Cross-sectional study finds poor sleep common among medical trainees

Poor sleep quality affected 71.7% of participants in a cross-sectional study of 300 university students and medical trainees, with differences in sleep quality and daytime sleepiness found across six groups. The study compared internal medicine residents, surgical residents, interns, clinical medical students, preclinical medical students and non-medical students at the same university. Interns, internal medicine residents and preclinical students had higher adjusted odds of poor sleep quality than controls, while surgical residents reported greater daytime sleepiness than internal medicine residents.

Because the research was observational and did not follow participants over time, it cannot establish that medical training or particular lifestyle habits caused the differences. The preclinical group consisted of first- through third-year medical students who had not yet begun clinical clerkships, while the clinical group had moved beyond that stage. Non-medical controls were undergraduates enrolled in non-medical faculties at the same university.

Researchers measured sleep quality with the Pittsburgh Sleep Quality Index, or PSQI, and classified a score above 5 as poor sleep quality. They assessed daytime sleepiness with the Epworth Sleepiness Scale and perceived stress with the 14-item Perceived Stress Scale. The researchers also collected sociodemographic and lifestyle information, including screen use before sleep and while in bed, eating before sleep and the number of monthly on-call shifts worked by residents.

PSQI scores differed significantly across the six groups, as did Epworth Sleepiness Scale scores, with both comparisons producing p values below 0.001. Perceived-stress scores did not differ significantly, with p = 0.448. After adjustment, interns and residents had higher PSQI scores than the non-medical controls, with all adjusted p values no greater than 0.002.

An age-adjusted multivariable logistic regression estimated higher odds of poor sleep quality for interns than for controls, at 3.12 with a 95% confidence interval of 1.12 to 8.70. Internal medicine residents also had higher adjusted odds, at 3.58 with a 95% confidence interval of 1.29 to 9.90, as did preclinical medical students, at 6.49 with a 95% confidence interval of 1.59 to 26.55. Age was not independently associated with poor sleep quality in that model.

The preclinical estimate had the widest confidence interval of the three reported comparisons, indicating greater uncertainty around its magnitude. The researchers also conducted subgroup, correlation and multivariable analyses of sociodemographic characteristics, lifestyle factors and pre-sleep behaviors. Sleep patterns also differed between the two resident specialties.

Surgical residents had higher PSQI scores than internal medicine residents, with p = 0.035, and higher Epworth Sleepiness Scale scores, with p = 0.008. Among residents, the number of monthly on-call shifts was correlated with PSQI scores at ρ = 0.275 and p = 0.010, representing a modest statistical association between on-call exposure and poorer reported sleep. The authors identified sleep hygiene, screen use in bed, late-night eating and on-call burden as factors associated with poor sleep and therefore as potential targets for interventions.

Subject of Research: Sleep quality, daytime sleepiness and associated factors among medical students, interns and residents

Article Title: Sleep quality across the medical career continuum: a cross-sectional study

Article References: Kasapoglu, U. S., Akkus, E., Danaci, E., Karayusuf, K., Turak, Y., Narin, Y. S., Yalcinkaya, E., Arikan, H., & Karakurt, S. (2026). Sleep quality across the medical career continuum: a cross-sectional study. BMC Medical Education. https://doi.org/10.1186/s12909-026-10375-8

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10375-8

Keywords: sleep quality, medical trainees, medical students, resident physicians, daytime sleepiness, on-call shifts, pre-sleep behaviors, cross-sectional study, Sleep, quality, across, medical