Prevalence of suboptimal health status and its association with insomnia and smartphone addiction among medical students in Palestine: A multi-university cross-sectional study

Background Suboptimal health status (SHS) is a reversible intermediate state between health and disease. It is associated with the early development of chronic conditions and is strongly influenced by lifestyle factors. Medical training may foster unhealthy lifestyle patterns that increase long-term health risk. This study assessed the prevalence of SHS and the associations of insomnia and smartphone addiction with SHS among medical students in Palestine. Methods A multi-university cross-sectional study was conducted among 461 medical students from five medical faculties in the West Bank, Palestine, between October 2025 and January 2026. Data were collected using a structured online questionnaire incorporating the 25-item Suboptimal Health Status Questionnaire (SHSQ-25), the Smartphone Addiction Scale–Short Version (SAS-SV), and the Athens Insomnia Scale (AIS). Group differences were examined using chi-square and independent t-tests, and binary logistic regression was performed to identify factors independently associated with SHS. Results Among 461 participants (mean age: 20.93 ± 2.02 years; 55.1% female), 47.5% were classified with SHS, 67.2% had smartphone addiction, and 65.5% reported insomnia. In multivariable logistic regression, insomnia showed the strongest association with SHS (AOR = 7.26, 95% CI: 4.26–12.39, p < 0.001), followed by smartphone addiction (AOR = 2.48, 95% CI: 1.47–4.20, p < 0.001). Conclusion SHS was common among Palestinian medical students; insomnia and smartphone addiction were independently associated with SHS. These findings support the need for further longitudinal research and targeted sleep and digital health focused interventions to address SHS and promote student well-being.