Relations Among Poor Sleep, Anxiety and Depression Among the Students of Health Sciences

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The research in the area of health sciences students’ sleep quality and mood disorders is lacking in Lithuania, as well as other European countries. The aim of this study was to compare prevalence of poor sleep, anxiety and depression among the students according to the study programmes and to assess the relations among poor sleep, depression and anxiety. The study sample consisted of 672 Klaipeda State University of Applied Sciences students (95.5% were female), from 18 to 46 years of age. Sleep quality was evaluated by Pittsburgh Sleep Quality Index, anxiety by Hospital Anxiety and Depression Scale, sociodemographic questions were used. The chi-square test or Fisher exact test was used to estimate association between categorical variables. P-values less than 0.05 were interpreted as statistically significant. Poor sleep was more prevalent among Beauty Therapy (26.4%, 95% CI 22.2-30.56) and Nursing (21.3%, 95% CI 17.42 – 25.17) students, as compared with persons studying in Oral Health programmes (14.8%, 95% CI 11.46 – 18.17), p<0.05. Depression mean score was higher in Beauty Therapy students (4.76), as compared to Oral Health (3.69) students, p<0.05. Beauty Therapy (9.99) or Physiotherapy students (8.24) had higher anxiety mean score, as compared to Oral Health students (7.14), p<0.05. Anxiety mean score was significantly higher (8.45) among the ones with disturbed sleep, as compared to normally sleeping students (5.86), p<0.001. Depression mean score (4.77) was higher among the students having disturbed sleep, as compared to the students which sleep was not disturbed (2.87), p<0.001. Poor sleep and anxiety were more prevalent among the students aged 20 years and older as compared to the students, aged 18 and 19 years. Second and third year students more often had poor sleep or anxiety as compared to the first-year students. Poor sleep and anxiety were more common among Beauty Therapy and Physiotherapy students than among Oral Health Students. Among the students who slept poorly, symptoms of anxiety and depression were statistically significantly more frequent than those students whose sleep was not disturbed. Depression and anxiety mean scores were statistically significantly higher among the students who had poor sleep, as compared to the ones who had normal sleep, in all age and year of studying groups.

1. Ahrberg, K., Dresler, M., Niedermaier, S., Steiger, A., & Genzel, L. (2012). The interaction between sleep quality and academic performance. Journal of Psychiatric Research, 46, 1618-1622.

2. Al-Faris, E. A., Irfan. F., Van Der Vleuten, C. P. M., Naeem, N., Alsalem, A., Alamiri, N., Alraiyes, T., Alfowzan, M., Alabdulsalam, A., Ababtain, A., Aljabab, S., Bukhari, M., Alsinaidi, O., & Alofaisan, Y. (2012). The prevalence and correlates of depressive symptoms from an Arabian setting: A wake up call. Medical Teacher, 34(1), 32-36.

3. Angelone, A. M., Mattei, A., Sbarbati, M., Di Orio, F. (2011). Prevalence and correlates for self-reported sleep problems among nursing students. Journal of Preventive Medicine and Hygiene, 52(4), 201-208.

4. Arora, A., Kannan, S., Gowri, S., Choudhary, S., Sudarasanan, S., & Khosla, P. P. (2016). Substance abuse amongst the medical graduate students in a developing country. The Indian Journal of Medical Research, 143(1), 101–103.

5. Azad, M. Ch., Fraser, K., Rumana, N., Abdullah, A. F., Shahana, N., Hanly, P. J., & Turin, T. Ch. (2015). Sleep Disturbances among Medical Students: A Global Perspective. Journal of Clinical Sleep Medicine, 11(1), 69-73.

6. Beiter, R., Nash R, McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). The prevalence and correlates of depression, anxiety and stress in a sample of college students. Journal of Affective Disorders, 173, 90–96.

7. Buysse, D. J., Reynolds, C. F., Monk, T. H., Berman, S. R., Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index (PSQI): A new instrument for psychiatric research and practice. Psychiatry Research, 28(2), 193-213.

8. Cheung, T., Wong, S. Y., Wong, K. Y., Law, L. Y., Ng., K, Tong, M. T., Wong, K. Y., Ng. M. Y., & Yip, P. S. (2016). Depression, Anxiety and Symptoms of Stress among Baccalaureate Nursing Students in Hong Kong: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 13, 779.

9. Dyrbye, L. N., West C. P, Satele, D., Boone, S., Tan L., Sloan, J., & Shanafelt T. D. (2014). Burnout among U.S. medical students, residents, and early career physicians’ relative to the general U.S. population. Academic Medicine: Journal of the Association of American Medical Colleges, 89(3), 443–451.

10. Elani, H. W., Allison, P. J., Kumar, R. A., Mancini, L., Lambrou, A., & Bedos, C. (2014). A systematic review of stress in dental students. Journal of Dental Education, 78(2), 226–242.

