Chronotype, Sleep, and Attention Levels Among Undergraduate Medical Students in South India: A Cross-Sectional Study

Chronotype refers to an individual's preferred timing for sleep and daily activities within a 24-hour cycle. It is influenced by the endogenous circadian rhythm. This study aims to determine chronotype prevalence, sleep, and the association with attention among medical students.

Undergraduate medical students at a university were asked to fill in two validated questionnaires, including (i) the Morningness-Eveningness Questionnaire for chronotype and (ii) the Mindful Attention Awareness Scale for attention, along with a pre-tested questionnaire for background information and other influencing factors. Data were analyzed using SPSS software version 20.0 (IBM Corp., Armonk, NY). Proportions were calculated, and a test of significance for difference in proportions was calculated using the chi-square test.

A total of 976 students participated in the study. Of them, 67% were females with a mean age of 19.1 (SD ±1.4) years. The most common chronotype was intermediate (655, 67.1%), followed by moderately evening (172, 17.6%) and moderately morning (134,13.7%). Late bedtime, extreme hours of sleep, staying in a hostel, and perceived academic pressure were significantly associated with evening chronotype (p < 0.05). Attention levels were mostly moderate (491, 50.3%) or high (474, 48.6%), with only 11 (1.1%) reporting low attention. High attention was significantly associated with morning chronotype, earlier sleep times, six to eight hours of sleep, day-scholar status, and lower academic pressure (p < 0.05).

Students with a morning chronotype showed a significantly higher proportion of high attention levels. Sleep timing, duration, and perceived academic pressure are important factors affecting both chronotype and attention. Tailoring academic schedules to align with students' chronotypes could potentially improve attention and thus cognitive performance.