The correlation between academic stress, sleep quality, and acne severity: a longitudinal cohort study

Objective: To evaluate the relationship between acne severity, sleep quality, and stress levels in undergraduate students and to create a predictive model for acne severity. Methods: This longitudinal cohort study was conducted at Isra University Hyderabad on 150 acne-prone undergraduate students. The Perceived Stress Scale, Sleep Quality Scale, and Comprehensive Acne Severity Scale were used for data collection during the non-examination and examination periods, respectively. Results: The mean age of the study participants was 20.08±1.42 years. A statistically significant rise was observed in perceived stress (p<0.01), sleep quality (p<0.01), and acne severity (p<0.01) during the examination period. A statistically significant association of acne severity was observed with male gender (X2-9.51, p<0.05). A significant positive correlation of acne severity was observed with perceived stress (r=0.95, P<0.01) and sleep quality (r=0.95, P<0.01). Among predictors of acne severity, age (p<0.05), stress score (p<0.05), and sleep score (p<0.05) were found to be significant predictors whereas BMI was found to be non-significant (p>0.05). Conclusion: Acne is correlated with higher stress levels and poor sleep quality. Young age, high stress, and poor sleep are significant predictors of acne severity. This makes acne breakouts common among students, particularly during periods of examinations.