ArticlePDF Available

SLEEP PATTERNS OF MEDICAL STUDENTS; THEIR RELATIONSHIP WITH ACADEMIC PERFORMANCE: A CROSS SECTIONAL SURVEY

Authors:

Abstract

Objectives: To identify sleep patterns of medical students and determinethe relationship between sleep habits and academic performance. Background: Humanbeings adopt three different sleeping patterns; monophasic, biphasic and polyphasic. Sleepallows synaptic molding to return by developing faster memory union. When such memoryprocessing is not present, memory keeping is reduced which can have an adverse effecton the academic performance of students. Professional education in the field of medicinerequires learning a greater amount and variety of syllabi to practice as a satisfactory medicalgraduate. Among medical students, the burden of the extensive curriculum often results inthe development of non-recuperative sleeping patterns, which can, in turn, affect their overallacademic performance. This study strives to deduce the sleeping patterns of students and theconnection between those sleeping patterns and academic performance. Study Design: Across-sectional questionnaire based survey. Setting: Jinnah Medical & Dental College, Karachi.Period: 2013. Methods: Sleep patterns of 347 medical students from year 1 -4. The resultsof the midterm examinations were cross-tabulated with the sleep patterns to determine therelationship between them. Results: Our study showed that out of 347 medical students, 38.9%(n=135) had monophasic, 46.7% (n=162) had biphasic and 14.4% (n=50) had a polyphasicsleep pattern. 67.4% of monophasics, 87.0% of biphasics and 66.0% of polyphasics passedtheir midterm examination. Conclusion: Biphasic students performed the best in their midtermexaminations. This is in agreement with scientific proof that sleeping in two phases matchesthe body’s instinctive circadian rhythm, hormonal regulation and memory creation. These twophases are sleeping once at night and having one shorter period during the day. Professionalcolleges should advise and educate students in order to encourage them to acquire adequatesleep through appropriate sleeping patterns by which they may support their academic learning.
Professional Med J 2015;22(7):919-923. www.theprofesional.com
SLEEP PATTERNS OF MEDICAL STUDENTS
919
The Professional Medical Journal
www.theprofesional.com
SLEEP PATTERNS OF MEDICAL STUDENTS;
THEIR RELATIONSHIP WITH ACADEMIC PERFORMANCE: A
CROSS SECTIONAL SURVEY.
Dr. Zeba Saeed1, Dr. Zainab Hasan2, Dr. Maria Atif
ORIGINAL PROF-2898
ABSTRACT… Objectives: To identify sleep patterns of medical students and determine
the relationship between sleep habits and academic performance. Background: Human
beings adopt three different sleeping patterns; monophasic, biphasic and polyphasic. Sleep
allows synaptic molding to return by developing faster memory union. When such memory
processing is not present, memory keeping is reduced which can have an adverse effect
on the academic performance of students. Professional education in the eld of medicine
requires learning a greater amount and variety of syllabi to practice as a satisfactory medical
graduate. Among medical students, the burden of the extensive curriculum often results in
the development of non-recuperative sleeping patterns, which can, in turn, affect their overall
academic performance. This study strives to deduce the sleeping patterns of students and the
connection between those sleeping patterns and academic performance. Study Design: A
cross-sectional questionnaire based survey. Setting: Jinnah Medical & Dental College, Karachi.
Period: 2013. Methods: Sleep patterns of 347 medical students from year 1 -4. The results
of the midterm examinations were cross-tabulated with the sleep patterns to determine the
relationship between them. Results: Our study showed that out of 347 medical students, 38.9%
(n=135) had monophasic, 46.7% (n=162) had biphasic and 14.4% (n=50) had a polyphasic
sleep pattern. 67.4% of monophasics, 87.0% of biphasics and 66.0% of polyphasics passed
their midterm examination. Conclusion: Biphasic students performed the best in their midterm
examinations. This is in agreement with scientic proof that sleeping in two phases matches
the body’s instinctive circadian rhythm, hormonal regulation and memory creation. These two
phases are sleeping once at night and having one shorter period during the day. Professional
colleges should advise and educate students in order to encourage them to acquire adequate
sleep through appropriate sleeping patterns by which they may support their academic learning.
Key words: Sleep patterns, medical students, academic performance
1. MBBS, MPH
Assistant Professor,
Department of Community Health
Sciences, Jinnah Medical & Dental
College.
2. MBBS, MSc.
Assistant Professor,
Department of Community Health
Sciences, Jinnah Medical & Dental
College.
3. MBBS, MPH
Assistant Professor,
Department of Community Health
Sciences, Jinnah Medical & Dental
College.
