Abstract
Excessive daytime sleepiness (EDS) is highly prevalent among medical students and can have serious negative outcomes for both students and their patients. Little is known about the magnitude and predictors of EDS among medical college students. A meta-regression analysis was conducted to achieve these two targets. A systematic search was performed for English-language studies that reported the prevalence of EDS among medical students using the Epworth sleepiness scale (ESS), age, sex, sleep duration and sleep quality as predictive variables. A total of nine observational studies (K = 9, N = 2587) were included in the analyses. Meta-regression analyses were performed using mean age (years), sex (proportion of male subjects), sleep duration (hours/night) and sleep quality index score (continuous scale) as moderators for EDS—with the prevalence of EDS as an outcome variable. An interaction term of sleep duration X sleep quality was created to assess if these two variables simultaneously influenced the outcome variable. Utilizing the ESS, the pooled prevalence of EDS among medical students was 34.6% (95% Confidence Interval (CI) 18.3–50.9%). Meta-regression models of age, sex, sleep duration and sleep quality alone revealed poor predictive capabilities. Meta-regression models of sleep duration–sleep quality interaction revealed results with high statistical significance. The findings from this review contribute supporting evidence for the relationship between sleep duration and sleep quality scores (i.e., sleep duration X sleep quality score) in predicting EDS in medical students.
Highlights
Excessive daytime sleepiness (EDS) is a significant health problem [1] with serious consequences, including accidents and injury to self and others [2,3], reduced occupational performance at work or school [4,5], impaired cognitive and social functioning [6], poor physical health [7,8] and increased risk of dementia later in life [9]
46% of the respondents self-identified as male
This review found the prevalence of EDS, among medical students in six countries for which data were derived, was similar to prevalence rates reported by the general population in the same or similar countries
Summary
Excessive daytime sleepiness (EDS) is a significant health problem [1] with serious consequences, including accidents and injury to self and others [2,3], reduced occupational performance at work or school [4,5], impaired cognitive and social functioning [6], poor physical health [7,8] and increased risk of dementia later in life [9]. There is a small group of standardized and psychometrically sound tools that have been used most commonly in EDS research, including the Epworth sleepiness scale (ESS), Stanford sleepiness scale, Karolinska sleepiness scale, Swiss narcolepsy scale [17] and, more recently, the Flinders fatigue scale [18]
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