The Relationship Between Sleep Deprivation, Cognitive Function, and Academic Performance among Medical Students: A Cross-sectional Study

The Relationship Between Sleep Deprivation, Cognitive Function, and Academic Performance among Medical Students: A Cross-sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Relationship Between Sleep Deprivation, Cognitive Function, and Academic Performance among Medical Students: A Cross-sectional Study Ayesha Basharat, Ayesha Abbas, Ayesha Javed, Khush Tabba, Danish Ali Ashraf, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5045345/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective: To analyze the intensity of sleep deprivation among medical students, understand its effects on cognitive function, and investigate any relationships it may have with academic achievement. Methods : A quantitative cross-sectional study was conducted at various medical colleges in Pakistan over 4 months. The sample size of 351 was calculated via OpenEpi software. Data were collected online via a self-generated questionnaire using convenience sampling. The internal consistency of the questionnaire was confirmed with Cronbach’s alpha after a pilot study on 20% of the sample. SPSS 26 was used to analyze the relationships among sleep deprivation, cognitive function, and academic performance using via chi-square test, with significance set at p<0.05. Results: Among the 351 medical students, 63.5% reported that more sleep could improve academic outcomes, whereas 8.3% reported poor performance. Over 20% experienced cognitive issues such as forgetfulness, and more than 35% had not experienced major sleep disturbances in the past month. Furthermore, our study revealed weak negative associations between sleep deprivation and both cognitive function and academic performance, with no significant correlation between cognitive function and academic performance. Conclusion: Our study revealed weak negative correlations between sleep deprivation and both cognitive function and academic performance, suggesting that poor sleep is only marginally associated with increased cognitive failure and lower self-reported performance. Additionally, no significant link was found between cognitive function and academic performance, indicating that cognitive failure does not have a strong effect on perceived academic success. Psychology Educational Psychology School Counseling Sleep deprivation Academic performance Cognitive function Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Sleep is crucial for memory acquisition, retention, and overall cognitive function. Quality sleep aids learning, memory consolidation, and executive functions (1). The American Academy of Sleep Medicine recommends at least seven hours of sleep per night for optimal health (2). However, medical students often face demanding schedules that can lead to poor sleep quality and an increased prevalence of sleep problems compared with other fields (3). The relationship between sleep and cognition is particularly important in medical education, where the processing, assimilation and retrieval of considerable chunks of information is not only vital but also, most often, hostile. The curriculum of medical education is dense, reading lists are long, and assessments are relentless—all require a sustained level of cognitive focus that can be mentally straining over the course of an entire day. As a result, medical students (consumed by never-ending competitions for good grades) may choose to trade in their sleep time for some study hours. Ignoring the fact that the human mind works like a computer and functions as long as it has time to rest , this is always bad from a longer perspective, because sleep is not just about relaxing muscles. Studies reveal a significant global issue of sleep disturbances among medical students, with prevalence rates varying by region: 19% in China(4), 70% in Hong Kong(5), 35.5% in Malaysia(6) and 30.6% in India(7) . In Pakistan 67.3% of medical students are poor sleepers(8). Research consistently links sleep quality to academic performance, with poor sleep negatively affecting cognitive function and exam results(9)(10).During a study in which 144 medical students taking the preclinical board exam completed a survey about their subjective stress, grade, and sleep quality, 59% of all participants exhibited clinically relevant sleep disturbances (PSQI > 5) during exam preparation. This study, along with other studies, highlights that sleep deprivation impairs reaction times, alertness, and cognitive processes, contributing to lower academic performance and creating a cycle of poor sleep and academic struggle.(10)(11)(12) The prevalence of chronic sleep deprivation in medical students is well documented, leading to impaired memory, problem-solving, and attention. These cognitive functions are essential not only for academic success but also for clinical competence, where quick thinking and accurate memory ensure patient safety and high-quality care. Over time, chronic poor sleep worsens these deficits, resulting in continuous brain fog and long-term impairment. In addition to academics, this can also impair clinical judgment and decision-making, potentially leading to serious, even life-threatening, consequences in patient care. This investigation aims to understand the effects of sleep deprivation on cognitive function and its correlation with academic performance among medical students. Identifying these impacts can help educational institutions create targeted strategies and support systems for students. By promoting awareness of the consequences of sleep deprivation, we hope to enhance academic excellence and mental acuity. This study aims to benefit the medical community and society by addressing this enduring issue. Materials And Methods Study population: The target population for the study was medical university students in Pakistan. The sample was selected from eight medical universities via convenience sampling (13). The inclusion criteria was medical students at Pakistani universities who were currently enrolled and willing to participate. The study ran from May to August 2024 and was approved by the ethical review committee of the Foundation University School of Health Sciences Islamabad. All the participants provided their consent. We calculated our sample size via OpenEpi software, aiming for a 95% confidence level, 5% precision, and a minimum of 351 students from a total of 4000. Pilot Study: For the pilot study, we used a survey with 3 sections: sleep troubles, academic performance, and cognitive function. We tested the survey with 70 students from nonmedical universities in Pakistan to ensure that it was reliable (14). The results showed good reliability for the questions we used. For the main study, respondents were selected using non-probability convenience sampling, which helps make the findings applicable to the broader population. Ethical approval was granted by the ethical review committee at the Foundation University School of Health Sciences Islamabad, and