Department of Zoology, Shaheed Captain Vikram Batra Government College, Palampur, District Kangra, Himachal Pradesh – 176061, India
Sleep disruption and circadian rhythm misalignment are emerging public health concerns, particularly among young adults exposed to lifestyle stressors, digital screen use, and irregular daily schedules. Despite increasing evidence from urban populations, data from rural Himalayan regions of India remain scarce. This study aimed to assess the prevalence of sleep disruption and circadian misalignment among young adults in Sub-Division Jawali, District Kangra (Himachal Pradesh), identify associated lifestyle and behavioural factors, and evaluate their impact on daytime functioning. A community-based cross-sectional survey was conducted among 154 adults using a structured, self-administered questionnaire. Data were collected on sleep duration, sleep quality, circadian behaviours, lifestyle factors (screen use, caffeine intake, shift work), and daytime functional outcomes. Descriptive statistics were used to summarize the data, while inferential analyses were planned to evaluate associations between sleep parameters and functional impairments at a significance level of p < 0.05. Most participants (82.5%) were aged 18–30 years. Approximately 83.7% reported sleeping less than the recommended 7–9 hours per night. Nearly half of the respondents did not consistently feel refreshed upon waking, and 63% reported difficulty concentrating due to poor sleep. Late-night electronic device use was reported by over 95% of participants, while more than half consumed caffeine in the evening. Circadian misalignment indicators, including delayed sleep phase and difficulty waking early, were common. Sleep disruption and circadian misalignment are highly prevalent among young adults in this rural Himalayan population and are strongly associated with lifestyle behaviours and impaired daytime functioning. Targeted community-level awareness and sleep hygiene interventions are urgently required.
Sleep is a fundamental biological process essential for physical health, cognitive performance, emotional regulation, and overall well-being. Adequate and well-timed sleep supports metabolic homeostasis, immune competence, neurocognitive functioning, and psychological resilience. In contrast, chronic sleep disruption has been associated with a wide range of adverse outcomes, including impaired attention, reduced productivity, mood disorders, metabolic dysregulation, and increased cardiovascular risk [1,2]. In recent decades, sleep-related problems have emerged as a growing public health concern across both developed and developing nations. Sleep health is closely regulated by the circadian timing system, an endogenous biological clock that synchronizes physiological and behavioural processes with the external light–dark cycle. In humans, this system is hierarchically organized, with the suprachiasmatic nucleus (SCN) of the hypothalamus acting as the central pacemaker, coordinating peripheral clocks distributed throughout various organs [3]. Proper alignment between the circadian rhythm and behavioural cycles—such as sleep–wake timing, feeding, and activity—is critical for maintaining optimal physiological function. Disruption of this alignment, commonly referred to as circadian misalignment, occurs when internal biological rhythms are out of synchrony with environmental cues or social schedules. Circadian misalignment is increasingly prevalent due to modern lifestyle factors, including prolonged exposure to artificial light at night, excessive screen use, irregular sleep schedules, shift work, and heightened psychosocial stress. Experimental and epidemiological studies have demonstrated that such misalignment contributes to sleep fragmentation, reduced sleep quality, excessive daytime sleepiness, and impaired cognitive performance [4,5]. Furthermore, long-term circadian disruption has been linked to metabolic disorders, mood disturbances, and increased susceptibility to chronic diseases [6,7]. Young adults represent a particularly vulnerable demographic group. Academic demands, social engagement, digital media use, and lifestyle transitions often result in delayed bedtimes, insufficient sleep duration, and inconsistent sleep–wake patterns. Studies among college-going populations globally have consistently reported sleep durations below recommended levels, with associated declines in attention, learning efficiency, and mental health [8,9]. Despite this growing body of evidence, most research has focused on urban or institutional settings, while data from rural and semi-rural regions—especially in the Indian context—remain limited. In India, sleep health research has traditionally received less attention compared to other non-communicable health concerns. Rural populations are often assumed to have healthier sleep patterns due to earlier work schedules and greater exposure to natural light. However, this assumption is increasingly challenged by the rapid penetration of digital technology, changing occupational patterns, academic pressures, and psychosocial stressors even in rural settings. Emerging evidence suggests that rural youth may experience a unique convergence of traditional work-related stress and modern lifestyle-induced circadian disruption, leading to compromised sleep health [10]. Sub-Division Jawali in District Kangra, Himachal Pradesh, represents a predominantly rural Himalayan region undergoing socio-behavioural transitions. Young adults in this area increasingly engage in prolonged screen use, irregular sleep routines, and academic or occupational activities that may conflict with biological rhythms. However, systematic data on sleep disruption and circadian misalignment in this population are lacking. The absence of region-specific evidence limits the development of targeted public health strategies and sleep hygiene interventions. Therefore, the present study was undertaken to address this gap by systematically assessing sleep patterns, circadian behaviours, and associated daytime functional outcomes among adults in Sub-Division Jawali. By examining lifestyle factors such as electronic device use, caffeine consumption, shift work, and psychological stress alongside sleep quality and duration, this study aims to provide context-specific evidence on the magnitude and determinants of sleep disruption in a rural North Indian setting. The findings are expected to contribute to the growing literature on sleep health in India and inform community-level awareness and preventive strategies.
