Association between Sleep Quality and Mental Health among Medical Students in a University Center in Tehran, Iran
Background:Poor sleep quality and mental health problems are relatively common among medical students, and have many consequences in their lives and education. Moreover, some studies have reported that the above two issues affect each other. In Iran, limited studies have been conducted in this field. Therefore, this study was conducted with the aim to determine the frequency of poor sleep quality and mental health problems among medical students and the association between these two variables.
Methods: In this cross-sectional study, which was conducted from January to April 2021, 320 medical students of Shahid Beheshti University of Medical Sciences (Tehran, Iran) participated. Sampling was performed through the stratified method based on gender and educational phase. Data was collected using an online questionnaire including the following components: a researcher-made sociodemographic characteristics questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Depression, Anxiety, and Stress Scale-21 items (DASS-21).
Results: The mean age of 320 participants was 22.95 ± 2.59 years and 145 (45.3%) were men. The percentage of medical intern participants (34.7%) was higher than that of basic science (34.4%) and medical extern (30.9%). The mean PSQI score was 8.11 ± 2.99, which shows overall poor sleep quality. The comparison between poor sleepers and good sleepers in terms of sociodemographic variables showed that only grade point average was significantly lower in poor sleepers (P = 0.049). The prevalence of some levels of depression, anxiety, and stress among participants was 100%, 100%, and 95.3%, respectively. There were also significant associations between poor sleep quality and all three components of mental health of depression (P < 0.001), anxiety (P < 0.001), and stress (P < 0.001).
Conclusion: Poor sleep quality and mental health problems are interrelated among medical students, and reduce their academic performance. The high prevalence of these problems indicates the importance of the issue, which requires immediate action by the authorities to decrease its consequences.
Abdulah, D. M., & Piro, R. S. (2018). Sleep disorders as primary and secondary factors in relation with daily functioning in medical students. Ann.Saudi.Med, 38(1), 57-64. doi:10.5144/0256-4947.2018.57 [doi]. Retrieved from PM:29419528
Al-Khani, A. M., Sarhandi, M. I., Zaghloul, M. S., Ewid, M., & Saquib, N. (2019). A cross-sectional survey on sleep quality, mental health, and academic performance among medical students in Saudi Arabia. BMC Res Notes., 12(1), 665. doi:10.1186/s13104-019-4713-2 [doi];10.1186/s13104-019-4713-2 [pii]. Retrieved from PM:31639038
Al, S. T., Zaher, A. S., Turk, T., Abbas, F., & Alkhatib, M. (2017). Psychological distress among medical students in conflicts: a cross-sectional study from Syria. BMC Med Educ., 17(1), 173. doi:10.1186/s12909-017-1012-2 [doi];10.1186/s12909-017-1012-2 [pii]. Retrieved from PM:28931387
Alotaibi, A. D., Alosaimi, F. M., Alajlan, A. A., & Bin Abdulrahman, K. A. (2020). The relationship between sleep quality, stress, and academic performance among medical students. J Family Community Med, 27(1), 23-28. doi:10.4103/jfcm.JFCM_132_19 [doi];JFCM-27-23 [pii]. Retrieved from PM:32030075
Becker, S. P., Jarrett, M. A., Luebbe, A. M., Garner, A. A., Burns, G. L., & Kofler, M. J. (2018). Sleep in a large, multi-university sample of college students: sleep problem prevalence, sex differences, and mental health correlates. Sleep Health., 4(2), 174-181. doi:S2352-7218(18)30006-8 [pii];10.1016/j.sleh.2018.01.001 [doi]. Retrieved from PM:29555131
Correa, C. C., Oliveira, F. K., Pizzamiglio, D. S., Ortolan, E. V. P., & Weber, S. A. T. (2017). Sleep quality in medical students: a comparison across the various phases of the medical course. J Bras Pneumol., 43(4), 285-289. doi:S1806-37132017000400285 [pii];10.1590/S1806-37562016000000178 [doi]. Retrieved from PM:29365004
Damiano, R. F., de Oliveira, I. N., Ezequiel, O. D. S., Lucchetti, A. L., & Lucchetti, G. (2020). The root of the problem: identifying major sources of stress in Brazilian medical students and developing the Medical Student Stress Factor Scale. Braz J Psychiatry., 43(1), 35-42. doi:S1516-44462020005022201 [pii];10.1590/1516-4446-2019-0824 [doi]. Retrieved from PM:32696807
