Self-medication for sleep problems in university students: a more concerning issue for medical students

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Data may be preliminary. 26 February 2026 V1 Latest version Share on Self-medication for sleep problems in university students: a more concerning issue for medical students Authors : Selvi Ceran 0000-0002-7984-2440 [email protected] , Gonca Aşut , Pelin Kutlutürk , Ahmet Bostan , Cem Aykanat , Idil Soyuyüce , Özgür Güven , and Yasemin Duman Authors Info & Affiliations https://doi.org/10.22541/au.177212383.38799925/v1 155 views 85 downloads Contents Abstract Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Background: Sleep deprivation is a significant issue among university students. Self-medication is frequently reported among medical students. There is limited information from Türkiye and globally regarding self-medication for sleep issues among students. Objective: This study aimed to determine sleep quality, self-medication with prescription sleep aids, and associated factors in a group of university students. Method: This descriptive study was conducted with 437 participants, including 286 medical students and 151 non-medical university students. A sociodemographic and insomnia coping strategies questionnaire, the Pittsburgh Sleep Quality Index(PSQI), the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI) were used to collect data after participants provided their informed consent. Results: More than half of the students (52%) had poor sleep quality, with medical students showing poorer sleep quality (57% vs. 43%, p=0.004). The use of prescription sleep medications for self-medication was significantly higher among medical students (12.2% vs. 4%, p = 0.005). Independent risk factors for self-medication included male sex (OR = 2.6, CI95% 1.26-5.4), medical education (OR = 4.25, CI95% 1.64-11), history of psychotropic drug use (OR = 2.9, CI95% 1.22-7.14), living in a dormitory (OR = 3.87, CI 95% 1.79-8.33), and higher BAI scores (OR = 1.08, CI 95% 1.04-1.12). Conclusion: This study highlights the significant prevalence of poor sleep quality among university students. Male sex, a history of psychotropic drug use, dormitory living, and higher anxiety levels were identified as independent risk factors for self-medication. Our results emphasize the need for targeted interventions to address sleep disorders and reduce the reliance on self-medication practices among university students. Self-medication for sleep problems in university students: a more concerning issue for medical students Selvi Ceran 1 , Gonca Aşut 1 , Pelin Kutlutürk 2 , Ahmet Bostan 3 , Cem Aykanat 4 , Idil Soyuyüce 5 , Özgür Güven 6 , Yasemin Duman 7 1 Başkent University Faculty of Medicine, Department of Psychiatry, Ankara, Turkiye 2 Kulu State Hospital, Psychiatry Clinic, Konya, Turkiye 3 Etlik City Hospital, Obstetrics and Gynecology Clinic, Ankara, Turkiye 4 Ondokuz Mayıs University, Department of Pathology, Samsun, Turkiye 5 Vitos Klinikum Department of Psychiatry, Hessen, Germany 6 Gazi University, Department of Emergency Medicine, Ankara, Turkiye 7 Gazi University, Department of Pediatrics, Ankara, Turkiye Corresponding author: Selvi Ceran email: [email protected] Phone:+905062849610 Fax: +903122036868 Address: Yukarı Bahçelievler Mahallesi, Şehit Temel Kuloğlu Sokak No: 30, Başkent Üniversitesi, 06490 Çankaya/Ankara Abstract Background: Sleep deprivation is a significant issue among university students. Self-medication is frequently reported among medical students. There is limited information from Türkiye and globally regarding self-medication for sleep issues among students. Objective: This study aimed to determine sleep quality, self-medication with prescription sleep aids, and associated factors in a group of university students. Method: This descriptive study was conducted with 437 participants, including 286 medical students and 151 non-medical university students. A sociodemographic and insomnia coping strategies questionnaire, the Pittsburgh Sleep Quality Index(PSQI), the Beck Anxiety Inventory (BAI), and the Beck Depression Inventory (BDI) were used to collect data after participants provided their informed consent. Results: More than half of the students (52%) had poor sleep quality, with medical students showing poorer sleep quality (57% vs. 43%, p=0.004). The use of prescription sleep medications for self-medication was significantly higher among medical students (12.2% vs. 4%, p = 0.005). Independent risk factors for self-medication included male sex (OR = 2.6, CI95% 1.26-5.4), medical education (OR = 4.25, CI95% 1.64-11), history of psychotropic drug use (OR = 2.9, CI95% 1.22-7.14), living in a dormitory (OR = 3.87, CI 95% 1.79-8.33), and higher BAI scores (OR = 1.08, CI 95% 1.04-1.12). Conclusion: This study highlights the significant prevalence of poor sleep