Correspondence Address:
Dr. Zeba Saeed
Assistant Professor
Department of Community Health
Sciences, Jinnah Medical & Dental
College, 22-23, Shaheed-e-Millat
Road, Karachi 74800
zebasaeed437@gmail.com
Article received on:
20/04/2015
Accepted for publication:
21/05/2015
Received after proof reading:
09/07/2015
Article Citation: Saeed Z, Hasan Z, Arif M. Sleep patterns of medical students; their relationship
with academic performance: a cross sectional survey. Professional Med J
2015;22(7):919-923.
INTRODUCTION
Sleep is an important, reversible and involuntary
action coupled with repeated periods of time
when the person will be awake. It is a source of
diversion from day to day stress and a state of mind
denoted by a temporary lack of consciousness as
well as reduced vigilance and responsiveness.1,2
There is a large variety of duration of sleep
between species, but for humans, eight hours
of good quality sleep at night is important.
There are three different types of sleep patterns;
monophasic (sleeping once for more than 6 hours
every 24 hours), biphasic (sleeping twice every 24
hours) and polyphasic (taking multiple naps per
day). Szymanski (1920) happened to be one of
the rst to describe “polyphasic” sleep activity.
Sleeping for eight hours a day is considered
adequate by experts with a biphasic pattern being
the healthiest.
Most human beings experience anger, lethargy
and inability to concentrate when in need of
sleep.3,4 Partial sleep impecunious (less than
6 hours of sleep per night) can lead to lack of
attention, attentiveness, rememberance, and
judgemental thinking in a person’s day to day
life. Even students who regularly obtain 8 hours
of sleep per night but shift their sleep schedule
by more than 2 hours may experience attention,
Professional Med J 2015;22(7):919-923. www.theprofesional.com
SLEEP PATTERNS OF MEDICAL STUDENTS
920
2
concentration, rationalizing and psychomotor
difculties, as well as increased touchiness,
apprehension, and sadness.5 The sleep-wake
cycle follows a pattern and works in coordination
with other patterns in the human body, for example,
deep body temperature and cellular mitosis.6
Therefore, we inclined to maintain comparatively
non uctuating rourines and sudden changes
in sleep-wake schedules may cause internal
separation among these patterns, which in turn
may cause adverse effects such as dullness or
lethargy, lack of attention, problems in focusing ,
and low performance caliber.
Research in the neurosciences continues to provide
proof that sleep plays a role in the processes
of learning and memory. Combining evidence,
from the molecular to the phenomenological,
undoubtedly conrms that subconscious memory
reprocessing during sleep is an essential part
of how our memories are formed and ultimately
molded.7,8 Therefore sleep has a relevant part
to play in academic learning and memorization.
Alternatively, inadequate sleep and/or irregular
sleeping patterns usually hamper these functions.
Current studies have shown that the type of
sleeping pattern an individual follows has a
substantial impact on the academic performance
of students and their learning abilities. First of all,
poor or inconsistent sleep is often associated
with behavioral and thinking or mental processing
difculties. Secondly, these impairments often
reduce academic achievement and retention.
Finally, this fall in neurocognitive functioning can
easily be reversed by adopting healthy sleep
schedules (xed bedtimes and waking times, no
extended periods of sleep deprivation, etc.)
With regards to the sleep-wake patterns of the
student, the admission of a student at an institute
of higher education is dependant on many
factors that may cause changes in sleep habits,
such as stress of better academic performance,
socialintegrations, and change in sleeping
situations, decrease in parental supervision,
and restless college/university timetables. It is
then easy to understand that, across the years
atinstitution, a lot of students may develop
unhealthy sleep patterns.9 As indicated by the
International Classication of Sleep Disorders
(DCSC, 2001), sleep-wake patterns are usually
followed by unpleasant outcomes during daytime:
reduced levels of motivation, achievement,
ability to focus, awareness and humor, as well
as increase restlessness and lethargy. Hence
it is reasonable to assume that those university
students that develop such sleep patterns may
suffer adverse outcomes in their academic
advancement. However, literature regarding this
particular subject among university students is
hard to nd.10
This study was conducted to ascertain the sleep
pattern of medical students. Furthermore, it
determined the connection between the sleep
patterns and academic performance in a collective
examination conducted within three months of
survey.
MATERIALS AND METHODS
We conducted a questionnaire-based survey of
undergraduate medical students at Jinnah Medical
& Dental College, Karachi, across a timespan of
two months. Students from rst to fourth year
MBBS were included using convenience sampling.
Final year students were excluded due to their
study break. A questionnaire was constructed
which included questions on sleeping pattern,
duration of sleep, problems with recalling and
ability to focus on studies. The questionnaire was
distributed to all 397 enrolled students of these
batches. 347 responders submitted completed
questionnaires through the Student Affairs
Department. Academic performance of students
was evaluated in terms of their performance in
midterm examination which was held within one
month of this survey. Students performance was
measured as Pass (>50% aggregate marks) or
Fail (<50% aggregate marks). Permission to
conduct the study was obtained from the college
administration and Departmental Heads before
the start of study. The participants consent was
obtained and condentiality was assured. Data
was analyzed using SPSS version 16.0 to obtain
descriptive frequencies and cross tabulation of
Professional Med J 2015;22(7):919-923. www.theprofesional.com
SLEEP PATTERNS OF MEDICAL STUDENTS
921
3
sleep patterns with academic performance.
