Poor sleep quality is widespread among healthcare students in a conflict-affected context and is associated with increased stress, mental health issues, and avoidant coping, while regular physical activity was associated with better sleep quality.
The majority of healthcare students in Lebanon reported poor sleep quality.
The vast majority of healthcare students reported moderate to high levels of perceived stress.
Half of the healthcare students reported avoidant coping as their dominant coping strategy.
Being a nursing student was the strongest academic-discipline predictor of poorer sleep quality.
Experiencing mental health problems was significantly associated with poorer sleep quality.
Exercising three or more times per week was associated with better sleep quality.
The study used a cross-sectional design with bivariate and multivariable analyses to examine predictors of sleep quality.
This research surveyed 452 healthcare students in Lebanon — a country experiencing ongoing conflict — to understand how well they sleep, how stressed they feel, and how they cope with difficulties. The study found that sleep problems are extremely common in this population: more than three-quarters of students reported poor sleep quality, nearly all reported moderate to high stress, and half relied on avoidant coping (such as denial or disengagement) as their primary way of dealing with problems. Students who were nursing or pharmacy majors, those experiencing mental health difficulties, those feeling socially isolated, those with high stress levels, and those who used avoidant coping strategies all tended to sleep worse. The only factor linked to better sleep was exercising at least three times a week. This research suggests that poor sleep among healthcare students is not just an individual problem but is shaped by academic pressures, mental health challenges, social circumstances, and the broader conflict environment in which students live and study. The finding that avoidant coping — rather than more active problem-solving approaches — was associated with worse sleep highlights the potential importance of how students respond psychologically to stress, not just how much stress they experience. From a practical standpoint, this research suggests that universities and healthcare programs, especially in conflict-affected regions, might consider investing in mental health support services, teaching students more adaptive coping skills, and promoting regular physical activity as part of student wellness programs. Since these students are the future healthcare workforce, their well-being during training has implications not just for their own health but for the quality of care they will eventually provide to patients.
El Hajal C, Sejaan AlAchkar M, Sakr F, Habre M, Akiki Z. (2026). Stress, coping, and other determinants of poor sleep quality among healthcare students in a conflict region: a cross-sectional study.. Medical education online. https://doi.org/10.1080/10872981.2026.2639215