quality among university students. Male sex, a history of psychotropic drug use, dormitory living, and higher anxiety levels were identified as independent risk factors for self-medication. Our results emphasize the need for targeted interventions to address sleep disorders and reduce the reliance on self-medication practices among university students. Keywords: Anxiety, sleep quality, self-medication, students Key Points • Poor sleep quality was identified in 52% of university students, a rate higher than that reported in the general adult population. • Twenty-six percent of students reported engaging in self-medication for sleep problems within the past year. • The use of prescription sleep medications without consulting a physician was significantly more common among medical students compared to non-medical students. • Male sex, medical education, dormitory residence, a history of psychotropic drug use, and higher anxiety levels were identified as independent risk factors for self-medication with prescription drugs. • The findings highlight the need for early identification of sleep problems and the development of safe coping strategies among university students. Plain Language Summary Sleep problems are common among university students, but many students try to manage these problems on their own instead of seeking professional help. In this study, we examined sleep quality and the use of self-medication for sleep problems among medical and non-medical university students in Turkey. More than half of the students had poor sleep quality, and about one in four reported using alcohol or medications on their own to help them sleep within the past year. Medical students were more likely than non-medical students to use prescription sleep medications without consulting a doctor. Being male, studying medicine, living in a dormitory, having a history of psychiatric medication use, and having higher anxiety levels were linked to a greater likelihood of self-medicating with prescription drugs. These findings suggest that sleep problems and unsafe medication practices are common among university students. Increasing awareness about healthy sleep habits and providing better psychological support services may help reduce the need for self-medication and improve students’ overall well-being and academic performance. Introduction Self-medication (SM) is defined by the World Health Organization (WHO) as the selection and use of medication to treat self-diagnosed diseases or symptoms [1]. It also includes various behaviors to prevent or manage disease. Self-medication is a serious public health problem in both developing and developed countries [2] and can cause serious consequences including delayed diagnosis, drug resistance, development of comorbidity, and death [3]. Age, gender, and health knowledge affect individuals’ attitudes towards SM [4]. In addition, higher education level and occupational status have been reported as determinant factors for SM [5]. University students are risky individuals in terms of SM, especially because of their high level of education and their ability to obtain information about drugs via the Internet. Sleep disturbance and poor sleep quality are common among university students [6]. Poor sleep quality has been reported with different prevalences in different countries (30% to 76%) [7, 8]. In the literature, there are few studies investigating the prevalence of alcohol, drug, and over the counter (OTC) drug use and related problems in university students to reduce sleep problems [9]. Students in health care professions are also at risk for SM [10]. The rate of SM in medical students was reported to be over 70% in a year, with the most used medications being antipyretics and analgesics [11]. As far as we know, research has yet to be done on how university students manage their sleeping problems and the prevalence of SM in Türkiye. In this study, we aimed to investigate the prevalence of sleep quality and self-medication for insomnia among university students. Our further aim was to determine whether medical students and non-medical students differ in terms of sleep quality and the methods they use to manage sleep disturbances. We also examined characteristics related to the previous year’s use of sleep aids and misuse of prescription medications for SM purposes among medical and non-medical students. Material and Methods Study design and participants This descriptive study was conducted between 01/04/2018 and 01/05/2018 (during a period when students did not have midterm or final exams). It included a total of 437 participants (response rate 50%), consisting of 286 medical and 151 non-medical students from XXXXX University, a foundation (private, non-profit) university located in Ankara, the capital of the country. Data source and variables After the informed consent form was signed, the