RESULTS
Mean age of the participants was 20±6 months;
male to female ratio was 1:3. Distribution of sleep
patterns is shown in Fig. 1. 50% of the monophasic,
58.2% of biphasic and 32% in polyphasic had
sufcient sleep. 20.4% of monophasic overslept
as compared to 32% of biphasic and 58%
polyphasic, respectively.
Sleep Pattern Academic Performance
Pass Fail
Monophasic 67.4% 32.6%
Biphasic 87.0% 13.0%
Polyphasic 66% 34%
Table-I. Relationship of sleep patterns with academic
performance.
DISCUSSION
Our results show that most students had a
biphasic sleep pattern and most students
with adequate sleep duration had this pattern.
However, they are inclined to oversleep more than
monophasics, but not as much as polyphasics.
Biphasic pattern was also linked with increased
pass percentage, meaning that there were
higher chances of academic improvement. The
second most common pattern happened to be
monophasic; half of the students with this pattern
had sufcient sleep and held the least probability
of oversleeping. The least common pattern was
polyphasic, but these students overslept the
most, which was consistent with insufcient
restful sleep. There was no notable difference
in academic performance between mono and
polyphasic students.
Sufcient sleep duration is necessary for the
best possible performance as it enables medical
students to hold on to information during the
learning process.11 In comparison to other studies,
we observed that the standard requirement for
sleep (6-8hrs) was attained among majority of our
students, indicating difference with other studies
where problems with sleep duration were reported
among medical students.12 Our results were in
line with the research on students in which the
mean sleep duration came out to be 7.7 hours.13
We found that biphasics were able to continue
with ample sleep duration most effectively.
We found that students who sleep enough
are more likely to be biphasics, as compared
to monophasics and polyphasics. Most
possible cause might be recurrent naps among
polyphasics which cause a hurdle in forming a
uniform method and schedule of study. This fact
is also evident in another study conducted with
university students.5 Moreover, our study agreed
with the hypothesis about the importance of rapid
eye movement (REM) sleep and its importance
in memory collection.14 Previous studies showed
that a continuous sleep allows a person to get
the most of REM sleep, therefore a better ability
to remember events. We were able to notice the
same outcome in our students: biphasics had
the most amount of recalling ability. Monophasics
do get a part of REM sleep, but denitely not as
much as biphasics.
As far as polyphasics are concerned, although
they had the highest amount of sleep duration,
however their ability to remember events was
very low, mainly because of absences of constant
REM sleep. In regards to study patterns, it was
noted that a regular study method is benecial
for students as constant reinforcements help in
remembering the events.15
The sleeping pattern of students was not different
Fig-I. Frequency of sleeping patterns
Professional Med J 2015;22(7):919-923. www.theprofesional.com
SLEEP PATTERNS OF MEDICAL STUDENTS
922
on the level of sleepiness they have during study,
a nding already proven by a study conducted
in Pakistan, where most of the students reported
day time sleepiness.16,17 We found that students
having a greater amount of recall actually scored
higher in exams in comparision to those who had
a lower level of recall. This nding is idicative of
a direct link of sleeping patterns with academics.
Depending on the ndings of our study we believe
that the knowledge about sleeping patterns may
be essential for a better understanding of the
academic recall at medical colleges, and may be
used to enhance greater success in academics.
For example, information about sufcient sleeping
methods may help student to learn efciently and
with less wastage of resources including time,
effort, energy and motivation.
As a connection between sleep and academic
performance, it was shown18 that students with
more uniform sleep-wake patterns (shorter sleep
inconsistencies, fewer night awakenings, later
school rise times, earlier rise times on weekends)
reported higher GPA, whereas students with lower
grades reported increased daytime drowsiness,
also as a result of shorter sleeping nights.
Some studies in undergraduates pointed out
that non uniformities of 2-4 hours in the sleep-
wake schedules are linked with greater tiredness,
moodiness and lower level of performance, and
that18,19 students with irregular sleeping schedules
had increased daytime lethargy in comparison to
regular class mates .
It is also necessary that students should have
same timings either for going to bed and rising
up in the morning to avoid disturbance of the
patterns inside the body, as this particular pattern
stability leads to better sleep. Good quality of
sleep is therefore important to enable university
students to understand, resolve and retain huge
amounts of knowledge and information during
study.5
However, researchers who have studied
relationships between sleep hygiene and
applications in nonclinical sub groups and overall
sleep standard have produced variable ndings,
may be because of controversial methods.