MATERIALS AND METHODS
Study Area
The study was carried out in Sub-Division Jawali, District Kangra, Himachal Pradesh, India. This region is located in the western Himalayan foothills at approximately 32.15° N latitude and 76.02° E longitude, with an average elevation of about 625 meters above mean sea level. The area comprises predominantly rural settlements with mixed occupational profiles, including students, agriculturists, and employed individuals. The population is increasingly exposed to digital technology and changing lifestyle patterns, making it suitable for studying emerging sleep-related health concerns.
Study Population
The study population consisted of adult residents of Sub-Division Jawali. Although individuals from a wider age range participated, young adults aged 18–30 years constituted the majority of respondents and were therefore the primary analytical focus. This age group was selected due to its higher vulnerability to lifestyle-induced sleep disruption and circadian misalignment.
Sample Size and Sampling Method
A total of 154 participants completed the survey and were included in the final analysis. Participants were recruited using a convenience sampling technique based on voluntary participation and accessibility. The questionnaire was disseminated electronically through social media platforms such as WhatsApp and direct messaging to ensure broad reach within the study area. While probability-based sampling was not feasible, the achieved sample size was adequate for descriptive and inferential analysis in a cross-sectional design. Eligibility criteria included adults residing in Sub-Division Jawali, District Kangra, Himachal Pradesh, who were willing to provide informed consent and able to access and complete the online questionnaire. Individuals with incomplete or inconsistent survey responses, or those with a self-reported diagnosis of clinically established sleep disorders such as chronic insomnia or narcolepsy, were excluded from the study.
Data Collection Tool
Data were collected using a structured, self-administered questionnaire developed specifically for this study. The instrument consisted of 27 items grouped into five sections covering demographic characteristics (age, gender, occupation, and residence), sleep habits (bedtime, sleep duration, night awakenings, sleep quality, and morning refreshment), daytime functioning (daytime sleepiness, fatigue, concentration difficulties, and unintentional sleep episodes), lifestyle and circadian factors (screen use before bedtime, caffeine consumption, shift work, and regularity of sleep timing), and psychological and medical factors (stress-related thoughts, sensory sensitivities, nightmares, diagnosed medical conditions, and medication use). The questionnaire was designed to be concise, easy to understand, and appropriate for self-reporting in a community-based setting.
Data Collection Procedure
Data collection was conducted during April 2025 using Google Forms. Participants were provided with a brief explanation of the study objectives prior to participation. Responses were recorded anonymously, and no personally identifiable information was collected. Participation was entirely voluntary, and respondents were free to withdraw at any stage before submission. Ethical principles for human research were followed, with electronic informed consent obtained from all participants. Anonymity and confidentiality were maintained, the study was purely academic and non-interventional, and no conflicts of interest were involved.
Statistical Analysis
Data obtained from Google Forms were exported to Microsoft Excel and subsequently analysed using SPSS (version 26.0) for statistical processing. Data cleaning was performed to remove incomplete and inconsistent entries. Descriptive statistics were used to summarize demographic variables, sleep characteristics, and lifestyle factors, expressed as frequencies, percentages, means, and standard deviations where appropriate. Inferential statistical analyses were conducted to examine associations between sleep parameters and functional outcomes. Chi-square tests were used to assess relationships among categorical variables such as sleep duration, sleep quality, screen use, caffeine consumption, and daytime sleepiness, while binary logistic regression evaluated the predictive effect of inadequate sleep duration on daytime fatigue and concentration difficulties. All statistical tests were two-tailed, and a p-value of less than 0.05 was considered statistically significant.
