Back to Journals » Advances in Medical Education and Practice » Volume 9

Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students

Authors El Hangouche AJ, Jniene A, Aboudrar S, Errguig L, Rkain H, Cherti M, Dakka T

Received 12 January 2018

Accepted for publication 2 May 2018

Published 7 September 2018 Volume 2018:9 Pages 631—638


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Md Anwarul Majumder

Abdelkader Jalil El Hangouche,1–3 Asmaa Jniene,1 Souad Aboudrar,1 Leila Errguig,1 Hanan Rkain,1 Mohammed Cherti,2 Taoufiq Dakka1

1Exercise Physiology and Autonomic Nervous System Team “EPE-SNA”, Laboratory of Physiology, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco; 2Department of Cardiology, Ibn Sina Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco; 3Laboratory of Physiology, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tangier, Morocco

Purpose: Poor quality of sleep and excessive daytime sleepiness affect cognitive ability and have a negative impact on the academic performance of medical students. This study aims to determine the prevalence of excessive daytime sleepiness, sleep quality and psychological distress as well as assess their association with low academic performance in this population.
Participants and methods: A cross-sectional study was conducted among 457 medical students from the Faculty of Medicine and Pharmacy of Rabat, Morocco, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth Sleepiness Scale to determine the quality of sleep and excessive daytime sleepiness, respectively. Sociodemographic variables and psychological distress (Kessler Psychological Distress Scale) were also measured. Multivariate linear regression was performed in order to evaluate the link between low academic performance and sleep quality after adjusting for other covariates.
Results: Among the included students, the median age was 20 (19; 21) years; 70.7% of the participants were females. Almost one-third of the students (36.6%) had excessive daytime sleepiness and this was more frequently observed in female students (43% vs 20.1%, <0.001). Furthermore, 58.2% of the students were poor sleepers (PSQI ≥5), while 86.4% of them had psychological distress. The bivariate analysis showed that psychological distress was associated with decreased risk of low performance (ß=0.04; 95% CI=0.005–0.07; P=0.024). Being a poor sleeper was statistically associated with poor academic performance (ß= −0.07; 95% CI=−0.14 to −0.002; P=0.04) in the multivariate analysis. In our study, daytime sleepiness was not statistically associated with academic performance.
Conclusion: A poor sleep quality determined by PSQI ≥5 was related to poor academic achievement at the end of the study year in medical students.

Keywords: quality of sleep, daytime sleepiness, psychological distress, academic performance, medical students

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]