What you believe matters: Linking behavioural and cognitive factors to college students’ sleep quality and mental health

Objective: Extending previous research on sleep quality and college students’ mental health, this study tested behavioural and cognitive precedents to sleep quality to inform future health interventions and programmes. Design: Cross-sectional surveys. Setting: The study took place in a large US Midwestern university. Method: Data were collected from two cross-sectional online surveys of college students to test the predictive utility of the theory of planned behaviour and the health belief model regarding sleep quality. The relationship between these cognitive predictors and the reported use of popular at-home sleep hygiene behaviours were additionally tested for their relationship to sleep quality and mental health variables. Results: Crucially, none of the tested popular behavioural remedies were linked to college students’ approved sleep or better mental health across both studies. However, when testing the role of cognitive factors on sleep quality, the health belief model was partially validated, and the theory of planned behaviour was fully validated. Increased perceptions of susceptibility and barriers and decreased self-efficacy were associated with worse sleep quality, which were in turn associated with stronger depression and anxiety symptoms and decreased well-being. In addition, positive attitudes, norms, and behaviour control were all indirectly related to college students’ better sleep quality and mental health. Conclusion: Cumulatively, these studies support the need to highlight cognitive factors when promoting sleep-related behaviours and provide example ways to do so.