CONCLUSION
It is concluded from our study that students
following biphasic sleeping pattern have adequate
sleep and improved academic performance than
students following monophasic and polyphasic
sleeping patterns.
Copyright© 18 May, 2015.
REFERENCES
1. Forster EM., Sleep Matters: The Impact of sleep on
health & well-being. Mental Health Foundation. 2011
http://www.howdidyousleep.org/media/downloads/
MHF_Sleep_Matters_Report.pdf (accessed March
2015)
2. Hill CM., Hogan AM., KarmiloffSmith A. To sleep,
perchance to enrich learning? Archives of Diseases
in Childhood. 2007 Jul; 92(7): 637–643. doi: 10.1136/
adc.2006.096156 http://www.ncbi.nlm.nih.gov/pmc/
articles/PMC2083752/ (accessed march 2015)
3. NHS. Why lack of sleep is bad for your health. National
Health Services. 2012. http://www.nhs.uk/livewell/
tiredness and-fatigue/pages/lack-of-sleep-health-risks.
aspx (accessed March 2015)
4. Shneerson JM., Sleep Medicine;A guide to sleep & its
disorders. Second Edition. UK. Blackwell Publisher.
2005. ( accessed March 2015)
5. Brown FC., Buboltz WC Jr., Soper B. Relationship
of sleep hygiene awareness, sleep hygiene
practices, and sleep quality in university students.
2002 Spring;28(1):33-8. http://www.ncbi.nlm.nih.gov/
pubmed/12244643 (accessed March 2015)
6. Gruber R., Wiebe ST., Wells SA., et. al. Sleep and
academic success: mechanisms, empirical
evidence, and interventional strategies. Adolescent
medicine;state of the art reviews. 2010 Dec;21(3):522-
41, x. http://www.ncbi.nlm.nih.gov/pubmed/21302859 (
accessed March 2015)
7. Stickgold R., Sleep- dependent memory consolidation.
Nature. 2005 Oct 27;437(7063):1272-8. http://www.
ncbi.nlm.nih.gov/pubmed/16251952 ( accessed March
2015)
8. Walker MP., A rened model of sleep and the time
course of memory formation. The Behavioural &
Brain Sciences. 2005 Feb;28(1):51-64; discussion 64-
104. http://www.ncbi.nlm.nih.gov/pubmed/16047457(
4
Professional Med J 2015;22(7):919-923. www.theprofesional.com
SLEEP PATTERNS OF MEDICAL STUDENTS
923
5
accessed April 2015)
9. Allen GA., José T.,Helena AM., Sleep-wake patterns
and academic performance in university students.
University of Lisbon 2002. Paper presented at the
European Conference on Educational Research. T
his document was added to the Education-line database
on 07 October 2002 http://www.leeds.ac.uk/educol/
documents/00002200.htm ( accessed March 2015)
10. American Academy of Sleep Medicine. International
classication of sleep disorders, revised: Diagnostic
and coding manual. Chicago. Illinois.american
Academy of Sleep Medicine 2001. http://www.esst.org/
adds/ICSD.pdf (accessed April 2015)
11. Yang CM., Wu CH., Hsieh MH., et al. Coping with
sleep disturbances among young adults: a survey
of rst-year college students in Taiwan.Behavioural
Medicine. 2003 Fall;29(3):133-8. http://www.ncbi.nlm.
nih.gov/pubmed/15206832 ( accessed April 2015)
12. Ghanizadeh A., Kianpoor M., Rezaei M., et. al. Sleep
patterns and habits in high school students in
Iran. Annals of General Psychiatry. 2008, 7:5 http://
www.annals-general-psychiatry.com/content/7/1/5/(
accessed March 2015)
13. Owens J., Insufcient Sleep in Adolescents and Young
Adults: An Update on Causes and Consequences.
Paediatrics. 2014;134 (3) :pp.921 -e932 http://
pediatrics.aappublications.org/content/134/3/e921.full.
html (accessed March 2015)
14. Tilley AJ., Sleep learning during stage 2 and REM
sleep. Biological Psychology. 1979 Nov;9(3):155-
61.http://www.ncbi.nlm.nih.gov/pubmed/232669(
accessed April 2015)
15. Dembo MH., Eaton MJ., Self- regulation of Academic
Learning in Middle-Level Schools. The Elementary
School Journal. 200;100 (5)
16. Khan UA., Pasha SN., Khokkar SK., Rizvi AA., Sleep
habits and their consequences; A survey. Rawal med
. J Jan June : 2004; 29 ( 1);3-7 http://www.scopemed.
org/?mno=8899 ( accessed April 2015)
17. Shin C., Kim J., Lee S., et al. Sleep habits,
excessive daytime sleepiness and school
performance in high school students. Psychiatry
and Clinical Neurosciences. 2003;57 (4): 451-453
http://onlinelibrary.wiley.com/doi/10.1046/j.1440-
1819.2003.01146.x/full (accessed April 2015)
18. Curcio G., Ferrara M., De Gennaro L., Sleep loss,
learning capacity and academic performance. Sleep
medicine reviews. 2006 Oct;10(5):323-37. Epub 2006
Mar 24. http://www.ncbi.nlm.nih.gov/pubmed/16564189
( accessed March 2015).
