Patterns and Predictors of Sleep Disturbances among Nigerian Medical Students: A Cross-Sectional Study

Abstract

Background: Sleep disturbances represent a critical yet under-addressed public health challenge among medical students globally, with particular significance in resource-constrained settings like Nigeria. These disturbances compromise cognitive function, academic performance, mental health, and the long-term professional competency of future healthcare providers. Sleep disturbances represent a critical yet under-addressed public health challenge among medical students globally, with particular significance in resource-constrained settings like Nigeria, where they compromise cognitive function, academic performance, mental health, and long-term professional competency. Objectives: This study aimed to determine the prevalence, describe the detailed patterns (type, frequency, chronicity), and identify key socio-demographic and academic predictors of sleep disturbances among medical students at a Nigerian public university. Methods: The study design is cross-sectional. An analytic cross-sectional study was conducted among 381 undergraduate medical students at Rivers State University, selected via stratified random sampling. Data were collected using a structured, self-administered questionnaire incorporating the Pittsburgh Sleep Quality Index (PSQI) and items on specific sleep disturbance patterns. Sleep disturbance was defined as a global PSQI score >5. Data were analyzed using SPSS version 25. Descriptive statistics outlined patterns. Bivariate analysis (Chi-Square Test) and multivariate binary logistic regression were used to identify independent predictors, with statistical significance set at p < 0.05. Results: The prevalence of clinically significant sleep disturbance was 48.3%. Predominant patterns included abnormal sleep duration (<7 hours) affecting 90.3% of all participants, nocturia-related awakenings (69.3%), sleep maintenance insomnia (65.6%), and severe daytime dysfunction (67.5%). A striking 93.2% of students with sleep onset insomnia reported symptoms persisting for over six months, indicating chronicity. In multivariate analysis, being in the clinical academic phase (300L-600L) (adjusted odds ratio [AOR] = 2.1, 95% CI: 1.3-3.4) and female gender (AOR = 1.7, 95% CI: 1.1-2.6) emerged as significant independent predictors of sleep disturbances (Nagelkerke R² = 0.095). Conclusion: Sleep disturbances are highly prevalent, chronic, and multifaceted among Nigerian medical students, with those in clinical years and female students being at greatest risk. These findings necessitate a structured public health response within medical education, including mandatory integration of sleep hygiene education, gender-sensitive support programs, and institutional policy reviews.