written consent was obtained from each participant to ensure anonymity and data confidentiality. In total, 70 students were recruited from a population of 351, with all participants being currently enrolled in nonmedical universities in Pakistan and consenting to the study. After data collection, the responses were coded in SPSS 26. Following validation and reliability checks, parametric tests were conducted to meet the study's objectives (14). Assessment of Sleep Deprivation Sleep deprivation was assessed via responses to the following question: “During the past month, how often have you had trouble sleeping because...?” The overall sleep score was computed with low risk assigned a value of 1 and high risk assigned a value of 0, resulting in a total score ranging from 0 to 3. Sleep patterns were categorized as "poor" (0-1), "intermediate" (2), and "healthy" (3)(15). The sleep assessment questionnaire had a Cronbach’s alpha value of 0.719, indicating good reliability. Assessment of Academic Performance Academic performance was assessed via a self-report questionnaire on a seven-point scale ranging from "very bad" to "very good." Additional questions on test-taking confidence, perceived exam ease, and satisfaction with grades used five-point Likert scales. These measures showed reasonable validity and reliability with a Cronbach’s alpha of 0.618. Assessment of Cognitive Functioning Cognitive functioning was evaluated via a five-point Likert scale ranging from 0 (never) to 4 (very often) to measure the frequency of cognitive failure (16). The cognitive functioning questionnaire, comprising 15 items, was scored by summing the ratings, with higher scores indicating greater cognitive failure propensity. The questionnaire had a Cronbach’s alpha value of 0.656, indicating good reliability. Data analysis We used SPSS 26 to analyze our data. We calculated frequencies, percentages, means, and standard deviations. We also used Pearson’s correlation to determine whether there was a connection between sleep deprivation, academic performance, and cognitive function. Results Demographic characteristics The study involved 351 medical students of both genders from various universities across Pakistan. This diverse sample allowed for a comprehensive analysis. Descriptive Statistics 1. Cognitive Functioning The participants rated their cognitive performance on a five-point Likert scale ranging from 0 (never) to 4 (often). The average score was 46.31 (SD = 9.37), indicating moderate cognitive impairment. Scores were categorized as 1: low (0-44), 2: moderate (45-59), and 3: high (60-76), with 53.6% moderate, 7.7% high, and 38.7% low. Reliability was strong with a Cronbach's Alpha of 0.771.Although most respondents have moderate levels of cognitive impairment, our research reveals that there is a wide variety of impairments among respondents. 2. Sleep Patterns: Sleep patterns were assessed with scores ranging from 2 to 17, with an average of 10.28 (SD = 2.733). Scores were classified as healthy (11-17), intermediate (6-10), and poor (0-5). Most students had intermediate (49.3%) or healthy (45.3%) sleep patterns. Cronbach's Alpha was 0.587, indicating moderate reliability. Therefore our study revealed that most students had intermediate or healthy sleep patterns, with moderate variability. 3. Academic Performance: Academic performance was rated on a seven-point scale. Most students rated their performance as "Normal" (35.9%) or "Good" (27.1%). A majority (63.5%) believed that better sleep would improve performance. While attitudes on exam ease varied (mean = 2.49), respondents' judgments of their academic achievement were largely neutral to somewhat positive about receiving the marks they earned (mean = 2.29) and feeling confident during tests (mean = 2.41).Reliability was moderate with a Cronbach's Alpha of 0.618. Reliability Statistics Variables Being Assessed Cronbach’s Alpha Assessment of Sleep Pattern 0.719 Assessment of Academic Performance 0.618 Assessment of Cognitive Functions 0.656 Correlation Analyses 1. Sleep deprivation and cognitive function: The Pearson correlation coefficient was -0.126 (p = 0.018), indicating a modest but significant negative correlation. Higher sleep deprivation was slightly associated with more cognitive failure. 2. Sleep deprivation and academic performance: The Pearson correlation coefficient was -0.106 (p = 0.047), indicating a weak but significant negative correlation. Poorer sleep quality was modestly linked to lower perceived academic performance. 3. Cognitive Function and Academic Performance: The Pearson correlation coefficient was 0.022 (p = 0.687), indicating that there was no significant correlation. Cognitive function did not significantly impact self-reported academic performance. Total Cognition Score Total sleep score How do you think your academic performance is? Total Cognition Score Pearson Correlation 1 -.126 * .022 Sig. (2-tailed) .018 .687 N 351 351 351 Total sleep score Pearson Correlation -.126 * 1 -.106 * Sig. (2-tailed) .018 .047 N 351 351 351 How do you think your academic performance is? Pearson Correlation .022 -.106 * 1 Sig. (2-tailed) .687 .047 N 351 351 351 *. Correlation is significant at the 0.05 level (2-tailed). Discussion Summary of Key findings: Our research in Pakistan revealed that sleep deprivation among medical students is correlated with cognitive impairments and lower academic performance; however, improving sleep quality might have some positive influence on cognitive ability and performance. Key Takeaways: Sleep deprivation has a small effect on cognitive failure but not on academic success. Educational institutions should emphasize the importance of healthier sleeping practices for the well-being of all their students. Academic Performance among Medical Students: Most medical students in our study rated their academic performance as normal or good, indicating a positive perception of their abilities. This suggests that students are confident in their ability to navigate the challenging curriculum, feel that they are achieving their goals, and are content with their progress. Similarly, an overwhelming majority of students reported good academic performance in research conducted with medical students from Saudia Arabia (17). These self-assessments of good academic performance underscore the strengths within the student body. Moreover, they highlight the importance of continued support in terms of study skills, time management, and mental health resources to help students sustain and potentially enhance their academic success. Sleep Deprivation among Medical Students: Most medical students in Pakistan reported intermediate sleep patterns, falling between good and poor. This suggests that their sleep habits are average, reflecting a balance between academic demands and rest. However, another study revealed that in young individuals aged 18 to 25 years, continuous sleep deprivation, a sleep latency of >45 minutes, more than three awakenings of >5 minutes per night, and a sleep efficiency of less than 64% suggest poor