Sleep quality, mental health, lifestyle factors, and academic performance among medical students in three Syrian Universities: a cross-sectional study

Sleep quality significantly impacts cognitive function and mental health, yet medical students globally report high rates of sleep disturbances. This cross-sectional study investigates the prevalence of poor sleep quality and its associations with mental health and academic performance among medical students in three Syrian universities. An online survey was administered to 722 medical students from Kalamoon University, Al Sham Private University, and Syrian Private University. Validated tools, including `assessed sleep quality and psychological distress. Academic performance was measured via self-reported GPA. After exclusions, 682 participants were analyzed using SPSS v27, with chi-square tests and regression models (α = 0.05). Poor sleep quality (PSQI ≥ 5) was prevalent in 83.3% of participants, with significant variations across universities (p = 0.011). Sleep quality correlated with academic year (p = 0.037), physical inactivity (p = 0.001), unhealthy diet (p = 0.001), smoking (p = 0.001), and low academic attendance (p = 0.001). Poor sleepers exhibited higher depression (p = 0.001), anxiety (p = 0.001), and stress (p = 0.001) scores. No direct association emerged between sleep quality and GPA (p = 0.8). Preparatory-year students (OR = 0.355, p = 0.009), those with severe depression (OR = 0.537, p = 0.023), and severe stress (OR = 0.493, p = 0.034) were likelier to be low academic achievers. Poor sleep quality is alarmingly high among Syrian medical students and strongly linked to mental health challenges and modifiable lifestyle factors. Academic performance (GPA) showed no direct relationship with sleep quality, stress and depression .Targeted interventions promoting sleep hygiene, physical activity, and mental health support are urgently needed. Further longitudinal studies should explore causal pathways and cultural influences on sleep behaviors.