Quality of sleep and its associated factors among medical undergraduates in Sri Lanka: a cross-sectional study

Introduction: Sleep is an important physiological process that plays a significant role in memory consolidation, critical thinking and decision-making. Disrupted sleep patterns can greatly diminish academic performance and potentially have long-term effects on professional development.  
Objectives: To evaluate the quality of sleep and the factors associated with it among medical undergraduates in Sri Lanka.
Methods: A cross-sectional survey involving 1496 medical undergraduates aged 18-29 years was conducted in two medical faculties in Sri Lanka. Participants completed the validated Pittsburgh Sleep Quality Index (PSQI) questionnaire to assess the quality of sleep. A total PSQI overall score of 5 or above was used to categorize those with poor quality of sleep.  
Results: This study found that 71% of medical students reported experiencing poor sleep quality, with around 65% of participants across all academic years affected. Sleep duration was the most significantly affected domain of sleep quality as measured by PSQI, impacting 40% of participants. Students living in university indoor hostels reported significantly lower sleep quality (mean score=6.59) compared to those living at home (mean score=5.83; p=0.03). Additionally, participants who were overweight (mean score=6.92) reported significantly poorer sleep quality than those with normal body mass index (mean score=6.39; p=0.01) .    
Conclusions & Recommendations: Poor quality of sleep is significantly prevalent among medical undergraduates, highlighting a need for an education-based program to enhance sleep quality and integrate related activities into their curriculum.