sleep quality(18)(19). The results of these studies suggest that poor sleep quality is particularly common among university students, with between 30% and 70% of students classified as poor sleepers (18) (20). Cognitive Functioning among Medical Students: Most medical students in Pakistan reported moderate impairment of their cognitive abilities, indicating that they face some cognitive difficulties, but these issues may not be the primary cause of their academic struggles. According to the research, medical students must be able to perform cognitive tasks, such as recognizing the issue, gathering data, formulating a plan of action, executing the plan, and assessing the outcome, particularly in regard to making medical decisions and addressing problems(21). Our study highlights the importance of mental health support and cognitive training to promote students' well-being and effectiveness. Despite limited research, our work adds fresh perspectives to a neglected field, emphasizing the need for further investigation Relationship between Cognitive Function and Academic Performance Our study explored the connection between cognitive failure (such as forgetting appointments) and academic performance. Surprisingly, we found no significant link between the two variables. This means that common mental lapses do not have a significant effect on students' academic ability. Our research fills a gap in the literature, providing valuable insights for future studies. Relationship between Sleep Deprivation and Cognitive Function We have revealed the hidden link between sleep and cognitive health. It is clear that getting a good night's sleep is crucial for our brains to function at their best. When we do not get enough sleep, our cognitive abilities take a hit. This study revealed that even a small amount of sleep deprivation can have a significant impact on our thinking and memory. These findings are supported by the results of previous studies, which demonstrated that shortened sleep significantly affects proper brain function (18). The consequences of insufficient sleep have been studied, revealing the effects of sleep deprivation on working memory, attention, emotions, and hippocampal learning (19). Lack of sleep has been linked to cognitive deficiencies in medical interns working the traditional schedule of 85 hours, demonstrating that the brain regions required for the performance of cognitive tasks are less activated in sleep-deprived conditions than in well-rested conditions (18). Relationship between Sleep Deprivation and Academic Performance This study sought to assess the correlation between inadequate sleep and academic performance. The findings revealed that 63.5% of the participants believed that having enough sleep would help them perform better academically. This implies that a lack of sleep may have a negative effect on academic performance. The results of this study are consistent with previous studies which indicated that students with poor sleep quality usually have lower academic performance(9).Previous research has suggested that increased sleep promotes health and lowers levels of stress which leads to improved academic performance(14). What Can This Mean to Medical Students? Sleep matters! As medical students, they are already under pressure, and sleep deprivation can negatively impact their academic performance. Prioritize sleep to stay on top of your game. Future Research and Practical Applications More research on how sleep deprivation affects medical students over time is needed. Moreover, practical interventions such as seminars, physical activity, and stress-reduction techniques can help improve sleep quality. Supportive relationships and peer support groups can also promote healthy sleeping habits. Conclusion In conclusion, our study revealed weak negative associations between sleep deprivation and both cognitive function and academic performance, suggesting that poorer sleep is slightly linked to increased cognitive failure and lower self-assessed performance. No significant correlation was found between cognitive function and academic performance, indicating that cognitive failure does not strongly impact perceived academic achievements. Our research, which focuses on the relationships among sleep deprivation, academic performance and cognitive functioning, both validates and adds to the body of literature in this area. Medical students in Pakistan and perhaps other South Asian universities should be informed about documented sleep issues and their concomitant effects on cognitive function and academic performance. Students' academic performance and cognitive state will probably improve from better sleep. By recognizing these effects, educational institutions can develop student support networks and focused methods. By increasing awareness of the negative effects of sleep deprivation, we hope to improve academic performance. Declarations CONFLICTS OF INTEREST- None Financial support: None to report. Potential competing interests: None to report Contributions: A.B, A.A, A.J, K.T, D.A.A, H.F - Conception of the study A.B, A.A, A.J, K.T, D.A.A, H.F - Experiment/Study Conduction A.B, A.A, A.J, K.T, D.A.A, H.F - Analysis/Interpretation/Discussion A.B, A.A, A.J, K.T, D.A.A, H.F - Manuscript Writing A.B, A.A, A.J, K.T, D.A.A, H.F - Critical Review A.B, A.A, A.J, K.T, D.A.A, H.F - Facilitation and material analysis All authors approved the final version to be published and agreed to be accountable for all aspects of the work. References Vyazovskiy V V. Sleep, recovery, and metaregulation: explaining the benefits of sleep. Nat Sci Sleep [Internet]. 2015 [cited 2024 Jun 6];7:171–84. Available from: https://pubmed.ncbi.nlm.nih.gov/26719733/ Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, et al. Recommended Amount of Sleep for a Healthy Adult: A Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society. 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Available from: https://pubmed.ncbi.nlm.nih.gov/36831728/ Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5045345","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":350605052,"identity":"e36d743d-e107-43dc-a8c0-81d274e7e7ca","order_by":0,"name":"Ayesha Basharat","email":"data:image/png;base64,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","orcid":"https://orcid.org/0009-0001-1200-1428","institution":"Foundation University Islamabad","correspondingAuthor":true,"prefix":"","firstName":"Ayesha","middleName":"","lastName":"Basharat","suffix":""},{"id":350605053,"identity":"f003cbd3-e233-44ad-8f16-9edbbc7c5d1c","order_by":1,"name":"Ayesha Abbas","email":"","orcid":"https://orcid.org/0009-0001-2765-0121","institution":"Foundation University Islamabad","correspondingAuthor":false,"prefix":"","firstName":"Ayesha","middleName":"","lastName":"Abbas","suffix":""},{"id":350605054,"identity":"b8c2ed76-e151-441f-9149-990b4fd11582","order_by":2,"name":"Ayesha Javed","email":"","orcid":"https://orcid.org/0009-0001-7800-6125","institution":"Foundation University