The relationship between sleep quality and nomophobia among medical students

Medical students often experience sleep disturbances and maladaptive behavioral patterns, such as problematic smartphone use and nomophobia, due to the demanding nature of their studies and the stressful academic environment. This study aimed to evaluate the prevalence of poor sleep quality among medical students at Kermanshah University of Medical Sciences in western Iran, identify associated factors, and explore its relationship with nomophobia. By focusing on this population, we aim to highlight the unique challenges medical students face concerning their sleep health.

This descriptive-analytical cross-sectional study was conducted from August 25, 2023, to March 7, 2024. A total of 419 medical students were recruited through convenience sampling. Data were collected using a demographic information form, the Pittsburgh Sleep Quality Index (PSQI) (with a cut-off score > 5 indicating poor sleep quality) to assess sleep quality, and the Nomophobia Questionnaire (NMP-Q) to evaluate nomophobia. Statistical analyses included descriptive statistics, chi-square tests, one-way analysis of variance (ANOVA), Scheffé post-hoc tests, Pearson's correlation, and multiple logistic regression performed using STATA version 14. In the logistic regression, both odds ratios (OR) and adjusted odds ratios (AOR) were reported. Adjusted odds ratio (AOR) means that the effects of other variables under study, which may influence the relationship between a specific variable and sleep quality, have been controlled for in the analysis.

More than half of the medical students (53.7%) reported poor sleep quality (cut-off for poor sleep quality > 5). A significant proportion (80%) exhibited moderate to severe nomophobia. Multiple logistic regression analysis revealed that checking smartphones immediately upon waking (adjusted odds ratio [AOR] = 2.31, 95% CI: 1.30-4.07, P < 0.001) and higher nomophobia scores (AOR = 1.01, 95% CI: 1.01-1.02, P = 0.012) were independently associated with poor sleep quality after adjusting for potential confounders.

The high prevalence of poor sleep quality and nomophobia among medical students is concerning and highlights the urgent need for targeted interventions. Implementing educational programs on sleep hygiene and smartphone use, along with regular screening for sleep disturbances and accessible psychological support services, could effectively improve student well-being. Addressing academic stressors through institutional policy changes may also help reduce the burden of poor sleep quality in this population.