A cross-sectional study of sleep quality and its association with academic performance and psychological distress among medical students in Mansoura University, Egypt

Abstract Background Sleep plays a critical role in cognitive function and emotional well-being. Medical students are particularly susceptible to poor sleep due to academic pressure, contributing to psychological distress and affecting academic performance. This study investigates the prevalence of poor sleep quality among medical students at Mansoura University and its association with psychological distress and academic performance. Methods A total of 396 responses were collected between February and May 2024 using both online and physical questionnaires. Sleep quality was assessed via the Pittsburgh Sleep Quality Index (PSQI), psychological distress by the Depression Anxiety Stress Scale (DASS-21), and academic performance via GPA. Correlation, cross-tabulation, and multivariate regression analyses were conducted. Results Poor sleep was reported by 86.9% of students, with 63.9% showing symptoms of depression, 62.6% anxiety, and 44.2% stress. Correlation analysis revealed positive associations between PSQI and anxiety ( r = 0.471, p = 0.001), depression ( r = 0.478, p = 0.001), and stress ( r = 0.485, p = 0.001); while PSQI and GPA had a very weak negative correlation ( r = −0.042, p = 0.404). Cross-tabulation showed a significant relationship between sleep and depression ( p = 0.001), anxiety ( p = 0.001), and stress ( p = 0.006), but not with GPA ( p = 0.972). Multivariable regression indicated higher GPA predicted lower depression scores (coefficient = −2.309, p = 0.019). Conclusion Poor sleep quality is highly prevalent among Mansoura University medical students and significantly associated with higher depression, anxiety, and stress, though not academic performance. However, higher GPA predicted lower depression. Female gender and personal or family mental illness history were significant predictors of poor sleep and psychological distress, underscoring the need for targeted interventions in high-risk groups.