Association of self-efficacy and coping with sleep quality and disturbances with an emphasis on mediating role of eating behaviors and body mass index: A structural equation modeling approach

Sleep quality is influenced by various physiological and psychological parameters. We aimed to investigate the predictors of sleep quality, including eating behavior patterns, body mass index, self-efficacy, and coping strategies among university students. Three hypotheses were tested: 1) self-efficacy could predict sleep quality; 2) coping strategies could predict sleep quality and 3) eating behavior patterns and body mass index could mediate the association of self-efficacy and coping strategies with sleep quality. In a cross-sectional study, Sherer's self-efficacy questionnaire, Jalowiec coping scale, eating behavioral patterns, and Pittsburgh's sleep quality index questionnaires were collected from 250 female university students. The results of analyzing data using the structural equation modeling approach showed that the first and second hypotheses were fully confirmed but the third hypothesis was only partially supported. Higher self-efficacy and problem-focused coping strategies could positively predict better sleep quality, but higher emotion-focused coping strategies negatively predicted good sleep quality. Moreover, eating behavior patterns and body mass index could mediate the association between self-efficacy and emotion-focused (but not problem-focused) coping strategies with sleep quality. In brief, the total effects of self-efficacy, emotion-focused, and problem-focused coping strategies on sleep quality were beta = -0.260, beta = 0.327 and beta = -0.209; p < 0.001, respectively. The present study provides new evidence about the predictors of sleep quality among university students. However, further studies are required with longitudinal design and with more objective assessments of sleep quality.