




































 
 

Munaza Bibi 71 

  

Annals of Psychophysiology                                                                                                               Volume 4, July 2017     
©Advance Educational Institute & Research Centre                                                                   www.aeirc-edu.com 

ISSN 2412 - 3188 
 

Original Article 

Assessment of Sleep Quality of University Students 
Munaza Bibi 

Bahria University Karachi. 

Corresponding Author: Munaza.12star@yahoo.com 

 

Abstract 

Objective To assess   the   sleep   quality of   university students   of   Karachi, and its   association 

with   mobile   phone use, depression and academic performance. Methodology A random cross – 

sectional study was conducted on 221 students and data was collected from different universities 

of Karachi business students. Results show that depression, mobile phone use impact on sleep 

quality thus affect the academic performance of students. About 38.9% students were non-

depressed and 61.1% students were depressed. Sleep quality score shows that 8.6% students had 

good sleep and 91.4 % had poor sleep, academic performance is measured in terms of last semester 

GPA (38%) students had GPA 2.6-3.00, (30.3%) students had GPA 3.1-3.5, (15.4%) students had 

GPA 3.6-4.00, (14.5%) students had GPA2.1-2.5 and (1.8%) students’ had GPA <2.0. In terms of 

mobile phone use, (23.1%) students spend <5 hours, (19.9%) spend 6-8 hours, (24%) spend 9-10 

hours and (33%) spend >10 hours on mobile phone. Conclusion For the development and growth 

of this asset “sleep” is a very important aspect vital for normal functioning of physical and mental 

health of students. There is a need to control sleep problems and prevent its complications through 

proper counselling of students about the significance of sleep. Good quality of sleep can develop 

better academic, physical and psychological performance of university students.  

 

Keywords 

Sleep quality, Depression, Academic performance, Mobile phone use 

 

Introduction 

There are two categories of normal sleep first 

one is non-rapid eye movement (NREM) and 

second one is rapid eye movement (REM), 

further splitting up of (NREM) further 

divided into deep stages of sleep: stage N1, 

stage N2 and Stage N3. Need strong stimulus 

by NREM sleep for awakening. Phasic 

component of REM sleep which is resolute 

sympathetically by rapid eye movements, 

respiratory variation and twitches in muscle. 

REM sleep tonic component is Para 

sympathetically determined with no 

movement of eyes. Sleep (NREM) followed 

by sleep (REM) which occurs between 4-5 

times during 8 hours of normal sleep. Stage 

N3 in which presence of sleep in first third 

and REM sleep during the last third of the 

night. NREM problem such sleep walking 

occur in the presence of N3 stage of sleep 

along with first third during night. Stage N1 

is the time between alert and sleep it account 

for 2-5 % of sleep. Stage N2 is present 

throughout the sleep time, it accounts for 45-

55%of the whole sleep. Unconsciousness a 

physiologic condition in sleep in which brain 

is more receptive to both (internal and 

external) stimulus. During sleep brain is less 

reactive to senses (visual and auditory) and 

external stimulus during the period from 

conscious to sleep (Steven M.S. et al, 2015). 

There are two processes which control the 

sleep, the wake system process S endorse 

sleep and process C (circadian) that preserve 

alertness is stimuli across day to neutralize 

with process S for restlessness and alertness 

during the day. Process C is falling to prop up 

the sleep (process S).  

http://www.aeirc-edu.com/
mailto:Munaza.12star@yahoo.com


 
 

Munaza Bibi 72 

  

Annals of Psychophysiology                                                                                                               Volume 4, July 2017     
©Advance Educational Institute & Research Centre                                                                   www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 

The process S (homeostatic) of sleep is 

regulated by neurons, by invigorating the 

brain to promote the sleep. These neurons are 

there in Hypothalamus (pre-optic area) 

accountable to turn off the awakening system 

during the sleep time. The brainstem 

ascending system is accountable for 

sleeplessness. It has two main paths that 

move on the way from the brain stem, the first 

path; originate from cholinergic neurons in 

the upper Pons, which in reaction activates 

the thalamus for conduction of sensory 

nerves (information) to cerebral cortex. The 

second path, originates in the upper 

brainstem (cell groups) enter Hypothalamus 

as an alternative of thalamus upper brain stem 

contains the mono amine transmitters nor 

epinephrine, serotonin, dopamine and 

histamine .In Hypo thalamus it receives the 

inputs from nerve cells that include (melanin 

concentrating hormones and 

peptides),information traverse the forebrain 

(basal area) by getting inputs from 

acetylcholine and gamma – amino butyric 

acid containing cells, all information go 

through the cerebral cortex it provoke the 

nerve cells ( Harvey R.& Bruce, 2006). 

