Influence of stress, anxiety, and depression on sleep quality and academic performance of medical students in Fallujah University, Iraq

Background: There is a relation between sleep quality, mental health, and academic performance among medical students. Students who experience better sleep quality and have good mental health will exhibit higher academic performance compared to those who have reduced sleep quality and poor psychological health. Objective: To assess the relation between mental health problems, sleep quality, and academic performance among medical students in the stage of clinical training at the University of Fallujah, Iraq. Methods: In this cross-sectional study, a self-administered questionnaire was adopted that gathered three validated and previously used screening tools: The Pittsburgh Sleep Quality Index (PSQI), Depression Anxiety Stress Scale (DASS-21), and the AHELO Self-Assessment Questionnaire. Results: The findings revealed a high prevalence of anxiety, 40% of the students reported experiencing mild to moderate anxiety, while 24.1% showed severe anxiety, 20.0% experienced mild depression, and 10.8% had moderate depression. There was a significant negative correlation between stress and academic performance (Pearson's r = -.333, p < .001), between depression and academic performance (Pearson's r = -.437, p < .001), and between anxiety and academic performance (Pearson's r = -.417, p < .001). Conclusion: Mental health problems are prevalent among medical students represented by the study sample, and are significantly correlated to the students' academic performance.