# Prevalence of Poor Sleep Quality and Its Association with Dysmenorrhea Among Female Undergraduate Students at a Health Sciences University in the UAE

## TL;DR

This study found that poor sleep quality is common among female university students in the UAE and is linked to severe menstrual pain and daily life disruption.

## Contribution

The study identifies sleep disturbance as an independent predictor of severe dysmenorrhea and functional impairment, suggesting a modifiable factor for menstrual pain management.

## Key findings

- 68.9% of participants reported poor sleep quality, and 48.8% experienced severe dysmenorrhea.
- Severe sleep problems were strongly associated with severe dysmenorrhea and functional impairment.
- Sleep disturbance (PSQI Component 5) was the only independent predictor of severe dysmenorrhea.

## Abstract

Background: Poor sleep quality is common among university students and may contribute to adverse reproductive health outcomes, including dysmenorrhea. However, limited evidence exists on whether chronic sleep disturbance independently predicts dysmenorrhea severity or menstrual-related functional impairment after accounting for key confounders. Objectives: We aimed to determine the prevalence of poor sleep quality among female university students and to examine its association with (1) severe dysmenorrhea and (2) menstrual-related functional impairment. Methods: A cross-sectional study was conducted among female undergraduate students at Ras Al Khaimah Medical and Health Sciences University (United Arab Emirates). Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI), and perceived stress was assessed using the Perceived Stress Scale (PSS-10). Dysmenorrhea severity was assessed using a 0–10 visual analog scale; functional impairment was defined as moderate/severe disruption in ≥1 life domain. Multivariable logistic regression models estimated adjusted odds ratios (aORs) for the association between sleep quality and menstrual outcomes after controlling for age, BMI, socioeconomic status, and stress. A component-level analysis examined independent effects of PSQI dimensions. Results: Of the 254 participants, 68.9% reported poor sleep quality and 48.8% reported severe dysmenorrhea. In adjusted models, moderate sleep problems (aOR = 2.00, 95% CI: 1.09–3.67, p = 0.024) and severe sleep problems (aOR = 3.63, 95% CI: 1.45–9.06, p = 0.006) were significantly associated with severe dysmenorrhea. Severe dysmenorrhea strongly predicted menstrual-related functional impairment (aOR = 4.81, 95% CI: 2.63–8.77, p < 0.001). Poor sleep quality remained independently associated with functional impairment (aOR = 1.96, 95% CI: 1.05–3.65, p = 0.035). In component analysis, sleep disturbance (PSQI Component 5) was the only independent predictor of severe dysmenorrhea (aOR = 2.11, 95% CI: 1.31–3.41, p = 0.002). Conclusions: Poor sleep quality, particularly sleep disturbance, is associated with increased odds of severe dysmenorrhea and menstrual-related functional impairment in female university students. Sleep fragmentation may represent a key mechanistic and modifiable contributor to menstrual pain severity. Integrating sleep assessment into dysmenorrhea management and evaluating sleep-focused interventions in longitudinal and interventional studies are warranted.