Association between Sleep Quality and Perceived Stress Responses Among Medical University Students

Abstract

Medical education is associated with a heavy academic workload, irregular schedules, and chronic psychological pressure, all of which place medical students at high risk of poor sleep quality and elevated stress. Understanding the relationship between these two variables is essential for designing effective student-well-being interventions. This study aimed to assess sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to examine its correlation with perceived stress level among undergraduate medical students. A cross-sectional study was conducted among 106 medical students at the Faculty of Medicine, Tobruk, Libya. Sleep quality was assessed using the seven components and global score of the PSQI, and stress was measured using a validated stress assessment scale. Descriptive statistics (mean ± standard deviation) were calculated for each PSQI component and for PSQI-based sleep-quality categories. Pearson correlation was used to examine the relationship between the total PSQI score and stress level. The mean global PSQI score indicated a generally poor sleep profile, with sleep latency (2.02 ± 0.98) and sleep disturbances (1.38 ± 0.65) being the most affected components. Only 28 students (26.4%) had good sleep quality (PSQI 0–5), while 47 (44.3%) had poor sleep quality (PSQI 6–10) and 31 (29.2%) had very poor sleep quality (PSQI ≥ 11). A strong, statistically significant positive correlation was found between PSQI score and stress level (r = 0.807, r² = 0.651, p < .001). Poor sleep quality is highly prevalent among the medical students studied and strongly associated with elevated stress levels.