Chaabane Sonia, Chaabna Karima, Khawaja Salina, Aboughanem Jasmine, Mamtani Ravinder, Cheema Sohaila
J Glob Health. 2025 Apr 25;15:04099. doi: 10.7189/jogh.15.04099.
Sleep disturbances and their associated health issues are common among medical students. Despite this, the epidemiology of sleep disturbances among medical students in the Middle East and North Africa (MENA) region remains inadequately understood. Our objective was to synthesise the prevalence of sleep disturbances, including poor sleep quality, insufficient sleep duration, and excessive daytime sleepiness (EDS), and their variation in relation to academic performance and stress levels.
We performed a systematic review and meta-analysis. Two independent reviewers searched PubMed, Web of Science, Google Scholar, and the reference lists of relevant studies and reviews up to May 2024. We assessed the quality of the included studies using a risk of bias tool. We performed meta-analyses using random-effects models and used Cochran's Q between-subgroups statistic to test for differences across subgroups. We used the I statistic to assess the statistical heterogeneity. Further, we assessed the publication bias using Doi plots.
We included 150 studies conducted in 16 MENA countries. We found that 59.1% of medical students suffer from poor sleep quality (Pittsburgh Sleep Quality Index mean (x̄) = 8.5; 95% confidence interval (CI) = 7.0-10.1), 59.8% have insufficient sleep duration (<7 hours per night) averaging 6.1 hours per night (95% CI = 5.4-6.9), and 38.4% experience EDS (Epworth Sleepiness Scale x̄ = 8.6; 95% CI = 8.0-9.1). Our results indicate a significantly higher prevalence of poor sleep quality among students with moderate or high stress levels during the preclinical training period and in low-income MENA countries. A significantly higher prevalence of insufficient sleep duration was found among students during preclinical academic years. A significantly higher prevalence of EDS was found among students in public medical schools and those in low-income MENA countries. We observed no differences in poor sleep quality and EDS between students with poor and good academic performance.
Our findings highlight the substantial prevalence of sleep disturbances among MENA medical students. Medical schools must address this critical issue with targeted, locally informed, and culturally appropriate interventions. Further research is needed to assess the association between sleep disturbances and identify factors for tailored interventions that mitigate the adverse consequences on medical students' health and well-being.
Open Science Framework BF2A6.
睡眠障碍及其相关健康问题在医学生中很常见。尽管如此，中东和北非（MENA）地区医学生睡眠障碍的流行病学仍未得到充分了解。我们的目标是综合睡眠障碍的患病率，包括睡眠质量差、睡眠时间不足和白天过度嗜睡（EDS），以及它们与学业成绩和压力水平的关系。
我们进行了一项系统综述和荟萃分析。两名独立评审员检索了截至2024年5月的PubMed、科学网、谷歌学术以及相关研究和综述的参考文献列表。我们使用偏倚风险工具评估纳入研究的质量。我们使用随机效应模型进行荟萃分析，并使用 Cochr an Q 亚组间统计量检验亚组间的差异。我们使用 I 统计量评估统计异质性。此外，我们使用Doi图评估发表偏倚。
我们纳入了在16个中东和北非国家进行的150项研究。我们发现，59.1%的医学生睡眠质量差（匹兹堡睡眠质量指数平均值（x̄）=8.5；95%置信区间（CI）=7.0-10.1），59.8%的医学生睡眠时间不足（每晚<7小时），平均每晚6.1小时（95%CI=5.4-6.9），38.4%的医学生有白天过度嗜睡（Epworth嗜睡量表x̄=8.6；95%CI=8.0-9.1）。我们的结果表明，在临床前培训期间以及中东和北非低收入国家，中度或高压力水平的学生中睡眠质量差的患病率显著更高。在临床前学年的学生中，睡眠时间不足的患病率显著更高。在公立医学院校的学生以及中东和北非低收入国家的学生中，白天过度嗜睡的患病率显著更高。我们观察到学业成绩差和学业成绩好的学生在睡眠质量差和白天过度嗜睡方面没有差异。
我们的研究结果凸显了中东和北非医学生睡眠障碍的高患病率。医学院校必须通过有针对性的、基于当地情况和文化适宜的干预措施来解决这一关键问题。需要进一步研究来评估睡眠障碍之间的关联，并确定可定制干预措施的因素，以减轻对医学生健康和福祉的不利影响。
开放科学框架BF2A6。
