Sleep quality and associated factors among university students in Africa: a systematic review and meta-analysis study
Open accessAbstract
Background Poor sleep quality significantly impacts academic performance in university students. However, inconsistent and inconclusive results were found in a study on sleep among university students in several African nations. Therefore, this study aimed to estimate the pooled prevalence and associated factors of poor sleep quality among university students in Africa. Methods The databases PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar were searched to identify articles. A total of 35 primary articles from 11 African countries were assessed and included in this systematic review and meta-analysis. Data were extracted by using a Microsoft Excel spreadsheet and exported to STATA version 14 for analysis. The I2 test was used to assess the statistical heterogeneity. A random effect meta-analysis model was employed with 95% confidence intervals. Funnel plots analysis and Egger regression tests were used to check the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Results A total of 16,275 study participants from 35 studies were included in this meta-analysis and systematic review. The overall pooled prevalence of poor sleep quality among university students in Africa was 63.31% (95% CI: 56.91-65.71) I2 = 97.2. The subgroup analysis shows that the combined prevalence of poor sleep quality in East, North, West, and South Africa were 61.31 (95% CI: 56.91-65.71), 62.23 (95% CI: 54.07-70.39), 54.43 (95% CI: 47.39-61.48), and 69.59 (95% CI: 50.39-88.80) respectively. Being stressed (AOR= 2.39; 95% CI: 1.63 to 3.51), second academic year (AOR= 3.10; 95% CI: 2.30 to 4.19), use of the electronic device at bedtime (AOR= 3.97 95% CI: 2.38 to 6.61)) and having a comorbid chronic illness (AOR = 2.71; 95% CI: 1.08, 6.82) were factors significantly associated with poor sleep quality. Conclusion This study shows that there is a high prevalence of poor sleep quality among university students in Africa. Being stressed, in the second year, using electronic devices at bedtime, and having chronic illness were factors associated with poor sleep quality. Therefore, addressing contributing factors and implementing routine screenings are essential to reduce the burden of poor sleep quality. Systematic Review Registration https://www.crd.york.ac.uk/prospero/ , identifier CRD42023493140.
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Previous research has shown that students across different educational levels commonly experience sleep deprivation and that sleep quality is associated with academic performance in adolescents, university students, and broader student populations.
“Previous research has shown that students across different educational levels commonly experience sleep deprivation and that sleep quality is associated with academic performance in both adolescents (Musshafen et al., 2021) and university students (Bagheri et al., 2025; Nakie et al., 2024), as well as across broader student populations (Curcio et al., 2006).”
From The Effect of Sleep Quality on Academic Performance: A Systematic Review and Meta-Analysis Study (2026) · cites this paper as Nakie et al., 2024
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Sleep Quality as a Predictor for Academic Performance in Menoufia University Medical Students
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Sleep Hygiene Awareness, Practice, and Sleep Quality Among Nigerian University Students
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Sleep Quality and Mental Health Among Medical Students: A Cross-Sectional Study
Vidović, S., Rakić, N., Kraštek, S., Pešikan, A., Degmečić, D., Zibar, L., Labak, I., Heffer, M., & Pogorelić, Z. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14072274 · Cited by 43 · see citing works
“These factors may contribute to the high prevalence of poor sleep quality and mental health disorders among medical students [13,14].”
Aldabbour, B., Jaradat, R., Aljbour, O. A., Abdo, M., Aljbour, J., Dayya, A. A., Asad, M. D., & Abuabada, A. (2025) · Middle East Current Psychiatry · doi:10.1186/s43045-025-00507-z · Cited by 19 · see citing works
Dakanalis, A., Papadimitriou, K., Alexatou, O., Deligiannidou, G.-E., Pappa, M. H., Papadopoulou, S. Κ., Louka, A., Paschodimas, G., Mentzelou, M., & Giaginis, C. (2025) · Nutrients · doi:10.3390/nu17132174 · Cited by 14 · see citing works
“Students with stress and being in the second year as well as those utilizing electronic devices at bedtime and suffering from chronic diseases showed considerably poor sleep quality [35].”