Islamabad","correspondingAuthor":false,"prefix":"","firstName":"Ayesha","middleName":"","lastName":"Javed","suffix":""},{"id":350605055,"identity":"250b0c8d-654e-497e-8919-ce3c030f9684","order_by":3,"name":"Khush Tabba","email":"","orcid":"https://orcid.org/0009-0003-6624-0963","institution":"Foundation University Islamabad","correspondingAuthor":false,"prefix":"","firstName":"Khush","middleName":"","lastName":"Tabba","suffix":""},{"id":350605056,"identity":"3ed017b2-7d51-4fce-a98f-c174c4fa0929","order_by":4,"name":"Danish Ali Ashraf","email":"","orcid":"https://orcid.org/0000-0002-3013-9359","institution":"Foundation University Islamabad","correspondingAuthor":false,"prefix":"","firstName":"Danish","middleName":"Ali","lastName":"Ashraf","suffix":""},{"id":350605057,"identity":"2a2f8230-423d-4f60-aaf0-9a00a252d8fa","order_by":5,"name":"Hurmat Fatima","email":"","orcid":"https://orcid.org/0009-0003-4725-5406","institution":"Foundation University Islamabad","correspondingAuthor":false,"prefix":"","firstName":"Hurmat","middleName":"","lastName":"Fatima","suffix":""}],"badges":[],"createdAt":"2024-09-06 16:06:40","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-5045345/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5045345/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":64173417,"identity":"ac63bc34-91a3-4883-bc19-fdeecc3006ea","added_by":"auto","created_at":"2024-09-09 11:56:42","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":32047,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003elow cognitive impairment category consisting of scores ranging from 0-44, 2; moderate cognitive impairment category consisting of scores ranging from 45-59, and 3; high cognitive impairment category consisting of scores ranging from 60-76.\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-5045345/v1/cb52b69eea5161d77a715a91.png"},{"id":64173624,"identity":"ceaaed8f-2166-45e8-be7e-e9808e94099c","added_by":"auto","created_at":"2024-09-09 12:04:42","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":32754,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003e0 indicates poor sleep patterns, 1 indicates intermediate sleep patterns and 2 indicates healthy sleep patterns\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-5045345/v1/00594b3480ca1ad334860d9f.png"},{"id":64173420,"identity":"62fe66f7-cc65-4612-bf45-99d3846dcc75","added_by":"auto","created_at":"2024-09-09 11:56:42","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":27576,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDistribution of self-reported sleep quality among participants over the past month\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-5045345/v1/0e0d19a93120a5194de8e0aa.png"},{"id":64173625,"identity":"f060ac5d-f59d-4e64-abd7-4b63b8157d52","added_by":"auto","created_at":"2024-09-09 12:04:42","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":29327,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eDistribution of self-perceived academic performance among participants\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure4.png","url":"https://assets-eu.researchsquare.com/files/rs-5045345/v1/c0aaac919df64e0803f1c146.png"},{"id":64173419,"identity":"653750b9-b4f4-46d4-a108-7bf6b980b22d","added_by":"auto","created_at":"2024-09-09 11:56:42","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":31931,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eParticipants' Perceptions of Whether Academic Performance Improves with Increased Sleep\u003c/em\u003e\u003c/p\u003e","description":"","filename":"Figure5.png","url":"https://assets-eu.researchsquare.com/files/rs-5045345/v1/bb125cd72bb3bcd952c30df3.png"},{"id":64173626,"identity":"e60b7256-19ce-413b-8613-1776579c5224","added_by":"auto","created_at":"2024-09-09 12:04:47","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":433370,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5045345/v1/10628b41-3fd1-4b12-9aca-acc17f083c78.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eThe Relationship Between Sleep Deprivation, Cognitive Function, and Academic Performance among Medical Students: A Cross-sectional Study\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eSleep is crucial for memory acquisition, retention, and overall cognitive function. Quality sleep aids learning, memory consolidation, and executive functions (1). The American Academy of Sleep Medicine recommends at least seven hours of sleep per night for optimal health (2). However, medical students often face demanding schedules that can lead to poor sleep quality and an increased prevalence of sleep problems compared with other fields (3).\u003c/p\u003e\n\u003cp\u003eThe relationship between sleep and cognition is particularly important in medical education, where the processing, assimilation and retrieval of considerable chunks of information is not only vital but also, most often, hostile. The curriculum of medical education is dense, reading lists are long, and assessments are relentless\u0026mdash;all require a sustained level of cognitive focus that can be mentally straining over the course of an entire day. As a result, medical students (consumed by never-ending competitions for good grades) may choose to trade in their sleep time for some study hours. Ignoring the fact that the human mind works like a computer and functions as long as it has time to rest , this is always bad from a longer perspective, because sleep is not just about relaxing muscles.\u003c/p\u003e\n\u003cp\u003eStudies reveal a significant global issue of sleep disturbances among medical students, with prevalence rates varying by region: 19% in China(4), 70% in Hong Kong(5), 35.5% in Malaysia(6) and \u0026nbsp;30.6% in India(7) . In Pakistan 67.3% of medical students are poor sleepers(8). Research consistently links sleep quality to academic performance, with poor sleep negatively affecting cognitive function and exam results(9)(10).During a study in which 144 medical students taking the preclinical board exam completed a survey about their subjective stress, grade, and sleep quality, 59% of all participants exhibited clinically relevant sleep disturbances (PSQI \u0026gt; 5) during exam preparation. This study, along with other studies, highlights that sleep deprivation impairs reaction times, alertness, and cognitive processes, contributing to lower academic performance and creating a cycle of poor sleep and academic struggle.(10)(11)(12)\u003c/p\u003e\n\u003cp\u003eThe prevalence of chronic sleep deprivation in medical students is well documented, leading to impaired memory, problem-solving, and attention. These cognitive functions are essential not only for academic success but also for clinical competence, where quick thinking and accurate memory ensure patient safety and high-quality care. Over time, chronic poor sleep worsens these deficits, resulting in continuous brain fog and long-term impairment. In addition to academics, this can also impair clinical judgment and decision-making, potentially leading to serious, even life-threatening, consequences in patient care.