Correlation between sleep and academic performance in medical students: a questionnaire-based study

OBJECTIVES: Between 30% and 70% of college undergraduates appear to be affected by sleep deprivation and insomnia. They also face other specific sleep disturbances, such as Obstructive Sleep Apnea Syndrome (OSA). A significant number of these students consequently suffer from a reduction in learning abilities, memory consolidation, daytime alertness, and concentration. These sleep disturbances can lead to various negative outcomes, including impaired academic performance, increased stress levels, and deteriorating mental health. Sleep deprivation in this demographic can have far-reaching implications, affecting not only their academic success but also their overall well-being and long-term health prospects.

METHODS: A comprehensive survey based on the Epworth Sleepiness Scale (ESS) and STOP-Bang questionnaires was administered to all medical students at the University of Padua. The survey aimed to investigate their subjective assessment of sleep quality, the presence of risk factors for OSA, and the correlation of these factors to their academic performance. The ESS questionnaire was used to evaluate daytime sleepiness, while the STOP-Bang questionnaire assessed the risk of OSA based on factors such as snoring, tiredness, observed apnea, high blood pressure, BMI, age, neck circumference, and gender. The data collected were then analyzed to identify potential correlations between sleep quality, risk factors, and students’ academic performance.

RESULTS: Out of the 248 individuals who participated in the survey, up to 21% reported experiencing non-restful sleep, while 37.5% were exposed to significant daily sleepiness, as indicated by an Epworth mean score of 6.8 with a standard deviation of 3.5. Despite these findings, none of the respondents were identified as being at high risk for OSA based on the STOP-Bang scores. The analysis revealed that the STOP-Bang Questionnaire was exclusively associated with a decrease in the “Students’ Performance Score” (SPS), with an average decrease of 0.5 points for each 1-unit increase in STOP-Bang score. Additionally, it was found that for each 1-point increase in Body Mass Index (BMI), the SPS score decreased by 0.13 points. These results suggest a significant relationship between sleep disturbances, particularly those identified by the STOP-Bang score, BMI, and academic performance among medical students.

CONCLUSIONS: Based on the regression model used in this study, it can be concluded that there is a statistically significant association between the mean of college grades, STOPBang score, and Body Mass Index. However, this study does not establish a clear cause-and-effect relationship. The findings indicate that higher STOP-Bang scores and increased BMI are associated with lower academic performance among medical students. These results underscore the importance of addressing sleep-related issues and maintaining a healthy BMI to
potentially improve academic outcomes.
Further research is needed to explore the underlying mechanisms and to establish more definitive conclusions about the impact of sleep quality and related factors on academic performance.

CLINICAL SIGNIFICANCE: This study highlights an important correlation between sleep disorders, particularly those associated with OSA and elevated Body Mass Index, and the academic performance of medical students. The clinical significance of these findings underscores the need for timely assessment and management of sleep disorders and BMI to prevent potential negative repercussions on students’ mental health, cognitive abilities, and academic success.