de Moraes, A. C. F., da Silva, L. C. C., Lima, B. S., Marin, K. A., Hunt, E. T., & Ferreira, M. V. N. (2024) · Frontiers in Digital Health · doi:10.3389/fdgth.2024.1394901 · Cited by 14 · see citing works
The relationship between sleep quality and nomophobia among medical students
Sadeghi, N., Rezaeian, S., Janatolmakan, M., Mohammadi, M., Heidarian, P., & Khatony, A. (2025) · BMC Medical Education · doi:10.1186/s12909-025-07847-8 · Cited by 12 · see citing works
“Problematic smartphone use can affect psychological processes and brain function, disrupting sleep patterns and leading to sleep-wake cycle disturbances, insomnia, and reduced sleep quality [3, 16].”
InfluentialSelf-control moderates the impacts of physical activity on the sleep quality of university students
Yin, Z.-G., Yang, C., & Yu, X.-M. (2025) · Scientific Reports · doi:10.1038/s41598-025-88700-2 · Cited by 12 · see citing works
Exercise and sleep health in college students: Efficacy, mechanisms, and implications for practice
Fei, L.-L., Zhao, S.-X., Chen, Y., Hao, C., & Xin, Y. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i10.108884 · Cited by 9 · see citing works
Promotion of Cardiovascular Health in Africa
Ka, M. M., Gaye, N. D., Ahadzi, D., Baker-Smith, C. M., Ndao, S. C. T., Wambugu, V., Singh, G., Gueye, K., Seck, D., Dia, K., et al. (2024) · JACC Advances · doi:10.1016/j.jacadv.2024.101376 · Cited by 11 · see citing works
Nanyonga, B., Thomas, K. A., Ssesanga, T., Kaihangwe, A., Nelson, K. A., Ssenyondwa, D., Nassimbwa, N., Enomut, J. R., Tumuhimbise, A., Namirembe, P., et al. (2025) · Sleep Health · doi:10.1016/j.sleh.2024.12.007 · Cited by 7 · see citing works
Li, C., Wang, Y., Wang, J., Wang, Y., Luo, Y., Yan, N., Wang, Y., Sun, G., Zhang, Y., & Wang, W. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1450932 · Cited by 7 · see citing works
Haddaouy, A. E., Blaak, H., Elkhalladi, J., Essaidi, M., Iziki, H., Es-Sabir, F., & Omari, F. E. (2025) · BMC Nursing · doi:10.1186/s12912-025-03949-2 · Cited by 4 · see citing works
“In Morocco, more than 60% of nursing students report experiencing sleep disturbances [19], a figure that aligns with global trends observed among university populations, 64.81% [20].”
InfluentialAldabbour, B., Jaradat, R., Aljbour, O. A., Abdu, M., Aljbour, J., Dayya, A. A., Asad, M. D., & Abuabada, A. (2024) · Research Square · doi:10.21203/rs.3.rs-4652744/v1 · Cited by 4 · see citing works
Sleep Quality and Its Contributing Factors Among Patients With Obesity: A Cross-Sectional Study
Saeed, H. A., Mohsen, A. H., Alqayem, A. T., Hasan, S. H., Hasan, M., & Alzeera, H. A. (2024) · Cureus · doi:10.7759/cureus.74038 · Cited by 3 · see citing works
“Previous studies have shown that individuals with obesity often experience disrupted sleep, including difficulty falling asleep, frequent awakenings, and reduced restorative sleep [6-13].”