19. Fatima K., Rizvi F., Ali M., Afzal M., Sleep Patterns and
Sleep duration of Medical College Students. Annals of
Pakistan Institute of Medical Sciences.2001;7(2):79-81
http://apims.net/Volumes/Vol7 2/Sleep%20Pattern%20
and%20Sleep%20Duration%20of%20Medical%20
College%20Students.pdf (accessed March 2015).
AUTHORSHIP AND CONTRIBUTION DECLARATION
Sr. # Author-s Full Name Contribution to the paper Author=s Signature
1
2
3
Dr. Zeba Saeed
Dr. Zainab Hasan
Dr. Maria Atif
Principal investigator, conception
of design, data collection and
authorship
Data analysis & results, manuscript
preparation and intellectual review.
Literature review and discussion.
... An individual's sleep pattern is defined as the clock-hour schedule/plan of sleep and wake up times including nap habits as well as any sleep disruptions [2]. It is important to study an individual's sleep patterns as they are an indication of one's physiological and psychological performances [3]. Short sleep duration and poor sleep quality cause adverse effects on the body's physiological processes and are associated with increased risk of cardiometabolic disorders [4]. ...
... A study by Al-Abri et al [1] showed that biphasic and polyphasic sleep patterns were associated with short night sleep duration and long siesta and represented fragmented sleep in terms of frequent sleep episodes per day. These behavioral sleep patterns may alter sleep homeostasis and impair the circadian rhythm and can cause sleep phase shift that may negatively affect body physiological functions [3,4]. ...
Article
Full-text available
PurposeTo investigate the agreement in sleep pattern recording by self-reported sleep questionnaires and actigraphy in adults.Methods This is a cross-sectional study. Men and women who met inclusion criteria were recruited for this study. The inclusion criteria were apparently healthy Omani nationals ages 19 to 50 years. Sleep questionnaires were randomly distributed in Muscat either directly or via electronic and paper announcements. Data were collected from the participants using the self-reported questionnaires with four piloted questions for sleep pattern identification and through the actigraphy wristband given to subjects to wear for a week. Cohen’s kappa test was performed for agreement analysis.ResultsA total of 964 Omani subjects between ages 18 and 59 years of both genders were recruited and completed the questionnaires successfully. Out of these, only 321 subjects wore the actigraphy wristband for 1 week (response rate = 33%). Agreement analysis reported a mild level of agreement for the monophasic (41%), moderate level for biphasic (59%), and good level for polyphasic (70%) sleep patterns. The overall agreement level of sleep patterns between the two methods was 57%. There is a low specificity of self-reported assessment in reporting sleep pattern.Conclusion The average agreement level of subjective versus objective assessments of sleep patterns was moderate at 57% and self-reported sleep pattern is not specific. The study recommends the use of actigraphy along with sleep questionnaires for accurate assessment of sleep patterns in cohort studies.
... Poor sleep quality is associated with poor health, as well as an increased risk of cardiovascular and behavioral disorders [9]. It is important to study an individual's sleep patterns as they may affect physiological and psychological performances [10]. It has been previously reported that people in Oman have three major sleeping patterns: monophasic (single episode of sleep per day), biphasic (two episodes of sleep per day), and polyphasic (≥ 3 episodes of sleep per day) [11]. ...
Article
Full-text available
Purpose To describe the effect of seasonal variations on sleep patterns in a hot climate Arab region. Methods This is a cross-sectional study that included healthy Omani subjects of both genders between ages 18 and 59 years. Data for sleep pattern identification in summer and winter were collected from participants using an actigraphy wristband. Results Among 321 participants, in summer seasons, a polyphasic sleep pattern (40%) prevailed over other sleep patterns (P < 0.001). While in the winter season, monophasic sleep (31%) was the dominant pattern (P < 0.001). Subjects slept longer during the winter seasons with total hours of sleep during the day 48 min longer than in the summer, though the difference was not statistically significant (P > 0.05), while siesta duration in the summer was significantly longer (13 min, P < 0.01). In summer, the sleep quality was good (PSQI ≤ 5); however, it was poor (PSQI > 5) in winter (P < 0.05). Night sleep duration, daytime sleepiness, and sleep latency were not statistically different between the summer and winter seasons. Conclusion Sleep patterns may be influenced by seasonal changes. A polyphasic sleep pattern prevailed in summer while a monophasic pattern was the predominant sleep pattern in winter. In summer, the sleep quality was good and the siesta duration was longer compared to the winter.
