needed to clarify temporal and causal relationships.
Keywords: Chronotype, fatigue, mental health, sleep, Sudan, university students