{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T02:02:20Z","timestamp":1789610540815,"version":"build-2803163510"},"reference-count":81,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002347","name":"German Federal Ministry of Education and Research","doi-asserted-by":"publisher","award":["02WPM1681"],"award-info":[{"award-number":["02WPM1681"]}],"id":[{"id":"10.13039\/501100002347","id-type":"DOI","asserted-by":"publisher"}]},{"award":["02WPM1681"],"award-info":[{"award-number":["02WPM1681"]}],"id":[{"id":"https:\/\/ror.org\/04pz7b180","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>Sleep is a multidimensional health domain influenced by behavioural, psychological, and lifestyle factors. However, multinational evidence integrating insomnia severity and multiple sleep outcomes within the Mediterranean lifestyle framework remains limited. This study examined correlates of insomnia severity and key sleep outcomes in adults from Mediterranean and neighbouring countries participating in the MEDIET4ALL survey. Data were collected from 4010 adults (59.5% female) across 10 countries using a standardized multilingual e-survey. Insomnia severity was assessed as primary outcome using the Insomnia Severity Index (ISI), while sleep characteristics were assessed using sleep duration, sleep latency, sleep efficiency, and subjective sleep quality. Regression analyses examined sociodemographic, health-related, Mediterranean dietary, movement-related, psychological, and social correlates. Exploratory statistical indirect association analyses involving life satisfaction were also conducted. Insomnia severity showed the highest explained variance among sleep outcomes (adjusted R2 \u2248 0.29). Higher insomnia severity was associated with female sex, higher body mass index, and greater depression, anxiety, and stress (\u03b2 \u2248 0.15\u20130.17), whereas lower insomnia severity was associated with older age, better self-reported health status, higher life satisfaction, and greater adherence to Mediterranean dietary consumption patterns (\u03b2 \u2248 \u22120.04 to \u22120.11). Models for secondary sleep outcomes explained more modest variance and should be interpreted as exploratory. Across these outcomes, psychological well-being and distress showed the most consistent associations, while Mediterranean dietary dimensions and social participation showed smaller and outcome-specific associations. Exploratory indirect association analyses showed small but statistically significant indirect associations involving life satisfaction between Mediterranean dietary dimensions, social participation, and selected sleep outcomes, particularly sleep quality and insomnia severity. The findings confirm and contextualize established associations between sleep, psychological well-being, distress, Mediterranean lifestyle-related behaviours, and regional context within a large multinational sample. Psychological well-being and distress emerged as the most consistent correlates. Insomnia severity was the most robustly explained sleep outcome, whereas secondary sleep dimensions reflected more modest exploratory correlational profiles.<\/jats:p>","DOI":"10.3390\/ejihpe16070096","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:52:24Z","timestamp":1783007544000},"page":"96","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sleep Characteristics and Insomnia Severity in Relation to Mediterranean Lifestyle Adherence and Psychosocial Wellbeing: Findings from the MEDIET4ALL International Survey"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0347-8053","authenticated-orcid":false,"given":"Achraf","family":"Ammar","sequence":"first","affiliation":[{"name":"Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany"},{"name":"Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine of Sfax, University of Sfax, Sfax 3000, Tunisia"},{"name":"Interdisciplinary Laboratory in Neurosciences, Physiology, and Psychology: Physical Activity, Health, and Learning (LINP2), UFR STAPS, Paris Nanterre University, 92000 Nanterre, France"},{"name":"Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atef","family":"Salem","sequence":"additional","affiliation":[{"name":"Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany"},{"name":"High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2623-9557","authenticated-orcid":false,"given":"Khaled","family":"Trabelsi","sequence":"additional","affiliation":[{"name":"Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia"},{"name":"Department of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Montalvan","sequence":"additional","affiliation":[{"name":"School of Medicine, Universidad Cat\u00f3lica de Santiago de Guayaquil, Guayaquil 090615, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3692-9482","authenticated-orcid":false,"given":"Bassem","family":"Bouaziz","sequence":"additional","affiliation":[{"name":"Multimedia InfoRmation Systems and Advanced Computing Laboratory (MIRACL), University of Sfax, Sfax 3000, Tunisia"},{"name":"Higher Institute of Computer Science and Multimedia of Sfax (ISIMS), University of Sfax, Sfax 3000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Ali","family":"Boujelbane","sequence":"additional","affiliation":[{"name":"Department of Training and Movement Science, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany"},{"name":"High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Kerkeni","sequence":"additional","affiliation":[{"name":"High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia"},{"name":"Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwa","family":"Masmoudi","sequence":"additional","affiliation":[{"name":"Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3045-4153","authenticated-orcid":false,"given":"Hadeel Ali","family":"Ghazzawi","sequence":"additional","affiliation":[{"name":"Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam Tawfiq","family":"Amawi","sequence":"additional","affiliation":[{"name":"Department of Movement Sciences and Sports Training, School of Sport Science, The University of Jordan, Amman 11942, Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3149-6630","authenticated-orcid":false,"given":"Bekir Erhan","family":"Orhan","sequence":"additional","affiliation":[{"name":"Faculty of Sports Sciences, Istanbul Ayd\u0131n University, 34295 Istanbul, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-6469","authenticated-orcid":false,"given":"Raynier","family":"Zambrano-Villacres","sequence":"additional","affiliation":[{"name":"Facultad de Ciencias de la Salud y Desarrollo Humano, Universidad Ecotec, Km. 13.5, Samborond\u00f3n EC092302, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7346-4872","authenticated-orcid":false,"given":"Juliane","family":"Heydenreich","sequence":"additional","affiliation":[{"name":"Department of Experimental Sports Nutrition, Faculty of Sports Sciences, Leipzig University, 04109 Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1564-2658","authenticated-orcid":false,"given":"Christiana","family":"Schallhorn","sequence":"additional","affiliation":[{"name":"Department of Sports Economics, Sociology and History, Institute of Sport Science, Johannes Gutenberg-University Mainz, 55122 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6109-7393","authenticated-orcid":false,"given":"Tarak","family":"Driss","sequence":"additional","affiliation":[{"name":"Interdisciplinary Laboratory in Neurosciences, Physiology, and Psychology: Physical Activity, Health, and Learning (LINP2), UFR STAPS, Paris Nanterre University, 92000 Nanterre, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-0141","authenticated-orcid":false,"given":"Evelyn","family":"Frias-Toral","sequence":"additional","affiliation":[{"name":"Escuela de Medicina, Universidad Esp\u00edritu Santo, Samborond\u00f3n 0901952, Ecuador"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3930-5285","authenticated-orcid":false,"given":"Giuseppe","family":"Grosso","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5570-9573","authenticated-orcid":false,"given":"Piotr","family":"Zmijewski","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, 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