Determinants of sleep quality and its association with cognitive functions in undergraduate students: A cross-sectional study

Poor sleep quality, often resulting from poor sleep hygiene, is common among medical students. Educational interventions aimed at improving sleep knowledge are beneficial for sleep quality in healthy populations. However, sleep education is often given minimal attention in medical school curriculums. The aim of the study was to explore whether a short educational intervention could improve sleep knowledge, and consequently sleep quality, among medical students. We recruited preclinical- and clinical-stage medical students during the 2017-2018 academic year. Students completed a demographic survey, the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Assessment of Sleep Knowledge in Medical Education (ASKME) questionnaire. Students then attended a lecture on the physiology and importance of sleep. To assess the efficacy of the intervention, questionnaires were repeated 4 months thereafter. A total of 87 students (31 preclinical) with a mean age of 25.86 years (standard deviation [SD], 3.33), 51 of whom were women, participated in the study. At baseline, students had poor sleep quality with a PSQI mean score of 5.9 (SD, 2.37), without significant sleepiness, and a mean ESS score of 8.86 (SD, 4.32). The mean ASKME scores were consistent with poor sleep knowledge at 11.87 (SD, 4.32). After the intervention, the mean ASKME results improved to 14.15 (SD, 4.5; P < .001), whereas sleep quality did not. The effect was similar in preclinical and clinical medical students. Sleep knowledge was inadequate among medical students, who also experienced poor sleep quality. A short educational intervention improved sleep knowledge but was insufficient at improving sleep quality. Further studies are needed to determine which interventions may provide benefit in both sleep knowledge and sleep quality.

Background: Sleep plays essential role in restoring both cognitive and physical performance, up to now its particular impact within military populations remains unknown. Military cadets often go through demanding schedules and high-stress environments that can compromise both sleep quality and duration. Research has shown that insufficient or poor-quality sleep is associated with declined physical performance, affecting endurance, strength, and coordination. Yet, Maximum existing studies have focused on the general population, offering little awareness into the unique challenges faced by cadets. The strict nature of military training may increase the bad effects of sleep deprivation. Understanding the connection between sleep and performance in this context is crucial for improving training outcomes and decreasing the risk of injury. This study pursues to assess how variations in sleep quality and duration influence physical performance among military cadets. The results could notify the development of targeted strategies to magnify sleep hygiene and overall readiness in military training programs. Objective: Assess the impact of sleep quality and duration on physical performance in military cadets, inspect how inequality in sleep patterns affect physical fitness levels and overall performance. Methodology: A cross-sectional study was conducted involving military cadets to Inspect the Connection between sleep and physical performance. A total of 169 military cadets were included in the study as the sample size. Participants completed the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index to assess their sleep quality and duration. Physical activity levels were judged using the International Physical Activity Questionnaire (IPAQ). Statistical analyses were performed by SPSS version 29 to Find out the Connection between sleep variables and physical performance effects. The data was analyzed by using statistical technique chi square test. Result: The results of the study demonstrated a statistically significant relationship between sleep patterns and physical performance among cadets. The correlation analysis revealed that poor sleep hygiene and quality—measured using SHI and PSQI—were positively linked with decreased physical activity levels measured via IPAQ. The highest correlation was noted between stress before bed and poor sleep hygiene (73.3%), and between trouble staying awake and poor sleep quality (58%). A chi-square test confirmed these relationships were statistically significant, as p-values for all hypotheses were less than 0.05, leading to the rejection of the null hypothesis. This indicates a meaningful association between sleep quality, duration, and physical performance. The strongest associations were observed in the age group 21–23 years, non-smokers, and unmarried cadets, with the majority showing poor sleep quality and high physical activity. The findings emphasize the need to improve sleep hygiene to enhance physical performance among military cadets. Conclusion: This study comes to the conclusion that military cadets' physical performance is adversely affected by both inadequate sleep duration and poor sleep quality. Reduced strength, endurance, reaction time, and recuperation—all essential components of military training and preparedness—were linked to sleep deprivation. The results highlight how crucial it is to incorporate regulated sleep schedules, environmental changes, and instruction about good sleep hygiene into military training programs. Specific sleep-related interventions may improve mental and physical function while lowering the risk of damage. To guarantee peak performance and operational efficacy in military environments, sleep should be seen as an essential part of cadet health, in addition to physical training and a healthy diet.

