Abstract
<title>Abstract</title> <p>Background Poor sleep quality is common among university students and may cluster with behavioral and cardiometabolic risk markers. Clinical health professions students may be particularly vulnerable because of academic workload, clinical rotations, and irregular schedules. However, evidence from sub-Saharan remains limited. We determined the prevalence of poor sleep quality and examined its association with selected cardiometabolic risk markers among clinical health professions students in southwestern Uganda. Methods We conducted a cross-sectional study among 429 clinical-year undergraduate health professions students at Mbarara University of Science and Technology between April and June 2025. Poor sleep quality was defined as a Pittsburgh Sleep Quality Index global score of at least 6. Cardiometabolic risk markers included an above-normal blood-pressure reading, overweight/obesity by body mass index, central obesity by waist-to-hip ratio, and low physical activity. Modified Poisson regression with robust standard errors was used to estimate adjusted prevalence ratios with 95% confidence intervals. Results The mean age of participants was 24.9 years (SD, 3.6), and 277 (64.6%) were male. Poor sleep quality was reported by 307 participants (71.6%; 95% CI, 67.0-75.8). Students with low physical activity had a higher prevalence rate of poor sleep quality than those with adequate physical activity (aPR, 1.15; 95% CI, 1.02–1.29, p = 0.021). Central obesity was also associated with a higher prevalence of poor sleep quality (aPR, 1.13; 95% CI, 1.00-1.28, p = 0.043). Additionally, students with elevated blood pressure exhibited higher rates of poor sleep quality (aPR, 1.17; CI, 1.03–1.32, p- 0.012). Conclusion Poor sleep quality was common among clinical health professions students and was significantly associated with low physical activity, elevated blood pressure and central obesity. Findings support integration of sleep-health education and physical-activity promotion into student wellness programs.</p>