Sleep quality amongst 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.

Background: Smart phone addiction can disturb sleep quality in medical students by upsetting internal biological clock (SCN) and melatonin level which in turn adversely affects academic performance of medical students.&#x0D; Objectives: To correlate smart phone addiction (SPA), poor sleep quality and low academic score in medical students and its association with gender.&#x0D; Methodology: A Cross- sectional descriptive study was conducted on medical students of 4th and final year MBBS (who were mobile phone addict for more than one year). The percentage of last professional exam was taken as academic score. A proposed SPA diagnostic criterion was used to diagnose smart phone addict students. For SPA severity and sleep quality assessment Problematic Mobile Phone Use Questionnaire (PMPU-Q) and Pittsburgh Sleep Quality Index (PSQI) were used.&#x0D; Results: A total of 74 subjects having mean (SD) age of 22.24 (1.929) years presented with negative correlation between academic score and PSQI (p&lt; 0.05) were included in the study. There was no significant association between academic score and smart phone addiction. The male students had worse score in dependency and dangerous use on PMUQ scale. The female students were worse in dangerous and problematic use of smart phone on PMUQ scale.&#x0D; Conclusion: The SP dependency and poor subjective sleep quality of male students were negatively associated with their academic score. The female students with low academic score were worse at PSQI score, their academic score was not significantly correlated with their smart phone addiction.&#x0D; Keywords: Smartphone addiction, Sleep Quality, Academic Score

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.

IntroductionSleep is a complex physiological process present in all living beings, performing essential functions for various biological functions. The prevalence of sleep disorders has increased exponentially, as well as studies relating to sleep patterns of the general population.University students are especially vulnerable to a decrease in sleep quality, particularly medical students. Even so, the literature on sleep quality in medical students is scarce, especially when referring to Portugal, where studies are almost non-existent.ObjectivesTo evaluate sleep quality in medical students and to analyze the differences in sleep quality according to age, sex, cohabitation and physical activity. It is also intended to compare the sleep quality of medical students throughout the various phases of the medical course.MethodsThis is a cross-sectional study involving medical students at the University of Beira Interior, Covilhã, Portugal. All medical students were invited to complete the Pittsburgh Sleep Quality Index (PSQI), which has been validated for the portuguese population. First, the scores obtained in each of the components of the PSQI and the global PSQI score were analyzed for the global population. Lastly, the global PSQI score was correlated with each of the sociodemographic variables to verify the existence of a statistically significant relationship.Results296 students completed the instrument. Of these, 62.2% classify their sleep quality as good; 42.4% scored 2 in the sleep latency component; 50% reported sleeping 6 to 7 hours; 73.9% stated an adequate sleep efficiency; 85.5% mentioned few or no sleep disturbances; 83,8% said they never used sleep medication; and 60.8% had low or no sleepiness or daytime dysfunction.As for the overall PSQI score, 72.6% of the students had a score greater than 5, indicating a poor quality of sleep. 74.7% of female respondents have a low quality of sleep, as well as 67.7% of male respondents. Likewise, 91.3% of students who live alone have poor sleep quality, as well as 76.8% of those living with family members and 69.8% of those living with colleagues.Regarding the course year, 82.4% of the first-year students report a poor quality of sleep, as well as 77.5% of the second-year students, 72.1% of the third-year students, 77.8% of the fourth-year, 65.8% of the fifth-year students and 71.4% of the sixth-year students.ConclusionsMedical students seem to be more likely to have poor sleep quality, especially when compared to other university students. Thus, further studies are needed to prove this susceptibility as well as therapeutic interventions aimed at improving sleep parameters.Disclosure of InterestNone Declared

Predictors of sleep quality in medical students during COVID-19 confinement

A cross-sectional survey administered to first- and second-year podiatric medical students aimed to investigate the effect of coffee intake, energy drink consumption, and perceived stress on sleep quality in medical students during their preclinical studies. Ninety-eight of 183 students contacted (53.6%) completed a questionnaire comprising standard instruments measuring sleep quality (Pittsburgh Sleep Quality Index), daytime sleepiness (Epworth Sleepiness scale), and perceived stress (ten-item Perceived Stress Scale). Furthermore, we investigated coffee and energy drink consumption. Logistic regression was conducted to identify factors associated with poor sleep quality and the relation between sleep quality and academic performance (grade point average). High prevalences of poor sleep quality, excessive daytime sleepiness, and perceived stress were reported. In addition, higher odds of developing poor sleep quality were associated with coffee and energy drink intake, perceived stress, and excessive daytime sleepiness. The total Pittsburgh Sleep Quality Index score was inversely correlated with grade point average. First- and second-year podiatric medical students have poor sleep quality. Further research is needed to identify effective strategies to reduce stress and decrease coffee and energy drink intake to minimize their negative effect on sleep quality and academic performance in podiatric medical students.

