Psychological factors related to professional examinations and their association with sleep quality among Medical students

  • Shahzaib Maqbool
  • Omaima Sundus
  • Muhammad Sarfraz Khan
  • Arham Ihtesham
  • Waleed Inayat Mohamed
  • Rabia Arshad
Keywords: Medical undergraduates, Professional exams, Psychological Factors, Sleep quality.


Background: In our country, medical education is considered a challenging, tough, and stressful process, which is significantly associated with depression, anxiety, and stress, particularly during exam seasons, adversely affecting the sleep quality of medical students. The objective of our study is to evaluate the depression, anxiety and stress levels, and determine their impact on sleep quality of medical students during exams.
Materials and Methods: It was a descriptive cross-sectional study involving 391 students of Rawalpindi Medical University. Data was collected through a questionnaire. The questionnaire consisted of (1) socio-demographic details, (2) Depression, Anxiety and Stress Scale-21(DASS-21), (3) The Pittsburgh Sleep Quality Index (PSQI). Chi-square and t-tests were applied taking P<0.05 as significant. Spearman rho test was applied to measure the strength of association. Data analysis was done via (SPSS) v.23.0.
Results: Out of 391 students, 197 (50.4%) were female while 194 (49.6%) were male. The mean age was 21.63 years (SD=1.59). Fourth-year students (n=117, 29.9%) formed the majority of the participants followed by final-year 108(27.6%), second-year 94 (24%), and third-year 72 (18.4%). 167(42.71%) students suffered from depression, 50.4% from anxiety and 351(89.8%) from stress. Quality of sleep was poorest (PSQI>5) in second-year students with a mean value of 9.72 for global sleep quality. Quality of sleep was significantly associated with anxiety and depression.
Conclusion: Depression, anxiety, and stress are common among second as well as third-year students. Second-year students have the poorest quality of sleep. The sleep quality is significantly associated with anxiety and depression.


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How to Cite
Maqbool S, Sundus O, Khan M, Ihtesham A, Mohamed W, Arshad R. Psychological factors related to professional examinations and their association with sleep quality among Medical students. JRMC [Internet]. 15Jul.2021 [cited 12Aug.2022];25(1):40-7. Available from:

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