... It is well known that humans have many different sleep patterns, which are thought to arise from variability in environmental conditions such as warmer climates and industrialization [13]. Research has demonstrated three different types of sleep patterns observed in humans: monophasic, biphasic, and polyphasic [14,15]. Monophasic is defined as one 6-8 hour sleep cycle. ...
Article
Full-text available
Introduction: Neurodegenerative disorders such as Alzheimer’s disease (AD) are increasingly prevalent amongst older populations. Sleep irregularities are one of the chief complaints in people diagnosed with sleep disorders. Sleep has been hypothesized to ensure metabolic homeostasis and remove neurotoxic waste. Inadequate sleep leads to an accumulation of Amyloid-Beta (Aβ) levels which is associated with neurodegenerative diseases including AD and other dementias. Sleep is the driver of the glymphatic system, located in the perivascular space. The glymphatic system eliminates soluble proteins, including Aβ, from the central nervous system; transporting cerebrospinal fluid through the brain; and distributing macromolecules across the brain. This research proposal aims to identify optimal sleep patterns that decrease neurodegeneration by increasing glymphatic system functioning. Methods: This study presents an ad-hoc study conducted over a 6-month period utilizing participants who have reported a family history of AD. Aß accumulation and cortisol levels will be measured to identify signs of neurodegeneration using brain scans, such as Positron Emission Tomography, and blood tests. Other parameters such as memory, energy rating, and sleep latency will be measured. Results: Reduced slow-wave sleep may lead to a disruption in the glymphatic system. Monophasic sleep is said to have the most slow-wave sleep, and least rapid eye movement sleep which is most similar to wakefulness. Therefore, we hypothesize that monophasic sleep will slow neurodegeneration compared to biphasic and polyphasic sleep, contrary to popular belief that biphasic sleep is more beneficial than monophasic sleep. Discussion: In this experiment, we expect to see increased glymphatic clearance after monophasic sleep. There are many factors that can impact sleep patterns and glymphatic clearance including work style, environment, culture, race, sex, and genetic markers for AD. Conclusion: Further research that applies this suggested methodology should account for these variabilities when making conclusions on the optimal sleep pattern for plaque clearance in the brain. This proposal may improve research on AD by identifying the effects different sleep patterns have on the brain and neurodegeneration. Future research may study changes in sleep habits as a preventative measure for individuals who are at risk for or have been diagnosed with AD.
... 7 It was observed that people in the Middle East may have all these kinds of sleep patterns. 8,9 Nevertheless, there is no study confirming the pattern of sleep using an objective method such as actigraphy. ...
Article
Full-text available
Background: Sleep patterns have changed continuously worldwide and it can be influenced by social, cultural, and environmental factors. These patterns may be associated with poor sleep quality and daytime sleepiness. The aim of the study was to investigate sleep patterns and quality in Omani adults using actigraphy. Subjects and methods: This was a cross-sectional study conducted between June 2015 and February 2017. Four hundred subjects agreed to participate in the study (52% male, 48% female). Subjects were randomly selected and enrolled in the study among young adults and middle aged individuals living in the City of Muscat. Subjects were asked to fill-in Epworth sleepiness scale (ESS) and Pittsburgh sleep quality index (PSQI). Actigraphy was used to measure their sleep patterns for one week. Results: The mean age of participants was 32.80±11.50 years. Four sleep patterns were identified: monophasic, bi-phasic (post-dawn), bi-phasic (afternoon siesta), and polyphasic (three sleep periods/24 hours). The study revealed that 35% of participants had biphasic-siesta sleep pattern, 28% polyphasic, 26% monophasic, and 11% biphasic-dawn. The biphasic siesta pattern was found to be associated with younger age group (25-34 years) (P=0.001). Polyphasic sleep was associated with higher ESS score (P=0.001) but not with poor sleep quality (P=0.24). There was no significant difference in night sleep duration among all the sleep patterns (P=0.07) but the polyphasic sleep pattern had higher total 24-hour day sleep duration (P=0.03). Nearly 90% of participants practiced afternoon siestas with mean duration of 45±43 minutes. Conclusion: The predominant sleep pattern among Omanis was biphasic-siesta and majority of people practiced afternoon siesta. Polyphasic sleep pattern is associated with daytime sleepiness.
... The following formulas was used in defining SE: Sleep Efficiency (SE) = TST/TIB×100 13 . Total Sleep time (TST) = night time sleep duration+ daytime nap duration -duration of nocturnal awakenings Time in Bed (TIB) = TST+ time spent in bed before sleep+ time in bed before getting up 12,14,13 . The above mentioned variables were analyzed using SPSS version 20. ...