Reduced sleep quality impairs learning, memory formation, attention, and executive function ability. Poor sleep quality or sleep hygiene has been shown to impair academic performance of undergraduate and medical students. The purpose of this study was to examine the association between sleep quality, sleep hygiene, and cognitive performance in Doctor of Physical Therapy (DPT) students. Fifty DPT students at the University of Kansas Medical Center completed the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index (SHI). Cognitive performance was assessed using the Continuous Performance Test (CPT) which is a test of sustained attention and the Trail-Making Task (TMT) to assess executive functioning. An actigraph was worn for one week to objectively characterize sleep outcomes. Spearman's correlations were performed to assess the association between self-report sleep quality, sleep hygiene, and outcomes on the cognitive tasks. Post-hoc Mann-Whitney and Kruskal-Wallis tests were conducted to examine group differences between sleep outcomes and cognitive performance for demographic variable categories. Twenty-three students (46%) reported poor sleep quality, and 27 participants (54%) had objectively-reported poor sleep quality. There was a significant positive correlation between SHI and Detectability (rs= 0.297, p= 0.036) and Omissions (rs=.343, p=0.015). There were group differences between sex and number of pets on the CPT outcomes, and there was a significant group difference between the number of drinks/week categories on the SHI. About half of the participants were identified as having poor sleep quality. Poorer sleep hygiene was associated with poorer discrimination and inattention, which could potentially impact the students' academic and clinical performance as well as their health and wellbeing. Also, certain demographic variables may modulate the results.

The impact of hospitalization on sleep in late-life is underexplored. The current study examined patterns of sleep quality before, during, and following hospitalization, investigated predictors of sleep quality patterns, and examined predictors of classification discordance between two suggested clinical cutoffs used to demarcate poor/good sleep. This study included older adults (n = 163; mean age 79.7 ± 6.9 years, 31% female) undergoing inpatient post-acute rehabilitation. Upon admission to inpatient post-acute rehabilitation, patients completed the Pittsburgh Sleep Quality Index (PSQI) retrospectively regarding their sleep prior to hospitalization. They subsequently completed the PSQI at discharge, and 3 months, 6 months, 9 months, and 1 year post discharge. Patient demographic and clinical characteristics (pain, depression, cognition, comorbidity) were collected upon admission. Using latent class analysis methods, older adults could be classified into (1) Consistently Good Sleepers and (2) Chronically Poor Sleepers based on patterns of self-reported sleep quality pre-illness, during, and up to 1 year following inpatient rehabilitation. This pattern was maintained regardless of the clinical cutoff employed (> 5 or > 8). Logistic regression analyses indicated that higher pain and depressive symptoms were consistently associated with an increased likelihood of being classified as a chronic poor sleeper. While there was substantial classification discordance based on clinical cutoff employed, no significant predictors of this discordance emerged. Clinicians should exercise caution in assessing sleep quality in inpatient settings. Alterations in the cutoffs employed may result in discordant clinical classifications of older adults. Pain and depression warrant detailed considerations when working with older adults on inpatient units when poor sleep is a concern.