participants were administered the Sociodemographic Data and Methods of Coping with Insomnia Questionnaire, Pittsburgh Sleep Quality Index (PSQI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI). Measurement Tools Sociodemographic Data and Methods of Coping with Insomnia Questionnaire: This was prepared by the researchers and consisted of two parts: sociodemographic data (age, gender, place of residence, with whom they lived, family type, employment status, current and past psychiatric and physical disease diagnosis-treatment information, and the methods they used to cope with insomnia in the last one year, such as alcohol-substance use, OTC and prescription-only drugs used without consulting a doctor) were questioned. In addition, there were questions to determine from whom (friends, family members, pharmacist, internet, etc.) they received medication advice before starting to use prescription-only drugs without consulting a specialist. The questionnaire was applied to 20 students who would not be included in the study, and the questions were reorganized in line with the feedback received. Pittsburgh Sleep Quality Index: The Turkish form [12] of the PSQI was used to measure sleep quality. The 18 items included in the scoring were grouped into seven components. Each item is evaluated in the range of 0-3 points. The sum of the seven component scores constitutes the PSQI’s result. The lowest total score is zero, and the highest is 21. A total score greater than 5 indicates poor sleep quality. Beck Anxiety Inventory (Turkish form): It is a self-report scale consisting of 21 items in a 0-3 Likert type aimed at evaluating anxiety symptoms. An increase in the scores indicates an increase in the anxiety experience. The Cronbach Alpha internal consistency coefficient was determined as 0.93 [13]. Beck Depression Inventory (Turkish form) : This self-report scale measures depression symptoms in vegetative, emotional, and cognitive domains and assesses the risk of depression and severity of depressive symptoms. It comprises 21 items, each rated on a 0-3 scale. Increasing scores indicate an increase in depressive symptoms [14]. Statistical Analysis Data were analyzed using SPSS 17.0 (Statistical Package for the Social Sciences, IBM) package program, and p< 0.05 was considered statistically significant in all analyses. Before pairwise comparisons, the conformity of continuous variables to the normality distribution was determined by the Kolmogorov-Smirnov test and visual methods. Sociodemographic descriptive data were presented as percentages and frequencies for categorical variables and median and IQR for continuous variables. Pearson chi-square and Fischer exact tests were used for pairwise comparisons, and the Mann-Whitney U test, a non-parametric test, was used for continuous variables because they did not fit the normal distribution. Logistic regression analysis was applied to determine the predictors of self-medication through misuse of prescription-only drugs. Sex, faculty (medical/non-medical), living arrangements (dormitory vs. house), anxiety and depression scores, and history of psychotropic medication use were included as covariates based on both bivariate comparisons and prior evidence suggesting their associations with both poor sleep quality and self-medication behaviors. Given the conceptual overlap between sleep quality (PSQI), anxiety, and depression, multicollinearity was assessed before model construction. As strong correlations were observed between PSQI and both BDI and BAI scores, PSQI was not retained in the final regression model to avoid multicollinearity and to preserve model parsimony. Dependent variables: Sleep quality (poor sleep quality: PSQI score>5); Alcohol use for insomnia in the last 1 year: present (included those who reported using more than once a month)/absent; OTC use for insomnia in the last 1 year (yes/no); Misuse of prescription sleeping pills for self-medication: (yes/no) These were obtained with the following questions prepared by the researchers: “In the last year, have you used a prescription drug to relieve your insomnia without consulting a doctor?”; “If you used a prescription medicine in the last 1 year without consulting a doctor, did you consult with someone?”; I used a medication recommended to me for sleep disturbance by a doctor in the past /used a medication recommended to me by a family member/consulted my friend/consulted my pharmacist/researched on the internet (yes/no) Independent variables: Age, gender, faculty (medical-non-medical) living conditions (dormitory, home), with whom (alone, family or friends) employment status (yes/no) chronic physical illness (yes/no) smoking (yes/no), alcohol use (yes/no), history of psychiatric illness (yes/no), family history of psychiatric illness (yes/no), depression score (BDI), anxiety score (BAI) Demographic and Clinical