Center for Cognition and Brain Sciences, University of Macau, Macao SAR, China.
The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders Beijing Anding Hospital & the Advanced Innovation Center for Human Brain Protection, School of Mental Health, Capital Medical University, Beijing, China.
Sleep Breath. 2020 Sep;24(3):1151-1165. doi: 10.1007/s11325-020-02020-5. Epub 2020 Feb 18.
Poor sleep quality is common in medical students and is associated with a number of negative health outcomes. However, the prevalence estimates of poor sleep quality in medical students vary widely across studies. We thus conducted a meta-analysis of the prevalence of poor sleep quality and its mediating factors in medical students.
A systematic literature search of PubMed, EMBASE, Web of Science, PsycINFO, and Medline Complete was performed. The random-effects model was used to analyze the pooled prevalence of poor sleep quality and its 95% confidence intervals (CIs).
A total of 57 studies with 25,735 medical students were included. The pooled prevalence of poor sleep quality was 52.7% (95% CI: 45.3% to 60.1%) using the Pittsburgh Sleep Quality Index (PSQI). The pooled mean total PSQI score across 41 studies with available data was 6.1 (95% CI: 5.6 to 6.5). Subgroup analyses found that PSQI cutoff value and study region were associated with the prevalence of poor sleep quality (P = 0.0003 VS. P = 0.005). Across the continents, poor sleep quality was most common in Europe, followed by the Americas, Africa, Asia, and Oceania. Meta-regression analyses found that smaller sample size (slope = - 0.0001, P = 0.009) was significantly associated with higher prevalence of poor sleep quality.
Poor sleep quality is common among medical students, especially in Europe and the Americas continets. Due to the negative health outcomes, regular screening of poor sleep quality and effective interventions are needed for medical students.
医学生睡眠质量差较为常见，与许多负面健康结果相关。然而，不同研究中，医学生睡眠质量差的患病率估计值差异较大。因此，我们对医学生睡眠质量差的患病率及其中介因素进行了荟萃分析。
对 PubMed、EMBASE、Web of Science、PsycINFO 和 Medline Complete 进行了系统文献检索。采用随机效应模型分析了睡眠质量差的汇总患病率及其 95%置信区间（CI）。
共纳入 57 项研究，包含 25735 名医学生。采用匹兹堡睡眠质量指数（PSQI），睡眠质量差的汇总患病率为 52.7%（95%CI：45.3%至 60.1%）。在 41 项具有可用数据的研究中，PSQI 总分的汇总均值为 6.1（95%CI：5.6 至 6.5）。亚组分析发现，PSQI 截断值和研究区域与睡眠质量差的患病率相关（P=0.0003 与 P=0.005）。在各大洲中，欧洲的睡眠质量差最常见，其次是美洲、非洲、亚洲和大洋洲。元回归分析发现，样本量较小（斜率=-0.0001，P=0.009）与睡眠质量差的患病率较高显著相关。
医学生睡眠质量差较为常见，尤其是在欧洲和美洲。由于不良健康后果，需要定期筛查医学生的睡眠质量差，并采取有效的干预措施。
