*Co esponding au ho : D . B. Anoosha
Copy igh © 2025 Au ho (s) e ain he copy igh o his a icle. This a icle is published unde he e ms o he C ea i e Commons A ibu ion Liscense 4.0.
Assessmen o sleep quali y and i s impac on he men al well-being o adolescen s
D . B. Anoosha * , Sania Tabassum, Sa a Siddiqua and Suhana Anjum
Depa men o Pha macy P ac ice, Vaageswa i College o Pha macy, (A ilia ed o JNTU Hyde abad), Beside LMD police
s a ion, Ramak ishna colony, Ka imnaga , Telangana, India-505481.
Wo ld Jou nal o Biology Pha macy and Heal h Sciences, 2025, 21(01), 166-173
Publica ion his o y: Recei ed on 29 No embe 2024; e ised on 06 Janua y 2025; accep ed on 09 Janua y 2025
A icle DOI: h ps://doi.o g/10.30574/wjbphs.2025.21.1.0015
Abs ac
Backg ound: Sleep is i al o b ain de elopmen , body healing, p oduc ion o epai molecules, and long- e m memo y
o ma ion. Poo sleep quali y in adolescen s can lead o psychological p oblems such as dep ession, s ess, and anxie y,
which can nega i ely a ec daily li e and academic pe o mance. Add essing hese issues is essen ial o ensu e op imal
sleep quali y o op imal b ain unc ion.
Aim: The pu pose o his s udy was o in es iga e he ela ionship be ween sleep pa e ns and men al heal h in
adolescen s.
Me hod: A c oss-sec ional s udy was conduc ed, measu ing sleep quali y wi h PSQI and s ess, anxie y, and dep ession
wi h he DASS-Y ques ionnai e among 350 s uden s om di e en middle colleges and p i a e schools.
Resul : A s udy ound ha 13-15-yea -olds ha e a highe p e alence o poo sleep (83%), while 16-18-yea -olds ha e
mo e balanced sleep (51% poo , 49% good). Nea ly hal o he 350 pa icipan s expe ienced poo sleep quali y, wi h
s ess, anxie y, and dep ession being he mos common. The s udy ound a signi ican ela ionship be ween sleep quali y
and men al heal h.
Conclusion: Sleep dep i a ion inc eases men al illness ulne abili y, highligh ing he need o heal hy sleep habi s.
Clinical pha macis s collabo a e wi h medical p o essionals o imp o e adolescen s' physical and psychological heal h
h ough echniques and counseling, p omo ing good sleep habi s.
Keywo ds: Anxie y; DASS-Y; Dep ession; Mood; Sleep; S ess
1. In oduc ion
Sleep is a s a e o educed men al and physical ac i i y cha ac e ized by a change in consciousness and supp ession o
some senso y ac i i ies. Du ing sleep, muscle ac i i y dec eases, and in e ac ion wi h he su ounding en i onmen
occu s (1).
Acco ding o he Ame ican Academy o Sleep Medicine, i 's impo an o child en ages 6 o 12 o ge 9 o 12 hou s o
sleep, and eens age 13 o 18 should ge 8 o 10 hou s o es in 24 hou s (2).
Sleep is necessa y o he eco e y o he b ain and body, he syn hesis o es o a i e molecules, and he o ma ion o
long- e m memo y ha inc eases he ecall o p e ious lea ning and expe iences (3).
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Sleep quali y is de ined as a pe son's sa is ac ion wi h all aspec s o hei sleep expe ience. Sleep quali y has ou
cha ac e is ics: sleep e iciency, sleep la ency, sleep du a ion, and wake ulness a e sleep onse (4).
Good sleep means ge ing a good nigh 's sleep, no waking up oo o en, alling asleep wi hin 30 minu es, and ge ing he
ecommended amoun o you age g oup. Good sleep quali y is essen ial o a pe son's cogni i e unc ion, memo y
e en ion, and decision-making skills (5). On he o he hand, poo sleep quali y e e s o no mee ing he c i e ia o sleep
onse , du a ion, expe ience, e en ion, and eshness a e waking up (6). Poo sleep quali y includes a igue, i i abili y,
educed daily pe o mance, wo king memo y, and academic pe o mance (7).
