Evaluation of the relationship between stress and sleep quality with eating disorders

The aim of this study is to evaluate the relationship between stress levels, sleep quality, and exam anxiety in university students with eating disorders. A total of 499 university students, 291 females (58.3%) and 208 males (41.7%), with a mean age of 22.4 ± 1.57 years, were included in the study. Participants' general information, anthropometric measurements, health information, eating habits, stress levels (Perceived Stress Scale-PSS), exam anxiety levels (Text Anxiety Inventory-TAI), sleep quality (Pittsburgh Sleep Quality Index-PSQI) and eating attitudes (Eating Attitude Test-EAT-26) was evaluated. 71.6% of the students have normal BMI, their mean PSS score is 27.4±7.25, and their TAI score average is 43.0±13.28. Mean score of EAT-26 was 16.8±11.28 in males and 17.3±9.40 in females, and they were similar for both gender. While 66.9% of the participants have a normal eating attitude, 33.1% have an abnormal eating attitude and 78.4% of the students showed poor sleep quality. Individuals with poor sleep quality had higher mean EAT-26 score (17.6±10.17) than individuals with good sleep quality (16.6±10.39) (p<0.05), and a positive and statistically significant correlation was found between PSQI scores and EAT-26 scores ( p<0.05). However, there was no significant relationship between the perception of insufficient self-efficacy perception of stress/discomfort, PSS and EAT-26 (p>0.05). The mean TAI scores of those with abnormal eating attitudes (45.9±13.75) were higher than those with normal eating attitudes (41.6±12.82), and a positive correlation was found between the TAI and EAT-26 (p<0.05). Positive significant relationships were detected between PSS, TAI and PSQI. As a result of the logistic regression analysis, it was found that when the delusion (TAI sub-dimension) score increased by 1 unit, abnormal eating attitude increased by 7.1% (OR=1.071, p<0.05). It has been observed that university students are at risk of developing eating disorders. Adequate and balanced eating habits should be encouraged in these students and their eating habits should be evaluated.