Sleep Hygiene Practices and Sleep Quality Among Undergraduate Medical Students: A Cross-Sectional Study
DOI:
https://doi.org/10.55489/njcm.160920255548Keywords:
Circadian Rhythm, Sleep Quality, Sleep Hygiene, Technology, InsomniaAbstract
Introduction: The role of sleep in supporting psychological, mental, and physical health is well documented. Sleep hygiene practices are effective modifiable behaviours that can be beneficial to improve sleep quality among medical students who are in short supply of sleep due to a demanding course. Aim and Objective: To estimate the magnitude and beliefs about of poor sleep hygiene among medical students. To identify specific changes to needed to Sleep Hygiene Index (SHI).
Methods: A cross-sectional study involving 293 undergraduate medical students using a pre-designed, self-administered questionnaire was conducted. Validated instruments the SHI and Pittsburgh Sleep Quality Index were used.
Results: Poor sleep hygiene practices (47.4%) and poor sleep quality (69.3%) were prevalent among substantial number of medical students. Bedtime technology use, sleep latency (AOR=2.276), sleep disturbance (AOR=2.459), use of sleeping medication (AOR=6.559) and daytime dysfunction (AOR=2.128) had a significant association with poor sleep hygiene practices (p<0.05). The area under the ROC curve for SHI as a tool for predicting good sleep quality was 0.663.
Conclusions: Regularization of sleep schedules by conducting time-management workshops among students and addition of items in SHI, on bedtime technology use along with dietary changes and daytime exposure to sunlight to improve sleep quality is recommended.
References
Grandner MA. Sleep, health, and society. Sleep Med Clin 2020;15(2):319-340. DOI: https://doi.org/10.1016/j.jsmc.2020.02.017 PMid:32386705
Morin CM, Jarrin DC. Epidemiology of insomnia: prevalence, Course, risk factors, and public health Burden. Sleep Med Clin 2022;17(2):173-191. DOI: https://doi.org/10.1016/j.jsmc.2022.03.003 PMid:35659072
Banks S, Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007;3(5):519-528. DOI: https://doi.org/10.5664/jcsm.26918 PMid:17803017 PMCid:PMC1978335
Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society on the recommended amount of sleep for a healthy adult: methodology and discussion. Sleep 2015;38(8):1161-1183. DOI: https://doi.org/10.5665/sleep.4886 PMid:26194576 PMCid:PMC4507722
Logan RW, McClung CA. Rhythms of life: circadian disruption and brain disorders across the lifespan. Nat Rev Neurosci. 2019;20:49-65. DOI: https://doi.org/10.1038/s41583-018-0088-y PMid:30459365 PMCid:PMC6338075
Desai D, Patel M, Patel A. Study of sleep habits and related problems among medical students. J Neurol Neurophysiol. 2023;14(4):1-4. Available from: https://www.iomcworld.org/open-access/study-for-assessment-of-sleep-and-stress-in-medical-and-paramedical-students-100540.html#7
Hauri P. Current concepts: the sleep disorders. Kalamazoo, MI: The Upjohn Company; 1977.
Hershner SD, Chervin RD. Causes and consequences of sleepiness among college students. Nat Sci Sleep. 2014 Jun 23;6:73-84. DOI: https://doi.org/10.2147/NSS.S62907 PMid:25018659 PMCid:PMC4075951
Brown FC, Buboltz WC Jr, Soper B. Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behav Med. 2002 Spring;28(1):33-38. DOI: https://doi.org/10.1080/08964280209596396 PMID: 12244643.
AlShareef SM. The impact of bedtime technology use on sleep quality and excessive daytime sleepiness in adults. Sleep Sci. 2022 Apr-Jun;15(Spec 2):318-327. DOI: https://doi.org/10.5935/1984-0063.20200128
Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the sleep hygiene index. J Behav Med. 2006;29(3):223-227. DOI: https://doi.org/10.1007/s10865-006-9047-6 PMid:16557353
Mastin DF, Siddalingaiah HS, Singh A, Lal V. Excessive Daytime Sleepiness, Sleep Hygiene, and Work Hours Among Medical Residents in India. Journal of Tropical Psychology. 2012;2:e4. DOI: https://doi.org/10.1017/jtp.2012.3
Buysse D, Reynolds CR, Monk T, Berman S, Kupfer D. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193-213. DOI: https://doi.org/10.1016/0165-1781(89)90047-4 PMid:2748771
Aloba OO, Adewuya AO, Ola BA, Mapayi BM. Validity of the Pittsburgh sleep quality index (PSQI) among Nigerian university stu-dents. Sleep Med. 2007;8(3):266-270. DOI: https://doi.org/10.1016/j.sleep.2006.08.003 PMid:17368977
Pan WH, Yeh WT. How to define obesity? Evidence based multiple action points for public awareness, screening, and treatment: an extension of Asian-Pacific recommendations. Asia Pac J Clin Nutr. 2008;17(3):370-374. PMID: 18818155.
