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Impact of chronotype and sleep quality on academic performance in medical students: which phase of the course is most critical?


Sleep disorders have a high prevalence in college students, especially in medical students, and are related to impairments in physical, cognitive and mental health.


To evaluate the sleep of medical students and to establish their possible correlations with academic performance parameters across the phases of the medical course.


This is a cross-sectional observational field study which was conducted with 250 medical students from a university, located in the city of João Pessoa, Brazil, from February to April 2019. Participants were divided into three groups according to the phase of the medical course: basic and clinical cycles and internship. The Pittsburgh Sleep Quality Index (PSQI) and the Morningness-Eveningness Questionnaire (MEQ) were used for the evaluation of sleep variables. Specific questionnaires for the evaluation of sociodemographic, general health and academic performance variables were also used, including the Student Revenue Coefficient, an attitudinal evaluation and the grade regarding a learning check of a discipline randomly chosen in each semester.


The medical students of the present study were characterized by mean age of 22,78 (± 4,71) years, intermediate chonotype in MEQ (48,28 ± 10,49 points), poor sleep quality in PSQI (7,31 ± 3,41 points), sleep latency of 26,22 (± 25,49) minutes, sleep duration of 6h13min (± 1h09min), mean sleep onset time of 23h30min (± 1h10min) and mean wake-up time of 6h15min (± 1h02min). There was no statistically significant relationship between the PSQI total score and the academic performance measures from the total sample and between the course phases. However, sleep latency, sleep onset and end times, and the MEQ score correlated with academic performance [(r=-0,152; p=0,026) (r=-0,136; p=0,047) (r=-0,15; p=0,036) (r=0,178; p=0,008), respectively]. Similar results were found in the basic cycle, except for the time of end of sleep [(r=-0,301; p=0,005) (r=-0,246; p=0,035) (r=0,288; p=0,004), respectively].


It was observed that medical students have poor sleep quality, so those students who have a higher sleep latency, sleep later and have a lower MEQ score presented a lessened academic performance, especially in the basic cycle of the medical course. Higher attention to medical students should be offered by educational institutions, aiming at minimizing the health problems caused by sleep disorders.


Sleep. Sleep wake disorders. Academic performance. Students, medical.


Área Básica


Centro Universitário de João Pessoa - Paraiba - Brasil, Universidade Federal do Rio Grande do Norte - Rio Grande do Norte - Brasil


Cloací Leal Rodolfo Martins Filho, Byanca Eduarda Silva de Arruda, Elce Correia Cabral da Silva, Júlia Elizabeth Nagrad de Farias Albuquerque, Maria Luiza Silva Normandes, Catarina Zulmira Souza de Lira, Mario André Leocadio Miguel, John Fontenele Araújo, Patrícia Vidal Negreiros Nóbrega