\u003c/p\u003e\n\u003cp\u003eThis investigation aims to understand the effects of sleep deprivation on cognitive function and its correlation with academic performance among medical students. Identifying these impacts can help educational institutions create targeted strategies and support systems for students. By promoting awareness of the consequences of sleep deprivation, we hope to enhance academic excellence and mental acuity. This study aims to benefit the medical community and society by addressing this enduring issue.\u003c/p\u003e"},{"header":"Materials And Methods","content":"\u003cp\u003e\u003cem\u003eStudy population:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe target population for the study was medical university students in Pakistan. The sample was selected from eight medical universities via convenience sampling (13). The inclusion criteria was medical students at Pakistani universities who were currently enrolled and willing to participate. The study ran from May to August 2024 and was approved by the ethical review committee of the Foundation University School of Health Sciences Islamabad. All the \u0026nbsp;participants provided their consent. We calculated our sample size via OpenEpi software, aiming for a 95% confidence level, 5% precision, and a minimum of 351 students from a total of 4000.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePilot Study:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eFor the pilot study, we used a survey with 3 sections: sleep troubles, academic performance, and cognitive function. We tested the survey with 70 students from nonmedical universities in Pakistan to ensure that it was reliable (14). The results showed good reliability for the questions we used.\u0026nbsp;For the main study, respondents were selected using non-probability convenience sampling, which helps make the findings applicable to the broader population. Ethical approval was granted by the ethical review committee at the Foundation University School of Health Sciences Islamabad, and written consent was obtained from each participant to ensure anonymity and data confidentiality. In total, 70 students were recruited from a population of 351, with all participants being currently enrolled in nonmedical universities in Pakistan and consenting to the study. After data collection, the responses were coded in SPSS 26. Following validation and reliability checks, parametric tests were conducted to meet the study\u0026apos;s objectives (14).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssessment of Sleep Deprivation\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSleep deprivation was assessed via responses to the following question: \u0026ldquo;During the past month, how often have you had trouble sleeping because...?\u0026rdquo; The overall sleep score was computed with low risk assigned a value of 1 and high risk assigned a value of 0, resulting in a total score ranging from 0 to 3. Sleep patterns were categorized as \u0026quot;poor\u0026quot; (0-1), \u0026quot;intermediate\u0026quot; (2), and \u0026quot;healthy\u0026quot; (3)(15). The sleep assessment questionnaire had a Cronbach\u0026rsquo;s alpha value of 0.719, indicating good reliability.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssessment of Academic Performance\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAcademic performance was assessed via a self-report questionnaire on a seven-point scale ranging from \u0026quot;very bad\u0026quot; to \u0026quot;very good.\u0026quot; Additional questions on test-taking confidence, perceived exam ease, and satisfaction with grades used five-point Likert scales. These measures showed reasonable validity and reliability with a Cronbach\u0026rsquo;s alpha of 0.618.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAssessment of Cognitive Functioning\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eCognitive functioning was evaluated via a five-point Likert scale ranging from 0 (never) to 4 (very often) to measure the frequency of cognitive failure (16). The cognitive functioning questionnaire, comprising 15 items, was scored by summing the ratings, with higher scores indicating greater cognitive failure propensity. The questionnaire had a Cronbach\u0026rsquo;s alpha value of 0.656, indicating good reliability.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eData analysis\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe used SPSS 26 to analyze our data. We calculated frequencies, percentages, means, and standard deviations. We also used Pearson\u0026rsquo;s correlation to determine whether there was a connection between sleep deprivation, academic performance, and cognitive function.\u003cem\u003e\u0026nbsp;\u003c/em\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cem\u003eDemographic characteristics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe study involved 351 medical students of both genders from various universities across Pakistan. This diverse sample allowed for a comprehensive analysis.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDescriptive Statistics\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e1. Cognitive Functioning\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe participants rated their cognitive performance on a five-point Likert scale ranging from 0 (never) to 4 (often). The average score was 46.31 (SD = 9.37), indicating moderate cognitive impairment. Scores were categorized as 1: low (0-44), 2: moderate (45-59), and 3: high (60-76), with 53.6% moderate, 7.7% high, and 38.7% low. Reliability was strong with a Cronbach\u0026apos;s Alpha of 0.771.Although most respondents have moderate levels of cognitive impairment, our research reveals that there is a wide variety of impairments among respondents.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2. Sleep Patterns:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSleep patterns were assessed with scores ranging from 2 to 17, with an average of 10.28 (SD = 2.733). Scores were classified as healthy (11-17), intermediate (6-10), and poor (0-5). Most students had intermediate (49.3%) or healthy (45.3%) sleep patterns. Cronbach\u0026apos;s Alpha was 0.587, indicating moderate reliability. Therefore our study revealed that most students had intermediate or healthy sleep patterns, with moderate variability.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3. Academic Performance:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAcademic performance was rated on a seven-point scale. Most students rated their performance as \u0026quot;Normal\u0026quot; (35.9%) or \u0026quot;Good\u0026quot; (27.1%). A majority (63.5%) believed that better sleep would improve performance. While attitudes on exam ease varied (mean = 2.49), respondents\u0026apos; judgments of their academic achievement were largely neutral to somewhat positive about receiving the marks they earned (mean = 2.29) and feeling confident during tests (mean = 2.41).Reliability was moderate with a Cronbach\u0026apos;s Alpha of 0.618.