# Health Information Mistrust Is Directly Associated with Poor Sleep Quality: Evidence from a Population-Based Study

## TL;DR

This study finds that mistrust in health information is directly linked to poor sleep quality, regardless of preventive health behaviors.

## Contribution

The study identifies mistrust in health information as a direct risk factor for poor sleep, independent of health behaviors.

## Key findings

- Higher mistrust is associated with poorer sleep quality (β = 0.09, p = 0.003).
- High-mistrust individuals are less likely to engage in preventive health behaviors.
- Preventive health behaviors do not mediate the relationship between mistrust and sleep quality.

## Abstract

Background: Mistrust in professional health information may undermine population health by reducing engagement in preventive care and contributing to poorer health outcomes. Although sleep quality is a sensitive indicator of both psychosocial stress and health behavior, little is known about how mistrust influences sleep at the population level, and whether preventive health behavior mediates this relationship. Methods: A weighted cross-sectional analysis of a representative adult sample (n = 2090) from South Tyrol, Italy was conducted. Survey data included mistrust toward professional health information (Mistrust Index), five preventive health behaviors (Health Behavior Checklist, HBC), and sleep quality (Brief Pittsburgh Sleep Quality Index, B-PSQI). Associations between mistrust, behavior, and sleep were examined using multivariable linear regression, robust regression (Huber’s M-estimator), and nonparametric correlation. Results: Sociodemographic characteristics were not significantly associated with mistrust when weighted data were applied. Higher mistrust was associated with poorer sleep quality (β = 0.09, p = 0.003). Preventive health behaviors varied significantly across mistrust levels, with high-mistrust individuals less likely to report regular engagement (all p < 0.01). Regression analyses confirmed that mistrust was independently associated with poorer sleep quality, while preventive behaviors showed no significant relationship with sleep. Conclusions: Mistrust in professional health information is independently associated with poorer sleep quality and lower engagement in preventive behaviors. However, preventive behavior does not appear to mediate this relationship. These findings highlight mistrust as a direct and potentially modifiable risk factor for sleep disturbance at the population level.