Sleep quality mediates the association between stress and physical quality of life in emerging adulthood

Background: Adjustments during the transition to adulthood can potentially lead to sleeping and psychological problems that affect quality of life. However, pathways between emotional health and quality of life were poorly understood in college students. Objective: To examine the associations between self-perceived stress, sleep quality, anxiety, and quality of life. The potential mediating effects of sleep quality and anxiety between stress and quality of life were also assessed. Methods: The study sample consisted of 367 college students (40% boys, mean age =20.2). Self-administrated questionnaires were utilized to assess socioeconomic status (SES), body mass index (BMI), self-perceived stress, anxiety, sleep quality, and quality of life. Results: Sleep quality was inversely correlated with BMI (r=0.11, p=0.03), while positively correlated with anxiety (r=0.01, p=0.02) and self-perceived stress (r=0.241, p=0.001). After controlling for age, gender, BMI, and SES, higher levels of self-perceived stress (β=-0.45, p<0.001) and poor sleep quality (β=-0.45, p<0.001) were related to poor physical quality of life. The negative effect of self-perceived stress was mediated by sleep quality, which in turn affected physical quality of life (p=0.002). Additionally, a higher level of self-perceived stress (β=-0.45, p<0.001) was associated with poor mental quality of life (β=-0.48, p<0.001). No mediation effect was found for mental quality of life. Conclusions: Different underlying mechanisms should be considered for the pathways linking stress to physical and mental quality of life. Future health programs may intervene on sleep behaviors to improve poor quality of life affected by stress.