Background: A good night's sleep is sleep with a sufficient duration, namely seven to eight hours a day. Sleep quality can be determined by sleep hygiene. People who practice sleep hygiene have better energy and cognitive function. Poor sleep quality due to poor sleep hygiene can affect person's mental and physical health. This often occurs in productive ages, such as students, due to demands and pressures regarding work. Objective: To determine the proportion of sleep quality and poor sleep hygiene implementation in Udayana University Medical Students. Method: This study is a quantitative descriptive study with a cross-sectional approach. The sample came from 245 students of the Undergraduate Medical Study Program, Faculty of Medicine, Udayana University, Class of 2021. Data were obtained using a questionnaire and presented in the form of a pie chart. Sleep quality assessment was based on the Pittsburgh Sleep Quality Index (PSQI) and sleep hygiene was based on the Sleep Hygiene Index (SHI). Results: A total of 211 (86.1%) medical students of Udayana University Class of 2021 had poor sleep quality and 34 (13.9%) had good quality. Even so, the majority of students have good sleep hygiene, which is 229 people (93.5%), while 10 people (4%) are in the moderate category, and 6 people (2%) are in the poor category. Conclusion: A total of 211 people (86.1%) of medical students at Udayana University have poor sleep quality and 6 people (2%) of all students have poor sleep hygiene. Keywords: Sleep Quality, Sleep Hygiene, Medical Students, Udayana University

Sleep quality refers to the subjective experience of sleep, encompassing aspects such as duration, depth and continuity. In contrast, sleep hygiene practices involve behaviours and habits conducive to healthy sleep patterns. This study aimed to explore the prevalence of good sleep quality and hygiene and the factors that affect good sleep hygiene and quality. A cross-sectional study was conducted among 384 Malaysian university students sampled from October to December 2023 using a validated self-administered questionnaire that included the Pittsburgh Sleep Quality Index (PSQI) and Sleep Hygiene Index (SHI). The PSQI and SHI were used to measure sleep quality and hygiene, respectively. Data was analysed using SPSS v26. Approximately 94.0% (95% Confidence Interval (CI)=91.0-96.1) of the participants had good/normal sleep hygiene, while 60.2% (95% CI=55.1-65.1) had poor sleep quality. The multivariate binary logistic regression analysis showed that the participants who had good sleep hygiene had a 4.36-fold (95% CI=1.26-15.17, P=0.02) higher odds of having good sleep quality. Conversely, ethnicity (high odds ratio, P<0.001) and sleep hygiene were associated with a 4.22-fold (95% CI=1.19-14.95, P=0.03) higher odds of good sleep quality. Malaysian university students have a high prevalence of good sleep hygiene, but many have poor sleep quality. Although sleep hygiene may be directly affected by sleep quality, sleep quality can be affected by sleep hygiene and ethnicity.

Pregnancy-related psychophysiological changes are associated with the sleep alterations as the gestational weeks progress. The aim is to evaluate the effectiveness of sleep hygiene education programs during pregnancy. This prospective randomized controlled study based on pre-post-test after intervention consists of 30 studies and 30 control groups. Pregnant descriptive form, Beck Depression Index (BDI), Pittsburgh Sleep Quality Index (PSQI) and sleep hygiene index (SHI) questionnaires were used. Pregnant women with a score of 15 and above according to BDI were excluded from the study due to depression. Following the application of PSQI and SHI as a pretest, a sleep hygiene training program was applied to the intervention group twice with an interval of 15 days, and PSQI and SHI surveys were repeated as a posttest at the end of 1 month. End points with prespecified hypotheses were changes in sleep quality in different trimesters during antenatal follow-up (primary end point) and changes in sleep quality after the sleep hygiene education intervention from randomization to the end of the intervention period (secondary end point). 90% of all pregnant women had poor sleep quality in the pre-test, and 93.3% in the post-test. In the intervention group, the pre-test PSQI score was 8.10 ± 1.80 and the post-test PSQI score was 8.37 ± 2.05 (p < 0.001). In the control group, the pre-test PSQI score was 8.23 ± 2.54 and the post-test PSQI score was 9.77 ± 2.54, and the worsening of sleep quality became more evident (p < 0.05). While the SHI in intervention group was 16.57 ± 5.64 in the pre-test, it was 10.30 ± 3.78 in the post-test after sleep hygiene training (p < 0.001). In the control group, the pre-test SHI scores increased from 14.50 ± 3.78 to the post-test scores of 16.60 ± 4.36, resulting in a decline in sleep hygiene and sleep quality (p < 0.05). As the gestational week progressed, the deterioration in sleep quality increased. The poor sleep quality improved significantly after sleep hygiene education counseling. It is recommended to add sleep-related screenings to routine pregnancy follow-ups and to provide sleep hygiene education.

