The Effects of Sleep Quality and Resilience on Perceived Stress, Dietary Behaviors, and Alcohol Misuse: A Mediation-Moderation Analysis of Higher Education Students from Asia, Europe, and North America during the COVID-19 Pandemic
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Background: The coronavirus disease 2019 (COVID-19) pandemic has increased the already high levels of stress that higher education students experience. Stress influences health behaviors, including those related to dietary behaviors, alcohol, and sleep; yet the effects of stress can be mitigated by resilience. To date, past research studying the connections between dietary behaviors, alcohol misuse, sleep, and resilience commonly investigated singular relationships between two of the constructs. The aim of the current study was to explore the relationships between these constructs in a more holistic manner using mediation and moderation analyses. Methods: Higher education students from China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands, and the United States were enrolled in a cross-sectional study from April to May 2020, which was during the beginning of the COVID-19 pandemic for most participants. An online survey, using validated tools, was distributed to assess perceived stress, dietary behaviors, alcohol misuse, sleep quality and duration, and resilience. Results: 2254 students completed the study. Results indicated that sleep quality mediated the relationship between perceived stress and dietary behaviors as well as the relationship between perceived stress and alcohol misuse. Further, increased resilience reduced the strength of the relationship between perceived stress and dietary behaviors but not alcohol misuse. Conclusion: Based on these results, higher education students are likely to benefit from sleep education and resilience training, especially during stressful events.
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Sleep quality and psychological resilience are considered two factors that have the potential to alter the relationships between stress and health behaviors.
“In this line, sleep quality and psychological resilience are considered two factors that have the potential to alter the relationships between stress and health behaviors [47].”
From Gender Differences in Psychological Stress Factors of Physical Therapy Degree Students in the COVID-19 Pandemic: A Cross-Sectional Study (2022) · cites this paper as [47]
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Bickerdike, A., Dinneen, J., & O’Neill, C. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16224318 · Cited by 18 · see citing works
The Associations Between Leisure, Stress, and Health Behavior Among University Students
Kim, J.-H., & Brown, S. L. (2018) · American Journal of Health Education · doi:10.1080/19325037.2018.1516583 · Cited by 17 · see citing works
Jang, S. M., Sohn, S., & Yu, M. (2018) · Children and Youth Services Review · doi:10.1016/j.childyouth.2018.01.038 · Cited by 15 · see citing works
Prichard, J. R., & Hartmann, M. E. (2019) · Sleep Health · doi:10.1016/j.sleh.2019.01.006 · Cited by 13 · see citing works
Assessing the effectiveness of online cognitive behavioral therapy in adults with chronic insomnia
Bowen, L. A. (2020) · JAAPA · doi:10.1097/01.jaa.0000723140.42348.76 · Cited by 6 · see citing works
Predicting Alcohol Misuse Among College Students in the US and South Korea
Kim, S., Ahn, S., & Lim, T. (2015) · Journal of Ethnicity in Substance Abuse · doi:10.1080/15332640.2014.996313 · Cited by 5 · see citing works
Sleep Deprivation Dysregulates Brain Reward Circuitry: Implications for Psychiatric Disorders
Neisewander, J. L. (2020) · Biological Psychiatry · doi:10.1016/j.biopsych.2020.03.015 · Cited by 5 · see citing works
Bowen, L. A. (2019) · Digital Showcase Research, Scholarship, & Creative Works (University of Lynchburg) · Cited by 4 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
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Cited by
Sorted by citations
Berding, K., Bastiaanssen, T. F. S., Moloney, G. M., Boscaini, S., Strain, C. R., Anesi, A., Long-Smith, C., Mattivi, F., Stanton, C., Clarke, G., et al. (2023) · Molecular Psychiatry · doi:10.1038/s41380-022-01817-y · Cited by 153 · see citing works
Arora, T., Grey, I., Östlundh, L., Alamoodi, A., Omar, O. M., Hubert Lam, K.-B., & Grandner, M. (2022) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2022.101593 · Cited by 109 · see citing works
Bermejo-Franco, A., Sánchez-Sánchez, J. L., Gaviña-Barroso, M. I., Atienza-Carbonell, B., Balanzá-Martínez, V., & Clemente-Suárez, V. J. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19020810 · Cited by 45 · see citing works
“[47] who found a positive correlation between perceived stress and sleep quality, and a negative correlation between stress and resilience in a multi-country sample of students during COVID-19 pandemic.”
Background
- Authors
- Du, C., Zan, M. C. H., Cho, M. J., Fenton, J. I., Hsiao, P. Y., Hsiao, R., Keaver, L., Lai, C.-C., Lee, H., Ludy, M.-J., Shen, W., Swee, W. C. S., Thrivikraman, J., Tseng, K.-W., Tseng, W.-C., Doak, S., Folk, S. Y. L., & Tucker, R. M.
- Affiliations
- Michigan State University (US)
- Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia
- Leiden University (NL)
- Indiana University of Pennsylvania (US)
- Institute of Technology Sligo (IE)
- University of Taipei (TW)
- Bowling Green State University (US)
- Corresponding author
- Tucker, Robin M.
- ORCID
- Venue
- Nutrients
- Publisher
- MDPI AG
- Published
- 2021-01-29
- Volume
- 13
- Issue
- 2
- Pages
- 442
- ISSN
- 2072-6643 (ISSN-L)
- PMC
- PMC7911351
- OpenAlex
- W3128946485
- Cited by
- 108
- References
- 107
- Citations by year
- 2026: 8 · 2025: 14 · 2024: 15 · 2023: 23 · 2022: 30 · 2021: 18
- FWCI
- 14.66
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Nutrients (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
- Funders
- USDA National Institute of Food and Agriculture (Hatch #1012976)
- Michigan AgBioResearch (Not applicable)
- Indiana University of Pennsylvania Faculty Incidental Research Support award (Not applicable)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Health and Lifestyle Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- sleep quality, resilience, perceived stress, dietary behavior, alcohol abuse, university students, COVID-19 pandemic, mediation, moderation, sleep duration, sleep education, resilience training
- MeSH terms
- COVID-19, SARS-CoV-2, Adolescent, Adult, Alcoholism, Asia, Diet, Europe, Feeding Behavior, Female, Humans, Male, North America, Sleep, Stress, Physiological, Students, Universities, Global Health, Resilience, Psychological, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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