Objectives: To assess factors associated with poor sleep quality and excessive daytime sleepiness (EDS) in late pregnancy.Methods: A cross sectional study was carried out on 109 pregnant women in their third trimester admitted to Teaching Hospital Peradeniya using validated Sinhala translations of both Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Consecutive sampling was used from February to April 2021.Results: Application of PSQI demonstrated that 59.6% had a poor overall sleep quality (PSQI score&gt;5). Subcomponent analysis showed poor sleep duration (&lt; 06 hours per day) in 27.5%, sleep latency of over 30 minutes in 29.4%, poor sleep efficiency among 33.9% and day-time dysfunction in 30.3%. Poor overall sleep quality was associated with presence of foetal movements (OR=11.8, 95% CI=1.5-93.5) and backache (OR=3.8, 95% CI=1.2-12.3). Poor sleep duration was associated with the presence of one or more pregnancy related complications (OR=3.4, 95% CI=1.4-8.5) and advanced maternal age over 35 years (OR=3.7, 95% CI=1.4-9.7). Increased sleep latency over 30 minutes was seen in mothers over 34 weeks of gestation (OR=9.1, 95% CI=2.9-28.6) and over 10kg of weight gain (OR=5.3, 95% CI=1.2-24.4). Application of ESS demonstrated 26.6% had EDS, which was associated with maternal employment (OR=2.8, 95% CI=1.1-7.1) and higher educational status (OR=4.7, 95% CI=1.5-15.1). EDS did not result in poor sleep quality, however, mothers experiencing insomnia had a higher PSQI score (Mean ± SD 7.2±3.7 vs 6.2±3.4 hours, p=0.044).Conclusion: Majority of pregnant women in third trimester had poor overall sleep quality. EDS was seen among one fourth. Modifiable risk factors were associated with poor sleep quality and EDS.

ObjectiveThis study explored factors associated with sleep quality among medical students in Vietnam.DesignCross-sectional study.SettingThe study was conducted from December 2019 to February 2020 among medical students in Vietnam.ParticipantsMedical students were...

Objective: To determine the relationship between fatigue and sleep quality in medical students. Materials and Methods: We applied a sociodemographic characteristics questionnaire, Pittsburgh Sleep Quality Index (PSQI) and Piper Fatigue Scale (PFS) to 4th, 5th and 6th year medical students. Results: Thirty seven percent (n=290) of 4th, 5th and 6th year medical students were included in the study. Mean age was 23.47±1.33 years, 53.8% were male. Alcohol use was determined at a level of 40.3% (n=117), nutrition-drug usage at 40.7% (n=118), and smoking at 19% (n=55). Additionally, 86.2% of the participants (n=250) preferred to sleep in the dark, 37.9% (n=110) thought that drinks they used before going to bed partially affected their sleep quality. PSQI score was 10.56±2.54 (min:5-max:19), 98.6% of the participants had poor sleep quality. There was no significant relationship between the students’ academic years and sleep quality. PFS was 2.85±0.83(min:1-max:5), and 79%(n=229) had mild fatigue. A statistically significant relationship was determined between PSQI and PFS scores (p<0.05). Conclusion: Although a large proportion of participants had bad sleep quality, level of fatigue was mild. We determined a significant relationship between levels of fatigue and sleep quality. Arrangements should be made to improve poor sleep quality which affects students’ quality of life. Fatigue levels that affect sleep quality should also be reduced. Keywords: Fatigue, Sleep, Clinical training

BackgroundQuality of life (QOL) is reduced in patients with atrial fibrillation (AF). However, data regarding the association between sleep quality, one of the major components of QOL, and AF are insufficient. This cross‐sectional study aimed to elucidate whether sleep quality is reduced in patients with AF.MethodsWe recruited 2054 consecutive outpatients (64 ± 10 years, 1089 men) who had regularly presented to 26 clinics affiliated with the Tamagawa Medical Association, Tokyo, Japan. The patients were divided into paroxysmal AF (PaAF), persistent or permanent AF (PeAF), and non‐AF groups. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). The global PSQI score was calculated according to the answer to each question, and poor sleep quality was defined as a global PSQI score ≥6 points. Logistic regression analysis was used to obtain odds ratio for poor sleep quality in the PaAF and PeAF groups, relative to the non‐AF group.ResultsThe PaAF group showed significantly increased odds ratio for poor sleep quality (1.49, 95% confidence interval 1.02–2.17), after adjusting for multiple potential confounders. In contrast, no significant odds ratio for poor sleep quality was observed in the PeAF group (1.09, 95% confidence interval 0.70–1.71). Among the PSQI components, poor subjective sleep quality and sleep disturbances were the main determinants of poor sleep quality in the PaAF group.ConclusionSleep quality was found to be reduced in patients with PaAF, and this may be attributed to poor subjective sleep quality and sleep disturbances.