Article
Full-text available
Objective: To determine the sleep pattern of students as well as to calculate their sleep efficiency. Material and Methods: The study was conducted in the Physiology Department of Khyber Medical College, Peshawar. First and Second Year MBBS students of Khyber Medical College were selected who were above 18 years age.Students were given a self designed questionnaire to fill and then their sleep efficiency (SE) was calculated using total time in bed (TIB) and total sleep time (TST). Results: Total number of students inducted in the study was 115. Their average bedtime and wake up time were midnight and 7.00 AM respectively. The average time in bed was documented as 10 hours. The Total Sleep Time reported was around 7 and a half hours. The average Sleep Efficiency of the students was computed to be 83.9%. Only 1.7% students used sleep-inducing medications, while caffeine consumption was 17%. Students’ perception of their sleep quality and their work efficiency was good, on Likert scale. Conclusions: The average sleep efficiency computed was good when compared to standards around the world. The sleep patterns including bedtime and wakeup time of majority of the students were healthy.
Article
Full-text available
Introduction: Academic performance of medical laboratory students is influenced by multiple factors. All schools, colleges and universities have no worth without students. Students are the most essential asset for any educational institute. The social and economic development of the country is directly linked with student academic performance. The aim of this study is to determine the factors influencing the academic performance of students at the Faculty of Medical Laboratory Science. Material and Methods: • Study Design: A descriptive cross-sectional study. • Study area: Faculty of medical laboratory science/the international university of Africa, Khartoum, Sudan. Duration of Study: from February 2021 to June 2021. A self-administered questionnaire by Google form was being used. Medical laboratory students batch 3 and 4 with a cumulative grade point average (CGPA) of 3.5 (out of 4) were included and compared to medical laboratory students with a CGPA (Less than 2.5) who were available at the time of the study Students in the third and fourth class. Data were analyzed by the SPSS version23. Results: A total of 260 undergraduate medical laboratory students participated in the study.215 of them with a CGPA of 3.5 or more and 45students with a CGPA of less than 2.5. This study showed a statistically significant relationship between performance and, disease or disability of the medical laboratory student him\herself, education level of father, presence of a physician in the family, admission to the faculty whether it is general or private, secondary school certificate type, number of secondary schools examination attempts, sleeping hours per day, attendance to all academic and clinical laboratory activities and students own notes as a primary source of studying (p-value < 0.05). Conclusion: The study, therefore, concluded that students' academic performance could be influenced by some other factors which should be investigated in future research.
Article
Full-text available
Objective: To determine general sleep patterns and sleep duration of medical college students. Materials and Methods: This descriptive study was a survey of students from first year to fourth year MBBS class. Two hundred students voluntarily participated in this study after being explained the nature of the survey. Purposive sampling technique was applied. Questions were asked about their bed time, wake-up time during weekdays and weekends. Students were further asked about study timings and sleep pattern during examination. Results: Results of the study showed that 70% of students during weekdays went to bed after 12:00am. 82% went to bed after 2:00 am during weekends. Duration of sleep of 75% of students was less than six hours during weekdays. 40% of students remained awake the whole night just before examinations. Conclusion: Health Education program regarding duration and quality of sleep should be emphasized in colleges to increase the awareness of students about the importance of adopting healthy sleeping habits, thus leading to improved quality of life and academic performance of our students.
Article
Full-text available
We argue in this article that many educational reforms fail to give sufficient attention to im- proving student learning. An important com- ponent of academic success is students' motiva- tion and ability to take responsibility for their own learning. One way to increase academic performance is to teach students how to become self-regulated learners. We use Zirnmerman's model of academic self-regulation to identify 6 dimensions of behavior that influence learn- ing-motivation, methods of learning, use of time, control of one's physical and social envi- ronment, and performance. This model is unique in that it uses non-subject-matter outcomes of schooling to influence academic performance. We discuss each self-regulatory dimension in terms of the research supporting its effect on ac- ademic performance, as well as the developmen- tal concerns for students in middle-level schools. Finally, we offer suggestions for how teachers can help students acquire self-regulatory skills.
Article
Full-text available
College students are known for their variable sleep schedules. Such schedules, along with other common student practices (e.g., alcohol and caffeine consumption), are associated with poor sleep hygiene. Researchers have demonstrated in clinical populations that improving sleep hygiene knowledge and practices is an effective treatment for insomnia. However, researchers who have examined relationships between sleep hygiene and practices in nonclinical samples and overall sleep quality have produced inconsistent findings, perhaps because of questionable measures. In this study, the authors used psychometrically sound instruments to examine these variables and to counter the shortcomings in previous investigations. Their findings suggest that knowledge of sleep hygiene is related to sleep practices, which, in turn, is related to overall sleep quality. The data from their regression modeling indicated that variable sleep schedules, going to bed thirsty, environmental noise, and worrying while falling asleep contribute to poor sleep quality.
