Sleep Quality and Associated Factors in Preclinical Medical Students in Faculty of Medicine Vajira Hospital

Main Article Content

Chotiman Chinvararak
Pantri Kirdchok
Wisarat Pruttithavorn
Jidapha Tiamungkornpan
Chaniporn Leelaprasertwong
Nicharee Wongsrinant
Thanakit Malaikritsanachalee
Tharadon Mungkhantiwongsaku
Theerameth Pruangmethangkul
Parichat Ditsomboon
Pornpailin Thammasupapong
Ratchapong Thongpool
Wongsathorn Seehirunwong


Objective: To study the prevalence and associated factors of poor sleep quality in pre-clinical-year medical students, Faculty of Medicine Vajira Hospital, Navamindradhiraj University.

Method: A cross-sectional descriptive study was conducted on preclinical-year medical students in 2015. Self-reported questionnaires consisted of demographic data, Thai version of the Pittsburgh sleep quality index, Stress-5 questionnaires, sleep hygiene questionnaires and 1-year life stress event questionnaire. Descriptive statistics were presented as frequency, percent and mean. The chi-square test, Fisher’s Exact test and logistic regression analysis were used to find the associated factors of poor sleep quality.

Results: There were 204 preclinical medical-student participants; 54.9% were female. Prevalence of poor sleep quality was 77.9%. Majority of participants had moderate level of stress (41.2%). Poor sleep hygiene consisted of late meal and evening caffeine consumption were found (75.5% and 43.6%, respectively). Associated factors of poor sleep quality were the severe to very severe level of stress (ORAdj= 11.50, 95%CI = 2.54-51.99), severity of life stress events, and evening caffeine consumption.

Conclusion: Prevalence of poor sleep quality in preclinical medical students was substantial. Its associated factors were stress level, severity of life stress events, and evening caffeine consumption. Surveillance and relevant preventive measures should be taken.


Download data is not yet available.

Article Details

Original Articles


Mellinger GD, Balter MB, Uhlenhuth EH. Insomnia and its treatment. Prevalence and correlates. Arch Gen Psychiatry 1985; 42(3): 225-32.

Chaiarj S, Panya P. Insomnia and related factors. The Thai Journal of Nursing Council 2005; 20(2): 1-12.

Drake CL, Roehrs T, Roth T. Insomnia causes, consequences, and therapeutics: an overview. Depress Anxiety 2003; 18(4): 163-76.

Lohsoonthorn V, Khidir H, Casillas G, Lertmaharit S, Tadesse MG, Pensuksan WC, et al. Sleep quality and sleep patterns in relation to consumption of energy drinks, caffeinated beverages, and other stimulants among Thai college students. Sleep Breath 2013; 17(3): 1017-28.

Chanamanee P, Taboonpong S, Intanon T. Sleep quality and related factors among university students in southern Thailand. Songkla Med J 2006; 24(3): 163-73.

Preišegolavičiūtė E, Leskauskas D, Adomaitiene V. Associations of quality of sleep with lifestyle factors and profile of studies among Lithuanian students. Medicine 2010;46:482–9.

Al-Hashel JY, Ahmed SF, Alroughani R, Goadsby PJ. Migraine among medical students in Kuwait University. J Headache Pain 2014; 15: 26.

Hidalgo MP1, Caumo W. Sleep disturbances associated with minor psychiatric disorders in medical students. Neurol Sci 2002; 23(1): 35-9.

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; 12: 61.

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; 3(1): 51-4.

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; 11(1): 69-74.

Suen LK, Tam WW, Hon KL. Association of sleep hygiene-related factors and sleep quality among university students in Hong Kong. Hong Kong Med J 2010; 16(3): 180-5.

Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ.The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Res 1989; 28: 193-213.

Yamma C, Lueboonthavatchai P. Sleep Problems, Fatigue and Work Efficiency among Registered Nurse at King Chulalongkorn Memorial Hospital. J Psychiatr Assoc Thailand 2013; 58(2): 183-96.

Friedman L, Benson K, Noda A, Zarcone V, Wicks DA, O'Connell K, et al. An actigraphic comparison of sleep restriction and sleep hygiene treatments for insomnia in older adults. Journal of geriatric psychiatry and neurology 2000;13(1):17-27.

Lueboonthavatchai P. Role of stress areas, stress severity, and stressful life events on the onset of depressive disorder: a case-control study. J Med Assoc Thai 2009; 92(9): 1240-9.

Almojali AI, Almalki SA, Alothman AS, Masuadi EM, Alaqeel MK. The prevalence and association of stress with sleep quality among medical students. J Epidemiol Glob Health 2017;7(3):169-74.

Auaboonkanok P, Wongsawasd K, Wongpanich S, Waidee T, Ratprasit P, Senaveenin N et al. Prevalence of Clinical Medical Students who had Poor Sleep Quality; a Study in one of the Medical School in the Northeastern Thailand. Srinagarind Med J 2018; 33: 65-6.

Brick CA, Seely DL, Palermo TM. Association between sleep hygiene and sleep quality in medical students. Behav Sleep Med 2010; 8:113–21.

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 Suppl1:S37–41.

Alsaggaf MA, Wali SO, Merdad RA, Merdad LA. Sleep quantity, quality, and insomnia symptoms of medical students during clinical years: relationship with stress and academic performance. Saudi Med J 2016;37:173–82.

Kolkijkovin V, Phutathum S, Chatromyen P, Jantratikul A, Pattrayutawat M, Surinrat T et al. Vajira Med J 2017; 61(1): 9-20.

Nuallaong W. The study of stress factors in clinical medical students of the Faculty of Medicine, Thammasat University. Thammasat Medical Journal 2010; 10(2): 95-102.

Norphun N, Pitanupong J, Jiraphan A. Stress and Coping Strategies among Thai Medical Students in a Southern Medical School. Siriraj Medical Journal 2020; 72(3): 238-44.

Yusoff MS, Rahim AF, Yaacob MJ. Prevalence and sources of stress among Universiti Sains Malaysia medical students. Malaysia. J Med Sci 2010; 17(1):30-7.

Abdulghani HM, Alkanhal AA, Mahmoud ES, Ponnamperuma GG, Alfaris EA. Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia. J Health Popul Nutr 2011; 29(5): 516–22.

Lemma S, Patel SV, Tarekegn YA, Tadesse MG, Berhane Y, Gelaye B, et al. Th epidemiology of sleep quality, sleep patterns, consumption of caffeinated beverages, and Khat use among Ethiopian College students. Sleep Disord 2012;2012:1–11.

Tran J, Lertmaharit S, Lohsoonthorn V, Pensuksan WC, Rattananupong T, Tadesse MG, et al. Daytime sleepiness, circadian preference, caffeine consumption and use of other stimulants among Thai College students. J Public Heal Epidemiol 2014;8:202–10.

Whittier A, Sanchez S, Castañeda B, Sanchez E, Gelaye B, Yanez D, et al. Eveningness chronotype, daytime sleepiness, caffeine consumption, and use of other stimulants among Peruvian University students. J Caffeine Res 2014;4:21–7.

Waqas A, Khan S, Sharif W, Khalid U, Ali A. Association of academic stress with sleeping difficulties in medical students of a Pakistani medical school: a cross sectional survey. Peer J 2015;3:e840.