Poor sleep quality, a global public health concern, poses a significant burden on individuals, particularly health care university students facing intense academic stress. A three-center cross-sectional study was conducted at the Higher Institute of Nursing and Health Sciences in Tetouan (Morocco), Faculty of Medicine in Tangier (Morocco) and Faculty of Nursing in Valencia (Spain). We collected various data using a sociodemographic questionnaire, the Pittsburgh sleep quality questionnaire, the international physical activity questionnaire (IPAQ) and the smartphone addiction questionnaire short-version (SAS-SV). A total of 1210 students were included in our study (mean age 20.4 years, 67.2% female, nursing students (66.2%) and medical students (33.8%), 76.1% students from Morocco and 33.9% from Spain). Analysis revealed a higher prevalence of poor sleep quality among Moroccans students compared to Spanish ones (p < 0.001), that nursing students showed less favorable sleep quality than medical students (p < 0.011) and that living with a chronic disease was linked to less favorable sleep quality (p < 0.001). Lastly, intense or weak physical activity and smartphone addiction were correlated with poor sleep quality (p < 0.001). In the multivariate analysis, an association persisted between poor sleep quality and factors such as the country of study (Odds ratio (OR): 6.25 [95% Confidence Interval (CI): 4.34–9.09]), involvement in nursing studies (OR: 3.50 [95% CI: 2.36–5.27]), and the presence of chronic diseases (OR: 2.70 [95% CI: 1.72–4.16]), (p < 0.01 each). Our findings highlight the multifaceted factors affecting sleep quality in young university students. The implications underscore the imperative of interventions tailored to this demographic group.

Poor sleep quality can cause various health problems. Despite this evidence, much research demonstrates significant heterogeneity in the amounts that people sleep across cultures. This suggests that despite serving fundamental biological functions, sleep is also subject to cultural influence. Variations in chronotype and problematic smartphone use influence sleep quality, and both poor sleep and smartphone addiction can result in poor health and academic performance. This study aimed to measure the associations between chronotype, sleep quality, and smartphone addiction in a population of 1210 health sciences university students in Morocco and Spain. The Horne and Ostberg Morningness-Eveningness Questionnaire, Pittsburgh Sleep Quality Index, and Smartphone Addiction Scale were used to assess the study variables. The study found that the majority of students belonged to the "Neutral" chronotype (73.9%), that the prevalence of smartphone addiction was fairly high (46.3%), and that the prevalence of poor sleep quality was high (74.0%). Associations were found between chronotype and smartphone addiction (p < 0.001), subjective sleep quality (p = 0.006), sleep duration (p = 0.005), sleep disturbances (p = 0.013), and use of sleep medications (p = 0.003). Chronotype was also associated with gender (p = 0.009), country of study (p < 0.001), field of study (p < 0.001), and chronic health problems (p = 0.001). Associations between chronotype and field of study (p < 0.001 for the evening chronotype), sleep disturbance (p < 0.001 and p = 0.026 for both the evening and morning chronotypes), and smartphone addiction (p < 0.001 for the morning chronotype) were confirmed in the multivariate analysis. Our study highlights associations with chronotype that affect sleep quality and addictive behavior when young health sciences students use smartphones. This implies the need to teach or develop strategies to prevent or minimize the negative consequences of the chronotype on mental health and its effects on production. Educational activities on sleep hygiene strategies, the healthy use of smartphones taking into account the chronotype in health sciences students, are needed in order to benefit mental health offuture healthcare professionals.