Assessing Academic Stress And Sleep Quality As Modifiable Risk Factors For Early Rheumatoid Arthritis In Indonesian University Students

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease whose early detection remains limited among young adults. University students represent a vulnerable group due to high academic stress and lifestyle factors that may trigger early inflammatory symptoms. This study examines the influence of individual factors, academic stress, and sleep quality on the risk of early RA symptoms among Indonesian university students. A cross-sectional quantitative design was employed with 110 active undergraduate students selected through convenience sampling. Data were collected using an online questionnaire including demographics, the Perceived Stress Scale (PSS-10), the Pittsburgh Sleep Quality Index (PSQI), and an RA Symptom Checklist adapted from the EULAR criteria. Multiple linear regression analysis was conducted to assess relationships among variables. The results showed that individual factors, particularly BMI, physical activity, and family history, significantly predicted early RA symptom risk (β = 0.503, p < 0.001). Academic stress had a significant negative relationship (β = -0.165, p = 0.050), indicating that students with better stress management are less likely to show early RA symptoms. Sleep quality did not significantly predict RA risk (p = 0.396). The model explained 28.1% of variance in RA symptom risk. These findings highlight the importance of promoting healthy lifestyles, stress management, and early autoimmune awareness among university students. Future research should integrate biomarker data and longitudinal design to confirm causality and expand understanding of early RA risks in young populations.