 

An inside biological regulator of sleep in 

body is circadian rhythm, accountable for 

sleep and sleeplessness cycle in human 

beings. Circadian rhythm sustains the 

duration of sleep and restlessness per the day 

time and night. The process of bringing 

together of physiologic purpose with day 

night time called as photo entrainment. As 

the light changes into dark receptors sense 

these changes with encouragement of super 

chiasmatic nucleus (SCN) which contain 

20,000 nerve cells which activates the 

neurons where axons move down to the 

sympathetic (pre ganglionic) neurons in the 

lateral horn of spinal cord. Post ganglionic 

axons direct to pineal gland (present in dorsal 

thalamus) generates the sleep promoting 

neuro hormones melatonin. Melatonin level 

increases between 2:00 -4:00 A.M. 

Aberration in melatonin creation lead to sleep 

difficulty (Purves D. et al., 2001). One of the 

major physiologic process of human body is 

sleep, around 25-40% of young people 

experience sleep problem (Lazaratou H. et 

al., 2005 & Garcia L.M.A. et al., 2004). Study 

in China showed 16.9% adults suffering from 

sleep problem (Liu X. et al., 2000). Sleep 

plays an important role for the health and 

affecting stability of individuals, poor sleep 

affects emotions in the outward appearance 

of depression (Kimberly. O’ et al., 2016). 

Digital media use (including computer & 

mobile phone) among university students 

prior to sleep negatively effect on sleep. 

Good sleep is necessary for proper 

functioning of body physical & mental health 

of students (Kathryn .M. et al., 2016). Study 

showed that depression, pressures for 

academic performance and anxiety among 

university students result in inadequate 

quality of sleep (Seblewngel. L. et al., 2012).  

 

Study showed that respondents who left their 

mobile phone in switch on form had poor 

quality of sleep in relation to those who kept 

their mobile phone in switch off manner (Yen 

– S. L.et al., 2016). Association between 

depression and sleep quality can be a 

problem, especially for female students with 

volatility of emotional aspect were diagnosed 

as sleep deprived than in association with 

male students (Seoyoun K. et al., 2016). 1st 

year medical students gave more importance 

to studies workloads, pressures, and pressure 

about absence of response and 3rd year 

students gave high score to reservations 

about their future, in year 6th students gave 

high score to not accommodating academic 

climate”. Predominance of depression among 

students of medicine was 12.9% and along 

with female students it was 16.9% and 8.1 % 

http://www.aeirc-edu.com/


 
 

Munaza Bibi 73 

  

Annals of Psychophysiology                                                                                                               Volume 4, July 2017     
©Advance Educational Institute & Research Centre                                                                   www.aeirc-edu.com 

ISSN 2412 - 3188 
 

amongst male students. Study showed that 

students of medicine experienced more 

depression than other people (Marie. D. et al., 

2005). Ideation of suicides rate be found 

higher among university students of South 

Africa. Depression, tension and anxiety 

eventually forecast suicidal ideation among 

students of South Africa than ordinary 

population (Jason R. et al., 2016). 71.1% 

participants experienced sleeplessness and 

the nightmares rate of occurrence was modest 

problem among student’s population were 

about two per fourteen days, increased 

psychiatric symptoms are linked with sleep 

problems, circadian rhythm hindrance and 

nightmares (Sheaves B. et al., 2015). 

  

Methodology 

The study design was Cross sectional study 

conducted at one point in time or over a short 

period of time. The Target population for this 

study was business students of different 

universities of Karachi. A sample size of 221 

students, including both male and female. 

Non-probability, convenience sampling 

method was used for this study Instruments 

for this research was a well-structured 

questionnaire, prepared by using multi item 

Likert scale, Part1: questionnaire ascertained 

demographic information of respondents like 

gender, age, education, and department. Part 

2: comprised of the questions regarding 

depression, sleep quality, academic 

performance and mobile phone use in 

university students of Karachi. (PSQI) is self-

rated questionnaire which evaluate the sleep 

quality. The PSQI dealings with seven areas: 

subjective sleep quality, latency, extent, 

routine sleeps efficiency, sleeps disorder, 

utilization of sleeping medicines, and 

daytime dysfunction over the last month. 

