Autonomic echoes of student life: a mixed-method inquiry with meta-inferential integration of autonomic function, lifestyle narratives, and health behaviours among medical students

Medical students face intense academic and lifestyle transitions that can affect their physiological health and well-being. This mixed-method study explores the interplay between the autonomic nervous system activity, measured via heart rate variability (HRV) and lifestyle behaviours, measured with a 20-item questionnaire (LBQ-20) in 90 first-year medical students in South India. We also gathered narrative responses to understand subjective health perceptions and stress adaptation. HRV parameters, calculated individually for each participant and summarised using group-level means, indicate moderate overall autonomic variability (SDNN of 42.76±18.20 ms and RMSSD of 28.37±13.75 ms), while the mean LBQ-20 score of 9.46±3.16 indicates moderate overall adherence to health-promoting behaviours across the cohort. The correlation between the two is weak and non-significant. Thematic analysis of narratives highlight rigid academic routines, stress, poor sleep, and dietary challenges as major barriers to health. This study suggests that medical student well-being is shaped not only by personal lifestyle but also by systemic and psychological stressors.