El Hangouche, A. J., Jniene, A., Aboudrar, S., Errguig, L., Rkain, H., Cherti, M. et al. (2018). Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students. Adv.Med Educ.Pract., 9, 631-638. doi:10.2147/AMEP.S162350 [doi];amep-9-631 [pii]. Retrieved from PM:30233270
Farrahi, M. J., Nakhaee, N., Sheibani, V., Garrusi, B., & Amirkafi, A. (2012). Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath., 16(1), 79-82. doi:10.1007/s11325-010-0478-5 [doi]. Retrieved from PM:21614577
Fischbein, R., & Bonfine, N. (2019). Pharmacy and Medical Students' Mental Health Symptoms, Experiences, Attitudes and Help-Seeking Behaviors. Am.J Pharm Educ., 83(10), 7558. doi:10.5688/ajpe7558 [doi];ajpe7558 [pii]. Retrieved from PM:32001889
Gupta, S., Bhardwaj, A., Nadda, A., Gill, A., Mittal, A., & Gupta, S. (2020). A comparative study of sleep quality in different phases of the medical course: A study from Haryana (North India). J Family Med Prim.Care, 9(4), 2006-2010. doi:10.4103/jfmpc.jfmpc_1137_19 [doi];JFMPC-9-2006 [pii]. Retrieved from PM:32670956
Haile, Y. G., Alemu, S. M., & Habtewold, T. D. (2017). Insomnia and Its Temporal Association with Academic Performance among University Students: A Cross-Sectional Study. Biomed Res Int., 2017, 2542367. doi:10.1155/2017/2542367 [doi]. Retrieved from PM:28752093
Janatmakan, A. A., Morovatdar, N., Soltanifar, A., & Rezaee, R. (2020). Prevalence of Sleep Disturbance and Potential Associated Factors among Medical Students from Mashhad, Iran. Sleep Disord, 2020, 4603830. doi:10.1155/2020/4603830 [doi]. Retrieved from PM:32695519
Khaksarian, M., Behzadifar, M., Behzadifar, M., Jahanpanah, F., Guglielmi, O., Garbarino, S. et al. (2020). Sleep Disturbances Rate among Medical and Allied Health Professions Students in Iran: Implications from a Systematic Review and Meta-Analysis of the Literature. Int.J Environ.Res Public Health., 17(3). doi:ijerph17031011 [pii];10.3390/ijerph17031011 [doi]. Retrieved from PM:32033482
Khero, M., Fatima, M., Shah, M. A. A., & Tahir, A. (2019). Comparison of the Status of Sleep Quality in Basic and Clinical Medical Students. Cureus., 11(3), e4326. doi:10.7759/cureus.4326 [doi]. Retrieved from PM:31183305
Lawson, H. J., Wellens-Mensah, J. T., & Attah, N. S. (2019). Evaluation of Sleep Patterns and Self-Reported Academic Performance among Medical Students at the University of Ghana School of Medicine and Dentistry. Sleep Disord, 2019, 1278579. doi:10.1155/2019/1278579 [doi]. Retrieved from PM:31308977
Maheshwari, G., & Shaukat, F. (2019). Impact of Poor Sleep Quality on the Academic Performance of Medical Students. Cureus., 11(4), e4357. doi:10.7759/cureus.4357 [doi]. Retrieved from PM:31192062
Moutinho, I. L., Maddalena, N. C., Roland, R. K., Lucchetti, A. L., Tibirica, S. H., Ezequiel, O. D. et al. (2017). Depression, stress and anxiety in medical students: A cross-sectional comparison between students from different semesters. Rev.Assoc Med Bras (1992.), 63(1), 21-28. doi:S0104-42302017000100021 [pii];10.1590/1806-9282.63.01.21 [doi]. Retrieved from PM:28225885
Rezaei, M., Khormali, M., Akbarpour, S., Sadeghniiat-Hagighi, K., & Shamsipour, M. (2018). Sleep quality and its association with psychological distress and sleep hygiene: a cross-sectional study among pre-clinical medical students. Sleep Sci, 11(4), 274-280. doi:10.5935/1984-0063.20180043 [doi]. Retrieved from PM:30746046
Sahebi, A., Asghari, M. J., & Salari, R. S. (2005). Validation of Depression Anxiety and Stress Scale (DASS-21) for an Iranian Population. Journal of Develomental Psychology, 1(4), 36-54.
Shadzi, M. R., Salehi, A., & Vardanjani, H. M. (2020). Problematic Internet Use, Mental Health, and Sleep Quality among Medical Students: A Path-Analytic Model. Indian J Psychol.Med, 42(2), 128-135. doi:10.4103/IJPSYM.IJPSYM_238_19 [doi];IJPsyM-42-128 [pii]. Retrieved from PM:32346253
Shi, L., Liu, Y., Jiang, T., Yan, P., Cao, F., Chen, Y. et al. (2020). Relationship between Mental Health, the CLOCK Gene, and Sleep Quality in Surgical Nurses: A Cross-Sectional Study. Biomed Res Int., 2020, 4795763. doi:10.1155/2020/4795763 [doi]. Retrieved from PM:32908891
Zeng, W., Chen, R., Wang, X., Zhang, Q., & Deng, W. (2019). Prevalence of mental health problems among medical students in China: A meta-analysis. Medicine (Baltimore.), 98(18), e15337. doi:10.1097/MD.0000000000015337 [doi];00005792-201905030-00019 [pii]. Retrieved from PM:31045774
How to Cite
Copyright (c) 2022 International Journal of Body, Mind and Culture
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.