title: Nocturnal sleep problems among university students from 26 countries.
abstract: BACKGROUND
  The aim of this study is to estimate the prevalence of nocturnal sleeping problems and its associated factors among university students in mainly low- and middle-income countries.
  
  
  METHODS
  A cross-sectional survey was conducted with 20,222 undergraduate university students (mean age, 20.8; SD = 2.8) from 27 universities in 26 countries across Asia, Africa and the Americas.
  
  
  RESULTS
  Overall, 10.4% reported severe or extreme nocturnal sleeping problems (male, 10.2%; female, 10.5%) in the past month. Noctural sleeping problems differed by country, from 32.9% in Indonesia to 3.0 % in Thailand among Asian countries, from 13.7% in Mauritius to 7.5% in South Africa, and from 11.8% in Jamaica to 6.1% in Columbia in the Americas. In multivariate logistic regression analysis, coming from a poor family background, staying off campus (on their own or with parents or guardians), stress (history of child sexual abuse), poor mental health (depression and PTSD symptoms), health risk behaviour (tobacco use, heavy internet use, gambling, skipping breakfast and having sustained an injury), lack of social support and poor academic performance were associated with nocturnal sleeping problems.
  
  
  CONCLUSIONS
  A significant prevalence of past-month nocturnal sleeping problems was found. Potential factors associated with the risk of reporting sleeping complaints were identified, which may assist in prevention strategies to promote a better quality of sleep.
authors.affiliation: ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhonpathom, Thailand, 73170, karl.pel@mahidol.ac.th.
authors.forename: Karl
authors.initials: K
authors.lastname: Peltzer
authors.forename: Supa
authors.initials: S
authors.lastname: Pengpid
mesh_terms: D000293:Adolescent; D000328:Adult; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D013334:Students / Q000706:statistics & numerical data*; D055815:Young Adult