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CC BY-NC-ND 4.0 · Sleep Sci 2018; 11(04): 274-280
DOI: 10.5935/1984-0063.20180043
ORIGINAL ARTICLE

Sleep quality and its association with psychological distress and sleep hygiene: a cross-sectional study among pre-clinical medical students

Mojtaba Rezaei
1   Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences - Tehran - Tehran - Iran.
,
Moein Khormali
1   Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences - Tehran - Tehran - Iran.
2   Students' Scientific Research Center, Tehran University of Medical Sciences - Tehran - Tehran - Iran.
,
Samaneh Akbarpour
3   Department of Epidemiology & Biostatistics, School of Public Health, Tehran University of Medical Sciences - Tehran - Tehran - Iran.
,
Khosro Sadeghniiat-Hagighi
1   Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences - Tehran - Tehran - Iran.
,
Mansour Shamsipour
4   Institute for Environmental Research, Department of Research Methodology and Data Analysis,Tehran University of Medical Sciences - Tehran - Tehran - Iran.
5   Institute for Environmental Research (IER), Center for Air Pollution Research (CAPR), Tehran University of Medical Sciences - Tehran - Tehran - Iran.
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Objective: This study aimed to investigate subjective sleep quality and its association with demographics, psychological health, and sleep hygiene related behaviors in pre-clinical medical students.

Methods: In this cross-sectional study, a self-administered questionnaire consisting of demographics, sleep hygiene behaviors, Pittsburgh Sleep Quality Index (PSQI), and Depression, Anxiety and Stress Scale-21 (DASS21) was handed out to all medical students of Tehran University of Medical Sciences at pre-clinical stage.

Results: The questionnaire was filled out by 553 (89.7%) of 616 students approached. About 60% of our sample had a global PSQI score of more than 5 (cut off of poor sleep quality) with mean global PSQI score of 6.32 (SD=2.72). The prevalence of moderate to extremely severe depression, anxiety and stress scores were 26.1%, 29.61%, and 14.5% respectively. Poor sleep quality was associated with later year in the school, psychological distress and several lifestyle behaviors. Constructing a multivariate logistic model, depression, anxiety and some sleep hygiene behaviors were significantly associated with higher PSQI score.

Discussion: Our findings suggest that poor sleep quality is a common problem among pre-clinical medical students and is associated with some psychological symptoms and sleep hygiene behaviors. This issue demonstrates necessity of interventions to improve the sleep quality in this population group.

sleep - Students - Medical - behavior

Funding:

This study was funded by Tehran University of Medical Sciences (TUMS) project grant (94-02-178-28448).


Compliance with ethical standards:

All procedures performed in studies involving human Participants were in accordance with the ethical standards of the institutional the study was approved by the institutional ethnic committee (IR.TUMS.REC.1394.967).


Informed consent

: Informed consent was obtained from all individual participants included in the study verbally.




Publication History

Received: 17 March 2018

Accepted: 20 August 2018

Article published online:
16 October 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • REFERENCES