Characteristics of the Participants The mean age of the participants was 21.2 ± 2.2 years. The majority were female (284 participants, 65%), living at home (353 participants, 80.8%), and not employed (417 participants, 99.8%). Only 16% lived alone, while the remaining participants lived with family or friends. A comorbid physical illness was present in 4.3% of the participants, and 14 individuals (3.2%) had a current psychiatric disorder, including anxiety disorders (n=3), mood disorders (n=6), and ADHD (n=5). Thirty-three participants (7%) stated that they had been diagnosed with a psychiatric disorder in the past, including 9 with anxiety disorder, 14 with unipolar depression, 2 with obsessive-compulsive disorder, 1 with insomnia, 1 with ADHD, and 6 with other mental illnesses. Additionally, 54 (12%) of the participants stated that they had used at least one psychotropic medication in the past, including antidepressants (n=36), benzodiazepines (n=2), stimulants (n=6), and unspecified drugs (n=12). More than half of the students (52.4%) had poor sleep quality (PSQI > 5). There was a strong positive correlation between PSQI total scores and BDI and BAI scores, regardless of the student’s faculty (rho: 0.488, p < 0.001, and rho: 0.489, p < 0.001, respectively). It was also determined that 26% of the students reported using at least one self-medication for insomnia in the past year. Of these, 8% (n=35) used OTC drugs, 16% (n=35) used alcohol, and 9.8% (n=43) used prescription-only drugs for self-medication. Comparison of Sociodemographic and Clinical Characteristics of Medical and Non-medical Students There was a statistically significant difference in the median age (IQR) between medical students and others (p < 0.001). The percentage of medical students living alone was significantly higher than that of other students (20.5% vs. 11.4%, p = 0.022). Characteristics such as gender, place of residence, and employment status were similar between the groups. The percentage of poor sleep quality (PSQI > 5) was significantly higher among medical students compared to others (57% vs. 43%, p = 0.004). No significant differences were observed between the groups in BDI and BAI scores (p = 0.557 and p = 0.639, respectively). A detail of sociodemographic characteristics and scale scores for medical and non-medical students is provided in Supplement 1. Comparison of Medical and Non-Medical Students’ Characteristics Related to Self-Medication over the Past Year There was no statistically significant difference between the two groups regarding consulting a doctor for sleep problems in the past year (p = 0.289). However, medical students had significantly higher percentages of using prescribed medication for sleep without consulting a specialist in the past year compared to non-medical students (12.2% vs. 4%, p = 0.005). Additionally, more medical students used medication previously prescribed without re-consulting a doctor (6.3% vs. 1.3%, p = 0.018) and resorted to medication or methods found online (8.4% vs. 3.3%, p = 0.042). Detailed comparisons of medical and non-medical students’ self-medication practices in the past year are presented in Table 1. Comparison of good and poor sleepers according to sociodemographic and clinical features There was no statistically significant difference between good and poor sleepers regarding age, gender, and place of residence, although the percentage of poor sleepers living alone was significantly higher. Additionally, no statistically significant differences were found between good and poor sleepers concerning current psychiatric illness or past psychiatric history. The rates of poor sleep quality among medical students were comparable in both preclinical and clinical years. In contrast, among non-medical students, the proportion of poor sleepers was noticeably greater during the first three years. Detailed comparisons of the demographic and clinical characteristics of good and poor sleepers are presented in Table 2. Comparison of Sociodemographic and Clinical Characteristics of Students Used a Prescription Drug for Self-Medication last year and others When students were grouped based on whether they used a prescription drug for self-medication, regardless of their field of study, it was found that the percentage of self-medication was higher among male students (p = 0.003). Among medical students, self-medication was more common in those in the earlier grades (preclinical) (p < 0.001). In contrast, among non-medical students, the frequency of self-medication was similar across the first three grades and after the third grade. The percentage of poor sleep quality was significantly higher in students who resorted to self-medication (p = 0.047). Additionally, factors such as place of residence (p < 0.001), smoking (p = 0.029), current psychiatric illness (p = 0.033), past psychotropic drug