BackgroundSleep is an important component of human biological functioning and is necessary for optimal health and the maintenance of cognitive and psychological functions. Sleep hygiene is a collective term for the behaviors and environmental factors associated with good sleep.ObjectivesTo assess the prevalence of poor sleep hygiene practices and poor sleep quality among medical students and to test the hypothesis that poor sleep hygiene is correlated with poor sleep quality.MethodsThis cross-sectional study was conducted among 504 medical students at Tanta University, Egypt, using a random two-stage cluster sampling technique. Two validated questionnaires were used, the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index (SHI), in addition to a sociodemographic section.ResultsThe prevalence of poor sleep quality among the study participants was 71.2%. A total of 93.6% of the participants reported having poor sleep hygiene. There was a statistically significant positive correlation between sleep hygiene practices and sleep quality (r = 0.366, p < 0.001). The prevalence of poor sleep quality was the highest among students in the first grade (83.6%) and decreased to 66.0% among students in the fifth grade (p = 0.012). Using the bed for activities other than sleeping or sex; thinking, planning, or worrying when in bed; and doing important work before bedtime were the three most prevalent negative sleep hygiene practices, affecting 59.3%, 58.9%, and 54% of the participants, respectively.ConclusionPoor sleep hygiene practices and poor sleep quality are highly prevalent among Egyptian medical students. Medical students in their early academic years had a greater prevalence of poor sleep quality. Future educational programs on sleep hygiene are needed to raise awareness and possibly improve overall sleep quality in this population.

IntroductionPoor sleep quality and sleep hygiene among medical students is a concern, with limited data on students from alternative medical systems.MethodsThis cross-sectional study assessed 1,151 undergraduate yoga and naturopathy medical students from 10 Indian colleges. A structured questionnaire was used to collect sociodemographic and lifestyle data, while sleep quality, sleep hygiene, depression, anxiety, stress, and Internet addiction were evaluated using the Pittsburgh Sleep Quality Index (PSQI), the Sleep Hygiene Index (SHI), the Depression Anxiety Stress Scale (DASS-21), and the Internet Addiction Test (IAT). Logistic regression models were employed to compute adjusted odds ratios (AORs) as measures of association.ResultsThe average SHI and PSQI scores were 22.49 (±6.34) and 6.52 (±3.01), respectively. Poor sleep quality was reported by 59.8 and 24.7% had poor sleep hygiene. Severe depression (AOR = 5.15) and anxiety (AOR = 2.31) were linked to poor sleep hygiene, while severe stress (AOR = 0.55) was associated with poor sleep quality. Family residence was linked to lower odds of poor sleep hygiene (AOR = 0.14 for male participants, AOR = 0.26 for female participants) and better sleep quality (AOR = 1.46). Poor sleep hygiene was associated with sugary beverage consumption (AOR = 2.02), fried/packaged foods (AOR = 5.06 weekly, AOR = 8.52 daily), Internet addiction (AOR = 21.87 for male participants, AOR = 9.57 for female participants), and late device use (AOR = 3.80 for female participants).DiscussionDespite early exposure to lifestyle principles, yoga and naturopathy students experience poor sleep quality. Contributing factors include poor sleep hygiene, anxiety, stress, unhealthy eating habits, and Internet addiction. Targeted interventions are needed to improve sleep hygiene and overall wellbeing.

&lt;p class="AbstractContent"&gt;&lt;strong&gt;Objective:&lt;/strong&gt; Elderly are at risk of poor slepp quality and other health problems due to reduced sleep satisfaction. The objective of this study was to explore the association between sleep hygiene and sleep quality in elderly.&lt;/p&gt;&lt;p class="AbstractContent"&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This was a descriptive study with cross sectional design. The study was conducted in four elderly care institutions in Jakarta, Indonesia, involving a purposive sample of 103 elderly aged 60 to 111 years old. Data were collected using Sleep Hygiene Index (SHI) and Pittsburgh Sleep Quality Index (PSQI).&lt;/p&gt;&lt;p class="AbstractContent"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Over half of the residents had poor sleep hygiene (51.5%) and more than three quarter (81.6%) had poor sleep quality. The study revealed that there was a highly significant relationship between sleep hygiene and sleep quality (p = 0.001). The study also showed that those with poor sleep hygiene were 7.834 times more likely to have poor sleep quality.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="AbstractContent"&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Nurses need to include interventions that may address residents’ sleep problems. They also need to promote sleep hygiene and improve residents’ sleep quality.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;strong&gt;Keywords: &lt;/strong&gt;elderly, institution, sleep hygiene, sleep quality