  • 1 Oginska H, Pokorski J. Fatigue and mood correlates of sleep length in three age-social groups: School children, students, and employees. Chronobiol Int. 2006;23(6):1317-28.
  • 2 Ghoreishi A, Aghajani AH. Sleep quality in Zanjan university medical students. Tehran Univ Med J. 2008;66(1):61-7.
  • 3 Brick CA, Seely DL, Palermo TM. Association between sleep hygiene and sleep quality in medical students. Behav Sleep Med. 2010;8(2):113-21.
  • 4 Taylor DJ, Bramoweth AD. Patterns and consequences of inadequate sleep in college students: substance use and motor vehicle accidents. J Adolesc Health. 2010;46(6):610-2.
  • 5 Irish LA, Kline CE, Gunn HE, Buysse DJ, Hall MH. The role of sleep hygiene in promoting public health: A review of empirical evidence. Sleep Med Rev. 2015;22:23-36.
  • 6 Shimura A, Hideo S, Takaesu Y, Nomura R, Komada Y, Inoue T. Comprehensive assessment of the impact of life habits on sleep disturbance, chronotype, and daytime sleepiness among high-school students. Sleep Med. 2018;44:12-8.
  • 7 Hysing M, Pallesen S, Stormark KM, Jakobsen R, Lundervold AJ, Sivertsen B. Sleep and use of electronic devices in adolescence: results from a large population-based study. BMJ Open. 2015;5(1):e006748.
  • 8 Jin MJ, Yoon CH, Ko HJ, Kim HM, Kim AS, Moon HN, et al. The Relationship of Caffeine Intake with Depression, Anxiety, Stress, and Sleep in Korean Adolescents. Korean J Fam Med. 2016;37(2):111-6.
  • 9 Lemola S, Perkinson-Gloor N, Brand S, Dewald-Kaufmann JF, Grob A. Adolescents’ electronic media use at night, sleep disturbance, and depressive symptoms in the smartphone age. J Youth Adolesc. 2015;44(2):405-18.
  • 10 Mansouri A, Mokhayeri Y, Mohammadi Farrokhran E, Tavakkol Z, Fotouhi A. Sleep Quality of Students living in Dormitories in Tehran University of Medical Sciences (TUMS) in 2011. Iran J Epidemiol. 2012;8(2):71-82.
  • 11 Dimitriou D, Le Cornu Knight F, Milton P. The Role of Environmental Factors on Sleep Patterns and School Performance in Adolescents. Front Psychol. 2015;6:1717.
  • 12 Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rössler W. Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep. 2008;31(4):473-80.
  • 13 Abdulghani HM, Alrowais NA, Bin-Saad NS, Al-Subaie NM, Haji AM, Alhaqwi AI. Sleep disorder among medical students: relationship to their academic performance. Med Teach. 2012;34(Suppl 1):S37-41.
  • 14 Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med. 2006;29(3):223-7.
  • 15 Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213.
  • 16 Surani AA, Zahid S, Surani A, Ali S, Mubeen M, Khan RH. Sleep quality among medical students of Karachi, Pakistan. J Pak Med Assoc. 2015;65(4):380-2.
  • 17 Farrahi Moghaddam J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Reliability and validity of the Persian version of the Pittsburgh Sleep Quality Index (PSQI-P). Sleep Breath. 2012;16(1):79-82.
  • 18 Antony MM, Bieling PJ, Cox BJ, Enns MW, Swinson RP. Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychol Assess. 1998;10(2):176-81.
  • 19 Asghari A, Saed F, Dibajnia P. Psychometric properties of the Depression Anxiety Stress Scales-21 (DASS-21) in a non-clinical Iranian sample. Int J Psychol. 2008;2(2):82-102.
  • 20 Cates ME, Clark A, Woolley TW, Saunders A. Sleep Quality Among Pharmacy Students. Am J Pharm Educ. 2015;79(1):09.
  • 21 Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health. 2015;1(1):40-3.
  • 22 Kitamura S, Katayose Y, Nakazaki K, Motomura Y, Oba K, Katsunuma R, et al. Estimating individual optimal sleep duration and potential sleep debt. Sci Rep. 2016;6:35812.
  • 23 Suen LK, Hon KL, Tam WW. Association between sleep behavior and sleep-related factors among university students in Hong Kong. Chronobiol Int. 2008;25(5):760-75.
  • 24 Shamsuddin K, Fadzil F, Ismail WS, Shah SA, Omar K, Muhammad NA, et al. Correlates of depression, anxiety and stress among Malaysian university students. Asian J Psychiatr. 2013;6(4):318-23.
  • 25 Aboalshamat K, Hou XY, Strodl E. Psychological well-being status among medical and dental students in Makkah, Saudi Arabia: a crosssectional study. Med Teach. 2015;37(Suppl 1):S75-81.
  • 26 Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA. 1989;262(11):1479-84.
  • 27 James BO, Omoaregba JO, Igberase OO. Prevalence and correlates of poor sleep quality among medical students at a Nigerian university. Ann Nigerian Med. 2011;5(1):1-5.
  • 28 Loayza H MP, Ponte TS, Carvalho CG, Pedrotti MR, Nunes PV, Souza CM, et al. Association between mental health screening by self-report questionnaire and insomnia in medical students. Arq Neuropsiquiatr. 2001;59(2-A):180-5.