The Association of Unhealthy Eating Behaviors with Sleep Quality Outcomes Among University Students: A Cross-Sectional Study

<b>Background</b>: This study examined the association between specific unhealthy eating behaviors and sleep quality among university students. Understanding how dietary habits affect sleep during significant lifestyle transitions associated with university experience can inform health promotion strategies. <b>Methods</b>: A cross-sectional design was employed using a self-reported questionnaire to assess eating behaviors, timing of meals, and sleep-related behavior among a sample of international university students. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI) tool. Statistical analyses were used to assess the relationship between eating patterns, overall sleep quality, and its components. <b>Results</b>: More than half of the students had poor sleep quality (51.7%). Daytime dysfunction was significantly more common in females than in males (27.9% vs. 8.3%, respectively; <i>p</i> < 0.001). Conversely, poor sleep efficiency was more prevalent among males than females (27.5% vs. 15.8%; <i>p</i> = 0.008). Multivariate logistic regression revealed that, compared to students who did not frequently consume heavy evening meals, those who did were more likely to experience poor sleep quality (OR = 2.73, 95% CI: 1.575-4.731). Similarly, those who frequently substitute snacks for main meals were more likely to experience poor sleep quality than those who did not (OR = 2.68, 95% CI: 1.465-4.895). Finally, students who ate within three hours of bedtime had higher odds of poor sleep quality compared to those who had their last meal more than three hours before bedtime (OR = 2.06, 95% CI: 1.173-3.629). <b>Conclusions</b>: Unhealthy dietary habits, such as consuming heavy evening meals, substituting snacks for main meals, and having a short meal-to-bedtime interval, were significantly associated with poor sleep quality. Interventions promoting healthier dietary patterns and appropriate meal timing could help improve sleep in this population.