Poor sleep quality is a common problem among medical students and often leads to daytime hypersomnolence and fatigue. Having a good sleep hygiene is considered to be an effective way to improve sleep quality. The purpose of this study is to assess students' sleep hygiene awareness and practices and evaluate their sleep quality. The association of sleep quality with sleep hygiene awareness and practice was also explored. The study was a cross-sectional, self-administered, and questionnaire-based study. A total of 262 UniKL RCMP MBBS students were recruited to complete sleep questionnaires adopted from internationally recognized instruments, like Sleep Hygiene Index (SHI); to assess sleep hygiene and Pittsburgh Sleep Quality Index (PSQI); to assess sleep quality. It was found that more than half of the participants (57.3%) had good knowledge on sleep hygiene. However, most of them (82.4%) had poor sleep hygiene practice. 65.6% of the students were also found to have poor sleep quality. Sleep quality was strongly correlated with sleep hygiene practice (p&lt; 0.01) but not with sleep hygiene knowledge (p&gt; 0.05). Appropriate measures and sleep hygiene education should be emphasized in order to raise awareness on the importance of adopting a good practice of sleep hygiene among the students.

Abstract: Background: Sleep quality is particularly important for medical students who often face demanding schedules, high stress levels and an atypical sleep pattern. Objective: To evaluate subjective sleep quality among medical students and its association with sleep hygiene practices. Methods: This descriptive cross-sectional study design was carried out on 385 undergraduate medical students enrolled through simple random sampling. The questionnaire had three sections. The first part covered demographic information; the second part evaluated subjective sleep quality by using the Pittsburgh Sleep Quality Index; and the third part was related to a 13-item sleep hygiene questionnaire. Data was entered and analyzed using SPSS version 26. Pearson chi-square test was employed to identify the factors linked to deprived sleep quality. A p-value of ≤ 0.05 was considered statistically significant. Results: This study revealed that 55.3% of medical students experienced poor sleep quality with a mean PSQI score of 5.17+3.71, which was mostly influenced by subjective sleep quality. 45.19% of the study participants reported poor sleep hygiene practices. The analysis revealed that students with habits of watching television, a lack of exercise and taking daytime naps slept worse. A significant association was observed between poor sleep quality and deficient sleep hygiene practices (p&lt;0.01). Conclusion: Insufficient sleep hygiene practices are prevalent among students with poor sleep quality. Sleep hygiene education programs must be given due consideration because these will ultimately improve future doctors’ health and enhance their performance in the long term

Background:Sleep is a fundamental biological necessity of the body and its quality is dependent on good sleep hygiene. Few studies have been conducted on these topics, especially in medical students. Objective: To assess the association between sleep hygiene practices and sleep quality of medical students and their association with gender and place of abode. Material and Methods::A four months descriptive cross sectional survey was conducted among 597 medical students of Lahore Medical and Dental College, Lahore, recruited through a convenience sampling technique. Data was collected using a structured questionnaire consisting of background information, Sleep Hygiene Index and Pittsburgh Sleep Quality Index. Data was analyzed using Chi square, independent sample t tests and Correlation Coefficient (r). The cut-off point for statistical significance was p≤0.05. Results: Students exhibited poor sleep quality (81%) but good sleep hygiene (76%). Sleep hygiene and sleep quality were moderately correlated (r = 0.35; p&lt; 0.001). Poor sleep quality was associated with sleep latency (p&lt;0.001), interrupted sleep (p&lt;0.001), breathing issues (p=0.017), feeling too cold (p&lt;0.001) or too hot (p=0.006), night mares (p=0.002), bodily pains (p=0.008), day time sleepiness (p&lt;0.001), lack of enthusiasm (p&lt;0.001). Poor sleep hygiene was significantly associated with erratic bedtimes (p=0.001) or wake up times (p=0.002), use of stimulants (p&lt;0.001), mind alerting activities (p&lt;0.001), emotional disturbances (p&lt;0.001), using bed for other activities (p&lt;0.001), uncomfortable bed or bedroom (p&lt;0.001), working in bed (p=0.030) and worrying and planning (p=0.010). Conclusion: Medical students need counseling on enhancing sleep quality and hygiene. Multi-institutional studies must be conducted to assess other influences on sleep.