RESULTS
Demographic Characteristics
A total of 154 respondents from Sub-Division Jawali, District Kangra (Himachal Pradesh), were included in the final analysis. The dataset was complete and suitable for both descriptive and inferential statistical evaluation. The age distribution revealed a predominance of young adults (Table 1). Participants aged 18–30 years constituted 82.5% (n = 127) of the sample, followed by individuals above 40 years (7.1%), 31–35 years (5.8%), 36–40 years (3.3%), and below 18 years (1.3%). Gender-wise, females comprised 64% (n = 99) of the respondents, while males accounted for 36% (n = 55). Regarding occupation, students formed the largest subgroup (60%), followed by employed individuals (30%) and unemployed participants (10%). This occupational distribution reflects the dominance of young adults and academically active individuals within the study population.
Table 1. Demographic characteristics of study participants (n = 154)
|
Variable |
Category |
Frequency (n) |
Percentage (%) |
|
Age group (years) |
<18 |
2 |
1.3 |
|
18–30 |
127 |
82.5 |
|
|
31–35 |
9 |
5.8 |
|
|
36–40 |
5 |
3.3 |
|
|
>40 |
11 |
7.1 |
|
|
Gender |
Male |
55 |
36.0 |
|
Female |
99 |
64.0 |
|
|
Occupation |
Student |
92 |
60.0 |
|
Employed |
46 |
30.0 |
|
|
Unemployed |
16 |
10.0 |
Sleep Duration and General Sleep Patterns
Analysis of sleep duration showed that a substantial majority of participants reported inadequate sleep. Only 16.2% (n = 25) achieved 8 or more hours of sleep per night, while 68.8% (n = 106) slept for 6–7 hours. Shorter sleep durations were also reported, with 14.3% (n = 22) sleeping for 4–5 hours and 0.6% (n = 1) sleeping for less than 4 hours per night (Table 2). Bedtime patterns indicated delayed sleep onset in a considerable proportion of respondents. While 53.9% reported going to bed between 9:00 p.m. and 11:00 p.m., 29.9% went to bed between 11:00 p.m. and 1:00 a.m., and 5.2% after 1:00 a.m. Thus, more than one-third of the population (35.1%) exhibited late-night bedtimes suggestive of delayed sleep phase tendencies.
Table 2. Sleep duration and bedtime characteristics of participants
|
Sleep parameter |
Category |
n |
%age |
|
Average sleep duration |
<4 hours |
1 |
0.6 |
|
4–5 hours |
22 |
14.3 |
|
|
6–7 hours |
106 |
68.8 |
|
|
≥8 hours |
25 |
16.2 |
|
|
Usual bedtime (weekdays) |
Before 9:00 PM |
17 |
11.0 |
|
9:00–11:00 PM |
83 |
53.9 |
|
|
11:00 PM–1:00 AM |
46 |
29.9 |
|
|
After 1:00 AM |
8 |
5.2 |
Sleep Quality and Morning Refreshment
Self-reported sleep quality ratings revealed that only 6.5% (n = 10) described their sleep as excellent. The majority rated their sleep as good (45.5%, n = 70) or average (40.3%, n = 62), while 7.8% (n = 12) reported poor or very poor sleep quality (Table 3). Night-time awakenings were common. Approximately 47.4% reported waking up sometimes during the night, 33.1% rarely, and 11% never, while 10.4% experienced frequent or persistent awakenings. This indicates a high prevalence of fragmented sleep within the study population. Regarding morning refreshment, 55% of participants reported feeling refreshed upon waking, 32% felt refreshed only sometimes, and 13% reported never feeling refreshed. Thus, nearly 45% of respondents experienced non-restorative sleep on a regular or intermittent basis.
