Evaluation of medical student's sleep quality in covid-19 pandemic

ABSTRACT

Introduction: Sleep quality is influenced by several aspects, including factors related to the environment as well as psychological causes. In this context, the pandemic caused by the new SARS-Cov2 (severe acute respiratory syndrome coronavirus 2) had a large influence on the population's mental health, increasing levels of anxiety and stress, consequently reflected on the sleep quality. This is so also true for medical students;as a result of the scenario generated by the pandemic, in-person classes were replaced by distance education, which, added to the chaotic situation of fear, anxiety, frustration and social isolation, is interfering negatively in students' lives, and in their sleep. Objective: To analyze the sleep quality of medical students at a medical school in the interior of São Paulo state during the covid-19 pandemic. Methods: This is a crosssectional study that invited 544 students from De six years of the course, from a medical school in the interior of the state of São Paulo, to answer the Pittsburgh Sleep Quality Index (PSQI) and a questionnaire on aspects that may influence sleep. The REDCap platform was used to send, via email, the link to the questionnaires, which were available from September 28th to October 5th, 2020. Results: Of the 544 students invited, 375 answered the questionnaires. The mean score of PSQI was 8.63 (SD=3.16), with 82.4% (309 out of 375) of students having a poor sleep quality (PSQI>5). We observed an association between the quality of sleep given by the PSQI and the student's perception of anxiety (P<0.001), stress (P<0.001) and adaptation to distance education (P<0.001). The results for the seven components of the PSQI were analyzed for three study groups (1-2-year student, 3-4-year student and 5-6-year student) and associations were observed between the three studied groups and sleep duration, with students in the last two years sleeping less (<5/5-6h) than the remaining students, and with daytime dysfunction, with students in the first two years showing the highest percentage (75.5%). Conclusion: Sleep quality is poor in medical students, being associated with student's perception of anxiety, stress and difficulties in adapting to distance education. Active interventions should be implemented to improve sleep hygiene in medical students.