Association of Sleep Quality and Stress with Academic Performance among Undergraduate Dental Students of Bhubaneswar, India

Nagarajappa, Ramesh; Mohapatra, Upasana; Satyarup, Dharmashree; Panda, Sailaja

doi:10.1590/pboci.2024.064

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 24 • 2024 • https://doi.org/10.1590/pboci.2024.064 copy

Association of Sleep Quality and Stress with Academic Performance among Undergraduate Dental Students of Bhubaneswar, India

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To assess sleep quality and stress level and to analyze their effect on the academic performance of undergraduate dental students.

Material and Methods:

A cross-sectional descriptive survey was conducted among 234 undergraduate dental students at Bhubaneswar. Pittsburgh Sleep Quality Index (PSQI), consisting of 18 items rated on a 4-point Likert scale, assessed sleep quality. Kessler Psychological Distress Scale (K10) evaluated the stress level. Google Forms collected demographic details and marks obtained in their previous examination. Chi-square, Mann-Whitney U, Kruskal-Wallis tests, and Spearman correlation coefficient were used for analysis (p≤0.05).

Results:

Mean PSQI and K10 scores were 4.87±4.5 and 17.60±8.5, respectively. 38% of students had poor sleep quality, and mean actual sleep hours were 8.01±1.7. One-fourth (24.8%) of subjects had moderate to severe stress. Sleep quality significantly differed among the various academic years (p=0.001). A post-hoc test showed a difference between 1^st and 2^nd-year students and 1^st and 4^th-year students. A statistically significant difference between genders regarding the components of the K10 scale was observed. A non-significant positive correlation between total marks and K10 score and a negative correlation between marks and global PSQI score was found.

Conclusion:

Sleep quality and stress harm the academic performance of dental students.

Keywords:
Sleep Quality; Stress, Psychological; Students, Dental; Academic Performance

Variables	N (%)
Gender
Males	83 (35.5)
Females	151 (64.5)
Academic year
First-Year	67 (28.6)
Second Year	54 (23.1)
Third Year	43 (18.4)
Fourth-Year	49 (20.9)
Interns	21 (9.0)
Percentage of marks obtained in the last examination
35-54	33 (14.1)
55-74	134 (57.3)
≥ 75	67 (28.6)

Variables	Poor	Moderate	High	p-value
Variables	N (%)	N (%)	N (%)	p-value
Gender				0.767
Males	13 (39.4)	45 (33.6)	25 (37.3)
Females	20 (60.6)	89 (66.4)	42 (62.7)
Academic year				0.001^* * Statistically Significant.
First Year	7 (21.2)	43 (32.1)	17 (25.4)
Second Year	0 (0.0)	23 (17.2)	31 (46.3)
Third Year	8 (24.2)	34 (25.4)	1 (1.5)
Fourth-Year	11 (33.3)	29 (21.6)	9 (13.4)
Interns	7 (21.2)	5 (3.7)	9 (13.4)

Components of PSQI	Gender		p-value	Academic Year (Mean±SD)					p-value
Components of PSQI	Males Mean±SD	Females Mean±SD	p-value	First Year Mean±SD	Second Year Mean±SD	Third Year Mean±SD	Fourth Year Mean±SD	Interns Mean±SD	p-value
Subjective Sleep Quality	0.19±0.48	0.33±0.66	0.16	0.24±0.53	0.31±0.69	0.37±0.69	0.24±.0.56	0.24±0.54	0.89
Delays in Falling Asleep	1.02±0.87	1.04±0.94	0.95	0.88±0.86	1.09±0.88	1.05±0.98	1.10±0.92	1.19±1.08	0.57
Sleep Duration	0.35±0.67	0.34±0.72	0.71	0.18±0.52	0.46±0.79	0.33±0.68	0.41±0.76	0.48±0.87	0.22
Efficiency and Effectiveness of Sleeping	0.64±0.77	0.75±1.01	0.81	0.37±0.83	0.89±1.02	0.70±0.83	0.96±0.91	0.81±0.98	0.001^* * Statistically Significant.
Sleep Disorders	1.13±0.76	1.21±0.71	0.54	1.12±0.62	1.24±0.76	1.28±0.83	1.10±0.62	1.24±0.94	0.78
Hypnotic Drugs	0.29±0.74	0.42±0.87	0.21	0.30±0.76	0.43±1.86	0.47±0.96	0.39±0.81	0.29±0.72	0.81
Inadequate Performance Throughout the Day	0.81±1.24	1.00±1.38	0.37	0.88±1.20	0.87±1.40	1.16±0. 1.51	0.82±1.20	1.05±1.49	0.84
Global PSQI Score	4.43±3.97	5.11±4.72	0.58	3.97±3.57	5.30±4.87	5.35±4.97	5.02±4. 15	5.29±5.57	0.66

