Among healthcare university students during examination periods, 72.8% met clinical criteria for poor sleep quality, and TwoStep cluster analysis identified three distinct behavioral typologies—non-users, poly-substance users, and OTC supplement/caffeine users—with substance-utilizing profiles displaying significantly worse sleep quality and higher emotional eating.
A high prevalence of poor sleep quality was observed among healthcare university students during examination periods.
High sleep disturbances were significantly associated with multiple stimulant and substance use behaviors.
Poor sleep quality and younger age were independently associated with higher odds of energy drink use.
A cognitive disconnect was observed in tobacco usage, with conventional smoking negatively associated with self-perceived health but electronic cigarette use showing no significant association.
TwoStep cluster analysis identified three distinct student behavioral typologies during examination periods.
The study was cross-sectional in design and focused on healthcare university students.
This research suggests that healthcare university students experience significant lifestyle disruptions during exam periods, particularly with respect to sleep and substance use. Nearly three-quarters of the 265 students studied had poor sleep quality based on a standard clinical measure, and those with worse sleep were more likely to use energy drinks, smoke, consume more coffee, and use so-called 'smart drugs' or dietary supplements. Younger students and those with worse sleep were especially likely to turn to energy drinks as a coping strategy. The study also found that students naturally fell into three distinct groups: roughly one-third avoided stimulants and supplements, one-third used multiple substances (including tobacco, energy drinks, and smart drugs), and one-third relied mainly on caffeine and over-the-counter supplements. Students in the substance-using groups had notably worse sleep and higher levels of emotional eating—eating in response to stress or negative emotions—compared to non-users. An interesting pattern emerged around tobacco: students who smoked conventional cigarettes recognized the health risks (reflected in lower self-rated health scores), but those using e-cigarettes did not show this same awareness, suggesting a gap in how electronic cigarettes are perceived. This research suggests that exam stress does not affect all students the same way—different groups adopt different coping behaviors, many of which may compound health problems like sleep disruption. The findings point to a potential need for universities, particularly in healthcare education programs, to offer targeted support and stress management resources during high-pressure academic periods to help students develop healthier coping strategies.
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Upload Your LabsButucaru A, Mihăianu I, Iorga M, Șipoș L, Slăvescu D, Iurcov R. (2026). Behavioral Profiles of Exam Stress: Mapping Student Diet, Sleep, and Substance Use.. Nutrients. https://doi.org/10.3390/nu18172847