Maintaining a good sleep quality is a basic human need, because the poor sleep is associated with negative effects such as exhaustion, uncontrolled emotions, the inability to concentrate, the inability to remember or think clearly, poor university and work performance, psychological and academic stress, anxiety, depression and difficulty in resolving problems; also long-term effects such as cardiovascular diseases, diabetes mellitus type II, obesity, cancer, among others(1)
Not all medical students enjoy of good sleep quality and a sufficient number of hours, due to the high educational activity and various stressors with which they live daily at the university.
In our research work carried out in 410 students from 1st to 12th cycle of the Medical School of Ricardo Palma University in 2020, we found that 73.9% of medical students used electronic devices every day at the hour before sleep. The continuous use of these devices can alter the synchronization between the stages of sleep causing a negative impact on the habits, quality and hygiene of sleep; not using electronic devices one hour before sleep would lead to better sleep quality(2)
The 60.49% of the population of our study ingested harmful substances (coffee, energy drinks, alcohol and they smoked cigarettes), the substance most frequently was the coffee. Consuming substances with caffeine can have repercussions at a cognitive, interpersonal and behavioral level, causing in the majority of cases alterations associated with circadian rhythm and sleep(3)
The World Health Organization (WHO) recommends physical exercise for 30 minutes 5-7 times a week. In our study, we observed that 20.97% of medical students performed exercises with the indicated frequency, however 8 out of 10 university students have not practiced physical activity according to these recommendations(4)
. The physical exercise is an activity that is associated with the improvement of sleep due to the benefits that it causes at a psychological and physical level as well as at the level of quality of life, mood and general well-being, the prevention of non-communicable diseases and reducing the risk of complications in adults with pre-existing diseases. In addition, the aerobic exercise has significant benefits in relation to the quality of sleep has been confirmed(5)
Furthermore, a Spearman´s rho with a value of 0.505 was found in our study (represented graphically in figure 1
) showing that academic stress and sleep quality (measured by the SISCO SV Academic Stress Inventory and the Pittsburgh Sleep Quality Index, respectively) presented a positive correlation, observing that increasing the academic stress score increased the sleep quality score (a score greater than 5 is poor sleep quality); which meant that the increase in academic stress caused a poor sleep quality. This finding is similar to a study by Benham (2019) in Hispanic students at an university in the United States, where he obtained a Spearman´s rho of 0.51 by associating both variables(6)
Figure 1. Dispersion diagram of academic stress with sleep quality.
Source: Instituto de Investigación de Ciencias Biomédicas –Universidad Ricardo Palma
Lifestyle medicine is revolutionizing healthcare systems and medical education in universities. It is for this reason that Ricardo Palma University created in 2019 the First Chair of Lifestyle Medicine, for the purpose of developing activities and programs in undergraduate, postgraduate and continuing education. Its curricular incorporation and promoting a healthy lifestyle will be very beneficial for university students and staff of the institution due to the implications that it will generate in personal and professional development in the short and long term.
Authorship contributions: The authors participated in the collection of information, writing and final version of the article.
Conflicts of interest: The authors declare that they have no conflicts of interest in this research.
Received: February 21, 2021.
Approved: February 28, 2021.
Correspondence: Fiorella Rosemary Allende-Rayme.
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Herawati K, Gayatri D. The correlation between sleep quality and levels of stress among students in Universitas Indonesia. Enfermería Clínica. septiembre de 2019;29:357-61. DOI: https://doi.org/10.1016/j.enfcli.2019.04.044
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