PSQI consist of seven components scores 

ranging from (0-3), 0 score is good and 3 

score is very bad. The total score >5 indicate 

sleep problems and <5 indicate no sleep 

problem. CES-D is a questionnaire which is 

self-rated to quantify the depression 

symptoms in common population. CES-D 

score is the summation of 20 items; each 

piece is scored from 0-3. A score of 16 and 

above is well thought-out as depression. 

Collected Data was analyzed using SPSS v. 

16. 

 

Results 

The reliability of overall questionnaire value 

is .720 which is greater than 0.5 so the 

questionnaire used for this research is 

reliable. A random cross – sectional study 

was conducted, Results shows the association 

with depression, mobile phone use on sleep 

quality thus affect the academic performance 

of students. CES-D score shows that 38.9% 

students were non-depressed and 61.1% 

students were depressed. Sleep quality score 

(PSQI) shows that 8.6% students had good 

sleep and 91.4 % had poor sleep, academic 

performance is measured in terms of last 

semester GPA (38%) students had GPA 2.6-

3.00, (30.3%) students had GPA 3.1-3.5, 

(15.4%) students had GPA 3.6-4.00, (14.5%) 

students had GPA2.1-2.5 and (1.8%) students 

had GPA <2.0. In terms of mobile phone use, 

(23.1%) students spend <5 hours, (19.9%) 

spend 6-8 hours, (24%) spend 9-10 hours and 

(33%) spend >10 hours on mobile phone. A 

substantial proportion of subjects were sleep 

deprived and depressed, and increase use of 

mobile phone and related technologies 

reflecting the poor sleep quality trend in 

university students. Graphical 

representations are given below: 

http://www.aeirc-edu.com/


 
 

Munaza Bibi 74 

  

Annals of Psychophysiology                                                                                                               Volume 4, July 2017     
©Advance Educational Institute & Research Centre                                                                   www.aeirc-edu.com 

ISSN 2412 - 3188 
 

Figure1 shows PSQI Score. 

 

Figure2 shows Depression Score. 

 

 
 

 

Figure3 shows Last Semester GPA. 

 

 
 

Figure4 shows Time Spend on  

Mobile Phone. 

 
 

 

Discussion  

This study was done to assess the sleep 

quality of university students of Karachi. 

Subjects involved in this study were mainly 

business students. Students with poor sleep 

quality score had poor cognitive performance 

and depression. Poor sleep is considered as a 

key symptom to cause changes in 

neurotransmitters as a result it leads to 

depression among adults (David; 2010). 

(CES-D) score p- value is 0.001 which is less 

than 0.005, it shows association between 

depression and sleep quality of university 

students.  Based on CES –D 61.1% students 

had depression and 38.9 % were not 

depressed, by treating depression is likely to 

improve poor to good sleep quality (Nour, et 

al., 2016). 91.4% of the students in reality had 

poor sleep quality and 8.6% had good sleep 

quality, poor sleep quality has an association 

with decrease mental health and performance 

of students (Henrick, et al., 2007). For 

evaluating association between mobile phone 

use and sleep quality, students were asked 

how much time students spend on mobile 

phone, majority of students spend more time 

on mobile phone which ultimately affect their 

sleep (Teresa, et al., 2016). Mobile phone use 

indicates p-value is 0.002 which is less than 

http://www.aeirc-edu.com/


 
 

Munaza Bibi 75 

  

Annals of Psychophysiology                                                                                                               Volume 4, July 2017     
©Advance Educational Institute & Research Centre                                                                   www.aeirc-edu.com 

ISSN 2412 - 3188 
 

0.005 it is significant showing  association 

between mobile phone use and sleep quality.  