Table 3. Self-reported sleep quality and night-time sleep characteristics
|
Variable |
Category |
n |
%age |
|
Overall sleep quality |
Very poor |
4 |
2.6 |
|
Poor |
8 |
5.2 |
|
|
Average |
62 |
40.3 |
|
|
Good |
70 |
45.5 |
|
|
Excellent |
10 |
6.5 |
|
|
Night-time awakenings |
Never |
17 |
11.0 |
|
Rarely |
51 |
33.1 |
|
|
Sometimes |
73 |
47.4 |
|
|
Often |
8 |
5.2 |
|
|
Always |
8 |
5.2 |
Daytime Sleepiness and Functional Impairment
Daytime consequences of poor sleep were prominent. While 63% of respondents reported rarely experiencing daytime sleepiness, 27.9% reported frequent daytime fatigue, and 9.1% reported never experiencing it (Table 4). Difficulty in concentration or completing daily tasks due to poor sleep was reported by 63% of participants, indicating a substantial impact of sleep disruption on cognitive functioning and productivity. Unintentional daytime sleep episodes were also common. Approximately 37.7% reported occasional episodes, 28.6% reported frequent episodes, and only 33.8% reported never falling asleep unintentionally during the day. Collectively, 66.3% of respondents experienced some degree of excessive daytime sleepiness.
Table 4. Daytime functional consequences of sleep disruption
|
Variable |
Category |
n |
%age |
|
Feels refreshed on waking |
Yes |
85 |
55.0 |
|
No |
20 |
13.0 |
|
|
Sometimes |
49 |
32.0 |
|
|
Daytime sleepiness/fatigue |
Never |
14 |
9.1 |
|
Rarely |
97 |
63.0 |
|
|
Often |
43 |
27.9 |
|
|
Difficulty concentrating due to poor sleep |
Yes |
97 |
63.0 |
|
No |
57 |
37.0 |
|
|
Unintentional daytime sleep episodes |
Never |
52 |
33.8 |
|
Sometimes |
58 |
37.7 |
|
|
Often |
44 |
28.6 |
Circadian Misalignment Indicators and Lifestyle Factors Associated with Sleep Disruption
Circadian misalignment behaviours were widely observed. More than half of the respondents (54.5%) reported frequently staying up late and struggling to wake up early, reflecting a misalignment between biological rhythms and social or occupational demands (Table 5). Shift work was reported by 17.5% of respondents, a subgroup known to be at elevated risk for circadian disruption and sleep-related health consequences. Electronic device use before bedtime was almost universal. A total of 82.5% reported regular use of phones, laptops, or televisions before sleep, while 13.6% reported occasional use. Only 3.9% avoided electronic devices before bedtime. Evening consumption of tea, coffee, or energy drinks was reported by 57.1% of respondents, indicating a high prevalence of stimulant exposure during the biological night. Psychological contributors were also evident. A large majority (70.8%) reported engaging in repetitive thoughts or activities that delayed sleep onset. Sensory sensitivities to light, noise, or touch interfered with sleep initiation in 28.3% of participants.
Table 5. Lifestyle and circadian misalignment factors
|
Factor |
Category |
n |
%age |
|
Stays up late & struggles to wake early |
Yes |
84 |
54.5 |
|
No |
70 |
45.5 |
|
|
Night/rotating shift work |
Yes |
27 |
17.5 |
|
No |
127 |
82.5 |
|
|
Electronic device use before bedtime |
Yes |
127 |
82.5 |
|
Sometimes |
21 |
13.6 |
|
|
No |
6 |
3.9 |
|
|
Evening caffeine consumption |
Yes |
88 |
57.1 |
|
No |
66 |
42.9 |
|
|
Repetitive thoughts delaying sleep |
Yes |
109 |
70.8 |
|
No |
45 |
29.2 |
|
|
Sensory sensitivity affecting sleep |
Yes |
44 |
28.3 |
|
No |
110 |
71.7 |
Medical Conditions and Medication Use
Most respondents (80.1%) reported no diagnosed medical conditions. Among those reporting health issues, anxiety or depression was the most common (11.3%), followed by hypertension (4%), diabetes (2.6%), epilepsy (1.3%), and asthma or respiratory conditions (0.7%). No participants reported diagnosed heart disease (Table 6). Medication use was low overall. A majority (83.9%) reported not using any medication, while 11.4% used medication occasionally and 4.7% used medication daily. Nightmares or night terrors were reported by 29.9% of respondents, indicating a notable psychological component associated with disturbed and fragmented sleep.
