Since sleep problems are very common among university students, this study explored the interplay between symptoms of depression, anxiety, quality of sleep, and insomnia. The cross-sectional study was carried out at the University of Niš, Faculty of Medicine (Serbia) in 2016 and included 600 students of both genders. Students completed the questionnaire, which was compiled and developed from the Depression Anxiety Stress Scale, the Pittsburgh Sleep Quality Index, and the Insomnia Severity

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... Sleep problems are very frequent among university students: 432 (72%) and 258 (43%) students reported poor sleep quality or sub-threshold insomnia problems, respectively. Even 66 students (11%) reported moderate or severe insomnia. Above-threshold depression symptoms were reported by 168 students (28%) and anxiety symptoms by 180 of them (30%). Depression was strongly associated with poor sleep quality (χ 2 = 20.35; df = 1; p < 0.001), and insomnia severity (χ 2 = 13.05.; df = 1; p < 0.001). Above-threshold anxiety was associated only with insomnia severity (χ 2 = 16.42; df = 1; p < 0.001). It has been found that an anxiety pathway was strongly associated with insomnia severity, while a depression was more relevant for worsening the quality of sleep. Acta Medica Medianae 2020;59(1):44-50.