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eReliability Statistics\u003c/em\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"335\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"71.64179104477611%\" valign=\"top\"\u003e\n \u003cp\u003eVariables Being Assessed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.35820895522388%\" valign=\"top\"\u003e\n \u003cp\u003eCronbach\u0026rsquo;s Alpha\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"71.64179104477611%\" valign=\"top\"\u003e\n \u003cp\u003eAssessment of Sleep Pattern\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.35820895522388%\" valign=\"top\"\u003e\n \u003cp\u003e0.719\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"71.64179104477611%\" valign=\"top\"\u003e\n \u003cp\u003eAssessment of Academic Performance\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.35820895522388%\" valign=\"top\"\u003e\n \u003cp\u003e0.618\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"71.64179104477611%\" valign=\"top\"\u003e\n \u003cp\u003eAssessment of Cognitive Functions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"28.35820895522388%\" valign=\"top\"\u003e\n \u003cp\u003e0.656\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cem\u003e\u003c/em\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCorrelation Analyses\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e1. Sleep deprivation and cognitive function:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe Pearson correlation coefficient was -0.126 (p = 0.018), indicating a modest but significant negative correlation. Higher sleep deprivation was slightly associated with more cognitive failure.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e2. Sleep deprivation and academic performance:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe Pearson correlation coefficient was -0.106 (p = 0.047), indicating a weak but significant negative correlation. Poorer sleep quality was modestly linked to lower perceived academic performance.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003e3. Cognitive Function and Academic Performance:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe Pearson correlation coefficient was 0.022 (p = 0.687), indicating that there was no significant correlation. Cognitive function did not significantly impact self-reported academic performance.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"619\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"52.58064516129032%\" colspan=\"2\" valign=\"bottom\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"bottom\"\u003e\n \u003cp\u003eTotal Cognition Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"bottom\"\u003e\n \u003cp\u003eTotal sleep score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"bottom\"\u003e\n \u003cp\u003eHow do you think your academic performance is?\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.129032258064516%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eTotal Cognition Score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.451612903225808%\" valign=\"top\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e-.126\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e.022\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e.687\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.129032258064516%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eTotal sleep score\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.451612903225808%\" valign=\"top\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e-.126\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e-.106\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e.018\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e.047\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.129032258064516%\" rowspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eHow do you think your academic performance is?\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.451612903225808%\" valign=\"top\"\u003e\n \u003cp\u003ePearson Correlation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e.022\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e-.106\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.806451612903226%\" valign=\"top\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eSig. (2-tailed)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e.687\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e.047\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"31.147540983606557%\" valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"22.950819672131146%\" valign=\"top\"\u003e\n \u003cp\u003e351\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"100%\" colspan=\"5\" valign=\"top\"\u003e\n \u003cp\u003e*. Correlation is significant at the 0.05 level (2-tailed).\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"Discussion","content":"\u003cp\u003e\u003cem\u003eSummary of Key findings:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOur research in Pakistan revealed that sleep deprivation among medical students is correlated with cognitive impairments and lower academic performance; however, improving sleep quality might have some positive influence on cognitive ability and performance.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eKey Takeaways:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSleep deprivation has a small effect on cognitive failure but not on academic success. Educational institutions should emphasize the importance of healthier sleeping practices for the well-being of all their students.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAcademic Performance among Medical Students:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMost medical students in our study rated their academic performance as normal or good, indicating a positive perception of their abilities. This suggests that students are confident in their ability to navigate the challenging curriculum, feel that they are achieving their goals, and are content with their progress.\u003c/p\u003e\n\u003cp\u003eSimilarly, an overwhelming majority of students reported good academic performance in research conducted with medical students from Saudia Arabia (17). These self-assessments of good academic performance underscore the strengths within the student body. Moreover, they highlight the importance of continued support in terms of study skills, time management, and mental health resources to help students sustain and potentially enhance their academic success.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSleep Deprivation among Medical Students:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMost medical students in Pakistan reported intermediate sleep patterns, falling between good and poor. This suggests that their sleep habits are average, reflecting a balance between academic demands and rest.\u003c/p\u003e\n\u003cp\u003eHowever, another study revealed that in young individuals aged 18 to 25 years, continuous sleep deprivation, a sleep latency of \u0026gt;45 minutes, more than three awakenings of \u0026gt;5 minutes per night, and a sleep efficiency of less than 64% suggest poor sleep quality(18)(19). The results of these studies suggest that poor sleep quality is particularly common among university students, with between 30% and 70% of students classified as poor sleepers (18) (20).