The Sleep Quality Crisis among Medical Students: A Wake-up Call

Sleep is an essential physiological activity with many vital functions, including physical restoration, emotional regulation, and memory consolidation, to name a few.A sleep duration of seven to nine hours per night is considered ideal for young adults, according to the National Sleep Foundation. 1 Decreased sleep duration or quality may contribute to the development of cardiometabolic disease, psychiatric illness, and impaired academic or professional performance. 2,3edical students are a vulnerable segment of the young adult population, preparing to perform duties of immense public importance under stressful conditions involving long working hours.Medical school is known to have rigorous curricular requirements and intensely competitive and grueling examinations.Hence, it is hardly surprising that sleep problems are commonplace among medical students.A systematic review and meta-analysis of 109 studies from across the world was performed by Binjabr et al., examining the prevalence of sleep problems among medical students.Among the included studies, a total of 95 studies, comprising 54,894 participants, reported on the prevalence of poor sleep quality among medical students, with a resulting pooled prevalence of 55.6% (95% CI, 51.4-59.7%). 4Furthermore, among 35 of the included studies, the average sleep duration was about 6.5 hours per night. 4This is well below the recommended 7-9 hours per night of sleep.In this context, the findings of Chacko et al., published in this edition of the Indian Journal of Sleep Medicine, serve as a grim reminder of poor sleep among medical students. 5In this crosssectional study, Chacko et al. have found that 72.7% of medical students across the years of training have poor sleep quality.Further, depression and substance use were common among students with poor sleep quality.Hence, the findings are consistent with the current understanding that medical students have impaired sleep and a significant burden of mental health issues.However, the study has a few limitations.The confidence of our prevalence estimates is limited owing to the single-center setting and small sample size.Additionally, the lack of inclusion of a control group of non-medical students makes it unclear how the prevalence compares with that among the youth in the general population.A previous systematic review conducted by Dunn et al. had examined the prevalence of sleep problems (poor sleep quality or daytime sleepiness) among university students in India.Among the 12 included studies, seven were conducted in medical colleges and four in non-medical universities. 6One study included both medical and non-medical students. 7They found comparable rates of sleep problems among medical (17.3-72.9%)and non-medical (44-66%) college students. 6However, in the study