Molla A, Wondie T. Magnitude of Poor Sleep Hygiene Practice and Associated Factors among Medical Students in Ethiopia: A Cross-Sectional Study. Sleep Disord. 2021 Feb 15;2021:6611338. DOI: https://doi.org/10.1155/2021/6611338 PMid:33643669 PMCid:PMC7902132
Shad R, Thawani R, Goel A. Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India. Cureus. 2015 Oct 21;7(10):e361. DOI: https://doi.org/10.7759/cureus.361 PMID: 26623216 PMCID: PMC4659578.
Yazdi Z, Loukzadeh Z, Moghaddam P, Jalilolghadr S. Sleep hygiene practices and their relation to sleep quality in medical students of Qazvin University of Medical Sciences. In J Caring Sci. 2016;5(2):153-160. DOI: https://doi.org/10.15171/jcs.2016.016 PMid:27354979 PMCid:PMC4923839
Ali RM, Zolezzi M, Awaisu A, Eltorki Y. Sleep Quality and Sleep Hygiene Behaviours Among University Students in Qatar. Int J Gen Med. 2023 Jun 13;16:2427-2439. DOI: https://doi.org/10.2147/IJGM.S402399 PMid:37333875 PMCid:PMC10276586
Lemma S, Berhane Y, Worku A, Gelaye B, Williams MA. Good quality sleep is associated with better academic performance among university students in Ethiopia. Sleep Breath 2014;18(2):257-263. DOI: https://doi.org/10.1007/s11325-013-0874-8 PMid:23928956 PMCid:PMC3918486
Gilbert SP, Weaver CC. Sleep quality and academic performance in university students: a wake-up call for college psychologists. J College Stud Psychother 2010;24(4):295-306. DOI: https://doi.org/10.1080/87568225.2010.509245
Ding C, Lim LL, Xu L, Kong AP. Sleep and obesity. In J Obes Metab Syndr. 2018;27(1):4-24. DOI: https://doi.org/10.7570/jomes.2018.27.1.4 PMid:31089536 PMCid:PMC6489488
Albrecht U. The circadian clock, metabolism and obesity. Obes Rev 2017;18(S1):25-33. DOI: https://doi.org/10.1111/obr.12502 PMid:28164453
Desai D, Momin A, Hirpara P, Jha H, Thaker R, Patel J. Exploring the Role of Circadian Rhythms in Sleep and Recovery: A Review Arti-cle. Cureus. 2024 Jun 3;16(6):e61568. DOI: https://doi.org/10.7759/cureus.61568
Mahadule AA, Mittal S, Khapre M, Goel A, Patil PM, Mohan L. Sleep quality and sleep hygiene in preclinical medical students of tertiary care center amidst COVID-19 pandemic: a cross-sectional observational study. J Rural Med. 2022 Jul;17(3):137-142. DOI: https://doi.org/10.2185/jrm.2021-048 PMid:35847749 PMCid:PMC9263951
Iao SI, Jansen E, Shedden K, O'Brien LM, Chervin RD, Knutson KL, Dunietz GL. Associations between bedtime eating or drinking, sleep duration and wake after sleep onset: findings from the American time use survey. Br J Nutr. 2021 Sep 13;127(12):1-10. DOI: https://doi.org/10.1017/S0007114521003597 PMid:34511160 PMCid:PMC9092657
Castro-Santos L, Lima MO, Pedrosa AKP, Serenini R, deMenezes RCE, Longo-Silva G. Sleep and circadian hygiene practices association with sleep quality among Brazilianadults. Sleep Med X 2023; 6: 100088. DOI: https://doi.org/10.1016/j.sleepx.2023.100088 PMid:38162593 PMCid:PMC10757201
Heo JY, Kim K, Fava M, Mischoulon D, Papakostas GI, Kim MJ, Kim DJ, Chang KJ, Oh Y, Yu BH, Jeon HJ. Effects of smartphone use with and without blue light at night in healthy adults: A randomized, double-blind, cross-over, placebo-controlled comparison. J Psychi-atr Res. 2017 Apr;87:61-70. DOI: https://doi.org/10.1016/j.jpsychires.2016.12.010 PMid:28017916
Seun-Fadipe CT, Aloba OO, Oginni OA, Mosaku KS. Sleep Hygiene Index: Psychometric Characteristics and Usefulness as a Screening Tool in a Sample of Nigerian Undergraduate Students. J Clin Sleep Med. 2018;14(8):1285-1292. DOI: https://doi.org/10.5664/jcsm.7256 PMid:30092898 PMCid:PMC6086965
Hanley JA, McNeil BJ. The meaning and use of the area under a receiver operating characteristics (ROC) curve. Radiology. 1982;143(1):23-36. DOI: https://doi.org/10.1148/radiology.143.1.7063747 PMid:7063747
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Suhasini R Kanyadi, Varsha M Shindhe, Ravikiran P Kamate, Shivalingappa B Javali

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
The authors retain the copyright of their article, with first publication rights granted to Medsci Publications.