use (p = 0.014), BDI score (p < 0.001), and BAI score (p < 0.001) were all associated with self-medication. Detailed results are presented in Table 3. Logistic regression A logistic regression analysis was also conducted to identify independent risk factors for self-medication with prescription-only drugs, as outlined in Table 4. The variables that were independently linked to self-medication with prescription-only drugs included: medical education (OR = 4.25 p = 0.003), male sex (OR = 2.61, p = 0.01) higher anxiety scores (OR = 1.08, p < 0.001) psychotropics history (OR = 2.95, p = 0.017), and living in dormitory (OR = 3.87, p = 0.01) Discussion Given that SM for poor sleep quality and sleep disorders is a significant concern among university students, we examined the frequency of SM, differences between medical and non-medical students in terms of SM, and the factors associated with the misuse of prescription-only drugs for SM. Our findings revealed that 26% of students engaged in self-medication, including the use of alcohol, OTC medications, and prescription-only drug misuse as sleep aids over the past year. This highlights that a substantial proportion of university students resort to self-medication to manage insomnia. We found that the percentage of poor sleep quality among students was 52%, considerably higher than the rates reported in the adult population (33%) [15]. Studies utilizing the PSQI have reported that the percentage of poor sleep quality among university students falls within a range of 30% to 76%, consistent with our results [7, 8]. We also found that the percentage of poor sleep quality among medical students (57.5%) was significantly higher than that of non-medical students (43%). The anxiety and depression scores of medical and non-medical students were similar, suggesting that the higher prevalence of sleep problems in the medical student group may be due to isolated sleep issues rather than sleep symptoms associated with mood disorders. There was no significant difference between medical and non-medical students in terms of seeking medical advice for insomnia, using OTC medications or alcohol as sleep aids in the past year. However, the misuse of prescription-only medications was significantly higher among medical students (17% vs 7%). Medical students were also more likely than non-medical students to rely on pharmacy recommendations or online searches when deciding on self-medication with prescription sleep drugs. Additionally, they were more prone to using a drug they had previously taken without consulting a doctor compared to non-medical students. In a meta-analysis by Montgomery et al. (2011), the rates of self-medication among medical students ranged widely, from 12% to 99% [16]. This range can be attributed to the results from different countries, varying health policies, and the questionnaires used in the studies. Unlike previous studies, our findings address self-medication with both prescription and non-prescription-only drugs. No significant difference was found between medical and non-medical students in terms of using herbal or OTC medications for insomnia. Consistent with the data from our study, the literature reports that students frequently resort to self-medication for insomnia and other symptoms and that medical education increases these rates [10, 17]. These results may be related to the poor sleep quality observed among medical students. Another possible reason could be the confidence gained by health-related students through their medical training, skills, and knowledge, which may lead to a higher tendency to self-medicate. Due to their medical training and perspectives, many doctors and medical students struggle with the experience of being a patient [16]. The percentage of poor sleep quality was similar in both the preclinical and clinical phases. However, we found that most medical students who resorted to self-medication with prescription sleep drugs were in the early years of their education (preclinical phase). The literature presents conflicting results on this topic. A study from Saudi Arabia reported findings like ours, with a higher percentage of self-medication among preclinical medical students [18]. However, other studies have found higher rates of self-medication in students in the later years of medical training. This may be due to lacking extensive clinical training; preclinical health faculty students may resort to self-diagnosis and self-medication for minor health problems. Additionally, they may overestimate their ability to diagnose and treat medical conditions early. Also, peer influence may contribute, with new students emulating older peers normalizing self-medication. The stress of making the transition to university life may exacerbate this tendency. In addition, the risks associated with self-medication may need to be fully understood