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J Family Community Med. 2020 Jan-Apr;27(1):23-28. doi: 10.4103/jfcm.JFCM_132_19. Epub 2020 Jan 13.

The relationship between sleep quality, stress, and academic performance among medical students.

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College of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.



Sleep is essential for the body, mind, memory, and learning. However, the relationship between sleep quality, stress, and academic performance has not been sufficiently addressed in the literature. The aim of this study was to assess the quality of sleep and psychological stress among medical students and investigate the relationship between sleep quality, stress, and academic performance.


This cross-sectional study targeted all medical students in their preclinical years at a Saudi medical college in 2019. All students were asked to complete an electronic self-administered questionnaire comprising the Pittsburgh Sleep Quality Index (PSQI), the Kessler Psychological Distress Scale (K10), questions on the students' current overall grade point average, and other demographic and lifestyle factors. The associations between categorical variables were analyzed using Pearson's Chi-squared test at 0.05 significance level.


The mean PSQI score was 8.13 ± 3.46; 77% of the participants reported poor quality of sleep and 63.5% reported some level of psychological stress (mean K10 score: 23.72 ± 8.55). Poor quality of sleep was significantly associated with elevated mental stress levels (P < 0.001) and daytime naps (P = 0.035). Stepwise logistic regression model showed that stress and daytime nap were associated with poor sleep quality. Whereas, poor sleep or stress did not show any significant association with academic performance.


Poor sleep quality was significantly associated with elevated levels of strees. However, they did not show any statistically significant relationship with academic performance.


Academic performance; medical education; medical students; sleep; sleep quality; stress

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