Survey Of Sleep Quality Condition And Its Influencing Factors Among Medical Students

Objective: Sleep is a basic physiological need of human being,a process necessary to maintain life activities.Currently,college students are encountering a series of sleep problems,mainly including sleep insufficiency and having trouble falling asleep.This condition will,undoubtedly,influence individual study-work efficiency and daily activity,not only affecting academic performance but also threatening physical and mental health.Medicine is a major with remarkable features.It contains a lot of medical and health knowledge,thus medical students are better at preventing and controlling disease than students of other majors.However,heavy schoolwork,scientific research pressure and a tough job market may trigger negative effect on sleep of medical students.In this study,5497 college students in China Medical University were investigated by ways of cross-sectional survey to learn general condition of sleep quality in medical students and its influencing factors.Methods: Undergraduate students in China Medical University including freshmen,sophomores,juniors and seniors were investigated by completing questionnaires.The survey was conducted by class meetings and the procedure of questionnaire completion was guided and supervised by trained investigators.The questionnaires mainly include Pittsburgh Sleep Quality Index,Health Promoting Lifestyle Profile II and Morningness-Eveningness Questionnaire.Data entry was completed by Epidata3.1 and data analysis was conducted by SPSS 21 and SAS 9.4.Student's t test was used to compare PSQI scores of male and female.Completely randomized design analysis of variance was used to compare PSQI scores of different grades,paternal educational background,mental factors,lifestyles,circadian typology and internet use while pairwise comparison was assessed by LSD-t test.Binary logistic regression was used to identify factors independently associated with overall sleep quality.In the binary logistic regression model,sleep disturbance(PSQI score more than 5 points was identified as sleep disturbance and PSQI score less than 5 points was identified as normal sleep)was treated as a dependent variable and factors significant in the completely randomized design analysis of variance were treated as independent variables.Ordinal logistic regression was used to identify factors independentlyassociated with seven dimensions of sleep quality.In the ordinal logistic regression model,score of each dimension of sleep quality were treated as dependent variables and factors significant in binary logistic regression were treated as independent variables.Results:(1)Basic information: the study received a total of 5497 valid questionnaires.The PSQI score of medical student was(4.41±2.24)points and the rate of sleep disturbance was 27.1%.(2)The results of One-Way ANOVA showed that senior grades,father's low educational level,mother's low educational level,anxiety,depression,inferiority,late night eating,skipping breakfast,eveningness,longtime online chatting,longtime online video watching and game playing might be risk factors for overall sleep quality while stress management and spiritual growth might be protective factors for overall sleep quality.The results of binary logistic regression analysis showed that senior grades,anxiety,depression,inferiority and eveningness might be independent risk factors for overall sleep quality while stress management might be an independent protective factor for overall sleep quality.(3)Ordinal logistic regression analysis of seven dimensions of sleep quality was conducted.Anxiety and depression might be independent risk factors for subjective sleep quality while stress management might be an independent protective factor for subjective sleep quality.Senior grades,anxiety,depression,inferiority and eveningness might be independent risk factors for sleep latency while stress management might be an independent protective factor for sleep latency.Depression might be an independent risk factor for sleep duration while senior grades and stress management might be independent protective factors for sleep duration.Depression might be an independent risk factor for habitual sleep efficiency.Senior grades,anxiety,depression and inferiority might be independent risk factors for sleep disturbances while stress management might be an independent protective factor for sleep disturbances.Senior grades and anxiety might be independent risk factors for use of sleeping medication while stress management and eveningness might be independent protective factors for use of sleeping medication.Anxiety,depression,inferiority and eveningness might be independent risk factors for daytime dysfunction while stress management might be an independent protective factor for daytime dysfunction.Conclusion: Sleep quality of medical students was poor.Risk factors influencing their sleep quality included senior grades,anxiety,depression,inferiority and eveningness.On the contrary,stress management is protective to their sleep quality.