A mixed methods study of sugar sweetened beverage consumption and sleep quality among university students in West Virginia

University students are at a higher risk of poor sleep quality due to academic and behavioral stressors. This study examined the association between sugar-sweetened beverage (SSB) intake and sleep quality among university students in West Virginia, United States using a mixed-methods approach. A cross-sectional web-based survey was administered among students aged ≥ 18 years enrolled at a university from April to December 2024. The survey collected information on demographics, daily SSB use (≥ 1/day), and sleep quality assessed using the Pittsburgh Sleep Quality Index. Students’ perceptions of the impact of SSBs on sleep were captured through an open-ended question. Quantitative data were analyzed using logistic regression, and qualitative responses were analyzed thematically. Among 426 participants, 33.1% reported daily SSB use. After adjusting for demographic, socioeconomic, and behavioral covariates, daily SSB intake was associated with lower odds of good sleep quality (OR = 0.55, 95% CI: 0.32–0.93, p = 0.03). Of the total sample, 304 participants responded to the open-ended question. Seven themes emerged from the qualitative analysis of which the most frequently reported themes were perceived effects of SSBs on sleep (36.2%), timing of consumption (17.1%), and avoidance strategies (15.1%). Daily SSB intake was associated with poor sleep quality among university students. Qualitative findings suggest that this relationship is complex and influenced by multiple behavioral and contextual factors. These results highlight the need for multifaceted health promotion strategies targeting multiple health behaviors to improve sleep quality among university students.