Evaluation of Sleep Quality and Its Determinants Among Undergraduate Medical Students Across Different Phases of Medical Training

Abstract

Background
Adequate sleep is vital for learning, cognitive performance, and mental well-being. However, medical students are particularly prone to sleep disturbances due to academic pressure, irregular schedules, and lifestyle behavior. This study is done to  find out the prevalence of poor sleep quality among undergraduate medical students and its association with gender, different phases of medical training and physical activity levels as per energy expenditure recorded according to Metabolic Equivalent Task (MET-min/week).

Methods
A cross-sectional study was conducted among 267 undergraduate medical students using a semi-structured self-administered questionnaire. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), where a global score ≥5 indicated poor sleep. Data on demographics, academic year (≤2 years vs >2 years), and physical activity (<600 vs ≥600 MET-min/week) were collected. Group comparisons were performed using appropriate statistical tests, with p < 0.05 considered significant.

Results
Overall, 57.7% of students had poor sleep quality. Females reported significantly more frequent sleep disturbances (92.3% vs 75.3%) and daytime dysfunction (82.1% vs 56.0%) than males (p < 0.001 for both). Junior students (≤2 years) had a higher prevalence of poor sleep (64.9% vs 50.4%, p = 0.016), more weekly sleep disturbances (94.8% vs 70.7%, p < 0.001), and greater daytime dysfunction (74.6% vs 60.2%, p = 0.012) compared with senior students. Students with low physical activity experienced more frequent sleep disturbances (86.3% vs 76.8%, p = 0.046) and higher daytime dysfunction (72.0% vs 59.6%, p = 0.036) than moderately active peers. Poor sleep was more common among students with low physical activity (61.9% vs 50.5%).

Conclusion
Poor sleep quality affected over half of medical students. Females had more frequent sleep disturbances and daytime dysfunction. Junior students showed significantly poorer sleep than seniors. Lower physical activity was associated to significantly more frequent sleep disturbances and daytime dysfunction.