Quality of Sleep and its Impact on the Academic Performance of Undergraduate Medical Students

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.

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.

Introduction: Poor sleep quality has proven to impact students’ academic performance, interpersonal skills, and learning capacity and health. The objective of this study was to assess the quality of sleep and its association with perceived stress and junk food consumption among MBBS students studying at a Medical College, Pokhara. Methods: A cross sectional study was conducted among 240 MBBS students studying at Gandaki Medical College using a self-administered questionnaire from November to December, 2023. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality which includes seven sleep items, with higher scores indicating lower quality and a cumulative score of less than five indicating good sleep quality. The study used both descriptive and inferential statistics. Multivariate logistic regression was computed to examine the association of perceived stress and junk food consumption with sleep quality at the 5% level of significance. Results: Out of total 240 respondents, 68.3% had poor sleep quality, 64.2% slept for six or less than six hours in the past one month. After adjusting with socio-demographic characteristics, students who reported that they consumed junk food more than three times in last week were 3.68 (AOR 3.68, CI 95%, 1.34-10.09) times more likely to have poor sleep quality as compared to those who consumed two or less times a week. Students who perceived moderate level stress had 2.49 (AOR 2.491, CI 95%, 1.19-5.23) times and who perceived high level of stress had 20.13 (AOR 20.13, CI 95%, 4.66-86.98) times likelihood of having poor sleep quality as compared to who perceived mild level of stress. Conclusions: The study revealed poor sleep quality; and sleep quality was significantly influenced by junk food intake and stress levels among undergraduate medical students.

Introduction: Sleep quality is strongly related to psychological and physical well-being. Medical students experience long duration of study period, academic over load, frequent exams, fear of failure and highly demanding lifestyle. They are vulnerable to poor sleep quality. Aim: To find the prevalence of sleep quality and daytime sleepiness and their associated factors among medical undergraduate students in Tamil Nadu, India. Materials and Methods: This was a cross-sectional study conducted among 367 undergraduate medical students from first year to final year of a Government Medical College, Chennai, Tamil Nadu, India. A self-administered questionnaire was used to collect data on socio-demographic characteristics, lifestyle behavioural factors, mobile phone usage and academic performance. Pittsburgh Sleep Quality Index (PSQI) and Epworth Daytime Sleepiness Scale (EDSS) were used to assess sleep quality and excessive daytime sleepiness, respectively. Descriptive statistics was used to express baseline characteristics. Chi-square test was be applied to test associated factor. Pearson correlation coefficient was used to find correlation between continuous variables. Results: Poor quality of sleep and excessive daytime sleepiness was found among 54.2% and 28.6% of students respectively. Poor sleep quality and excessive daytime sleepiness was significantly associated with increased duration of mobile phone usage (p=0.030 and p=0.009 respectively). Significant association was found between sleep quality and academic performance (p=0.004). Statistically significant correlation was found between sleep quality and duration of mobile phone usage (r=0.18, p=0.0001) as well as sleep quality and excessive daytime sleepiness (r=0.14, p=0.005). Conclusion: Prevalence of poor quality sleep and excessive daytime sleepiness was found to be high among medical students. Mobile phone overuse was significantly associated with poor sleep quality and excessive daytime sleepiness. Students with good quality of sleep had better academic performance when compared to poor sleepers. Excessive daytime sleepiness was found in increasing pattern among those with poor quality sleep

Sleep duration and quality in relation to non-alcoholic fatty liver disease in middle-aged workers and their spouses

Introduction: Sleep is essential for both physical and mental health. Studies have shown that sleep problems are prevalent among university students. The purpose of this study was to investigate the association between sleep quality and academic performance among dental students at a Malaysian university. Methods: All dental students of the university were invited to participate in this cross-sectional study, which used a self-administered Pittsburgh Sleep Quality Index (PSQI) scale and the psychological health domain of the Lifestyle and Habits Questionnaire- Brief. The academic performance was determined by their Grade Point Average (GPA). Descriptive statistics, independent t-tests, Pearson’s Chi square test for independence, and ANCOVA tests were used to analyse the data. Results: A total of 341 students (233 females and 108 males) participated in the study, with 36.7% reporting poor sleep quality (PSQI &gt; 5). There was a significant difference in academic performance between students with good and poor sleep quality. Controlling for gender and psychological health, poor sleep quality was associated with lower GPA in both preclinical (adjusted mean GPA: 2.84 for poor sleepers, 3.28 for good sleepers, P &lt; 0.001) and clinical year students (adjusted mean GPA: 2.99 for poor sleepers, 3.13 for good sleepers, P = 0.003). Conclusion: Dental students with poor sleep quality performed worse academically than students with good sleep quality after controlling for gender and psychological health. This finding was consistent in both the preclinical and clinical phase groups.