Sleep problems and poor sleep quality are important issues for medical students. This study aimed to investigate the sleep patterns, measure the prevalence of poor sleep quality, and identify the predictors of poor sleep among medical students in King Khalid University (KKU), Saudi Arabia. This cross-sectional study enrolled 318 medical students during October-November, 2015. Participants were selected by convenience sampling and data were collected using self-administered questionnaires to obtain information regarding socio-demographic variables and indicators of sleep quality. The overall mean sleep quality score was 6.79 with a standard deviation of 3.06. Poor sleep quality was reported by 74.2% students. Significantly high mean sleep quality scores (Pittsburgh Sleep Quality Index) were observed for students with very poor subjective sleep quality (mean = 10.50, SD = 2.58), least sleep efficiency (mean = 11.21, SD = 2.23), shorter sleep duration (mean = 7.83, SD = 2.88), sleep onset latency more than 30 minutes (mean = 7.82, SD = 2.53), sleeping after midnight (mean = 7.53, SD = 2.95), and use of sleep aiding medication (mean = 8.78, SD = 3.5). Significant differences were observed between good sleepers and poor sleepers regarding these sleep characteristics. Poor sleep was predicted by sleep behaviours such as going to sleep after midnight (AOR = 2.18, 95% CI: 1.20, 3.94) and sleep duration of less than seven hours (AOR = 7.49, 95% CI: 4.24, 13.22). Medical students of KKU have poor sleep quality. Longer sleep latency, going to sleep after midnight, and shorter sleep duration are important problems in this group.

Poor sleep quality is common in medical students and is associated with a number of negative health outcomes. However, the prevalence estimates of poor sleep quality in medical students vary widely across studies. We thus conducted a meta-analysis of the prevalence of poor sleep quality and its mediating factors in medical students. A systematic literature search of PubMed, EMBASE, Web of Science, PsycINFO, and Medline Complete was performed. The random-effects model was used to analyze the pooled prevalence of poor sleep quality and its 95% confidence intervals (CIs). A total of 57 studies with 25,735 medical students were included. The pooled prevalence of poor sleep quality was 52.7% (95% CI: 45.3% to 60.1%) using the Pittsburgh Sleep Quality Index (PSQI). The pooled mean total PSQI score across 41 studies with available data was 6.1 (95% CI: 5.6 to 6.5). Subgroup analyses found that PSQI cutoff value and study region were associated with the prevalence of poor sleep quality (P = 0.0003 VS. P = 0.005). Across the continents, poor sleep quality was most common in Europe, followed by the Americas, Africa, Asia, and Oceania. Meta-regression analyses found that smaller sample size (slope = - 0.0001, P = 0.009) was significantly associated with higher prevalence of poor sleep quality. Poor sleep quality is common among medical students, especially in Europe and the Americas continets. Due to the negative health outcomes, regular screening of poor sleep quality and effective interventions are needed for medical students.

