Sleep hygiene and sleep quality among yoga and naturopathy medical students in India: a multi-site cross-sectional study

Karishma Silwal ¹ Dr Prakash Babu Kodali ² Hemanshu Sharma ¹ Nair Dhiren Ajit ³ Abhay M Shankaregowda ³ Renjish Mohanan ⁴ Jerin Subha M ⁴ Vibhas K ⁵ Sivaraman S ⁵ Kinjal Bhalavat ⁶ Dhilip VR ⁷ Jyoti Nair ⁸ Vanitha Shetty ⁹ Vineetha AN ⁹ Dhanya UM Kumar ¹⁰ Rakesh Gupta ¹⁰ Ayswarya Rohini Pandian ¹¹ Vakeel Khan ¹ Pradeep MK Nair ^12*

• ¹ Sant Hirdaram Medical College of Naturopathy and Yogic Sciences for Women, Bhopal, Madhya Pradesh, India
• ² Central University of Kerala, Kasaragod, Kerala, India
• ³ Swami Vivekanand Subharti University, Meerut, Uttar Pradesh, India
• ⁴ Nandha Naturopathy and Yoga Medical College, Erode, Tamil Nadu, India
• ⁵ Excel Medical College for Naturopathy and Yoga, Komarapalayam, India
• ⁶ Balvantrai Mehta Naturopathy Centre, Vadodara, India
• ⁷ JSS institute of Naturopathy and Yogic Sciences, Coimbatore, India
• ⁸ Swani Vivekanandha Naturopathy and Yoga Medical College, Tamilnadu, India
• ⁹ Alva's College of Naturopathy and Yogic Sciences, Moodbidri,, Karnataka, India
• ¹⁰ Government Yoga and Naturopathy Medical College, Chennai, India
• ¹¹ International Institute of Yoga and Naturopathy Medical Sciences, Chengalpattu, India
• ¹² Mirakle Integrated Health Centre, Pollachi, India

Poor sleep quality and hygiene among medical students is a concern, with limited data on students from alternative medical systems.This cross-sectional study assessed 1151 undergraduate yoga and naturopathy medical students from 10 Indian colleges. A structured questionnaire collected sociodemographic and lifestyle data, while sleep quality, sleep hygiene, depression, anxiety, stress, and internet addiction were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Sleep Hygiene Index (SHI), Depression Anxiety Stress Scale (DASS-21), and Internet Addiction Test (IAT). Logistic regression models were employed to compute adjusted odds ratios (AOR) as measures of association.The average SHI and PSQI scores were 22.49 (±6.34) and 6.52 (±3.01), respectively.Poor sleep quality was reported by 59.8%, and 24.7% had poor sleep hygiene. Severe depression (AOR: 5.15) and anxiety (AOR: 2.31) were linked to poor sleep hygiene, while severe stress (AOR = 0.55) was associated with poor sleep quality. Family residence was linked to lower odds of poor sleep hygiene (AOR: 0.14 for males, AOR: 0.26 for females) and better sleep quality (AOR: 1.46). Poor sleep hygiene was associated with sugary beverage consumption (AOR: 2.02), fried/packaged foods (AOR: 5.06 weekly, AOR: 8.52 daily), internet addiction (AOR: 21.87 for males, AOR: 9.57 for females), and late device use (AOR: 3.80 for females). Discussion: Despite early exposure to lifestyle principles, yoga and naturopathy students experience poor sleep quality. Contributing factors include poor sleep hygiene, anxiety, stress, unhealthy eating habits, and internet addiction. Targeted interventions are needed to improve sleep hygiene and overall well-being.