THE EFFECT OF SLEEP QUALITY ON GRADE POINT AVERAGE AND CLINICAL EXAMINATION SCORES IN NORTHERN BORDER UNIVERSITY MEDICAL STUDENTS

ABDELRAHMAN MOHAMED AHMED ABUKANNA; ALMUJTABA ALSHANGITY; HAFIZ OSMAN IBN IDRIS ALMISBAH; MOHAMMED OBAID ALENAZI; ZAKARIYA M S MOHAMMED; OMAIMA A HAMID

doi:10.22159/ajpcr.2025v18i6.53235

Authors

ABDELRAHMAN MOHAMED AHMED ABUKANNA Department of Internal Medicine, College of Medicine, Northern Border University, Arar, Saudi Arabia
ALMUJTABA ALSHANGITY Department of Internal Medicine, College of Medicine, Northern Border University, Arar, Saudi Arabia
HAFIZ OSMAN IBN IDRIS ALMISBAH Department of Internal Medicine, College of Medicine, Northern Border University, Arar, Saudi Arabia https://orcid.org/0000-0002-3507-4646
MOHAMMED OBAID ALENAZI Department of Ear, Nose, and Throat, College of Medicine, Northern Border University, Arar, Saudi Arabia. https://orcid.org/0009-0007-6565-0441
ZAKARIYA M S MOHAMMED Department of Mathematics, College of Science, Northern Border University, Arar, Saudi Arabia
OMAIMA A HAMID Department of Obstetrics and Gynecology, College of Medicine, Northern Border University, Arar, Saudi Arabia

DOI:

https://doi.org/10.22159/ajpcr.2025v18i6.53235

Keywords:

Sleep quality, Clinical examination scores, Academic performance, Insomnia severity index, Epworth sleepiness scale, Pittsburgh sleep quality index

Abstract

Objectives: Sleep disturbances are more common in medical students than in non-medical students and the general population. This study aimed to evaluate the sleep quality of medical students at Northern Border University in relation to their clinical examination scores.

Methods: We used a cross-sectional design that involved medical students in their clinical years at Northern Border University. A pre-designed questionnaire was administered online. The relationships between Grade Point Average (GPA) and Pittsburgh Sleep Quality Index (PSQI) and GPA and Epworth Sleepiness Scale (ESS) were evaluated using correlation coefficients. IBM SPSS (version 26, SPSS Inc., Chicago, IL, USA) was used.

Results: A total of 247 students participated in the study. The leading cause of disturbed sleep was the inability to sleep within 30 min. Suffering from mild to very severe difficulty in falling asleep was found in (58.7%), followed by “difficulty staying asleep” in (41.7%) and “problems waking up too early” in (38.9%). Regarding the impact of sleep quality on clinical test scores, (59.9%) indicated that it has a negative effect. There was a weak negative correlation between students’ GPA and ESS, as well as GPA and PSQI.

Conclusion: A significant percentage of the study group had bad sleep quality. The most important reasons for the bad sleep quality were difficulty staying asleep and waking up early. Most of the study group came to the clinical examinations without sleeping the night before, negatively affecting their examination scores. The study found a significant negative correlation between sleep quality and academic performance.

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References

Weinger MB, Ancoli-Israel S. Sleep deprivation and clinical performance. JAMA. 2002;287(8):955-7. doi: 10.1001/jama.287.8.955, PMID 11866625

Gates M, Wingert A, Featherstone R, Samuels C, Simon C, Dyson MP. Impact of fatigue and insufficient sleep on physician and patient outcomes: A systematic review. BMJ Open. 2018 Sep 21;8(9):e021967. doi: 10.1136/bmjopen-2018-021967, PMID 30244211

Durmer JS, Dinges DF. Neurocognitive consequences of sleep deprivation. Semin Neurol. 2005 Mar;25(1):117-29. doi: 10.1055/s- 2005-867080, PMID 15798944

Khaksarian M, Behzadifar M, Behzadifar M, Jahanpanah F, Guglielmi O, Garbarino S, et al. Sleep disturbances rate among medical and allied health professions students in Iran: Implications from a systematic review and meta-analysis of the literature. Int JEnviron Res Public Health. 2020 Feb 5;17(3):1011. doi: 10.3390/ ijerph17031011, PMID 32033482

Safhi MA, Alafif RA, Alamoudi NM, Alamoudi MM, Alghamdi WA, Albishri SF, et al. The association of stress with sleep quality among medical students at King Abdulaziz University. J Fam Med Prim Care. 2020 Mar 26;9(3):1662-7. doi: 10.4103/jfmpc.jfmpc_745_19, PMID 32509668