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCognitive Functioning among Medical Students:\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eMost medical students in Pakistan reported moderate impairment of their cognitive abilities, indicating that they face some cognitive difficulties, but these issues may not be the primary cause of their academic struggles.\u003c/p\u003e\n\u003cp\u003eAccording to the research,\u0026nbsp;medical students must be able to perform cognitive tasks, such as recognizing the issue, gathering data, formulating a plan of action, executing the plan, and assessing the outcome, particularly in regard to making medical decisions and addressing problems(21).\u003c/p\u003e\n\u003cp\u003eOur study highlights the importance of mental health support and cognitive training to promote students\u0026apos; well-being and effectiveness. Despite limited research, our work adds fresh perspectives to a neglected field, emphasizing the need for further investigation\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRelationship between Cognitive Function and Academic Performance\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOur study explored the connection between cognitive failure (such as forgetting appointments) and academic performance. Surprisingly, we found no significant link between the two variables. This means that common mental lapses do not have a significant effect on students\u0026apos; academic ability. Our research fills a gap in the literature, providing valuable insights for future studies.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRelationship between Sleep Deprivation and Cognitive Function\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe have revealed the hidden link between sleep and cognitive health. It is clear that getting a good night\u0026apos;s sleep is crucial for our brains to function at their best. When we do not get enough sleep, our cognitive abilities take a hit. This study revealed that even a small amount of sleep deprivation can have a significant impact on our thinking and memory. These findings are supported by the results of previous studies, which demonstrated that shortened sleep significantly affects proper brain function (18). The consequences of insufficient sleep have been studied, revealing the effects of sleep deprivation on working memory, attention, emotions, and hippocampal learning (19).\u003c/p\u003e\n\u003cp\u003eLack of sleep has been linked to cognitive deficiencies in medical interns working the traditional schedule of 85 hours, demonstrating that the brain regions required for the performance of cognitive tasks are less activated in sleep-deprived conditions than in well-rested conditions (18).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eRelationship between Sleep Deprivation and Academic Performance\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThis study sought to assess the correlation between inadequate sleep and academic performance. The findings revealed that 63.5% of the participants believed that having enough sleep would help them perform better academically. This implies that a lack of sleep may have a negative effect on academic performance. The results of this study are consistent with previous studies which indicated that students with poor sleep quality usually have lower academic performance(9).Previous research has suggested that increased sleep promotes health and lowers levels of stress which leads to improved academic performance(14).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eWhat Can This Mean to Medical Students?\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSleep matters! As medical students, they are already under pressure, and sleep deprivation can negatively impact their academic performance. Prioritize sleep to stay on top of your game.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eFuture Research and Practical Applications\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;More research on how sleep deprivation affects medical students over time is needed. Moreover, practical interventions such as seminars, physical activity, and stress-reduction techniques can help improve sleep quality. Supportive relationships and peer support groups can also promote healthy sleeping habits.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, our study revealed weak negative associations between sleep deprivation and both cognitive function and academic performance, suggesting that poorer sleep is slightly linked to increased cognitive failure and lower self-assessed performance. No significant correlation was found between cognitive function and academic performance, indicating that cognitive failure does not strongly impact perceived academic achievements.\u003c/p\u003e\n\u003cp\u003eOur research, which focuses on the relationships among sleep deprivation, academic performance and cognitive functioning, both validates and adds to the body of literature in this area. Medical students in Pakistan and perhaps other South Asian universities should be informed about documented sleep issues and their concomitant effects on cognitive function and academic performance. Students\u0026apos; academic performance and cognitive state will probably \u0026nbsp;improve from better sleep.\u0026nbsp;\u003cbr\u003e\u0026nbsp;By recognizing these effects, educational institutions can develop student support networks and focused methods. By increasing awareness of the negative effects of sleep deprivation, we hope to improve academic performance.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eCONFLICTS OF INTEREST-\u0026nbsp;\u003c/strong\u003eNone\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFinancial support:\u003c/strong\u003e None to report.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePotential competing interests:\u0026nbsp;\u003c/strong\u003eNone to report\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContributions:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA.B, A.A, A.J, K.T, D.A.A, H.F -\u003c/p\u003e\n\u003cp\u003eConception of the study \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA.B, A.A, A.J, K.T, D.A.A, H.F -\u003c/p\u003e\n\u003cp\u003eExperiment/Study Conduction \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA.B, A.A, A.J, K.T, D.A.A, H.F -\u003c/p\u003e\n\u003cp\u003eAnalysis/Interpretation/Discussion \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA.B, A.A, A.J, K.T, D.A.A, H.F - Manuscript Writing\u003c/p\u003e\n\u003cp\u003eA.B, A.A, A.J, K.T, D.A.A, H.F - Critical Review \u0026nbsp;\u003c/p\u003e\n\u003cp\u003eA.B, A.A, A.J, K.T, D.A.A, H.F - Facilitation and material analysis\u003c/p\u003e\n\u003cp\u003eAll authors approved the final version to be published and agreed to be accountable for all aspects of the work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eVyazovskiy V V. 