Lack o quali y sleep can ha e a a ie y o nega i e e ec s on you men al heal h, including dep ession, anxie y, and
s ess. Fo example, dis up ed sleep cycles can in e e e wi h he elease o se o onin, an impo an neu o ansmi e
in ol ed in mood egula ion, and lead o dep ession. In addi ion, lack o sleep can impai execu i e con ol and wo sen
eelings o anxie y. Lack o sleep makes you body uncom o able and inc eases he elease o he s ess ho mone
co isol (8).
2. Ma e ials and Me hods
• S udy Si e: Ou s udy si e included a ious educa ional ins i u ions and heal hca e se ings, speci ically:
schools, colleges, and a hospi al
• S udy design: A p ospec i e obse a ional s udy.
• S udy pe iod: 6 mon hs.
2.1. Resea ch c i e ia:
• Inclusion c i e ia: Pa icipan s o bo h sexes and heal hy indi iduals be ween he ages o 13 and 18 we e
included in he s udy.
• Exclusion c i e ia:
o People who do no wan o pa icipa e will be excluded om he s udy
o Pa icipan s unde 13 yea s old and o e 18 yea s old
o Adolescen s who ha e a ch onic illness and use medica ions ha dis up sleep.
2.2. Pa ame e s o be conside ed
• Demog aphic de ails, pas d ug his o y, social his o y, and amily his o y.
• Sleep du a ion and sleep quali y.
• Pi sbu gh Sleep Quali y Index [PSQI].
• Dep ession, anxie y, and s ess scale - you h e sion [DASS-Y].
2.3. Sou ce o s udy
Ou sou ce o da a o his s udy is di ec communica ion wi h adolescen s, eache s, and school p incipals.
2.4. Resea ch p ocedu e
A e ob aining app o al om he e hics commi ee and highe au ho i ies o he school, we conside ed conduc ing he
s udy wi h school eenage s. S uden s who me he inclusion c i e ia and we e willing o pa icipa e in he s udy
ecei ed a s anda dized in oduc o y explana ion o he pu pose o he s udy and he meaning o he indi idual
ques ions on he a ious scales be o e da a collec ion. The Pi sbu gh Sleep Quali y Index [PSQI] and Child en's
Dep ession, Anxie y, and S ess Scale (DASS-Y) ques ionnai es we e adminis e ed wi h in o med consen and we e
s ic ly con iden ial. The gi en da a esul s a e subjec ed o s anda d so wa e o u he analysis. A e comple ing he
ou come assessmen , subjec s wi h poo sleep quali y and mood diso de s we e counseled in a counseling session by a
ained clinical pha macis .
2.5. S a is ical Analysis
• We collec ed he da a in a Mic oso Excel sp eadshee ( e sion 2021) and calcula ed he odds a io o he
associa ion o he ela ionship be ween ac i i ies pe o med in he hou be o e bed ime and sleep quali y.
• We calcula ed he Pea son co ela ion using he S a is ical Package o Social Sciences (SPSS) so wa e ( e sion
23.0) o compa e sleep quali y wi h dep ession, anxie y, and s ess.
• We calcula ed he Chi-squa e o show he ela ionship be ween sleep quali y and mood diso de s.
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3. Resul s
A o al o 350 comple ed ques ionnai es o eligible pa icipan s who me he inclusion c i e ia we e included in he
s udy.
Table 1 Demog aphic cha ac e is ics o pa icipan s (350)
Demog aphics
No.o candida es
Pe cen age (%)
AGE(Yea s)
13
35
10
14
69
19.71
15
95
27.14
16
45
12.86
17
43
12.29
18
63
18
GENDER
MALE
142
40.57
FEMALE
208
59.43
A o al o 350 pa icipan s be ween he ages o 13 and 18 ook pa in his s udy. In his g oup, 208 people (59.43%)
we e emale and 142 people (40.57%) we e male. is wo h no ing ha emale esponden s and 15-yea -old pa icipan s
(27.14%) we e he main g oups in his s udy.