by younger students. Addressing these factors could help educate and support young health students in making more informed healthcare decisions. In our study, the use of prescription sleep medications for self-medication in the past year was found to be associated with the male gender. However, the percentage of poor sleep quality was similar in both genders. This may be related to male students being less willing to seek help for mental health issues [19]. Goodhines et al (2019) investigated the use of alcohol, substances, and OTC medications as sleep aids in university students, and they similarly found a higher rate of self-medication for insomnia among males [9]. However, when examining the relationship between gender and self-medication in the broader medical literature, our findings contradict some results. A study conducted in Serbia among medical students found that women were more likely to self-medicate with prescription medications, including antidepressants and sedatives, beyond sleep medications (OR: 1.39) [20]. In studies conducted with university students in Slovenia [21] and Palestine [22], no gender differences were found in terms of self-medication. We found that students who use prescription sleep medications for self-medication also tend to consume stimulant drugs and beverages like coffee or energy drinks to stay awake during the day. In a recent study investigating the use of medications for sleep problems among medical students, it was found that nearly all students using sleep medication were also taking stimulant drugs. This was interpreted as indicating that stimulant use might negatively impact the sleep-wake cycle, potentially leading to the use or misuse of sleep medications [18]. In our study, consistent with the literature, we found that students who engaged in self-medication with prescription-only drugs had higher rates of past diagnosis of a psychiatric disorder and psychotropic medication and higher anxiety scores [20]. Goodhines and colleagues, however, did not find a relationship between anxiety and self-medication for sleep in their study investigating the use of alcohol, substances, and OTC medications as sleep aids [9]. This study is the first in Turkey to investigate sleep quality, the frequency of self-medication for sleep disorders, and whether there are differences between medical and non-medical students. The results show that most university students experience poor sleep quality, regardless of their field of study, and many resort to self-medication. Our study has some limitations. Since this research was conducted at a single university and the survey had a low response rate, the representativeness of the sample is compromised, limiting the generalizability of the findings. Additionally, the cross-sectional and descriptive design of the study does not allow for the determination of causal relationships. It should be noted that collecting information such as medical history and drug use in the past year through self-report questionnaires may have introduced recall bias. The results of this study are based on self-reported sleep data, and future research could benefit from incorporating objective sleep measurements, such as actigraphy and polysomnography. Finally, due to the potential stigma associated with stimulants and psychiatric medication use, participants may have refrained from disclosing this information, leading to potential information bias. The findings underscore the prevalent use of self-medication with prescription sleep aids in university students, especially among medical students. Factors such as male gender, medical education, a history of psychotropic drug use, dormitory living, and higher anxiety levels were identified as independent risk factors for self-medication. These results emphasize the need for targeted interventions to address sleep disorders and reduce the reliance on self-medication practices among university students. Improved awareness and support systems could mitigate these risks, enhancing academic performance and well-being. Developing interventions that provide students with information on sleep hygiene, relaxation techniques, healthy eating, and lifestyle habits (such as reducing caffeine consumption and engaging in regular exercise) could reduce the use of SM for sleep disorders. Ethics Approval & Funding Source Statement This study was approved by Baskent University Institutional Review Board and Ethics Committee (Project no: KA17/55). This research did not receive any specific grant from funding agencies in the public, commercial, or non-profit sectors. Conflict of Interest Disclosure The authors declare no potential conflict of interest. 