Quality and pattern of sleep and preexamination substance abuse-impact on academic performance in medical students

Abstract

Ambiguity persists regarding the role of chronotype, sleeping patterns, and afternoon naps on academic performance. Very little work has been done on the preexamination severity of insomnia leading to consequent substance abuse, which might further cause a decline in sleep quality, creating a vicious cycle. The aim of our study is to correlate the academic performance of medical students with the severity of preexamination insomnia and substance abuse and their general sleep quality and patterns. This is an observational and descriptive study with prospective longitudinal design. A semi-structured questionnaire, which included several scales pertaining to sleep quality and chronotype, was used to assess the relevant parameters among 710 medical students across several medical colleges of India just before their examinations. They were followed up after 1 month and then after 3 months to assess their academic performance and chronicity of insomnia according to Athens Insomnia Scale. Several statistical tests were conducted between the various dependent variables, and finally, linear logistic multivariate regression analysis was done between the predictors, variables, and the outcome. About 78.6% of students were found to be having generalized poor quality of sleep, while 30.8% were found to be suffering from moderate–severe clinical insomnia before their examination. About 30.4% of the students claimed to be using stimulants while 10.7% claimed to be using some sort of depressant before their examination. Significant correlation was found between preexamination insomnia and substance abuse. No significant correlation was found between our predictor variables and academic outcome. Those with higher degrees of insomnia before examination were found to have a statistically significant chance of developing chronic insomnia.