(P13-048-25) Associations Between Perceived Stress, Sleep Quality, and Diet Quality Among United States Military Academy Cadets

Objectives: While research has examined stress-sleep relationships in military personnel and college students, the interrelationships between stress, sleep, and dietary quality among service academy cadets remain unclear. This study examined temporal changes and associations between these factors.

Methods: United States Military Academy (USMA) cadets (n=268; age=20.1±1.6 years; body mass index [BMI]=25.2±2.7 kg/m²) completed baseline (BL, approximately 1 month into the Fall semester) and follow-up (POST, ~12 days prior to final December exams) measures including the Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index (PSQI), and VioScreen™ food frequency questionnaire. Diet quality was evaluated using the Healthy Eating Index-2020 (HEI-2020), with sensitivity analyses conducted using HEI-2005, 2010, and 2015 versions.

Results: PSS scores indicated moderate stress levels that significantly decreased from BL to POST [(mean ± SD): 22.7±7.0 to 20.8±7.4, respectively, p< 0.001; -5.4±28.7% change). PSQI scores indicated poor sleep quality at both timepoints but showed modest improvement (6.2±2.4 to 6.0±2.3, respectively, p< 0.001; -1.24±8.4%). Significant positive correlations were observed between PSS and PSQI scores at PRE (0.36, p< 0.001) and POST (0.46, p< 0.001), indicating that reduced stress was associated with improved sleep quality. Total HEI scores fell in the "needs improvement" range, declined from PRE (60.8±9.5) to POST (58.4±10.3, p< 0.001), and were not correlated with stress or sleep measures.

Conclusions: While reductions in perceived stress were associated with improved sleep quality among USMA cadets, these changes occurred within ranges still indicating moderate stress and poor sleep quality. Despite a lack of association between these outcomes and diet quality, the decline in HEI scores from an already suboptimal level suggests wellness programs designed for cadets should continue targeting all three domains. Future research should examine how these interrelated factors may impact academic performance and health outcomes in cadets, particularly given the high operational demands of academy life.

Funding Sources: US Army Medical Research and Development Command, Ft. Detrick, MD.

The opinions expressed in this abstract are the author’s own and do not reflect the view of the U.S. Army or DoD policy. For public release.