Introduction: Increased obesity rates in adolescents can lead to the emergence of new risk populations for the occurrence of sleep disorders. The emergence of sleep disorders will have a direct impact on decreasing the quality of sleep. This study aims to determine the effect of obesity on the sleep quality of students of the Faculty of Medicine, Udayana University.Method: The study design was cross sectional analytic with a total sample of 74 students of the Medical Faculty of Udayana University (37 samples of the Body Mass Index (BMI) obesity and 37 samples of the normal BMI). Sample selection is done randomly. Measuring sleep quality was done through filling in the Pittsburgh Sleep Quality Index (PSQI) questionnaire and measuring obesity was done by calculating BMI. The answers to the questionnaire were scoring and based on the global score, sleep quality was categorized into poor and good sleep quality. The PSQI questionnaire also included questions about health problems experienced by students in the past month. Data analysis is presented in the form of tables and narratives.Result: The results showed that in the obese student group there were 22 samples with poor sleep quality (53.7%) and 15 samples with good sleep quality (45.5%). In the normal IMT student group there were 19 samples with poor sleep quality (46.3%) and 18 samples with good sleep quality (54.5%). In 20 students with health problems, there were 15 samples with poor sleep quality and 5 samples with good sleep quality. In 54 students without health problems, 26 samples with poor sleep quality and 28 samples with good sleep quality. Analysis using chi-square showed obesity did not have a significant effect on sleep quality (p = 0.483). There was a significant effect of health problems on sleep quality (p = 0.039).Conclusion: Conclusions of the study were obesity did not have a significant effect on the quality of sleep of students of the Faculty of Medicine, Udayana University.

To compare pain characteristics, functional limitation, psychosocial factors, and sociodemographic characteristics between patients with chronic LBP reporting good or poor sleep quality. A secondary analysis of 444 patients with a current episode of chronic low back pain (CLBP). Sleep quality was measured by an item of the Pittsburgh Sleep Quality Index (PSQI). Pain intensity (two items from The Brief Pain Inventory, BPI), functional limitation (The Patient-Specific Functional Scale, PSFS, and BPI), and psychosocial factors (The Brief Screening Questions, BSQ) were also assessed. Features of participants with good and poor sleep quality were compared. Participants were classified as "good sleep quality" (n = 228) or "poor sleep quality" (n = 216). Those with poor sleep quality showed greater functional limitations (Good sleepers = 5.38 ± 2.54; Poor sleepers = 6.48 ± 2.35; p < 0.01), higher pain interference with functionality (Good sleepers = 35.90 ± 23.87; Poor sleepers = 50.84 ± 26.89; p < 0.01), and more significant psychosocial issues, such as anxiety [Good sleepers = 165 (37%); Poor sleepers = 186 (42%); p < 0.01], and depressive symptoms [Good sleepers = 37 (8%); Poor sleepers = 73 (16%); p < 0.01]. Chronic LBP patients with poor sleep quality significantly faced more functional limitation, increased pain interference, and a higher prevalence of psychological problems, including anxiety and depression, than those with good sleep quality. Our results emphasize the impact of poor sleep quality in clinical measures of LBP patients.

