Psychological factors related to professional examinations and their association with sleep quality among Medical students

Abstract

Background: In our country, medical education is considered a challenging, tough, and stressful process, which is
significantly associated with depression, anxiety, and stress, particularly during exam seasons, adversely
affecting the sleep quality of medical students. The objective of our study is to evaluate the depression, anxiety
and stress levels, and determine their impact on sleep quality of medical students during exams.
Materials and Methods: It was a descriptive cross-sectional study involving 391 students of Rawalpindi Medical
University. Data were collected through a questionnaire. The questionnaire consisted of (1) socio-demographic
details, (2) Depression, Anxiety and Stress Scale-21(DASS-21), (3) The Pittsburgh Sleep Quality Index (PSQI). Chisquare and t-tests were applied taking P<0.05 as significant. Spearman rho test was applied to measure the
strength of association. Data analysis was done via (SPSS) v.23.0.
Results: Out of 391 students, 197 (50.4%) were female while 194 (49.6%) were male. The mean age was 21.63 years
(SD=1.59). Fourth-year students (n=117, 29.9%) formed the majority of the participants followed by final-year
108(27.6%), second-year 94 (24%), and third-year 72 (18.4%). 167(42.71%) students suffered from depression,
50.4% from anxiety and 351(89.8%) from stress. Quality of sleep was poorest (PSQI>5) in second-year students
with a mean value of 9.72 for global sleep quality. Quality of sleep was significantly associated with anxiety and
depression.
Conclusion: Depression, anxiety, and stress are common among second as well as third-year students. Secondyear students have the poorest quality of sleep. The sleep quality is significantly associated with anxiety and
depression.
Keywords: Medical undergraduates, Professional exams, Psychological Factors, Sleep quality