The Relationship Between Academic Stress, Sleep Quality, and Psychological Wellbeing in Pasifika and New Zealand European Students at the University of Otago

Journal of Racial and Ethnic Health Disparities https://doi.org/10.1007/s40615-024-02043-8 The Relationship Between Academic Stress, Sleep Quality, and Psychological Wellbeing in Pasifika and New Zealand European Students at the University of Otago Willie Solomona Time1 · Ilaisaane Foli Fakapulia1 · Latika Samalia1 · Erik Wibowo1,2 Received: 14 March 2024 / Revised: 22 May 2024 / Accepted: 27 May 2024 © The Author(s) 2024 Abstract Background Pasifika students in New Zealand are overrepresented in poor academic outcomes, and their academic challenges may potentially influence their wellbeing. We aim to: 1) compare the academic stress, sleep quality, and psychological wellbeing of Pasifika and New Zealand European (NZE) anatomy students at the University of Otago, and 2) determine if academic stress mediates the association between their psychological wellbeing and sleep quality. Methods We launched a brief online survey to Pasifika and NZE students in our department. The survey included basic demographics, Perception of Academic Stress Scale, Pittsburgh Sleep Quality Index, Hospital Anxiety and Depression Scale, a short loneliness scale, a reduced morningness-eveningness scale, and the Epworth Sleepiness Scale. Results Perceived academic stress were comparable between NZE and Pasifika students, but Pasifika students reported poorer sleep quality than NZE students (t(113) = 14.41, P < .001). In addition, Pasifika students reported more loneliness (t(119) = 8.933, P < .001), less anxiety symptoms (t(120) = 2.469, P = .015), and less of a morning person (t(121) = 2.618, P = .010) than NZE students, but they had comparable depressive symptoms and daytime sleepiness. After controlling for age, ethnicity and gender, we found that academic stress fully mediated the relationship between anxiety or depressive symptoms and poor sleep quality. Furthermore, academic stress partially mediated the relationship between loneliness and poor sleep quality in our cohort. Conclusion Our findings highlight the importance for academic institutions to support students’ wellbeing, including ethnic minority students such as Pasifika students in New Zealand. Keywords Pasifika students · New Zealand European students · Sleep quality · Psychological wellbeing · Academic stress · Ethnic differences Introduction * Erik Wibowo Willie Solomona Time Ilaisaane Foli Fakapulia Latika Samalia 1 Department of Anatomy, University of Otago, Dunedin 9016, New Zealand 2 School of Medical Sciences, University of Sydney, Sydney 2006, Australia University students may experience stress due to academic and non-academic reasons [1]. Students have academic stressors such as from catching up with lectures, preparing for exams and doing assignments. Students may also have stressors due to sociocultural (e.g., adapting to a new place, forming new friendships) or health (e.g., medical, psychological) reasons. These stressors may potentially affect their sleep and psychological wellbeing while they study. As an example, medical students are prone to having insomnia symptoms during their studies [2–4]. These insomnia symptoms are also associated with increased risk of depressive symptoms [2]. However students may not always be able to manage their sleep due to their heavy workload and busy schedule [5]. Vol.:(0123456789) Journal of Racial and Ethnic Health Disparities Ethnic minority university students may be at higher risks of having poor sleep. Black students in the United States, for example, have higher rate of having short sleep duration than White students but their rates of insomnia symptoms are comparable [6]. Hispanic students also have poorer sleep quality than White students [7]. Another study further shows that there are higher proportions of White university students who get sufficient sleep than Asian, Black, and Hispanic students [8]. Various factors may influence sleep in university students. Biological sex has been known to influence sleep; e.g., insomnia prevalence is higher in females than in males starting from puberty onwards [9]. Health conditions can also affect sleep in university students. As an example, obesity is linked to short sleep duration [10]. Socio-cultural factors may potentially affect sleep too. For example, students who work part-time may have reduced sleep duration and experience excessive daytime sleepiness [11]. Overall these findings highlight the importance of supporting student wellbeing during their studies, especially those with elevated risks of having sleep issues. Pasifika Students in New Zealand In New Zealand, about 8% of the population are Pacific peoples based on the 2018 census [12]. The term “Pasifika” in New Zealand refers to indigenous people of the Pacific Islands. They either had migrated from the Pacific Islands or descendants of people who migrated from the Pacific region to New Zealand [13]. There are similarities and differences among the many Pacific ethnic groups in their cultures, languages and experience. In New Zealand universities, unlike New Zealand European (NZE) students, Pasifika students are present as ethnic minority students. As an example, internal data from the University of Otago show that about 9% of the medical students are Pasifika. In addition, there are approximately 90-100 Pasifika students who take undergraduate anatomy courses in the Department of Anatomy [14]. In our recent study [15], there are three main reasons for Pasifika students to study at the University of Otago. First, they prefer the education programs and scholarships that are offered by the university. Second, other people (e.g., family members, siblings) recommend the University of Otago as a place for their tertiary education. Third, some Pasifika students personally prefer to study away from home. Currently, however, there is no published information on the difference in their academic stress, sleep quality, and psychological wellbeing as compared to those of NZE students. In our recent 5-year retrospective review on students’ academic performance [14], Pasifika students are more likely to achieve lower marks in anatomy courses than NZE students. This finding is consistent with data from other studies in New Zealand which indicate ethnic disparity in academic performance between Pasifika and NZE healthcare professional [16], undergraduate science [17], and first-year undergraduate anatomy [18] students. Thus, there is a possibility that Pasifika students in New Zealand may have elevated academic stress, and this stress potentially influence their sleep and psychological wellbeing. Recently, we conducted several studies related to the experience of Pasifika students at the University of Otago. Majority of Pasifika students in the Department of Anatomy at the University of Otago come from other parts of New Zealand that have higher proportion of Pacific peoples [14, 19] so some experience a culture shock when they move to Dunedin because of the small pro (...truncated)