Disclosure: S. Paladugu: None. T. Thota: None. S. vasikarla: None. Introduction: Endocrine disorders are emerging as one of the emergences in response to a growing recognition of the academic stress and deviation from routine life habits + poor sleep quality that medical students commonly experience. They are the ones disrupting hormonal system, such as hypothalamic-pituitary-adrenal axis (HPA) and thyroid or reproductive hormones. The purpose of this study is to investigate the relationship between perceived stress, sleep quality, BMI and endocrine disorders in the Medical students(MBBS students). Objectives: 1. Assess stress and sleep quality in medical students. 2. Compare stress and sleep quality in students with and without endocrine disorders. 3. Determine correlations between stress, sleep, and endocrine dysfunction. 4. Evaluate the relevance of BMI in this context. Methods: Cross-sectional study was conducted among 250 undergraduate Medical (MBBS) students. Study population was categorised as follow: Those with (n = 32) and without endocrine disorders (n=218). Conditions included hypothyroidism, diabetes mellitus and PCOS. Stress(Perceived Stress Scale) Sleep quality (Pittsburgh Sleep Quality Index) BMI as standardized tools. Statistical analysis SPSS, p &amp;lt; 0.05 indicate significant. Results: High stress levels were more common in students with endocrine disorders (40.6%) than those without (19.7%), with a significant association (p = 0.0292; OR = 2.30). Moderate to severe sleep difficulties were also more prevalent in this group (56.3% vs 36.7%; p = 0.0349; OR = 2.22). Although not statistically significant, obesity was more frequent among students with endocrine disorders (6.3% vs 2.8%; OR = 1.97). Discussion: Findings reveal an association among stress, sleep deprivation and endocrine issues. The data suggest that stress may influence hormone regulation via the HPA axis, furthering this pathogenesis in disorders such as hypothyroidism and PCOS. Hormones are dysregulated by poor sleep which influences metabolism and appetite controlling hormones exacerbating endocrine dysfunction. It was not statistically significant, but trends suggesting some role in hormonal imbalance do exist particularly for BMI. Conclusions: High stress levels and poor sleep seem to be associated with endocrine diseases in medical ( MBBS)student participants. Although BMI was not statistically significant, it may have some clinical relevance. The results highlight that stress management, sleep hygiene and lifestyle may have a role in development of endocrine disorders. Larger longitudinal studies are needed to explore the correlation between perceived stress, sleep hygiene in the development of endocrine disorders. Presentation: Sunday, July 13, 2025

Female athletes with menstrual abnormalities have poor sleep quality. However, whether female athletes with poor sleep quality based on subjective assessment have distinctive changes in objective measures of sleep in association with menses remains unclear. This study aimed to compare changes in objective sleep measurements during and following menses between collegiate female athletes with and without poor subjective sleep quality. Female collegiate athletes (age range/mean ± standard deviation: 18-22/ 22.2±1.1) with regular menstrual cycles were recruited. The participants underwent home electroencephalogram monitoring during the first and second nights after the onset of menses and one night between the seventh and 10th nights after menses onset (mid-follicular phase). The Pittsburgh Sleep Quality Index (PSQI) was used to assess the subjective sleep quality. Interactions between the presence of poor subjective sleep quality (ie, PSQI ≥6) and changes in objective measures of sleep in association with menses were analyzed. Data of 45 athletes, including 13 with poor subjective sleep quality, showed that changes in arousal index in athletes with poor subjective sleep quality were distinctive from those in athletes without poor subjective sleep quality (p = 0.036 for interaction). In athletes with poor subjective sleep quality, the arousal index was significantly increased in menses (p for analysis of variance, 0.015), especially on the first night after the onset of menses compared with during the mid-follicular phase (p = 0.016). Collegiate female athletes with regular menstrual cycles are likely to have poor subjective sleep quality in association with more frequent arousal during the first night after the onset of menses than during the mid-follicular phase.

Background: Better sleep quality is associated with better mental health. This study aimed to link sleep quality of medical students with their psychiatric health and academic performance. Methods: Sleep quality of 104 medical students (52 each from 1st and 5th year of MBBS with equal gender distribution) was measured on Pittsburgh Sleep Quality Index (PSQI) while Hamilton Depression Rating Scale (HDRS) along with Hamilton Anxiety Rating Scale (HAM-A) was used to assess their psychiatric health, both of which were later correlated with their academic scores. Results: Sleep quality of 1st year medical students was significantly better as compared to their final year counterparts (p=0.001) and (p=0.000) respectively which affected indices of psychiatric health in such a way that 1st year medical students scored significantly lower on scales of depression as well as anxiety as compared to final year medical students (p=0.001), (p=0.000) and (p=0.001, p=0.000). Within 1st and final year (male and female) medical students, sleep quality had a strong positive correlation with scores of depression and anxiety (r=0.547, p=0.004), (r=0.587, p=0.002), (r=0.66, p=0.000) ,(r=0.490, p=0.011) and (r=0.518, p=0.007), (r=0.527, p=0.006), (r=0.541, p=0.004), (r=0.596, p=0.001) respectively, which in turn had a negative correlation with academic performance of theirs (r=-0.400, p=0.043), (r=-0.614, p=0.001) and (r=-0.550, p=0.004), (r=-0.573, p=0.002) respectively. Conclusion: Medical students with poor sleep quality, harbour higher degrees of depression and anxiety and perform poorly on academic front as compared to those with better sleep quality. Pak J Physiol 2023;19(3):15–9