Table 2 Dis ibu ion o esponden by sleep quali y elemen s (n=350)
Elemen s o sleep quali y
No. o esponden s
Pe cen age (%)
Subjec i e sleep quali y
Ve y good
140
40
Fai ly good
144
41.14
Fai ly bad
50
14.28
Ve y bad
16
4.57
Sleep La ency(min)
<15
69
19.7
16–30
143
40.85
31–60
108
30.86
>60
30
8.57
Sleep du a ion(h s)
>7
205
58.57
6-7
98
28
5-6
36
10.28
<5
11
3.14
Habi ual sleep e iciency (%)
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169
>85
84
84
75–84
07
07
65–74
06
06
<65
03
03
Sleep dis u bance
None
07
07
Mild
66
66
Mode a e
27
27
Se e e
00
00
Use o sleep medica ion
None
336
96
Mild
11
3.14
Mode a e
2
0.57
Se e e
1
0.29
Day ime dys unc ion
None
87
24.86
Mild
131
37.43
Mode a e
103
29.43
Se e e
29
8.29
Da a on elemen s o sleep quali y o 350 esponden s show ha subjec i e sleep quali y is mos ly ai ly good o e y
good. Sleep la ency is highes in he ange o 16–30 minu es, and mos pa icipan s slep o mo e han 7 hou s. Usual
sleep e iciency is mos ly o e 85%, while sleep dis u bances a e mos ly mild. Sleep medica ion use is gene ally low and
day ime dys unc ion a ies, wi h a signi ican p opo ion ha ing mild o mode a e le els.
Table 3 To al PSQI global sco e
To al PSQI Global Sco e
N
Pe cen age [%]
<5 (Good sleep quali y)
190
54.86
>5 (Poo sleep quali y)
160
45.79
This able shows he dis ibu ion o pa icipan s based on PSQI global sco es and he co esponding pe cen ages. F om
a o al o 350 pa icipan s, 190 (54.86%) had a o al PSQI sco e o less han 5, which indica es good sleep quali y.
Meanwhile, 160 subjec s (45.79%) had a o al PSQI sco e o 5 o highe , indica ing poo sleep quali y.
Table 4 DASS-Y
Ra ing
N
Pe cen age (%)
Dep ession
No mal
229
65.43
Mild
37
10.56
Mode a e
57
16.28
Se e e
20
5.71
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170
Ex emely Se e e
7
2
Anxie y
No mal
213
60.85
Mild
36
10.28
Mode a e
73
20.85
Se e e
16
4.57
Ex emely Se e e
12
3.43
S ess
No mal
251
71.71
Mild
37
10.57
Mode a e
28
8
Se e e
28
8
Ex emely se e e
6
1.71
Among adolescen s who we e e alua ed using he DASS-Y scale, 65.43% had no mal le els o dep ession and 34.57%
had mild dep ession, 16.28% had mode a e dep ession, and 2% had e y se e e dep ession. 60.85% show no mal
anxie y le els, while 39.15% expe ience anxie y ha is 10.28% mild, 20.85% mode a e, 4.57% se e e and 3.43% e y
se e e. In addi ion, 71.71% expe ienced no mal s ess le els and 28.29% expe ienced s ess, o which 10.57% had mild
s ess, 8% had mode a e s ess, 8% had se e e s ess, and 1.71% had e y se e e s ess.
Table 5 Rela ionship be ween Sleep Quali y and Mood diso de s
Sleep Quali y
Dep ession
Anxie y
S ess
Chi-Squa e
2.57Aa
471.543b
398.486b
580.086b
D
1
4
4
4
Asymp Sig.
0.109
<0.001
<0.001
<0.001
Chi-squa e es esul s show he ela ionship be ween sleep quali y and a ious men al heal h ac o s. The p- alues o
dep ession, anxie y, and s ess we e all less han 0.001, which indica ed a signi ican ela ionship be ween sleep quali y
and hese a iables. In his case, he chi-squa e alues o dep ession, anxie y, and s ess we e 471.543, 398.486, and
580.086, espec i ely, which indica es a signi ican ela ionship be ween sleep quali y and men al heal h.
4. Discussion
350 pa icipan s, ages 13 o 18, pa icipa ed in he cu en s udy, which examined sleep quali y and i s e ec s on
adolescen men al heal h. The p e alence o poo sleep quali y was 47.2%, simila o a s udy by A. Kesin ha e al. ha
in ol ed s uden s aged 12 o 17 and ound a p e alence o poo sleep quali y a 24%.