El Hangouche AJ, Jniene A, Aboudrar S, Errguig L, Rkain H, Cherti M, et al. Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students. Adv Med Educ Pract. 2018 Sep 7;9:631-8. doi: 10.2147/AMEP.S162350, PMID 30233270

Lumley S, Ward P, Roberts L, Mann JP. Self-reported extracurricular activity, academic success, and quality of life in UK medical students. Int J Med Educ. 2015 Sep 19;6:111-7. doi: 10.5116/ijme.55f8.5f04, PMID 26385285

Maheshwari G, Shaukat F. Impact of poor sleep quality on the academic performance of medical students. Cureus. 2019 Apr 1;11(4):e4357. doi: 10.7759/cureus.4357, PMID 31192062

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. doi: 10.3109/0142159X.2012.656749, PMID 22409189

Bahammam AS, Alaseem AM, Alzakri AA, Almeneessier AS, Sharif MM. The relationship between sleep and wake habits and academic performance in medical students: A cross-sectional study. BMC Med Educ. 2012 Aug 1;12:61. doi: 10.1186/1472-6920-12-61, PMID 22853649

Siddiqui AF, Al-Musa H, Al-Amri H, Al-Qahtani A, Al-Shahrani M, Al-Qahtani M. Sleep patterns and predictors of poor sleep quality among medical students in King Khalid University, Saudi Arabia. Malays J Med Sci. 2016;23(6):94-102. doi: 10.21315/mjms2016.23.6.10, PMID 28090183

Alqarni AB, Alzahrani NJ, Alsofyani MA, Almalki AA. The interaction between sleep quality and academic performance among the medical students in Taif University. Egypt J Hosp Med. 2018;70(12):2202-8. doi: 10.12816/0045053

Lee J, Graham AV. Students’ perception of medical school stress and their evaluation of a wellness elective. Med Educ. 2001 Jul;35(7):652-9. doi: 10.1046/j.1365-2923.2001.00956.x, PMID 11437967

Brick CA, Seely DL, Palermo TM. Association between sleep hygiene and sleep quality in medical students. Behav Sleep Med. 2010;8(2):113-21. doi: 10.1080/15402001003622925, PMID 20352547

Ho KY, Lam KK, Xia W, Chung JO, Cheung AT, Ho LL, et al. Psychometric properties of the Chinese version of the Pittsburgh sleep quality index (PSQI) among Hong Kong Chinese childhood cancer survivors. Health Qual Life Outcomes. 2021 Jul 6;19(1):176. doi: 10.1186/s12955-021-01803-y, PMID 34229705

Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep. 1991 Dec;14(6):540-5. doi: 10.1093/ sleep/14.6.540, PMID 1798888

Morin CM, Belleville G, Bélanger L, Ivers H. The insomnia severity index: Psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011 May 1;34(5):601-8. doi: 10.1093/ sleep/34.5.601, PMID 21532953

Giri P, Baviskar M, Phalke D. Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western Maharashtra, India. Ann Med Health Sci Res. 2013 Jan;3(1):51-4. doi: 10.4103/2141-9248.109488, PMID 23634330

Azad MC, Fraser K, Rumana N, Abdullah AF, Shahana N, Hanly PJ, et al. Sleep disturbances among medical students: A global perspective. J Clin Sleep Med. 2015 Jan 15;11(1):69-74. doi: 10.5664/jcsm.4370, PMID 25515274

Curcio G, Ferrara M, De Gennaro L. Sleep loss, learning capacity and academic performance. Sleep Med Rev. 2006 Oct;10(5):323-37. doi: 10.1016/j.smrv.2005.11.001, PMID 16564189

Ahrberg K, Dresler M, Niedermaier S, Steiger A, Genzel L. The interaction between sleep quality and academic performance. J Psychiatr Res. 2012 Dec;46(12):1618-22. doi: 10.1016/j.jpsychires.2012.09.008, PMID 23040161

James B, Omoaregba J, Igberase O. Prevalence and correlates of poor sleep quality among medical students at a Nigerian university. Ann Niger Med. 2011;5(1):1-5. doi: 10.4103/0331-3131.84218

Ah S, Mz Y, Fn M, Manh A, H MH, Aw A. Poor sleep quality among medical students in international Islamic university Malaysia (IIUM) and its association with mental health and other factors. IMJM. 2020;19(2):50-7. doi: 10.31436/imjm.v19i2.1564

