The association between sleep quality, stress, and academic performance in preclinical and clinical medical students

Abstract

Background: One of the well-known and indisputable facts is that sleep is an essential physiological necessity. Representing one-third of the average human lifetime, it is considered a behavioural and physiological component of human physiology. This study was conducted to measure the association between sleep quality, stress, and academic performance among preclinical and clinical medical students. Methods: A cross-sectional study was conducted on undergraduate medical students at King Saud University, and a computer-based questionnaire was used in interviewing students. Sleep quality was assessed using the Pittsburgh sleep quality index; stress was assessed using the Kessler psychological distress scale; and academic performance was assessed using grade point average. Results: Among the studied subjects, 76.9% of the participants reported poor sleep quality and 63.3% reported a high level of stress. Poor sleep quality was significantly associated with elevated mental stress levels (p < 0.001). In addition, the multivariable stepwise binary logistic regression showed that poor sleep quality and stress were significantly associated with students' academic performance. Conclusion: Poor sleep quality was highly associated with stress. Furthermore, both poor sleep quality and stress were significantly associated with students' academic performance. Poor sleep quality and high stress were more prevalent amongst clinical medical students; lastly, virtual learning improved students' stress and sleep quality.