This s udy emphasizes he impo ance o ge ing enough sleep, which is de ined as sleeping o a leas 8 hou s, ha ing
ew in e up ions, no using sleeping aids equen ly, ha ing a sleep la ency o less han 30 minu es, and no
expe iencing day ime dys unc ion due o sleep dep i a ion.
The p e alence o poo sleep quali y was highe in ou s udy (45.79%) han in he Malaysian su ey (24.0%), which
may be ela ed o socioeconomic ci cums ances and academic p essu e.
Adolescen s a e ad ised o ecei e a leas 8 o 10 hou s o sleep each nigh , and mo e han hal o he subjec s (58.57%)
slep o mo e han se en hou s. Six y- i e pe cen o hose su eyed had a sleep la ency longe han hi y minu es.
These esul s a e consis en wi h YaseminSimseke .al's 2019 s udy.
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Acco ding o Ranjee a Kuma i e al., habi ual sleep e iciency, which is calcula ed as he pe cen age o o al hou s in bed
and o al hou s o sleep, was mo e han 85% in many pa icipan s (93.14%), anking as he second mos encou aging
ac o in e ms o a ious PSQI componen s, a e no using medica ion. In s uden s, habi ual sleep e iciency was o e
75% in he majo i y o hem (85.7%), and i was also he second mos encou aging ac o inding abou di e en PSQI
componen s, ollowing 93.1% o hose who did no ake sleep aids.
75.14% o esponden s said hey had ouble pe o ming daily du ies, and his was associa ed wi h lowe a ings o he
quali y o hei sleep. Aysan E. e al. (2014) obse ed a co ela ion be ween sleep dep i a ion and wea iness, a en ion
de ici , poo academic pe o mance, and di icul y ca ying ou e e yday asks.
The To al PSQI Global sco e, which measu es o e all sleep quali y based on he se en componen s, showed ha 45.79%
o pa icipan s had a sco e g ea e han 5, indica ing poo sleep quali y, while 54.86% o pa icipan s had a sco e less
han 5, indica ing good sleep quali y.
Acco ding o he DASS-Y da a analysis o ecen s udies, he o al a es o s ess, anxie y, and dep ession we e 28.29%,
34.55%, and 34.15%, espec i ely. Acco ding o a ela ed s udy ha used he DASS-21 and was ca ied ou in Selango
(Lekh aj R. e al.), he p e alence o anxie y, s ess, and dep ession was 41.4%, 39.9%, and 42.1%, espec i ely.
Analyzing he connec ion be ween eenage s' sleep quali y and men al heal h was pa o he s udy. People wi h poo
sleep quali y a e mo e likely o expe ience s ess, anxie y, and dep ession han people wi h good sleep quali y. A s ong
associa ion was seen among he 160 people who had sleep issues. A possible connec ion be ween sleep p oblems and
mood diso de s in his popula ion was highligh ed by he ac ha o e 50% o he poo sleepe s had dep essi e
symp oms.
Addi ional insigh s we e e ealed by u he in es iga ion o he da ase . The complex ela ionship be ween sleep and
s ess in adolescen s is highligh ed by he ac ha 82% o pa icipan s wi h sleep p oblems epo ed ha ing high le els
o s ess. Fu he mo e, 68% o indi iduals showed signs o wo y, highligh ing he complex connec ion be ween anxie y
and sleep habi s in his age ange.
This demons a es a signi ican link be ween adolescen s' inadequa e sleep and nega i e men al heal h ou comes. I 's
impo an o no e ha hese esul s a e consis en wi h ea lie esea ch, including a s udy by Xuz. e al. in China ound
a simila link be ween sleep p oblems and men al heal h di icul ies in his age ange.
Men al heal h condi ions like anxie y, s ess, and dep ession a e associa ed wi h poo sleep quali y. I weakens he
body's s ess esponse and has an impac on mood egula ion and cogni i e unc ion. The e is a ecip ocal associa ion
be ween be e sleep and imp o ed men al wellness. I 's c i ical o unde s and how impo an i is o p e en poo sleep
quali y.
The e is an immedia e need o suppo in he o m o ac ions o gua an ee a no able dec ease in he psychological s ain
on eenage s. App op ia e measu es, such as cu icula modi ica ions, c ea ing a welcoming a mosphe e o eenage s
a home and a school, and p o iding counseling o he a ge sensi i e g oup, may imp o e psychological well-being.