K10 Components	Gender		p-value	Academic Year					p-value
K10 Components	Males Mean±SD	Females Mean±SD	p-value	First Year Mean±SD	Second Year Mean±SD	Third Year Mean±SD	Fourth Year Mean±SD	Interns Mean±SD	p-value
During the last 30 days, how often do you feel tired for no reason?	1.75±1.07	2.22±1.19	0.001^* * Statistically Significant.	1.90±1.14	2.04±1.13	2.23±1.13	2.16±1.18	1.95±1.07	0.51
During the last 30 days, how often do you feel nervous?	1.61±1.06	1.89±0.99	0.003^* * Statistically Significant.	1.78±0.99	1.85±1.12	1.86±0.89	1.80±0.98	1.52±0.98	0.59
During the last 30 days, how often do you feel so nervous that nothing could calm you down?	1.42±0.87	1.56±0.86	0.071	1.40±0.74	1.54±0.97	1.42±0.63	1.69±0.98	1.57±0.21	0.47
During the last 30 days, how often do you feel hopeless?	1.63±1.13	1.90±1.05	0.003^* * Statistically Significant.	1.81±1.16	1.76±1.18	1.95±1.06	1.73±0.93	1.71±1.06	0.53
During the last 30 days, how often do you feel restless and guilty?	1.64±1.05	1.75±0.97	0.148	1.64±0.85	1.81±1.25	1.63±0.87	1.76±1.03	1.71±1.01	0.99
During the last 30 days, how often did you feel so restless that you could not sit still?	1.39±0.79	1.51±0.82	0.127	1.48±0.80	1.41±0.77	1.37±0.76	1.59±0.96	1.48±0.68	0.73
During the last 30 days, how often do you feel depressed?	1.67±1.16	1.93±1.17	0.020^* * Statistically Significant.	1.96±1.23	1.65±1.07	2.00±1.18	1.80±1.15	1.76±1.22	0.42
During the last 30 days, how often do you feel that everything was an effort?	1.67±1.04	2.04±1.17	0.008^* * Statistically Significant.	2.01±1.27	1.74±1.07	1.98±1.14	1.86±1.00	2.00±1.18	0.74
During the last 30 days, how often do you feel that nothing could cheer you up?	1.48±1.03	1.88± 1.11	0.001^* * Statistically Significant.	1.81±1.23	1.57±1.06	1.86±1.10	1.69±0.85	1.81±1.29	0.41
During the last 30 days, how often do you feel worthless?	1.51±1.03	1.93±1.28	0.003^* * Statistically Significant.	1.85±1.38	1.63±1.14	1.79±1.13	1.78±1.05	1.90±1.41	0.66
Total K10 Scores	15.77±8.51	18.61±8.31	0.001^* * Statistically Significant.	17.63±8.95	17.00±8.82	18.12±7.48	17.86±8.19	17.43±9.28	0.56

Variables	Global PSQI Score		p-value	K10 Score				p-value
Variables	Good Sleep Quality (PSQI < 5)	Poor Sleep Quality (PSQI ≥ 5)	p-value	No Distress (K10 < 20)	Mild Distress (K10 20-24)	Moderate Distress (K10 25-29)	Severe Distress (K10 ≥ 30)	p-value
Gender
Males	53 (63.9)	30 (36.1)	0.68	71 (85.5)	2 (2.4)	3 (3.6)	7 (8.4)	0.019
Females	92 (60.9)	59 (39.1)		105 (69.5)	19 (12.6)	13 (8.6)	14 (9.3)
Academic Year
First-Year	48 (71.6)	19 (28.4)	0.407	50 (74.6)	3 (4.5)	7 (10.4)	7 (10.4)	0.810
Second Year	31 (57.4)	23 (42.6)		43 (79.6)	3 (5.6)	3 (5.6)	5 (9.3)
Third Year	24 (55.8)	19 (44.2)		31 (72.1)	6 (14.0)	2 (4.7)	4 (9.3)
Fourth-Year	29 (59.2)	20 (40.8)		36 (73.5)	7 (14.3)	3 (6.1)	3 (6.1)
Interns	13 (61.9)	8 (38.1)		16 (76.2)	2 (9.5)	1 (9.0)	2 (9.5)
Total	145 (62.0)	89 (38.0)		176 (75.2)	21 (9.0)	16 (6.8)	21 (9.0)

Spearman's rho		Marks Obtained in the Last Examination	Global PSQI Score	K10 Score
Marks Obtained in the Last Examination	Correlation Coefficient	1.000	0.029	-.015
Marks Obtained in the Last Examination	p-value	1.000	0.663	0.823
Global PSQI Score	Correlation Coefficient	0.029	1.000	0.523
Global PSQI Score	p-value	0.663	1.000	0.001
K10 Score	Correlation Coefficient	-0.015	0.523	1.000
K10 Score	p-value	0.823	0.001

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[1] Corresponding author: Upasana Mohapatra E-mail: upasanamohapatra.um@gmail.com