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Zhonghua Liu Xing Bing Xue Za Zhi. 2005 May;26(5):328\u0026ndash;31.\u003c/li\u003e\n\u003cli\u003eHUEN L, CHAN T, YU W, Wing Y. Do medical students in Hong Kong have enough sleep? Sleep Biol Rhythms. 2007 Jul;5:226\u0026ndash;30.\u003c/li\u003e\n\u003cli\u003eZailinawati AH, Teng CL, Chung YC, Teow TL, Lee PN, Jagmohni KS. Daytime sleepiness and sleep quality among Malaysian medical students. Med J Malaysia. 2009 Jun;64(2):108\u0026ndash;10.\u003c/li\u003e\n\u003cli\u003eGiri P, Baviskar M, Phalke D. Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western maharashtra, India. Ann Med Health Sci Res. 2013 Jan;3(1):51\u0026ndash;4.\u003c/li\u003e\n\u003cli\u003eNadeem A, Cheema MK, Naseer M, Javed H. Comparison of quality of sleep between medical and non-medical undergraduate Pakistani students. J Pak Med Assoc [Internet]. 2018 Oct 1 [cited 2024 Aug 2];68(10):1465\u0026ndash;70. Available from: https://pubmed.ncbi.nlm.nih.gov/30317343/\u003c/li\u003e\n\u003cli\u003eCurcio G, Ferrara M, De Gennaro L. Sleep loss, learning capacity and academic performance. Sleep Med Rev [Internet]. 2006 Oct [cited 2024 Jun 6];10(5):323\u0026ndash;37. Available from: https://pubmed.ncbi.nlm.nih.gov/16564189/\u003c/li\u003e\n\u003cli\u003eAhrberg K, Dresler M, Niedermaier S, Steiger A, Genzel L. The interaction between sleep quality and academic performance. J Psychiatr Res [Internet]. 2012 [cited 2024 Jun 7];46(12):1618\u0026ndash;22. Available from: https://pubmed.ncbi.nlm.nih.gov/23040161/\u003c/li\u003e\n\u003cli\u003eSuardiaz-Muro M, Ortega-Moreno M, Morante-Ruiz M, Monroy M, Ruiz MA, Mart\u0026iacute;n-Plasencia P, et al. Sleep quality and sleep deprivation: relationship with academic performance in university students during examination period. Sleep Biol Rhythms [Internet]. 2023 Jul 1 [cited 2024 Jun 7];21(3):377\u0026ndash;83. Available from: https://pubmed.ncbi.nlm.nih.gov/38469079/\u003c/li\u003e\n\u003cli\u003eFlueckiger L, Lieb R, Meyer AH, Mata J. How health behaviors relate to academic performance via affect: an intensive longitudinal study. PLoS One [Internet]. 2014 Oct 29 [cited 2024 Jun 7];9(10). Available from: https://pubmed.ncbi.nlm.nih.gov/25353638/\u003c/li\u003e\n\u003cli\u003eAlbqoor MA, Shaheen AM. Sleep quality, sleep latency, and sleep duration: a national comparative study of university students in Jordan. Sleep Breath [Internet]. 2021 Jun 1 [cited 2024 Aug 2];25(2):1147\u0026ndash;54. Available from: https://pubmed.ncbi.nlm.nih.gov/33034880/\u003c/li\u003e\n\u003cli\u003eRathakrishnan B, Singh SSB, Kamaluddin MR, Yahaya A, Nasir MAM, Ibrahim F, et al. Smartphone Addiction and Sleep Quality on Academic Performance of University Students: An Exploratory Research. Int J Environ Res Public Health [Internet]. 2021 Aug 2 [cited 2024 Jul 31];18(16). 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Determinants of Sleep Quality: A Cross-Sectional Study in University Students. Int J Environ Res Public Health [Internet]. 2023 Feb 1 [cited 2024 Aug 4];20(3). Available from: https://pubmed.ncbi.nlm.nih.gov/36767422/\u003c/li\u003e\n\u003cli\u003eOhayon M, Wickwire EM, Hirshkowitz M, Albert SM, Avidan A, Daly FJ, et al. National Sleep Foundation\u0026rsquo;s sleep quality recommendations: first report. Sleep Heal [Internet]. 2017 Feb 1 [cited 2024 Aug 4];3(1):6\u0026ndash;19. Available from: https://pubmed.ncbi.nlm.nih.gov/28346153/\u003c/li\u003e\n\u003cli\u003eBuysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res [Internet]. 1989 [cited 2024 Aug 4];28(2):193\u0026ndash;213. Available from: https://pubmed.ncbi.nlm.nih.gov/2748771/\u003c/li\u003e\n\u003cli\u003ePavlinac Dodig I, Qazzafi A, Lusic Kalcina L, Demirovic S, Pecotic R, Valic M, et al. The Associations between Results in Different Domains of Cognitive and Psychomotor Abilities Measured in Medical Students. Brain Sci [Internet]. 2023 Feb 1 [cited 2024 Aug 4];13(2). Available from: https://pubmed.ncbi.nlm.nih.gov/36831728/\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sleep deprivation, Academic performance, Cognitive function","lastPublishedDoi":"10.21203/rs.3.rs-5045345/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5045345/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e To analyze the intensity of sleep deprivation among medical students, understand its effects on cognitive function, and investigate any relationships it may have with academic achievement.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eA quantitative cross-sectional study was conducted at various medical colleges in Pakistan over 4 months. The sample size of 351 was calculated via OpenEpi software. Data were collected online via a self-generated questionnaire using convenience sampling. The internal consistency of the questionnaire was confirmed with Cronbach’s alpha after a pilot study on 20% of the sample. SPSS 26 was used to analyze the relationships among sleep deprivation, cognitive function, and academic performance using via chi-square test, with significance set at p\u0026lt;0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAmong the 351 medical students, 63.5% reported that more sleep could improve academic outcomes, whereas 8.3% reported poor performance. Over 20% experienced cognitive issues such as forgetfulness, and more than 35% had not experienced major sleep disturbances in the past month. Furthermore, our study revealed weak negative associations between sleep deprivation and both cognitive function and academic performance, with no significant correlation between cognitive function and academic performance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOur study revealed weak negative correlations between sleep deprivation and both cognitive function and academic performance, suggesting that poor sleep is only marginally associated with increased cognitive failure and lower self-reported performance. Additionally, no significant link was found between cognitive function and academic performance, indicating that cognitive failure does not have a strong effect on perceived academic success.\u003c/p\u003e","manuscriptTitle":"The Relationship Between Sleep Deprivation, Cognitive Function, and Academic Performance among Medical Students: A Cross-sectional Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-09-09 11:56:38","doi":"10.21203/rs.3.rs-5045345/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"27c6ecb2-3481-4be7-8ef7-3659be156647","owner":[],"postedDate":"September 9th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":37227338,"name":"Psychology"},{"id":37227339,"name":"Educational Psychology"},{"id":37227340,"name":"School Counseling"}],"tags":[],"updatedAt":"2024-09-09T11:56:38+00:00","versionOfRecord":[],"versionCreatedAt":"2024-09-09 11:56:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5045345","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5045345","identity":"rs-5045345","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}