Trinh, H. H., Nguyễn, T. T., Nguyen, T. Q., Ngo, N. T., Nguyen, S. T., Nguyen, C. V., Mac, T. D., & Nguyen, T. H. (2025) · International Journal of Preventive Medicine · doi:10.4103/ijpvm.ijpvm_88_25 · Cited by 2 · see citing works
Sleep Quality in Nursing Students: Systematic Review and Meta-Analysis of Prevalence Studies
Castaño, J. H. O., Cañón-Montañéz, W., Bedoya-Carvajal, O. A., Uribe, J. C. G., & Noriega, A. A. (2025) · Aquichan · doi:10.5294/aqui.2025.25.4.2 · Cited by 2 · see citing works
Benchehida, H., aameri, M. E., Razzak, S., Taibi, M., Bengueddour, R., Taïb, B., & Taboz, Y. (2025) · Mediterranean Journal of Nutrition and Metabolism · doi:10.1177/1973798x251315287 · Cited by 2 · see citing works
“49 Overall Stress didn ’ t impact food consumption or appetite for speci fi c food categories, but emotional eaters under stress were found to consume more high-fat and sweet foods as well as a denser meal compared to non-emotional eaters.”
Almalki, M. (2025) · JMIR Formative Research · doi:10.2196/67223 · Cited by 2 · see citing works
“University students, often facing academic pressures and irregular schedules, are particularly vulnerable to the excessive use of smart devices at bedtime [4-6].”
Taebi, M., Eghbali, T., Balvardi, M., Ghonchehpour, A., Forouzi, M. A., & Hossienzadeh, A. (2025) · Sleep Science and Practice · doi:10.1186/s41606-025-00136-9 · Cited by 2 · see citing works
“The current stud’y focus on allied medical students is particularly relevant, as this population often experiences high levels of stress and irregular schedules, which can exacerbate sleep issues (Nakie et al. 2024).”
Sleep quality in medical students: Any relationship with fatigue severity?
Acar, R. C., AÇAN, E., Konak, O. K., & Başoğlu, Ö. K. (2025) · Sleep Epidemiology · doi:10.1016/j.sleepe.2025.100126 · Cited by 1 · see citing works
Prediction of Sleep Pattern for University Students using Machine Learning
Widya, M. F. A., Utoro, R. K., Roedavan, R., Soegiarto, D., Moorthy, K., & Pratondo, A. (2025) · IEEE International Conference on Communication, Networks and Satellite (COMNETSAT) · doi:10.1109/comnetsat68601.2025.11324868 · Cited by 1 · see citing works
“Sleep is vital for health, cognition, and emotional balance, yet often neglected by college students due to academic demands, social activities, and lifestyle habits [1], [2].”
Almalki, M., Ahmed, M. A., Alzahrani, A. M., Mehmood, A. K., Felix, H. C., Almalki, R., Alhashemy, B., & Musawi, H. (2026) · INQUIRY The Journal of Health Care Organization Provision and Financing · doi:10.1177/00469580251413526 · Cited by 1 · see citing works
“3,25,26 Practical measures include awareness workshops on screen-time management, university-wide campaigns to discourage bedtime phone use, and integration of digital health literacy modules into first-year orientation curricula.”
The Effect of Sleep Quality on Academic Performance: A Systematic Review and Meta-Analysis Study
Zhou, J., Liu, Y., Yue, C., Wang, M., Chen, K., & Rosales, K. P. (2026) · Behavioral Sciences · doi:10.3390/bs16050634 · Cited by 1 · see citing works
“…tional levels commonly experience sleep deprivation and that sleep quality is associated with academic performance in both adolescents (Musshafen et al., 2021) and university stu‑ dents (Bagheri et al., 2025; Nakie et al., 2024), as well as across broader student populations (Curcio et al., 2006).”
