Prevalence of sleep problems among medical students: a systematic review and meta-analysis

Aim Several studies have shown high prevalence rates of sleep problems among medical students, including insufficient sleep duration, poor sleep quality, and excessive daytime sleepiness. This review aims to systematically summarize the existing literature on sleep problems among medical students and consequently estimate the prevalence of these disturbances. Subject and Methods The MEDLINE, EMBASE, ScienceDirect, and ProQuest Medical databases, the Google Scholar engine, and reference lists of retrieved articles were systematically searched and evaluated for quality. Results Forty-three studies involving a total of 18,619 students from 13 countries were included in the analyses. Results showed that the mean pooled sleep duration (K = 16,N = 10,512) was 6.3 h per night for medical students, [95% confidence interval (CI) 6.0-6.6]. The results also indicated that 55% [95% CI 48.0%-62.0%] of students reported poor sleep quality (K = 33,N = 15,462) according to the Pittsburgh Sleep Quality Index (PSQI); the mean pooled score of 6.3. Excessive daytime sleepiness (K = 18,N = 5688) was reported by 31.0% [95% CI 24.4%-37.7%] of students according to the Epworth Sleepiness Scale (ESS). Age and gender were not significant moderators for sleep quality or excessive daytime sleepiness. Some differences were obtained between countries, suggesting that cultural values, local conditions, and environment all have an impact on sleep practices and attitudes. Conclusion Sleep problems are highly prevalent among medical students and are therefore a severe problem. Prevention and intervention programs targeting these are therefore highly recommended for future studies.