11. Eller, T., Aluoja, A., Vasar, V., & Veldi, M. (2006). Symptoms of anxiety and depression in Estonian medical students with sleep problems. Depression and Anxiety, 23, 250-256.

12. Feng, G., Chen, J., & Yang, X. (2005). Study on the status and quality of sleep-related influencing factors in medical college students. Zhonghua Liu Xing Bing Xue Za Zhi, 26, 328-331.

13. Ghoreishi, A., & Aghajani, A. H. (2008). Sleep quality in Zanjan university medical students. Tehran University Medical Journal, 66, 61-67.

14. Hidalgo, MP., & Caumo, W (2002). Sleep disturbances associated with minor psychiatric disorders on medical students. Neurological Science, 23, 35-39.

15. Hope, V., & Henderson, M. (2014). Medical student depression, anxiety and distress outside North America: a systematic review. Medical Education, 48(10), 963-79.

16. Loyaza, H. M. P., Ponte, T. S., & Carvalho, C. G. (2001). Association between mental health screening by self-report questionnaire and insomnia in medical students. Arquivos de Neuro-Psiquiatria, 59, 180-185.

17. Mazurek, MB., Melnyk, B., Slevin, C., Militello, L., Hoying, J., Teall, A., & McGovern, C. (2016). Physical health, lifestyle beliefs and behaviors, and mental health of entering graduate health professional students: Evidence to support screening and early intervention. Journal of the American Association of Nurse Practitioners, 28(4), 204-211.

18. Misra, R., & McKean, M. (2000). College students’ academic stress and its relation to their anxiety, time management, and leisure satisfaction. American Journal of Health Studies, 16, 41-52.

19. Pacheco, J. P., Giacomin, H. T., Tam, W. W., Ribeiro, T. B., Arab, C., & Italla C. (2017). Mental health problems among medical students in Brazil: a systematic review and meta-analysis. Revista Brasileira de Psiquiatria, 39(4), 369-378.

20. Pagnin, D., De Queiroz, V., Carvalho, Y. T., Dutra, A. S., Amaral, M. B., & Queiroz, T. T. (2014). The relation between burnout and sleep disorders in medical students. Academic Psychiatry, 38, 438-444.

21. Palatty, P. L., Fernandes, E., Suresh, S., & Baliga, M. S. (2011). Comparison of sleep pattern between medical and law students. Sleep Hypnptherapy, 13, 1-2.

22. Pasha, S. N., & Khan, U. A. (2003). Frequency of snoring and symptoms of sleep apnea among Pakistani medical students. Journal of Ayub Medical College Abbottabad, 15, 23-25.

23. Polychronopoulou, A., & Divaris K. (2005). Perceived sources of stress among Greek dental students. Journal of Dental Education, 69, 687–692.

24. Preišegolavičiūtė, E., Leskauskas, D., & Adomaitienė, V. (2010). Associations of quality of sleep with lifestyle factors and profile of studies among Lithuanian students. Medicina, 46(7), 482–489.

25. Rajab, LD. (2001). Perceived sources of stress among dental students at the University of Jordan. Journal of Dental Education, 65(3), 232–241.

26. Sarokhani, D., Delpisheh, A., Veisani, Y., Sarokhani, M. T., Manesh, R. E., & Sayehmiri, K. (2013). Prevalence of depression among university students: a systematic review and meta-analysis study. Depression Research and Treatment, 37, 38-57.

27. Suen, L. K., Hon, K. L., & Tam, W. W. (2008). Association between sleep behavior and sleep-related factors among university students in Hong Kong. Chronobiology International, 25, 760-775.

28. Sherina, M. S., Rampal, L., & Kaneson, N. (2004). Psychological stress among undergraduate medicalstudents. Medical Journal of Malaysia, 59(2), 207-211.

29. Tafoya, S. A., Jurado, M. M., Yepez, N. J., Fouilloux, M., & Lara, M. C. (2013). Sleep difficulties and psychological symptoms in medicine students in Mexico. Medicina,73, 247-251.

30. Veldi, M., Aluoja, A., & Vasar, V. (2005). Sleep quality and more common sleep-related problems in medical students. Sleep Medicine, 6(3), 269-275.

31. Wallace, B., Masiak, J., & Pabis, M. (2013). Depression in medical students: reviewing its prevalence, risk factors, consequences, and management in order to provide student treatment recommendations for the Polish medical education system. Polish Journal of Public Health, 123(3), 259–264.

32. Yusoff, M. S., Abdul, Rahim, A. F., Baba, A. A., Ismail, S. B., Mat, Pa, M. N., & Esa, A. R. (2013). The impact of medical education on psychological health of students: a cohort study. Psychology, Health & Medicine, 18(4), 420-430.

33. Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361-370.

34. Zailinawati, A. H., Teng, C. L., Chung, Y. C., Teow, T. L., Lee, P. N., & Jagmonhi, K. S. (2009). Daytime sleepiness and sleep quality among Malaysian medical students. Medical Journal of Malaysia, 64, 108-110.

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