Effects of COVID-19 2021 lockdown on the sleep quality and mental health of undergraduate medical and dental students of Pakistan: A cross-sectional study

  1. Naveen Siddique Sheikh
  2. Aiza Anwar
  3. Iqra Pervaiz
  4. Zunaira Arshad
  5. Huma Saeed Khan
  6. Farida Hafeez

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Abstract

Background and objectives

The COVID-19 pandemic has been recognized as a cause of direct and indirect psychological consequences that impact mental health such as acute stress disorders, anxiety, irritability, poor concentration, and insomnia. This study was planned to evaluate the sleep quality and mental health of undergraduate students amidst the COVID-19 lockdown of 2021.

Materials and Methods

This observational cross-sectional study was conducted in Lahore, Pakistan, where 261 undergraduate medical and dental students enrolled at a private medical and dental school were approached from March to May 2021. The Pittsburg Sleep Quality Index (PSQI) was used to identify the sleep quality along with the Generalized Anxiety Disorder Scale (GAD-7) to establish anxiety symptoms and the Physical Health Questionnaire (PHQ-9) for depression symptoms.

Results

The results show that 212 (81.2%) female and 49 (18.8%) male students participated in the study. Of the participants 75.1% experienced poor sleep quality, 90% had symptoms of depression, and 85.4% had symptoms of anxiety. The mean score on the PSQI scale was 8.59±4.10, on the GAD-7 scale was 11.36±5.94 and on the PHQ-9 scale was 13.70±6.81. Multiple regression analysis showed that anxiety symptoms ( β = 0.315, p = 0.000) and depression symptoms ( β = 0.398, p = 0.000) were significant predictors of sleep quality amongst the undergraduate medical and dental students.

Conclusion

A high majority of the study participants are experiencing poor sleep quality along with suffering from depression and anxiety amidst the COVID-19 lockdown. It is concluded from the analysis that anxiety and depression symptoms are significant predictors of sleep quality. Relevant authorities need to set up systems that help undergraduate medical students in alleviating and coping with these symptoms midst the COVID-19 pandemic.

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  1. ScreenIT

    SciScore for 10.1101/2021.07.17.21260690: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: This observational cross-sectional study was conducted from March to May 2021 at a teaching institute affiliated with a tertiary care hospital in Lahore Pakistan, after obtaining approval from the Institution’s ethical review board.
    Consent: Informed electronic consent was the first part of the questionnaire.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power AnalysisThe sample size was calculated by using the Raosoft sample size calculator by keeping a 5% margin of error, 95% confidence interval, and 1050 as the population size with 50% response distribution.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data were analyzed via SPSS (Statistical Package for the Social Science) software version 26.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This research warrants enhancements and does not come without its limitations. The study is cross-sectional which hinders disentangling causality of whether the sleep disturbance is due to the COVID-19 pandemic directly or were there confounding factors that contributed to sleep disturbances as well. Though causality can not be determined, the study still, however, suggests that the pandemic might have an effect on sleep disturbance and the mental health of undergraduate medical and dental students. Even though the sample size is adequate, the results should be generalized for the entire population of undergraduate medical and dental students of Pakistan with caution.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2021.07.17.21260690v1 on medRxiv