Int. J. Environ. Res. Public Health 2010, 7 12 success, health status, and risk behaviours are cyclically interdependent. Given that investigating a few isolated variables obscures confounding relationships [63], this study links these various features together in order to capture the wider landscape of university students‘ wellbeing, educational satisfaction and achievement. As regards satisfaction, students exhibited high to medium satisfaction with their educational experiences. This is in agreement with other surveys where, depending on the aspect of the learning experience that was inquired about, between 26 and 97% of students reported that they were satisfied with their educational experience [32]. There were also no gender differences in the reported satisfaction levels, in support of both El Ansari & Oskrochi [32] who found no gender differences in a study of one university in the UK, and Kerridge & Mathews [49] who reported gender differences in only one out of 12 satisfaction questions that they inquired about in the UK. The substantial pressure on children, parents, and schools to maximize academic performance [64] has resulted in a growing interest in the potential factors that impact on educational outcomes. About 20% of the sample experienced (sometimes or very often) a sleep disorder or insomnia during the year preceding the survey. Health complaints limit students‘ capacity to perform adequately at university [26,65]. Our findings support such assertions, as sleep disorder/insomnia was significantly and negatively associated with the students‘ module mark (actual achieved grade). However, the repercussions of disappointing academic results may be manifold, as such disappointments might also further affect existing health problems, initiating a vicious circle in which health conditions and study problems negatively influence each other [26]. This highlights the importance of the early detection of such health complaints through university health programmes. Although the majority of students in our sample perceived their health as good to excellent, and kept (to some extent or very much) an eye on their health, perceived health and health awareness were associated either with students´importance of good grades or how they rated their own academic performance. A close link between health, well-being and academic performance has also been acknowledged by others [2], suggesting the need for quality programmes at universities which take into account health as an important factor. Other studies have found that poor school performance was associated with health-compromising behaviours and physical, mental, and emotional problems [11-13]. Our study findings supported such a link, where the frequency of binge drinking in the last month was negatively correlated with the importance of good grades. However, it is also important to note that in our sample, other health behaviours such as smoking, physical activity or nutritional factors did not display, in the bivariate analyses, significant associations with module mark as educational outcome and were therefore excluded from further analyses. Others have highlighted the relevance of physical activity and healthy nutrition for good school performance in children [22,24,25]. Nevertheless, the lack of significant associations between physical activity and module mark are conceivable. For instance, although many studies have shown positive relationships between academic achievement and physical activity [66,67], few have shown no correlation [68] or an inverse relationship [69]. The point to note is that, in university students, the association between binge drinking and academic achievement seems to be the most relevant relationship. From the present cross-sectional study, no conclusions can be made in terms of causal relationships, but it is very likely that the relationship between alcohol use and educational achievement is reciprocal as our conceptual model