Lemma S, Gelaye B, Berhane Y, Worku A, Williams MA. Sleep quality and its psychological correlates among university students in Ethiopia: A cross-sectional study. BMC Psychiatry. 2012;12:237. doi: 10.1186/1471-244X-12-237, PMID 23270533

Al-Khani AM, Sarhandi MI, Zaghloul MS, Ewid M, Saquib N. A cross-sectional survey on sleep quality, mental health, and academic performance among medical students in Saudi Arabia. BMC Res Notes. 2019 Oct 21;12(1):665. doi: 10.1186/s13104-019-4713-2, PMID 31639038

Nsengimana A, Mugabo E, Niyonsenga J, Hategekimana CH, Biracyaza E, Mutarambirwa R, et al. Sleep quality among undergraduate medical students in Rwanda: A comparative study. Sci Rep. 2022 Aug;13:265. doi: 10.21203/rs.3.rs-2010523/v1

Saygın M, Öztürk Ö, Gonca T, Has M, Hayri UB, Kurt Y, et al. Investigation of sleep quality and sleep disorders in students of medicine. Turk Thorac J. 2016 Oct;17(4):132-40. doi: 10.5578/ ttj.30513, PMID 29404143

De Almeida FV, Silva BT, Paiva DG, Montina CB, Basso DA, De Azevedo NM, et al. Influence of sleep quality on academic performance of medical students. Rev Soc Bras Clin Med. 2020;18(1):6-10.

Tafoya SA, Jurado MM, Yépez NJ, Fouilloux M, Lara MC. Dificultades del sueño y síntomas psicológicos en estudiantes de medicina de la ciudad de México [Sleep difficulties and psychological symptoms in medicine students in Mexico]. Medicina (B Aires). 2013;73(3):247-51. PMID 23732201

Alhazzani N, Masudi E, Algarni A. The relationship between sleep patterns and academic performance among medical students at King Saud Bin Abdulaziz university for health sciences. Egypt J Hosp Med. 2018;70(7):1131-4. doi: 10.12816/0044537

Hershner SD, Chervin RD. Causes and consequences of sleepiness among college students. Nat Sci Sleep. 2014 Jun 23;6:73-84. doi: 10.2147/NSS.S62907, PMID 25018659

Elsayed H, Tashkandi A, Alsaiari N, Alyami G, Ahmed WA, Alrefaei A, et al. Assessment of sleep quality of medical students at Taibah University. Int J Med Dev Ctries. 2022;6(2):323-32. doi: 10.24911/IJMDC.51-1639409977

Phillips AJ, Clerx WM, O’Brien CS, Sano A, Barger LK, Picard RW, et al. Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing. Sci Rep. 2017 Jun 12;7(1):3216. doi: 10.1038/s41598-017-03171-4, PMID 28607474

Ahmed N, Sadat M, Cukor D. Sleep knowledge and behaviors in medical students: Results of a single center survey. Acad Psychiatry. 2017 Oct;41(5):674-8. doi: 10.1007/s40596-016-0655-3, PMID 28097529

Scullin MK. The eight hour sleep challenge during final exams week. Teach Psychol. 2019;46(1):55-63. doi: 10.1177/0098628318816142

Yaghmour KA, Alhmyri SM, Alhmyri BM, Sharaf R, Alasmari MA, Almilabi MM. The effect of sleep quality and mental health on academic performance among the medical students of King Abdulaziz University. Cureus. 2023 Sep 9;15(9):e44951. doi: 10.7759/cureus.44951, PMID 37818494

Jalali R, Khazaei H, Paveh BK, Hayrani Z, Menati L. The effect of sleep quality on students’ academic achievement. Adv Med Educ Pract. 2020 Jul 17;11:497-502. doi: 10.2147/AMEP.S261525, PMID 32765154

Corrêa CC, Oliveira FK, Pizzamiglio DS, Ortolan EV, Weber SA. Sleep quality in medical students: A comparison across the various phases of the medical course. J Bras Pneumol. 2017 Jul-Aug;43(4):285-9. doi: 10.1590/S1806-37562016000000178, PMID 29365004

Hammouda MA, El Rafey DS. Sleep quality and association with academic performance among fourth year medical students at Zagazig university. ZUMJ. 2024;30(1.1):76-82. doi: 10.21608/ zumj.2021.56954.2071

Falloon K, Bhoopatkar H, Moir F, Nakatsuji M, Wearn A. Sleep well to perform well: The association between sleep quality and medical student performance in a high-stakes clinical assessment. Sleep Adv. 2022 Jun 30;3(1):zpac019. doi: 10.1093/sleepadvances/zpac019, PMID 37193410