 

In terms of mobile phone use, (23.1%) 

students spend <5 hours, (19.9%) spend 6-8 

hours, (24%) spend 9-10 hours and (33%) 

spend >10 hours on mobile phone, excessive 

use of mobile affect sleep among students 

also claimed that Use of internet, online 

playing of game with mobile, sports and hi-

tech sophisticated gadgets was associated 

with reduced sleep quality including 

sleeplessness.33% students had difficulty in 

sleep after mobile phone use. Academic 

performance p-value is 0.001 which is less 

than 0.005 which also show significant 

association between academic performance 

and sleep quality (Eyvazlou, et al., 2016 & 

Lam L.T, 2014). A considerable connection 

was found between lower GPAs and lack of 

sleep. Academic performance is measured in 

terms of last semester GPA (38%) students 

had GPA 2.6-3.00, (30.3%) students had 

GPA 3.1-3.5, (15.4%) students had GPA 3.6-

4.00, (14.5%) students had GPA2.1-2.5 and 

(1.8%) students had GPA <2.0 (Kelly, et al; 

2001).  

An association between well sleep measures 

as a measurement of academic performance. 

Delayed bed timetable was linked with 

reduced academic performance in terms of 

CGPA among young person (Mari, et al., 

2016). Strong association was found between 

sleep troubles and reduced academic 

performance and educational behaviors 

(Jorge, et al., 2016). Students with poor sleep 

quality score had poor academic performance 

as compared to those with good sleep, poor 

sleep eventually influences the academic 

performance (Karl, et al.,2015).                                               

 

Conclusion 

From the results and studies it can be assayed 

that “sleep” is a very important aspect vital 

for normal functioning of physical and 

mental health of students.  Systemic 

interference is fundamental to promote 

healthy practice in the family, addressing in 

particular, and use of mobile phone, study 

pattern and sleep behaviors that impacts on 

sleep quality of student’s. There is a need to 

control sleep problems and depression to 

prevent its complications through proper 

counselling of students about the significance 

of sleep and cognitive health for good 

academic performance. Good quality of sleep 

can develop better academic, physical and 

psychological performance of university 

students. 

 

Recommendations 

Future studies should spotlight on detecting 

poor sleep quality causes and impact of sleep 

on suicidal ideation in order to understand 

possible interaction and co - morbidities and 

use longitudinal designs to comprehend the 

influence of these considered variables.  

 

Acknowledgement 

 I would like to acknowledge my research 

supervisor & teacher Mumtaz Khan (Bahria 

University), who encourage me and support 

me in writing of this paper. 

 

Conflict of Interest 

No competing interests were found in the 

preparation of this paper. 

 

References 

 Altevogt, B. M., & Colten, H. R. (Eds.). 

(2006). Sleep disorders and sleep 

deprivation: an unmet public health 

problem. National Academies Press. 

 Bantjes, J. R., Kagee, A., McGowan, T., & 

Steel, H. (2016). Symptoms of 

posttraumatic stress, depression, and 

anxiety as predictors of suicidal ideation 

among South African university 

students. Journal of American college 

health, 64(6), 429-437. 

http://www.aeirc-edu.com/


 
 

Munaza Bibi 76 

  

Annals of Psychophysiology                                                                                                               Volume 4, July 2017     
©Advance Educational Institute & Research Centre                                                                   www.aeirc-edu.com 

ISSN 2412 - 3188 
 

 Choueiry, N., Salamoun, T., Jabbour, H., 

El Osta, N., Hajj, A., & Khabbaz, L. R. 

(2016). Insomnia and relationship with 

anxiety in university students: A cross-

sectional designed study. PloS one, 11(2), 

e0149643. 

 Dahlin, M., Joneborg, N., & Runeson, B. 

(2005). Stress and depression among 

medical students: A cross‐sectional 

study. Medical education, 39(6), 594-604. 

 Eyvazlou, M., Zarei, E., Rahimi, A., & 

Abazari, M. (2016). Association between 

overuse of mobile phones on quality of 

sleep and general health among 

occupational health and safety 

students. Chronobiology 

international, 33(3), 293-300. 

 Garcia-Jimenez, M. A., Salcedo-Aguilar, 

F., Rodriguez-Almonacid, F. M., 

Redondo-Martínez, M. P., Monterde-

Aznar, M. L., Marcos-Navarro, A. I., & 

Torrijos-Martínez, M. P. (2004). The 

prevalence of sleep disorders among 

adolescents in Cuenca, Spain. Revista de 

neurologia, 39(1), 18-24. 

 Hysing, M., Harvey, A. G., Linton, S. J., 

Askeland, K. G., & Sivertsen, B. (2016). 

Sleep and academic performance in later 

adolescence: results from a large 

population‐based study. Journal of sleep 

research, 25(3), 318-324. 

 Kelly, W. E., Kelly, K. E., & Clanton, R. 