Teaching pa en s and educa o s he alue o quali y sleep in enhancing men al heal h is also c ucial.
To o e come he di icul despai , anxie y, and ension, his age g oup should be encou aged o engage in equen
ex acu icula ac i i ies and o seek ou assis ance om iends, amily, o eligious leade s.
The s udy's communi y-based app oach was i s s onges poin , di e en ia ing i om he majo i y o esea ch ha was
ei he hospi al- o school-based.
Howe e , he s udy had ce ain d awbacks. The s udy's esul s canno es ablish a cause-and-e ec ela ionship because
i was c oss-sec ional. I is ulne able o ecall bias because eenage s sel - epo ed how well hey slep and o he
cha ac e is ics. This may gi e an exagge a ed o e oneous pic u e a he han an ac ual one.
Acco ding o a subs an ial body o da a, he majo i y o eens polled epo ed ha ing good sleep.
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5. Conclusion
Ou s udy assessed eenage s' sleep quali y and i s co ela ion wi h men al heal h condi ions like anxie y, s ess, and
dep ession. The age g oup o 15 yea s old (27.14%) and emale esponden s we e mo e p e alen .
The o e all PSQI global sco e showed ha 45.79% o esponden s, o ewe pa icipan s, had poo sleep quali y. I was
disco e ed ha s uden s who epo ed ha ing poo sleep had excessi e dys unc ion du ing he day. This implies ha
insu icien sleep has a subs an ial e ec on hei e e yday ac i i ies and gene al unc ioning in addi ion o impai ing
noc u nal es .
O e all a es o s ess, anxie y, and dep ession we e ound o be 28.29 pe cen , 34.55%, and 34.15%, espec i ely. I
was disco e ed ha anxie y was mo e p e alen in eenage s.
Sleep quali y and psychological diso de s a e signi ican ly co ela ed, acco ding o he Pea son co ela ion analysis. A
compa ison o hose who slep well and hose who didn' e eal ha hose who didn' ge enough sleep we e mo e likely
o su e om men al heal h condi ions like dep ession, anxie y, and s ess. P olonged sleep dep i a ion can exace ba e
men al heal h issues by weakening he body's s ess esponse. Gi en he ecip ocal ela ionship be ween sleep and
men al heal h, i is impe a i e o p io i ize p ope sleep hygiene as a componen o men al well-being.
Es ablishing a egula sleep schedule, c ea ing a calming sleep en i onmen , and a oiding ca eine igh be o e bed a e
all ad ised o suppo heal hy sleep. In o de o encou age heal hy sleep habi s and a oid sleep- ela ed issues, i is
c i ical o inc ease awa eness o he alue o ge ing enough sleep on a global scale, pa icula ly among young adul s,
hei pa en s, and educa o s.
Teenage s' sleep and men al heal h can be g ea ly enhanced by encou aging hem o engage in yoga and medi a ion.
These echniques imp o e he quali y o sleep by lowe ing s ess and encou aging elaxa ion.
The e o e, a clinical pha macis wo king wi h a eam o wo medical p o essionals can help de elop he physical and
men al well-being o eenage s by p omo ing global imp o isa ion on heal hy sleep habi s h ough a ious echniques
and counseling.
Compliance wi h e hical s anda ds
Disclosu e o con lic o in e es
No con lic o in e es o be disclosed.
S a emen o e hical app o al
We ha e success ully ob ained app o al om bo h he E hics Commi ee and he ele an highe au ho i ies a he
school. This app o al was g an ed ollowing a comp ehensi e e iew o he esea ch p oposal, ensu ing ha all e hical
conside a ions and ins i u ional guidelines we e ho oughly add essed. The commi ee and he au ho i ies ha e
assessed he p oposed s udy o i s adhe ence o e hical s anda ds, pa icipan sa e y, and academic in eg i y. As a
esul , we a e now clea ed o p oceed wi h he esea ch ac i i ies unde he s ipula ed condi ions. We a e commi ed o
upholding he highes s anda ds o e hical conduc h oughou he du a ion o his p ojec .
S a emen o in o med consen
In o med consen was ob ained om all indi idual pa icipan s included in he s udy.
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