Tamuno-opubo, A. T., Ogunsemi, J. O., Akinsulore, A., Yekeen, O. K., Karatu, B. A., Idehen, E. E., & Agabi, O. M. (2026) · The Journal of Mental Health Training Education and Practice · doi:10.1108/jmhtep-08-2025-0088
Aldabbour, B., Jaradat, R., Aljbour, O. A., Abdu, M., Aljbour, J., Dayya, A. A., Asad, M. D., & Abuabada, A. (2024) · Research Square · doi:10.21203/rs.3.rs-4652744/v2
Sleep quality and its associated factors among university students in MalawiPreprint
Mzumara, T., Banda, O. K., Munthali, G. N. C., Banda, L. O. L., Saka, A., Kamata, C., Nambala, C., Mbughi, M., Lubanga, A. F., & Mwakilama, E. P. (2024) · Research Square · doi:10.21203/rs.3.rs-5401765/v1
Relationship between sleep quality, sleep duration, heart rate, and step counts in young adults
Arıkan, H., & Kara, A. (2024) · Turkish Journal of Kinesiology · doi:10.31459/turkjkin.1561346
Joshua, J. M. (2024) · International Journal of Vocational Education and Training Research · doi:10.11648/j.ijvetr.20241002.13
Factors Associated with Stress, Anxiety, and Depression Among Management School Students in Senegal
Namndiro, G., Tine, J. A. D., Sow, A., & Seck, I. (2025) · Central African Journal of Public Health · doi:10.11648/j.cajph.20251103.13
Sleep Quality and Other Predictors of Academic Performance in Rwandan Undergraduate StudentsPreprint
Nzamwita, F., Igihozo, C., Turikumana, P. D., Nshimiyimana, J., Nyangezi, P. M., Biracyaza, E., & Cloete, L. G. (2025) · Research Square · doi:10.21203/rs.3.rs-7474062/v1
Watson, L., & Reed, H. (2022) · Journal of integrative nursing and palliative care · doi:10.51847/ofkzdlsxjj
Assessment of Sleep Quality and Depression Among Medical Students: A Cross-Sectional Study
Alsalloum, T., Alawaisheh, A., Daoud, A., Alnajjar, A. Z., Meky, A., & Funjan, K. (2025) · Avicenna Journal of Medicine · doi:10.1055/s-0045-1815851 · Cited by 1 · see citing works
Xie, Y., Chen, Y., Han, Y., Zhai, S., Xiao, L., Yin, D., & Chen, Y. (2026) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1732946 · Cited by 1 · see citing works
Nzamwita, F., Igihozo, C., Turikumana, P. D., Nshimiyimana, J., Nyangezi, P. M., Biracyaza, E., & Cloete, L. G. (2026) · Advances in Medical Education and Practice · doi:10.2147/amep.s576834
“1 However, some studies reported higher prevalence rates, 4,39 which is slightly higher than our findings.”
Rahunathan, L., Arun, G. K., Suhana Nafais, A., Bhuvaneshwari, G., Harikrishnan, N., & Harini, N. (2025) · International Conference on Electronics, Communication and Aerospace Technology (ICECA) · doi:10.1109/iceca66444.2025.11383466
“Nakie et al., [8] (323) believed that poor sleep is prevalent in 63.31% of students, in that there is a cognitive and academic performance affect (including for both conditions).”
InfluentialLayno, S. C., & Prado, N. I. (2026) · Psychology and Education A Multidisciplinary Journal · doi:10.70838/pemj.530201
Duman, E., & Alkın, V. (2026) · Gümüşhane Üniversitesi Sağlık Bilimleri Dergisi · doi:10.37989/gumussagbil.1791232
Bibbiso, M. M., Tadele, E., Issaaga, W., Abdu, Z., & Zewdie, A. (2026) · Sleep Science and Practice · doi:10.1186/s41606-026-00177-8
Fear of compassion and self-reported insomnia among college students: A moderated mediation model
Zhang, Y., & Fu, L. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107000
Ndongo, J. M., Mbian, W. M., Ahmadou, Fongang, T. R. M., Njoya, E. G. N., Lele, E. C. B., Bekima, B. Y., Rengou, A. S. M., Guessogo, W. R., Foko, L. P. K., et al. (2026) · IBRO Neuroscience Reports · doi:10.1016/j.ibneur.2026.06.011
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Kone, E. P., Tian, J., & Hong-de, L. (2026) · Current Psychology · doi:10.1007/s12144-026-09666-6
“In African university samples, poor sleep quality is also highly prevalent and closely related to academic and psychosocial stressors (Nakie et al., 2024).”