Insomnia is a highly prevalent health problem, affecting about one-third of the adult population globally. University students are at a high risk for developing insomnia due to the stressful nature of academic life and often unhealthy sleeping habits. The aim of this study was to explore the prevalence of poor sleep quality and investigate sleep hygiene patterns among university students in Qatar. A cross-sectional study was conducted among university students using two validated instruments: the Pittsburgh Sleep Quality Index (PSQI) and the Sleep Hygiene Index (SHI). Data were analyzed using descriptive and inferential statistics, including correlation and multivariate regression analyses. Two thousand and sixty-two students responded to the web-based survey. The mean PSQI score (7.57±3.03) was indicative of poor sleep quality in approximately 70% of the students. Similarly, the mean SHI score (21.79±6.69) was indicative of poor sleep hygiene patterns in 79% of the students. Academic program type, marital status, gender, and sleep hygiene significantly influenced sleep quality. After controlling for all possible covariates in the multiple regression analysis, sleep hygiene remained as the only factor significantly predicting sleep quality. Students with a good sleep hygiene were about four times more likely to have a good sleep quality compared to those with poor sleep hygiene (adjusted OR= 3.66, 95% CI= 2.8-4.8, p <0.001). Poor sleep quality and inadequate sleep hygiene practices were highly prevalent among university students in Qatar. Sleep hygiene was found to be the only significant predictor of sleep quality such that those adopting healthy sleep hygiene practices were more likely to have better sleep quality. Interventions to raise awareness on the effect of sleep hygiene on sleep quality among university students are needed.

PurposePoor quality of sleep has a negative effect on academic performance of medical students. Quantity and quality of sleep in addition to average sleep time are strongly linked with students’ learning abilities, poor academic performance and poor interpersonal relationship which predispose them to mental illnesses. This study is aimed to assess magnitude and correlates of sleep quality among medical students in Ethiopia.MethodAn institutional based cross-sectional study was conducted among 576 undergraduate medical students. Data was collected by using interviewer administered structured questionnaires. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. The collected data were entered in to Epi-data version 3.1and analyzed using SPSS version 20. Logistic regression was used to identify the potential determinants of quality of sleep among undergraduate medical students. P-values less than 0.05 were considered statistically significant and strength of the association was presented by adjusted odds ratio with 95% C.I.ResultThe prevalence of poor sleep quality among undergraduate medical students was 62% (95%CI, 57.9, 65.3). The mean age (±SD) of the respondents was 21.5(±2.4), with age ranging from 18 to 28 and about 310 (53.8%) were males. Factors like, being depressed (AOR = 1.92,95%CI 1.16,3.19), poor social support (AOR = 5.39,95%CI 2.33,2.49), being stressed (AOR = 2.04,95%CI 1.26,3.31), and poor sleep hygiene (AOR = 3.01,95%CI 1.75,5.18) were associated with poor sleep quality at p-value < 0.05. Findings also showed that, one unit increase in grade point average was associated with 81.5% decrease (AOR = 0.185, 95%CI 0.13, 0.28) in poor sleep quality.ConclusionA substantial proportion of medical students are affected by poor sleep quality. Routine screening of sleep quality, sleep hygiene, depression and stress is warranted. Moreover, it is better to educating medical students about proper sleep hygiene and the consequences of poor sleep.