Background: Social support can be explained as the availability or existence of people who make us feel loved, cared for and valued, people on whom we can rely. Apart from physical health, social networking and interaction uplift mental health, well-being, and academic performance of individuals. Sleep has been associated with achievements in academic indicators of a person, as its deficit causes a lack of attention and concentration. Methods: A survey was designed to conduct cross-sectional study among the undergraduate medical students. The validated 12 item multidimensional scale of perceived social support and 19 self -rated questions of Pittsburgh sleep quality index was used for assessing the social support and sleep quality among the students and how it affected their academic performance. Data was collected in google forms and coded &amp; cleaned and then exported for statistical analysis, to SPSS version 20. Results: Of the total 385 undergraduate medical students, majority were female respondent and from 2nd Professional. Most of the students scored between 60-69% in their university exam. Majority of the student has poor sleep quality. The academic performance has statistically significant association with perceived social support while age of the student was significantly associated with poor quality of sleep. A negative correlation was noted between perceived social support and sleep quality. Conclusion: This study has highlighted the negative impact of a lack of perceived social support on the sleep quality of medical students. Results also showed evidence of an overall poor quality of sleep in the medical students.

Aim: The aim of this study is to evaluate the relationship between quality of sleep (QoS) and demographic, clinical, and psychosocial factors in kidney transplant recipients. Materials and Methods: We examined sixty-four kidney transplant recipients (26 female, 38 male). Clinical, demographic, and biochemical parameters were analyzed. The QoS was evaluated using Pittsburgh Sleep Quality Index (PSQI), health-related quality of life (HRQoL) with SF-36 Health Survey and depressive symptoms with Beck’s Depression Inventory (BDI). Results: A comparison of good and poor QoS (PSQI ≤ 5, PSQI > 5, respectively) groups showed a significant difference only in BDI scores (p < 0.001). There was no statistically significant difference regarding urea, creatinine, ferritin, albumin, and other laboratory parameters. Thirty-six of the 46 patients (80%) in the good QoS group were married, while 10 of 19 patients (52%) in the poor QoS group were single. Married individuals had significantly better QoS (p=0.026). A comparison of the domains of the HRQoL survey showed significantly better “physical function” in those with good QoS than those with poor QoS (51 ± 6 and 47 ± 8, respectively; p < 0.017). Conclusion: Patients with poor QoS had worse HRQoL. Routine screening of depressive symptoms, which may be manageable is required for improving QoS and HRQoL in these patients.

Background: Sleep hygiene habits are essential to maintaining a healthy lifestyle. Sleep deprivation is a prevalent problem worldwide. Multiple studies have shown a high prevalence of sleep insufficiency among medical students due to high academic load, caffeine intake, and high-stress levels. Objectives: This study explores the relationship between sleep quality, academic performance, and psychological distress among medical students at Alfaisal University, Riyadh, Saudi Arabia. Methods: This cross-sectional study was conducted on medical students of all academic years at Alfaisal University, Riyadh. Two popular surveys – the Pittsburgh sleep quality index (PSQI) and K10 - were used to assess sleep quality and psychological distress, respectively. In addition, the survey contained questions on socio-demographics and academic performance. Sociodemographic characteristics were assessed across groups having poor and good sleep quality. In multivariate analysis, we employed conscious variable selection to develop models. All statistical tests were two-sided at P &lt; 0.05 as statistically significant. Results: A total of 241 respondents participated in the study. Most respondents reported poor sleep quality (75.93%). The highest psychological distress was reported among respondents with poor sleep quality (48.63%). The relationship between Kessler's Psychological Distress score and sleep quality score was significantly positive and linear (P &lt; 0.0001). The mean PSQI score was higher in students with lower GPAs (1.50 - 2.99) than in those with higher GPAs (3.00 - 4.00). This shows that those students who sleep well perform academically better. Conclusions: The quality of sleep among medical students is poor, which is associated with psychological distress and poor academic performance. It is highly suggested that the awareness of sleep hygiene with healthy sleep habits be campaigned among medical students. Also, academic mentors, program directors, and coordinators play a crucial role in ensuring that medical students are not academically overwhelmed.

