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

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.