Date of Graduation


Document Type


Degree Name

Master of Science in Community Health Promotion (MS)

Degree Level



Health, Human Performance and Recreation


Robert E. Davis

Committee Member

Page Daniel Dobbs

Second Committee Member

Alex Russell


college students, depression, psychological distress, sleep quality, substance use


Poor sleep quality in college students is a major problem associated with adverse health outcomes, cognitive performance, substance use, and psychological distress. Our study explored how substance use and psychological distress are associated with the sleep quality of college students. We analyzed secondary data collected in 2019 using a cross-sectional survey design. Measures included participants’ demographic characteristics, sleep quality using the Pittsburg Sleep Quality Index (PSQI), drug use, depression using the Patient Health Questionnaire-9 (PHQ-9), and suicidality. After excluding participants with missing information for sleep quality, a total of 555 students remained for the analysis. Our bivariate analysis found that most of the variables associated with poor sleep quality. Also, finding suggested a strong correlation between poor sleep quality and indicators of psychological distress (depression, suicidal ideation, planning, and attempt). Furthermore, using a multivariable regression analysis, we found a significant association between depression and poor sleep quality. In addition, there were strong correlations between substances, with the exception of alcohol and binge drinking, and daytime dysfunction and sleep disturbances. Surprisingly, we found that none of the substances were associated with sleep duration. Initially, we had not contemplated self-stigma, but after analyzing the results, and its relevance to psychological dysregulation, we decided to include it in our analysis. We found significant associations between self-stigma and poor sleep, depression, suicidal ideation, plans, and attempts. Given the high prevalence of sleep problems in college students, these findings are valuable for institutions to address suicidality, depression, or substance use. Because sleep is a more easily modifiable behavior, it is more likely that students get help for sleeping problems than substance use or depression.