Article
Full-text available
Sleep problems are highly prevalent among young adults and affect different aspects of their quality of life. In this study, the authors aimed to investigate the young adults' coping strategies for these sleep disturbances and the effectiveness of the coping strategies upon sleep quality and daytime sleepiness. The subjects included 1,922 first-year college students, 44% of whom reported experiencing sleep problems, with insufficient sleep being the most common complaint (23.9%). Taking naps and adjusting sleep schedules were the coping strategies associated with better sleep quality. On the other hand, subjects who reported attempting a sleep-promoting activity, ignoring their sleep problems altogether, or trying unsuccessfully to find a way of coping with their sleep problems reported a poorer sleep quality. Although some coping strategies were associated with better sleep quality than others, the levels of daytime sleepiness were equally impaired in all coping groups to a degree that is equivalent to the sleepiness in patients with a moderate sleep-related breathing disorder.
Article
Chronic sleep loss and associated sleepiness and daytime impairments in adolescence are a serious threat to the academic success, health, and safety of our nation's youth and an important public health issue. Understanding the extent and potential short- and long-term repercussions of sleep restriction, as well as the unhealthy sleep practices and environmental factors that contribute to sleep loss in adolescents, is key in setting public policies to mitigate these effects and in counseling patients and families in the clinical setting. This report reviews the current literature on sleep patterns in adolescents, factors contributing to chronic sleep loss (ie, electronic media use, caffeine consumption), and health-related consequences, such as depression, increased obesity risk, and higher rates of drowsy driving accidents. The report also discusses the potential role of later school start times as a means of reducing adolescent sleepiness.
Article
Mounting evidence indicates that sleep is beneficial for learning, memory, attention, and academic success. However, the importance of sleep in these contexts has rarely been addressed in programs aimed at optimizing academic performance. This review aims to describe the role that sleep plays in processes pertaining to academic achievement. We first describe the basic sleep processes and their role with respect to cognitive and behavioral/emotional systems important for academic performance. We next review studies conducted to assess the association between sleep and academic performance, concluding by describing interventional programs being used to optimize sleep in the context of academic success.
Article
Pairs of subjects were presented with a 20-item picture series at bedtime. In the latter part of the night, a tape-recorded series of 10 words, the verbal equivalent of half the original series of pictures, was repeated 10 times during either Stage 2 or REM sleep. Morning recall and recognition for repeated words was found to be facilitated following repetition during Stage 2 sleep, but relatively unaffected following repetition during REM sleep. However, adjusting for recall, the number of additional words elicited through recognition was found to be significantly greater for REM repeated words than for Stage 2 repeated words. It was suggested that retrieval limitations, perhaps as a result of REM state dependency, rather than storage inhibition may be the main locus of the initial recall failure. By comparison, Stage 2 sleep would seem to present both a lower barrier to memory storage and retrieval compatibility with wakefulness.
Article
A questionnaire survey was carried out to examine the sleep habits and excessive daytime sleepiness (EDS) of 3871 high school students with a mean age of 16.8 years in Korea. The results showed that mean total sleep time was 6.3 h/day for male students and 6.5 h/day for female students, which may be insufficient for adolescence during puberty. The overall prevalence of EDS (defined as an Epworth sleepiness scale score of >10) was 15.9% (14.9% for boys and 18.2% for girls). The prevalence of EDS increased significantly (P < 0.001) with a decline in school performance.
Article
Research in the neurosciences continues to provide evidence that sleep plays a role in the processes of learning and memory. There is less of a consensus, however, regarding the precise stages of memory development during which sleep is considered a requirement, simply favorable, or not important. This article begins with an overview of recent studies regarding sleep and learning, predominantly in the procedural memory domain, and is measured against our current understanding of the mechanisms that govern memory formation. Based on these considerations, I offer a new neurocognitive framework of procedural learning, consisting first of acquisition, followed by two specific stages of consolidation, one involving a process of stabilization, the other involving enhancement, whereby delayed learning occurs. Psychophysiological evidence indicates that initial acquisition does not rely fundamentally on sleep. This also appears to be true for the stabilization phase of consolidation, with durable representations, resistant to interference, clearly developing in a successful manner during time awake (or just time, per se). In contrast, the consolidation stage, resulting in additional/enhanced learning in the absence of further rehearsal, does appear to rely on the process of sleep, with evidence for specific sleep-stage dependencies across the procedural domain. Evaluations at a molecular, cellular, and systems level currently offer several sleep specific candidates that could play a role in sleep-dependent learning. These include the upregulation of select plasticity-associated genes, increased protein synthesis, changes in neurotransmitter concentration, and specific electrical events in neuronal networks that modulate synaptic potentiation.