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Characteristic Medical students n(%) non-medical students n(%) p Any psychiatric medication use without a consult 29 (10.1%) 14 (9.4%) 0.805 a Doctor consultation for insomnia 16 (5.6%) 5 (3.3%) 0.289 a Alcohol use for sleep assistance (n:437) 44 (15.4%) 24 (15.9%) 0.889 OTC medication for sleep(n:437) 27 (9.4%) 8 (5.3%) 0.129 Prescription medication without consultation to MD (n:437) 35 (12.2%) 6 (4.0%) 0.005 Reusing past prescribed medication 18 (6.3%) 2 (1.3%) 0.018 b Family-recommended medication use 11 (3.8%) 3 (2.0%) 0.397 b Friend-recommended medication use 13 (4.5%) 2 (1.3%) 0.079 b Pharmacist-recommended medication use 10 (3.5%) 0 0.018 b Internet-researched medication use 24 (8.4%) 5 (3.3%) 0.042 b Stimulant medication used for daytime sleepiness 21 (7.3%) 14 (9.3%) 0.480 a Coffee, energy drink use, for daytime sleepiness 173 (60.5%) 69 (45.7%) 0.003 a n: number, OTC: Over the counter, MD: medical doctor a: Pearson Chi Square Test b: Fischer Exact Test Table 2. Comparison of good and poor sleepers according to sociodemographic and clinical features Age (years) median (IQR) 21(2) 21(2) 0.497 a Sex Female 126(61%) 158(69%) 0.075 b Male 81(39%) 71(31%) Residence Home 173(84%) 180(79%) 0.179 b Dormitory 33(16%) 48(21%) Living arrangement Alone 25(13%) 45(21%) 0 .033 b with family/friend 165(87%) 167(79%) Medical students Preclinical 1 91(75%) 109(66.5%) 0.111 b Clinical 30(25%) 55(33.5%) Non-medical students First three years 56(68.3%) 51(83.6%) 0.037 b Fourth years and later 26(31.7%) 10(16.4%) Working status (yes) 6(%2.9) 6(2.6%) 0.859 c Comorbidity 5(2.4%) 12(5.3%) 0.126 c Smoking status (still smoking) 65(31.4%) 91(39.7%) 0.070 b Alcohol consumption (yes) 101(48.8%) 133(58%) 0.052 b Current diagnosis of Psychiatric disorder (yes) 4(1.9%) 10(4.4%) 0.150 c Psychiatric disorder history (yes) 11(5.3%) 22(9.6%) 0.091 b Psychotropic history 36(12.6%) 18(11.9) 0.840 b Family psychiatric disorder history 18(8.7%) 32(14%) 0.084 b preclinical indicates the first three years of medical school, IQR: Interquartile range, PSQI: Pittsburgh Sleep Quality Index, a: Mann Whitney U Test, b: Pearson Chi Square Test, c: Fischer Exact Test Table 3: Comparison of sociodemographic and clinical characteristics of students who used a prescription drug for self-medication last year and non-user Age (years) median (IQR) 21(3) 22(1) <0.001 a Sex Female 18(43.9%) 266(67.2) 0.003 b Male 23(56.1) 130(32.8%) class medical students preclinic 33(16.4%) 168 (83.6%) 0.001 c clinic 2 (2.4%) 83 (97.6%) non-medical students before 3rd class 4 (3.7%) 103 (96.3%) 0.638 c after 3rd class 2 (5.6%) 34 (94.4%) Residence House 18(45%) 331(83.8%) <0.001 b Dormitory 22(55%) 64(16.2%) Living Arrangement Alone 8(23.5%) 62(16.8%) 0.322 v with Family members /Friends 26(76.5%) 307(83.2%) Working status (yes) 0 12(3%) 0.614 c Physical Illness 1(2.4%) 18(4.6%) 1 c Smoking status (still smoking) 21(51.2%) 135(34.1%) 0.029 b Alcohol consumption 27(65.9%) 207(52.3%) 0.097 b Current diagnosis of Psychiatric disorder(yes) 4(9.8%) 10(2.5%) 0.033 c Psychiatric disorder history 5(12.2%) 28(7.1%) 0.220 c Psychotrop history 10(24.4%) 44(11.1) 0.014 b Family psychiatric disorder history 9(22%) 17(11.3%) 0.026 b Poor sleeper (PSQI>5) 27(67.5%) 202(51%) 0.047 b Beck depression İnventory score median (IQR) 17(13) 10(11) <0.001 a Beck Anxiety Scale score median (IQR) 18(9) 9(11) <0.001 a SM: Self-medication, PSQI: Pittsburgh Sleep Quality Index, IQR: Interquartile range, a: Mann Whitney U Test, b: Pearson Chi Square Test, c: Fischer Exact Test Table 4. Logistic regression for self-medication with predictors of prescription sleep aid Education (medical) 4.25 1.64-11.00 0.003 Sex(male) 2.61 1.26-5.40 0.010 BAI 1.08 1.04-1.12 <0.001 Psychotropic history(yes) 2.95 1.22-7.14 0.017 Living arrangement(dormitory) 3.87 1.79-8.33 0.001 1 OR: odds ratio, CI: confidence interval 2 BAI: Beck Anxiety Inventory Information & Authors Information Version history V1 Version 1 26 February 2026 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords anxiety self-medication sleep quality students Authors Affiliations Selvi Ceran 0000-0002-7984-2440 [email protected] Baskent Universitesi Tip Fakultesi View all articles by this author Gonca Aşut Baskent Universitesi Tip Fakultesi View all articles by this author Pelin Kutlutürk TC Saglik Bakanligi Kulu Devlet Hastanesi View all articles by this author Ahmet Bostan TC Saglik Bakanligi Ankara Etlik Sehir Hastanesi View all articles by this author Cem Aykanat Ondokuz Mayis Universitesi Tibbi Patoloji Anabilim Dali View all articles by this author Idil Soyuyüce Vitos Herborn gGmbH View all articles by this author Özgür Güven Gazi Universitesi Tip Fakultesi View all articles by this author Yasemin Duman Gazi Universitesi Tip Fakultesi View all articles by this author Metrics & Citations Metrics Article Usage 155 views 85 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Selvi Ceran, Gonca Aşut, Pelin Kutlutürk, et al. 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