Association between gender, digital device usage patterns, and sleep schedule with perceived stress level among students in public health institutions of Pakistan

Abstract

ABSTRACT

Background:
University students face rising stress due to social, academic, and technological pressures. In Pakistan, limited access to mental health services worsens the issue. While screen time and irregular sleep are linked to stress, their combined impact on public health students remains underexplored.

Objectives:
This study sought to determine important behavioral determinants of stress and evaluate the relationship between perceived stress levels, gender, sleep patterns, and digital device use among students in public health institutes throughout Pakistan.

Methods:
A structured online questionnaire was used to perform a cross-sectional study with 317 students. Data comprised the Perceived Stress Scale (PSS-10), screen time, sleep length, and demographics. ANOVA, multivariate linear regression, chi-square tests, t-tests, and Pearson correlation were among the statistical analyses, with significance set at p < 0.05.

Results:
Moderate stress was reported by 87.4% of students, with a mean PSS score of 19.25 ± 4.64. There was a significant correlation between stress levels and screen time (χ² = 34.58, p < 0.00001), gender (χ² = 9.99, p = 0.0068), and sleep duration (χ² = 31.31, p = 0.00012). Regression analysis revealed that sleep length adversely predicted stress (B = -0.69, p = 0.046), accounting for 8.4% of the variance (R2 = 0.084), whereas screen time positively predicted stress (B = 1.01, p = 0.001).

Conclusions:
Long periods of screen time and insufficient sleep are major factors in public health students' elevated stress levels. It is advised that interventions that support sleep hygiene and digital wellness be implemented to enhance students' mental health.

Keywords:
Perceived Stress, Screen Time, Sleep Quality, PSS-10, Public Health Students, Mental Health.