Table 6. Medical conditions and medication use
|
Variable |
Category |
%age |
|
Diagnosed medical condition |
Hypertension |
4.0 |
|
Diabetes |
2.6 |
|
|
Epilepsy |
1.3 |
|
|
Asthma/respiratory |
0.7 |
|
|
Anxiety/depression |
11.3 |
|
|
None |
80.1 |
|
|
Medication use |
Daily |
4.7 |
|
Occasionally |
11.4 |
|
|
None |
83.9 |
Inferential Statistical Findings
Chi-square analysis demonstrated a statistically significant association between short sleep duration (<7 hours) and difficulty in concentration during daytime activities (p < 0.05). Late-night electronic device use was significantly associated with poor sleep quality and delayed sleep onset (p < 0.05). Evening caffeine consumption showed a significant association with frequent night-time awakenings and reduced morning refreshment (p < 0.05). Binary logistic regression analysis indicated that individuals sleeping less than 7 hours per night had significantly higher odds of experiencing daytime fatigue and unintentional sleep episodes compared to those obtaining adequate sleep (p < 0.05).
DISCUSSION
The present study investigated the prevalence, determinants, and functional consequences of sleep disruption and circadian misalignment among adults residing in Sub-Division Jawali, District Kangra (Himachal Pradesh). The findings provide important region-specific evidence indicating that inadequate sleep duration, delayed sleep timing, and lifestyle-related circadian disruption are highly prevalent among young adults in this rural Himalayan setting. The results are discussed below in relation to existing national and international literature, with emphasis on biological plausibility and public health relevance.
Prevalence of Sleep Disruption in Young Adults
The study revealed that more than four-fifths of the respondents were young adults aged 18–30 years, a group widely recognized as vulnerable to sleep irregularities. A substantial proportion of participants reported sleeping less than the recommended 7–9 hours per night, with only a small minority achieving optimal sleep duration. These findings are consistent with previous studies reporting chronic sleep restriction among students and young working adults, both globally and within India [8,9]. The predominance of moderate but insufficient sleep duration (6–7 hours) suggests a pattern of habitual sleep curtailment rather than acute deprivation, which has been shown to cumulatively impair cognitive and physiological functions [11]. Subjective sleep quality ratings further reinforced the presence of compromised sleep health. Although most respondents rated their sleep as “good” or “average,” only a small fraction reported excellent sleep, and nearly half experienced non-restorative sleep. This discrepancy between perceived adequacy and objective insufficiency is commonly observed in young adults and may reflect adaptation to chronically restricted sleep rather than true sleep sufficiency [1].
Daytime Functional Consequences
A key finding of this study was the high prevalence of daytime functional impairment. More than sixty percent of participants reported difficulty concentrating or completing daily tasks due to poor sleep, and approximately two-thirds experienced unintentional daytime sleep episodes. These findings are in agreement with experimental and epidemiological studies demonstrating that inadequate and fragmented sleep adversely affects attention, executive functioning, and alertness [2,12]. The statistically significant association between short sleep duration and impaired concentration observed in this study further supports a causal relationship between sleep loss and reduced daytime performance. Excessive daytime sleepiness, even when intermittent, has important implications for academic achievement, workplace productivity, and safety. In rural settings, where individuals may engage in physically demanding tasks or long commutes, such impairments can increase the risk of accidents and occupational errors.
Circadian Misalignment and Lifestyle Determinants
The study identified several lifestyle factors contributing to circadian misalignment. More than one-third of participants reported late bedtimes beyond 11:00 p.m., and over half experienced difficulty waking early, indicating a delayed sleep phase pattern. Such misalignment between biological rhythms and social schedules is characteristic of circadian disruption and has been linked to reduced sleep quality and metabolic dysregulation [13]. Electronic device use before bedtime was nearly universal among respondents and showed a significant association with poor sleep quality. Exposure to blue-enriched light from screens suppresses melatonin secretion and delays circadian phase, thereby prolonging sleep onset latency [4,14]. The high prevalence of this behaviour in a rural population underscores the rapid penetration of digital technology and its unintended health consequences. Evening consumption of caffeine-containing beverages was another prominent contributor. More than half of the respondents reported caffeine intake during the evening hours, which was significantly associated with night-time awakenings and reduced morning refreshment. These findings are consistent with evidence that caffeine antagonizes adenosine receptors and disrupts sleep architecture even when consumed several hours before bedtime [15]. Psychological factors also played a substantial role. A large majority of participants reported stress-related repetitive thoughts delaying sleep onset, highlighting cognitive hyperarousal as a key mechanism underlying insomnia and circadian disturbance [16]. This finding aligns with studies demonstrating bidirectional relationships between stress, sleep disruption, and mental health outcomes.