C. (2001). The relationship between sleep 

length and grade-point average among 

college students. College Student 

Journal, 35(1), 84-86. 

 Kim, S., Park, J., Kim, H., Kim, T. K., 

Min, Y., Kim, J., & Yang, J. (2016). How 

much does depressive mood affect sleep 

for high school students? European 

Psychiatry, 33, S742. 

 Lam, L. T. (2014). Internet gaming 

addiction, problematic use of the internet, 

and sleep problems: a systematic 

review. Current psychiatry reports, 16(4), 

444. 

 Lazaratou, H., Dikeos, D. G., 

Anagnostopoulos, D. C., Sbokou, O., & 

Soldatos, C. R. (2005). Sleep problems in 

adolescence A study of senior high school 

students in Greece. European child & 

adolescent psychiatry, 14(4), 237-243. 

 Lee, Y. S., & Low, B. S. (2016). Sleep 

pattern among electronic device users and 

its relationship with users’ practice in 

Malaysia university community. Sleep 

and Biological Rhythms, 14(3), 271-277. 

 Lemma, S., Gelaye, B., Berhane, Y., 

Worku, A., & Williams, M. A. (2012). 

Sleep quality and its psychological 

correlates among university students in 

Ethiopia: a cross-sectional study. BMC 

psychiatry, 12(1), 237. 

 Liu, X., Uchiyama, M., Okawa, M., & 

Kurita, H. (2000). Prevalence and 

correlates of self-reported sleep problems 

among Chinese adolescents. Sleep: 

Journal of Sleep Research & Sleep 

Medicine. 

 Lizandra, J., Devís-Devís, J., Pérez-

Gimeno, E., Valencia-Peris, A., & Peiró-

Velert, C. (2016). Does sedentary 

behavior predict academic performance in 

adolescents or the other way round? A 

longitudinal path analysis. PloS 

one, 11(4), e0153272. 

 Minges, K. E., & Redeker, N. S. (2016). 

Delayed school start times and adolescent 

sleep: a systematic review of the 

experimental evidence. Sleep medicine 

reviews, 28, 86-95. 

 Nutt, D., Wilson, S., & Paterson, L. 

(2008). Sleep disorders as core symptoms 

of depression. Dialogues in clinical 

neuroscience, 10(3), 329. 

 O'Leary, K., Small, B. J., Panaite, V., 

Bylsma, L. M., & Rottenberg, J. (2017). 

Sleep quality in healthy and mood-

disordered persons predicts daily life 

http://www.aeirc-edu.com/


 
 

Munaza Bibi 77 

  

Annals of Psychophysiology                                                                                                               Volume 4, July 2017     
©Advance Educational Institute & Research Centre                                                                   www.aeirc-edu.com 

ISSN 2412 - 3188 
 

emotional reactivity. Cognition and 

Emotion, 31(3), 435-443. 

 Orzech, K. M., Grandner, M. A., Roane, 

B. M., & Carskadon, M. A. (2016). Digital 

media use in the 2 h before bedtime is 

associated with sleep variables in 

university students. Computers in human 

behavior, 55, 43-50. 

 Paiva, T., Gaspar, T., & Matos, M. G. 

(2016). Mutual relations between sleep 

deprivations, sleep stealers and risk 

behaviours in adolescents. Sleep 

Science, 9(1), 7-13. 

 Pallos, H., Gergely, V., Yamada, N., 

Miyazaki, S., & Okawa, M. (2007). The 

quality of sleep and factors associated with 

poor sleep in Japanese graduate 

students. Sleep and Biological 

Rhythms, 5(4), 234-238. 

 Purves, D., Augustine, G. J., Fitzpatrick, 

D., Katz, L. C., LaMantia, A. S., 

McNamara, J. O., & Williams, S. M. 

(2001). Neurotransmission in the Visceral 

Motor System. 

 Sheaves, B., Porcheret, K., Tsanas, A., 

Espie, C. A., Foster, R. G., Freeman, D., & 

Goodwin, G. M. (2016). Insomnia, 

nightmares, and chronotype as markers of 

risk for severe mental illness: results from 

a student population. Sleep, 39(1), 173-

181. 

 Steven M.S., Benbadis S.R. & Armon C. 

2015. Normal sleep, sleep physiology, and 

sleep deprivation. Medscape. 

http://www.aeirc-edu.com/

