Daytime sleepiness reflects depression, anxiety, and stress among students at the University of Ghana Medical School

Abstract

Background: Due to high academic demands, many medical students reportedly sleep fewer hours than they would desire. However, the impact of their sleep habits on their mental health is unclear. Objective: This study aimed to determine the level of sleep deprivation among University of Ghana Medical School students and assess the relationship between sleep deprivation and depression, anxiety, and stress. Methods: This cross-sectional study recruited 112 medical students from the University of Ghana Medical School. A series of self-administered questionnaires were used to obtain data from participants. Sleep was assessed using the sleep deprivation index (SDI) and the Epworth sleepiness scale (ESS), whereas mental health status was assessed using the Depression Anxiety Stress Scale (DASS). Results: Males (43.8%, n =49) and females (56.2%, n =63) from both preclinical (39.3%, n = 44) and clinical (61.7%, n =68) years participated in this study. Self-reported sleep duration was 5.6±0.12 hours on weekdays and 7.2 ± 0.13 hours on weekends, resulting in an SDI of 1.56 ± 0.12 hours. Regarding daytime sleepiness, 53.8% of the participants were classified as normal, 31.3%as excessive, and 15.1% as severe on the ESS. When compared to students with normal daytime sleepiness, students with severe daytime sleepiness scored significantly higher on measures of depression (3.4 ± 0.4 vs 6.9 ±0.6), anxiety (3.9± 0.5versus 8.0± 0.8) and stress (2.7 ± 0.5versus6.9 ± 0.9). The evidence indicated a weak positive correlation between daytime somnolence, as measured by the DASS, and depression, anxiety, and stress (r2= 0.199, p< 0.0001). However, there was no correlation between these mental health conditions and sleep deprivation (r2= 0.020, p= 0.1). Further analysis revealed that daytime sleepiness significantly predicted depression, anxiety, and stress, as measured by the DASS. Conclusion: Our findings showed that sleep deprivation among medical students could lead to daytime sleepiness and an increased risk of developing depression, anxiety, and stress. Furthermore, daytime sleepiness was predictive of the mental health status of the study participants