The need to prevent sleep disorders in medical students as an important aspect of health protection

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Introduction.
Sleep is a complex physiological process. It contributes to the recovery of the organism and fulfils anti-stress and adaptation functions. Sleep efficiency and quality are closely related to the activity of cognitive processes and the ability to learn [0].
Sleep is a component of a healthy lifestyle, and its disruption can lead to the development of a number of adverse effects [1]. Thus, in a one-week modelling of sleep deprivation, respondents showed a significant decrease in cognitive abilities, as well as the development of hypotonia [2]. No less significant consequences were studied by scientists from Saudi Arabia. They traced a reliable mutual correlation between the quality of sleep and the level of emotional exhaustion. Thus, each of the studied parameters could occur, both primary and secondary. In students with medium level of stress, sleep quality disturbance was 10 times more frequent, and with high level of stress 24 times more frequent, compared to respondents with low level of stress. The negative impact of these factors on academic performance has also been traced [3].A number of studies have found that medical university students have more pronounced sleep problems than the general population in their age group. The reasons for this may include higher levels of stress and emotional strain, as well as reduced sleep duration. According to the results of screening monitoring, a reliable relationship between sleep quality and anxiety of respondents, as well as between the level of anxiety and sleep duration was established [4, 5].The International Association of Sleep Medicine (WASM) has identified the main components of healthy sleep - duration, integrity, depth [6]. Consequently, the assessment of each of these components, as well as their totality, is an important aspect in interpreting the results. Timely detection of sleep component disorders, as well as the development of innovative methods of prevention, is an urgent task of modern medicine, in particular hygiene and medical prevention.

Purpose of work.To assess the quality and duration of sleep of medical university students at the beginning of autumn and spring semesters.

Materials and methods of the study. The study involved students of N.N. Burdenko VSMU, studying from the 1st-4th year of medical, paediatric and dental faculties. Sleep quality was studied in two stages - at the beginning of the autumn semester (n=46 (67.4% girls and 32.6% boys)) and at the beginning of the spring semester (n=35 (82.9% girls and 17.1% boys)).The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. It included 19 questions, represented by a self-assessment block and a block of respondent's sleep assessment by a partner or neighbour, if available.From the 19 proposed questions, 7 components of sleep quality (k) were formed. K- 1- subjective assessment of sleep quality, k- 2- sleep latency, k- 3- sleep duration, k- 4- sleep efficiency, k- 5- sleep disturbance, k- 6- use of sleeping medication, k- 7- daytime dysfunction. Each component was scored 0-3, depending on the selected answers to the list of questions asked. 0- indicates no impairment in the component, 1- minor impairment, 2- severe impairment, 3- severe impairment. At the end of the calculation of components, the sum of scores k- 1 - k- was evaluated. The sum from 0-4 indicates no sleep quality disorders, from 5 and above - problems with sleep quality [7].The distribution of data was assessed using the Shapiro-Wilk criterion. The indicators were compared between each other using Pearson's Chi-square. Statistical processing of the data was carried out in the programme StatTech v. 4.0.7 (developer - StatTech LLC, Russia).

Results of the study. A comparison of the results of two groups of students was performed: the first group, tested at the beginning of the autumn semester and the second group, tested at the beginning of the spring semester.In order to determine the quality of sleep, its components were calculated. K-1 represented the self-assessment of sleep quality. Analysing the data obtained, it can be noted that only 4.3% of the participants of the first group of the study and 5.7% of the second group of the study had a rating of "very good", "very bad" had 2.2% and 11.4% respectively. It is important to note that the majority of those tested rated their sleep quality as "good enough". K- 2 - sleep latency - time spent on falling asleep, the acceptable value is 15 minutes. Only 67.4% and 45.7% of the respondents did not have sleep latency, and some of the testees, namely 17.4% and 28.6%, noted that they could not fall asleep for more than 30 minutes.K-3 - sleep duration did not differ significantly in both groups. The shortest duration of sleep was recorded in the first group and was 3 hours, while in the second group this value was an hour longer. The maximum duration reached 10 hours. The majority of students had a sleep duration of less than 8 hours, namely 82.6% and 77.1% of respondents respectively. Analysing K-4, it was found that the majority of students have effective sleep, namely 84.8% and 94.3% of students. Expressed and serious problems were found only in 11.9% and 5.2% of students.When studying K-5, sleep disturbance of different degrees of severity was found in 100% and 85.7% of students studying in a medical university. In our opinion, it is also important to note that statistically significant differences (p< 0.020) were found when assessing K-5 depending on the study group.When answering the question "How often have you used sleeping medications?", the majority of the respondents, namely 91.3% and 82.9% of the first and second group respondents respectively, answered "Not once during the last month". The answer "three or more times a week" was chosen by 4.4% and 5.7% of students. It is important to note that the frequency of use of sleeping pills in the studied students was approximately equal to medical students from other countries, for whom the frequency of use corresponded to 5.7% and 9% [8].When considering K-7, it was noted that pronounced and serious daytime dysfunction was observed in half of the subjects, namely 47.8% and 54.3%, with only 15.2% and 14.3% of the respondents having no problems. To determine the sleep quality index, the sum of the scores for components 1-7 was calculated. The absence of sleep quality disorders was found in 26.1% and 31.4% of respondents, while sleep problems of varying degrees of severity were found in the majority of medical university students, namely in 73.9% and 68.6% of test participants. It is important to note that the majority of students with sleep quality problems are female, namely 70.6% (p=0.488) and 87.5% (p=0.352). These results are in line with other studies where the female gender is a risk group for sleep quality disorders [9].

Conclusion. It was found that the duration and quality of sleep of medical university students is insufficient regardless of the period of the academic year. Violations in components and total index were found in the majority of students. It was also revealed that in the second half of the academic year its disorders develop to a greater extent, compared to the first one. Of particular interest are the data indicating the propensity to disturb sleep quality in female students.

 

About the authors

Maxim Valeryevich Popov

N.N. Burdenko Voronezh State Medical University

Email: sportandorthodox@mail.ru
ORCID iD: 0000-0002-1480-4013
SPIN-code: 4302-5811

first-year postgraduate student of the Department of Health Management

Russian Federation, 10 Studencheskaya St., Voronezh, 394036, Russia

Olga Andreevna Zubkova

N.N. Burdenko Voronezh State Medical University

Email: oaz.zubkova03@mail.ru
ORCID iD: 0000-0002-2544-6610
SPIN-code: 4534-8840

student

Russian Federation, 10 Studencheskaya St., Voronezh, 394036, Russia

Natalia Evgenievna Nekhaenko

N.N. Burdenko Voronezh State Medical University

Author for correspondence.
Email: nehaenko_natalia@mail.ru
ORCID iD: 0000-0002-5916-3248
Scopus Author ID: 394946

Doctor of Medical Sciences, Professor, Head of the Department of Health Care Management, N.N. Burdenko Voronezh State Medical University.

Russian Federation, 10 Studencheskaya St., Voronezh, 394036, Russia

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