Sleep Disturbances and Their Association With Academic Performance Among Medical Students: A Systematic Review

Abstract

Background: Sleep is a fundamental physiological process essential for cognitive functioning, memory consolidation, emotional regulation, and overall health. Medical students are particularly vulnerable to sleep disturbances because of demanding academic schedules, prolonged study hours, clinical responsibilities, examination stress, and lifestyle factors. Increasing evidence suggests that inadequate sleep quality and quantity may adversely affect academic performance; however, the magnitude and consistency of this association remain unclear. Objective: To systematically review and synthesize the available evidence regarding the prevalence of sleep disturbances among medical students and their association with academic performance. Methods: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including PubMed, Scopus, Web of Science, Embase, and Google Scholar were searched for studies published between January 2000 and December 2025. Observational studies assessing sleep quality, sleep duration, insomnia, daytime sleepiness, or other sleep-related parameters among undergraduate or postgraduate medical students and reporting academic performance outcomes were included. Data on study characteristics, sleep assessment tools, prevalence of sleep disturbances, and academic outcomes were extracted and narratively synthesized. Results: A total of 32 studies involving approximately 21,500 medical students across multiple countries met the inclusion criteria. The prevalence of poor sleep quality ranged from 32% to 78%, while insufficient sleep duration (<7 hours per night) was reported in 40–85% of participants. Most studies demonstrated a significant association between poor sleep quality and lower academic achievement. Students experiencing sleep disturbances were more likely to report reduced grade point averages, impaired concentration, decreased examination performance, increased absenteeism, and poorer cognitive functioning. Excessive daytime sleepiness and insomnia symptoms were also consistently associated with adverse academic outcomes. Several studies identified stress, electronic device use before bedtime, caffeine consumption, and irregular sleep schedules as major contributing factors. Conclusion: Sleep disturbances are highly prevalent among medical students and are consistently associated with poorer academic performance. Interventions aimed at improving sleep hygiene, stress management, and mental well-being may contribute to enhanced academic outcomes and overall student health. Medical institutions should prioritize sleep health promotion as part of student wellness programs.