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. 2025 Aug 12;25(1):2740.
doi: 10.1186/s12889-025-23719-8.

Sleep quality among clinical postgraduate students: a cross-sectional study in Kerala, India

Gopinathan Bhaskaran Gopika  1 , G K Mini  2   3 , Ameer Ameera  1 , R Parvathi  1 , P K Malavika  1 , Reshma George  1 , Kamala Swarnam  1   4 , Marthanda Pillai A  1   5
Affiliations

Sleep quality among clinical postgraduate students: a cross-sectional study in Kerala, India

Gopinathan Bhaskaran Gopika et al. BMC Public Health. .

Abstract

Background: Sleep disturbances and stress are common among postgraduate medical students, adversely affect their physical and mental health, academic performance, and patient care. However, the existing evidence does not provide a comprehensive understanding of sleep pattern of medical students in India. We studied sleep pattern and associated factors of clinical medical postgraduate students in Kerala state of India.

Methodology: This cross-sectional study assessed sleep patterns, lifestyle behaviors, and stress levels among 150 postgraduate medical students (aged between 25 and 44 years) from four medical institutions (one government and three private) in Kerala, India. Data were collected using a pretested structured questionnaire. Questions regarding socio-demographics, work pattern and lifestyle factors were also included. We used Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, and the Perceived Stress Scale-10 (PSS-10) to measure stress levels. Both bivariate and multivariate analysis were performed.

Results: The prevalence of poor sleep quality was 62.7% (95% confidence interval (CI): 54.4-70.4%), based on the PSQI. Stress levels, measured by the PSS-10, reported that 10.7% (95% CI: 6.2-16.7%) had severe stress. Medical specializations, lack of exercise, family relationship challenges, social anxiety, and severe stress were significantly associated with poor sleep. Those who were having severe stress were more likely to report poor sleep quality compared to their counterparts (adjusted odds ratio (AOR):11.61, CI:1.35-99.39). Medical post graduates were more likely to report poor sleep quality compared to the surgical specialty (AOR: 2.27, CI:1.06-4.87).

Conclusion: Poor sleep quality and stress are highly prevalent among postgraduate medical students in Kerala. Better management of sleep hygiene by physicians is likely to increase the advice and treatment provided for their patients' sleep quality.

Keywords: India; Kerala; Lifestyle behaviors; Postgraduate medical students; Sleep quality; Stress.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical clearance was obtained from the Institutional Ethics Committee (IEC) of Ananthapuri Hospitals and Research Institute, Thiruvananthapuram, Kerala (Ref no-AHRI/EC/208/Jan 2024 dated January 26, 2024). Both verbal and written informed consent was obtained from the respondents. In the participant information sheet, respondents were informed of the study’s goal, confidentiality, and their right to decline or withdraw at any time. The study adhered to all the ethical procedures as outlined in the Helsinki declaration. Consent for publication: No consent to publish was needed for this study as the researchers did not use any details, images or videos related to individual participants. Competing interests: The authors declare no competing interests.

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