Background: Depression is one of the most common mental disorders and one of the leading causes of disability and suicide. Approximately 50 – 90% of patients with depression experience sleep disturbance as an additional symptom. Sleep disorders not only represent as a primary factor for patients with depression to seek for professional help but also represent as a risk factor for suicide and self-harm. A good sleep quality can improve mood and support the recovery process in patients with depression. Methods: The type of research used in this study is a cross-sectional study employing a demographic and PSQI (Pittsburgh Sleep Quality Index) questionnaire to assess sleep quality among patients with depression at Outpatient Psychiatric Department of Dr. Soetomo General Hospital. This study utilized primary data obtained through guided-interviews and secondary data collected from the patient's medical records. Results: Based on 81 respondents at Outpatient Psychiatric Department of Dr. Soetomo General Hospital, most respondents were female patients around 18 – 25 years old. According to the PSQI (Pittsburgh Sleep Quality Index) score, 74 respondents (91.35%) had poor subjective sleep quality. The PSQI components include fairly good subjective sleep quality (41.98%), poor sleep latency (64.2%), very good sleep duration (34.57%), very good sleep efficiency (49.38%), fairly frequent sleep disturbance (50.62%), frequently use of sleep medication (65.43%), and fairly poor daytime disfunction (40.74%). Conclusion: Based on a cross-sectional study of 81 patients with depression at the Outpatient Psychiatric Department of Dr. Soetomo General Hospital, it can be concluded that the majority of respondents were female patients aged 18 – 25 years. According to the PSQI (Pittsburgh Sleep Quality Index) score, 74 respondents (91.35%) had poor sleep quality. The PSQI components include subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction. The main factors contributing to poor sleep quality among respondents were physical comorbidities and drugs interactions from medications being taken.

ObjectiveTo identify the differences in cardiac autonomic control between older people with good and poor sleep quality.Material and MethodsThis is a cross-sectional study with 40 older people aged ≥ 60 years, registered at a community health center in Petrolina, Pernambuco, Brazil. The sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). To assess heart rate variability (HRV), the RR intervals (RRI) were recorded for 10 min with a validated smartphone app and a wireless transmitter Polar H7 positioned on the patient’s chest. The HRV parameters were calculated with Kubios HRV, and the data were analyzed in SPSS. Subjects with good and poor sleep quality (PSQI >5) were compared with the Mann-Whitney U test.ResultsA total of 31 older people were included in the final analysis, with 18 (58.1%) of them having poor sleep quality. Older people with good sleep quality have similar cardiac autonomic control to those with poor sleep quality. The medians of time (mean RRI, pNN50, SDNN, and RMSSD) and frequency-domain HRV parameters (LFms2, LFnu, HFms2, HFnu, and LF/HF ratio) were statistically similar (p > .05) in older people with good and poor sleep quality. According to the effect size, the HRV indicators were slightly better among those with good sleep quality.ConclusionThere were no statistical differences in cardiac autonomic control between older people with good and poor sleep quality.

Introduction: Adequate sleep has a crucial role in enhancing cognitive skills especially memory retention. Poor night time sleep quality and the consequent daytime sleepiness affect physical and cognitive health of students and their academic performance. The aim of this study is to find whether or not poor academic performance is a consequence of poor sleep quality among Pakistani medical students.Methods: It was an observational, cross-sectional study conducted with undergraduate medical students. Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep quality. Academic performance was assessed by mean grade point average (GPA) of the students. The data were analyzed using the Statistical Package for the Social Sciences (SPSS) 22.0 (IBM Corp., Armonk, NY, USA).Results: There were 512 (64.24%) students with global PSQI score ≥5 indicating poor sleep quality. The mean GPA of poor sleepers was 2.92 ± 1.09 which was significantly lower than that of good sleepers (p < 0.0001). In the group of students who scored lower GPA (2.0-2.7), 28.2% had very bad subjective sleep quality, 29.05% had sleep latency of 16-30 min, 29.4% had sleep duration of <5-7 h, 27.8% had sleep efficiency of <85%, and 37.7% experienced daytime dysfunction almost every day.Conclusion: Medical students of Pakistan have poor sleep quality which has a negative impact on their academic performance. Adequate sleep is essential to refresh the students every day and help them in learning and memory processing. Medical students and their facilitators should comprehend the negative effects of sleep deprivation on student academics and should take adequate measures to improve the sleep quality of students.

Sleep quality and associated factors among undergraduate medical students during Covid-19 confinement