Profiles of sleep hygiene, insomnia, sleep locus of control, and psychological well-being among nursing students: a cluster analysis.

INTRODUCTION: Psychological well-being is crucial for nursing students, who often face academic and clinical stressors that disrupt their sleep patterns. Insomnia severity, sleep hygiene, and sleep locus of control are key sleep-related factors that potentially influence mental health. However, the combined effects of these factors on psychological well-being remain underexplored, particularly among Indian nursing students. METHODS: A cross-sectional analytical study was conducted among 418 nursing students from two nursing colleges in Northwestern India. Data were collected using validated instruments measuring insomnia severity (Athens Insomnia Scale), sleep hygiene (Sleep Hygiene Index), sleep locus of control (Sleep Locus of Control Scale), and psychological well-being (WHO-5 Well-Being Index). Statistical analyses included descriptive statistics, Spearman's correlation, two-stage cluster analysis (hierarchical and k-means), and multiple linear regression, with statistical significance set at p < 0.05. RESULTS: Three distinct sleep profiles were identified: insomnia-prone (21.3%), intermediate (51.4%), and adaptive (27.3%). The Insomnia-Prone cluster exhibited the highest insomnia severity, poorest sleep hygiene, least adaptive sleep locus of control beliefs, and lowest psychological well-being. The Adaptive cluster showed the most favorable sleep characteristics and highest well-being. Regression analysis revealed that insomnia severity (β = -0.31, p < 0.001), poor sleep hygiene (β = -0.13, p = 0.004), and chance-oriented sleep locus of control (β = -0.12, p = 0.04) significantly predicted lower psychological well-being, collectively explaining 20% of the variance in the data. CONCLUSION: The three distinct sleep profiles identified in this study highlight the differential vulnerability of psychological well-being across the student population. Sleep-related behavioral and cognitive factors are associated with the psychological well-being of nursing students. Addressing maladaptive sleep patterns through tailored interventions could support the psychological well-being of nursing students.