Poor sleep quality and daytime sleepiness in medical students: role of late bedtimes

Oliveira, Aldo da Silva; Porto, Luís Alberto Maciel; Ibiapina, Mariana Sousa; Tavares, Karla Ianara Silva; Rocha, Lanni Sarmento da; Albuquerque, Edoarda Vasco de Albuquerque; Medeiros, Luciane de Souza; Ximenes-da-Silva, Adriana

doi:10.1590/1806-9282.20250630

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Original Article • Rev. Assoc. Med. Bras. 71 (11) • 2025 • https://doi.org/10.1590/1806-9282.20250630 linkcopy

Poor sleep quality and daytime sleepiness in medical students: role of late bedtimes

Authorship SCIMAGO INSTITUTIONS RANKINGS

SUMMARY

OBJECTIVE: This study assessed sleep quality and habits affecting sleep among medical students in Alagoas, Brazil.

METHODS: An online survey was conducted using the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale, and a questionnaire on caffeinated beverage and calming herbal tea intake, medication use, and daily screen time was administered.

RESULTS: A total of 165 students participated, 56.36% of whom were female. The Pittsburgh Sleep Quality Index results showed that 58.2% were poor sleepers, 15.2% had poor sleep quality, and 26.7% were good sleepers. Only 36% met the recommended 7–9 h of sleep per day. Shorter sleep duration correlated with poorer sleep quality and increased daytime sleepiness (rho=-0.5). No significant sex differences were observed. Participants were categorized as early-to-bed (51.5%, 23.9±4.9 years; 62% women) and late-to-bed (48.5%, 23.7±5.7 years; 50% women). The late-to-bed group showed poorer sleep quality, greater daytime sleepiness, and 1.4 h less sleep than the early-to-bed group (p<0.01). A later sleep schedule was significantly associated with poorer sleep quality, shorter duration, and greater daytime sleepiness (p<0.01). The semester of study did not significantly influence bedtime (p=0.45). No significant group differences were found in beverage or medication use.

CONCLUSION: This study highlights the need for targeted interventions to improve sleep quality and duration by addressing late bedtimes and contributing factors to daytime sleepiness.

KEYWORDS:
Students, medical; Sleep wake disorders; Sleep deprivation; Circadian rhythm; Sleep hygiene; Questionnaires

	Group	n	Mean (±SD)	Mean difference	95%CI	Cohen's d	p
Epworth score	Early-to-bed	85	9.0 (±4.4)	−1.57	−3.36 to −0.49	−0.4	<0.001
Epworth score	Late-to-bed	80	10.9 (±4.9)	−1.57	−3.36 to −0.49	−0.4	<0.001
PSQI global score	Early-to-bed	85	6.6 (±2.8)	−1.92	−2.42 to −0.72	−0.6	<0.001
PSQI global score	Late-to-bed	80	8.2 (±2.7)	−1.92	−2.42 to −0.72	−0.6	<0.001
Sleep latency	Early-to-bed	84	24.2 (±19.4)	1.47	1.18 to 1.76	0	0.7
Sleep latency	Late-to-bed	80	25.4 (±24.2)	1.47	1.18 to 1.76	0	0.7
Total sleep period	Early-to-bed	84	7.2 (±0.9)	−1.22	−7.98 to 5.53	1.6	<0.001
Total sleep period	Late-to-bed	80	5.8 (±1.0)	−1.22	−7.98 to 5.53	1.6	<0.001

Group		Time screen
		<2 h	2–4 h	4–6 h		6–8 h	>8 h	Total
Early-to-bed	n	2	9	27		26	21	85
Early-to-bed	% of total	1.2	5.5	16.4		15.8	12.7	51.5
Late-to-bed	n	0	7	17		27	29	80
Late-to-bed	% of total	0	4.2	10.3		16.4	17.6	48.5
Fisher's exact test, p=0.24
Group		Coffee consumption
Group		No	Yes		Total
Early-to-bed	n	36	49		85
Early-to-bed	% of total	21.8	29.7		51.5
Late-to-bed	n	25	55		80
Late-to-bed	% of total	15.2	33.3		48.5
Chi-squared test, p=0.14
Group		Consumption of energy drinks
Group		No	Yes		Total
Early-to-bed	n	65	20		85
Early-to-bed	% of total	39.4	12.1		51.5
Late-to-bed	n	51	29		80
Late-to-bed	% of total	30.9	17.6		48.5
Chi-squared test, p=0.07
Group		Consumption of relaxing teas
Group		No	Yes		Total
Early-to-bed	n	63	22		85
Early-to-bed	% of total	38.2	13.3		51.5
Late-to-bed	n	62	18		80
Late-to-bed	% of total	37.6	10.9		48.5
Chi-squared test, p=0.61
Group		Consumption of hypnotics
Group		No	Yes		Total
Early-to-bed	n	78	7		85
Early-to-bed	% of total	47.3	4.2		51.5
Late-to-bed	n	69	11		80
Late-to-bed	% of total	41.8	6.7		48.5
Chi-squared test, p=0.25

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Associação Médica Brasileira R. São Carlos do Pinhal, 324, 01333-903 São Paulo SP - Brazil, Tel: +55 11 3178-6800, Fax: +55 11 3178-6816 - São Paulo - SP - Brazil
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[TFN1] D: standard deviation; CI: confidence interval; PSQI: Pittsburgh Sleep Quality Index.