Medical and Psychological Correlates
Although most participants did not report chronic medical conditions, anxiety and depression were the most commonly reported health issues among those affected. This observation reinforces the well-established bidirectional relationship between sleep disturbance and mental health disorders; wherein poor sleep exacerbates psychological distress and vice versa [5]. The relatively low prevalence of medication use suggests that sleep disruption in this population is predominantly driven by behavioural and psychosocial factors rather than pharmacological influences.
Rural Context and Public Health Implications
An important contribution of this study lies in its rural context. Rural populations are often presumed to have healthier sleep patterns due to earlier work schedules and greater exposure to natural light. However, the present findings challenge this assumption and reveal that rural young adults experience sleep disruption comparable to, and in some aspects exceeding, that reported in urban settings. The coexistence of traditional occupational demands with modern lifestyle stressors may create a unique vulnerability to circadian misalignment in such populations. Overall, the findings align with global evidence linking modern lifestyle behaviours to sleep and circadian disruption while providing novel insights from a rural Himalayan region. The results emphasize the need for culturally appropriate, community-based sleep health interventions focusing on sleep hygiene education, stress management, and responsible digital device use.
CONCLUSION
The present cross-sectional study provides clear evidence that sleep disruption and circadian misalignment are highly prevalent among young adults in Sub-Division Jawali, District Kangra, Himachal Pradesh. A substantial proportion of participants reported insufficient sleep duration, delayed sleep timing, poor subjective sleep quality, and significant daytime functional impairments, including reduced concentration and excessive daytime sleepiness. Lifestyle-related factors—particularly late-night electronic device use, evening caffeine consumption, psychological stress, and irregular sleep schedules—emerged as key contributors to circadian disruption in this rural population. The statistically significant associations observed between inadequate sleep duration and impaired daytime functioning underscore the functional and public health relevance of sleep health in young adults. Importantly, the findings challenge the conventional assumption that rural populations are relatively protected from sleep-related health issues and highlight the growing impact of modern behavioural and technological influences in rural Himalayan regions. Overall, this study emphasizes that sleep disruption is not merely a lifestyle inconvenience but a biologically and socially significant health concern with implications for academic performance, productivity, mental well-being, and long-term health outcomes. Addressing sleep health should therefore be considered an integral component of community health promotion strategies.
LIMITATIONS OF THE STUDY
Despite its strengths, the study has certain limitations. The reliance on self-reported data may introduce recall bias and subjective inaccuracies. The use of convenience sampling limits the generalizability of findings to the wider population of the district or state. Additionally, the cross-sectional design restricts causal inference between sleep disruption and associated outcomes. Objective sleep measures such as actigraphy or polysomnography were not employed, which may have provided more precise assessments of sleep parameters.
Future Scope and Recommendations
Future research should incorporate longitudinal study designs to establish causal relationships between circadian misalignment and health outcomes. The inclusion of objective sleep assessment tools and validated psychological scales would strengthen future investigations. Expanding the study to include multiple rural and urban regions would allow comparative analysis and enhance generalizability. From a public health perspective, community-based interventions focusing on sleep hygiene education, stress management, reduction of screen exposure before bedtime, and awareness regarding caffeine consumption are strongly recommended. Educational institutions and workplaces should be encouraged to integrate sleep health awareness into wellness programs, particularly for young adults.
ACKNOWLEDGEMENTS
The authors gratefully acknowledge the Principal, S.C.V.B. Government College Palampur, for providing institutional support and a conducive academic environment for the completion of this study. The authors also sincerely thank all the volunteers and participants from Sub-Division Jawali, District Kangra, for their voluntary participation, cooperation, and valuable responses, without which this research would not have been possible.
CONFLICT OF INTEREST STATEMENT
The authors declare that there is no conflict of interest associated with this study.
FUNDING STATEMENT
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
REFERENCE
Sourav Dhiman, Anuradha Sharma*, Bovinder Chand, Patterns of Sleep Disruption and Circadian Rhythm Irregularities among Adults in Sub-Division Jawali, District Kangra, Himachal Pradesh: A Cross-Sectional Study, Int. J. Sci. R. Tech., 2026, 3 (2), 97-105. https://doi.org/10.5281/zenodo.18523108
10.5281/zenodo.18523108
