Sleep Quality, Daytime Sleepiness and Mental Health in Undergraduate Medical Students: A Cross-sectional Descriptive Study

Introduction: Sleep deprivation is a growing problem, especially among medical students who must meet high academic standards, as well as, their parent’s expectations. Since poor sleep quality and daytime sleepiness have important consequences in the mental health of medical undergraduate students, the management of these problems would begin with and be guided by assessment of these sleep-related and mental health parameters.

Aim: To evaluate the sleep quality and effects of sleep deprivation on the psychological well-being and mental health of undergraduate medical students.

Materials and Methods: This was a cross-sectional descriptive study conducted by Department of Psychiatry, G.S. Medical College and Hospital, Pilkhuwa, Hapur, Uttar Pradesh, India, on undergraduate students, for a period of a month in May 2022. Four hundred medical undergraduate students from 1st, 2nd, 3rd part 1 and 3rd part 2 Bachelor in Medicine and Bachelor in Surgery (MBBS) years, who fulfilled the inclusion and exclusion criteria, were enrolled in the present study after their informed consent was taken. Epworth Sleepiness Scale (EPSS), Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale 21 (DASS-21), and Psychological General Well-Being Index (PGWBI) were used to assess the participants. Sleep quality and sleepiness were correlated with anxiety depression, stress, and subjective general well-being using Spearman’s coefficient with significance at 0.05 and 0.001 levels.

Results: The study participants were in the age group of 17-24 years and majority of the students (n=130, 32.5%) were 20-year-old. Females accounted for near half of the study participants (n=190, 47.5%). Most of the students in the participant group had poor sleep quality with a mean of 6.75±1.811 and issues of daytime sleepiness (10.68±3.481). The DASS-21 revealed severe anxiety (15.5±2.473) and moderate stress (22.89±3.396) levels. Significant positive correlation was seen between the anxiety (r=0.110; p-value <0.05) and stress (r=0.452; p-value <0.01) index with EPSS. A significant positive correlation was found between anxiety (r=0.118, p-value <0.05), stress (r=0.410; p-value <0.01) and psychological well-being (r=0.119; p-value <0.01) and PSQI score.

Conclusion: The study revealed that, many undergraduate medical students in different semesters slept insufficiently and struggled with daytime tiredness. Among the students, higher stress and anxiety levels, along with a low level of subjective psychological well-being were discovered. Additionally, the study revealed higher levels of anxiety and stress in medical undergraduates, who had poorer sleep quality and excessive daytime sleepiness. Also, students with poor quality of sleep had lower psychological general well-being.