Esparza, W. D., Jiménez, S. O. I., Vinueza-Fernandez, I., & Espinosa-Pinos, C. A. (2026) · Communications in computer and information science · doi:10.1007/978-3-032-30833-7_54
Dandago, S. K., Murtala, H. H., Sardauna, Z. M., Anyebe, E. E., & Toluwase, I. R. (2026) · Research Square · doi:10.21203/rs.3.rs-9872902/v1
Rahayu, M., Mega, N. N. P., & Yekti, Y. N. D. (2026) · Jurnal Sistem dan Manajemen Industri · doi:10.30656/jsmi.v10i1.11335
Camacho, C. R., & Delgado, M. G. (2026) · Behavioral Sciences · doi:10.3390/bs16071186
“It also converges with systematic evidence linking perceived stress with poorer sleep quality and insomnia symptoms in undergraduate students (Gardani et al., 2022; Nakie et al., 2024).”
Nyaaba, E., & Baada, J. N. (2026) · Psychology Health & Medicine · doi:10.1080/13548506.2026.2714467
Tekin, V., Delibaş, S., Keten, E. S., Şahan, M., Koçer, M., & Yetki̇n, S. (2026) · Healthcare · doi:10.3390/healthcare14162666
“University students are particularly susceptible to sleep disturbances; a meta-analysis of African university students reported a pooled prevalence of poor sleep quality at 63.3% [2], whereas global medical student data suggest comparably high rates [3].”
InfluentialShunta-Suntasig, K. J., Chicaiza-Manobanda, T. E., Chipantiza-Barroso, P. A., & Medina-Naranjo, G. R. (2026) · Cuaderno de enfermería. Revista científica. · doi:10.62574/ekcqad31
Pirak, A., Kashani, Z. A., Yazdkhasti, M., Yousefabadi, S. R., & Zeh, R. G. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107963
Health-risk behaviours among university students in Bulawayo, Zimbabwe
Moyo, G., & Silinda, F. T. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1914098
AGYAPONG, L., Apreku, J. B., Acheampong, I., Kpeglo, G., Ansaful, O. N. K., Sagoe, E., Dadzie, C. E., Sirbah, A. C., Yusif, M. A., Apalebilah, S., et al. (2026) · BioMed Research International · doi:10.1155/bmri/8968775
“Within African tertiary institutions, poor sleep quality affects nearly two-thirds of students (63%), fueled by a triad of chronic illness, academic stress, and presleep electronic device exposure [8].”
Asante, J., Poku, C. A., Budu, H. I., Amankwaa¹, F., Gyamfi, B. A., Lamptey, S. N. O., Adjei¹, P. A., Boateng, E. K., Lumor, D. A., & Osei-Wusu³, P. (2026) · Research Square · doi:10.21203/rs.3.rs-11087155/v1
Ba, F., Guene, A., Faye, A., Diallo, K., Diouf, I., Diop, L., Sène, M., & Ba, E. (2026) · Advances in Applied Physiology · doi:10.11648/j.aap.20261102.12
Wang, H., Guo, L., Wang, J., Chen, Z., & Han, W. (2026) · Frontiers in Public Health · doi:10.3389/fpubh.2026.1988584
- Authors
- Nakie, G., Takelle, G. M., Rtbey, G., Andualem, F., Tinsae, T., Kassa, M. A., Tadesse, G., Fentahun, S., Wassie, Y. A., Segon, T., Kibralew, G., & Melkam, M.
- Affiliations
- University of Gondar (ET)
- Woldia University (ET)
- Mattu University (ET)
- Corresponding author
- Nakie, Girum
- ORCID
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2024-03-11
- Volume
- 15
- Pages
- 1370757-1370757
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC10979362
- OpenAlex
- W4392652567
- Cited by
- 55
- References
- 142
- Citations by year
- 2026: 26 · 2025: 20 · 2024: 8 · 2022: 1
- FWCI
- 4.02
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Education › Educational Outcomes and Influences
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- sleep quality, university students, prevalence, stress, academic year, sleep disorders, Africa, academic performance, sleep duration, sleep environment, sleep quality interventions, sleep education
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