Sleep Quality, Academic Load and Mental Health among Medical Students: A Cross-Sectional Study

Abstract

Background: Medical students worldwide experience high rates of poor sleep quality and mental health challenges due to intensive academic demands. This study examined the prevalence of poor sleep, depression, and anxiety, and their association with academic load among medical students at the University of Calabar, Nigeria. Methods: A cross-sectional survey of 400 undergraduate medical students was conducted using stratified random sampling. The Pittsburgh Sleep Quality Index (PSQI), Patient Health Questionnaire-9 (PHQ-9), and Generalized Anxiety Disorder-7 (GAD-7) were administered. Academic load was assessed by weekly study hours and perceived academic pressure. Descriptive and multivariable logistic regression analyses were conducted. Results: Mean age was 22.1±2.4 years; 58% female. Poor sleep quality (PSQI>5) was found in 61.0%, depression (PHQ-9≥10) in 36.5%, and anxiety (GAD-7≥10) in 41.2%. High academic load (>40 hours/week) increased the odds of poor sleep (aOR=2.3, 95%CI:1.5–3.6) and mental health symptoms. Poor sleep quality independently predicted depression (aOR=2.6, 95%CI:1.8– 3.9) and anxiety (aOR=2.1, 95%CI:1.5–3.0). Conclusion: Poor sleep quality and psychological distress are highly prevalent among medical students and strongly associated with heavy academic load. Strategies to optimize academic workload, promote sleep hygiene, and improve mental health support are essential.