Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"



Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018




Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."



Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018




Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."



Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018




Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."



Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
Lucknow
On Sep 2018




Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."



Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata




Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
Muzaffarnagar.
On Aug 2018




Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".



Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
Bengaluru.
On Aug 2018




Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".



Dr. Mamta Gupta
Consultant
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018




Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.


Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."



Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
E-mail: drrajendrak1@rediffmail.com
On May 11,2011




Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."



Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
E-mail: ravi.dr.shankar@gmail.com
On April 2011
Anuradha

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.


Dr. Anuradha
E-mail: anuradha2nittur@gmail.com
On Jan 2020

Important Notice

Original article / research
Year : 2024 | Month : June | Volume : 18 | Issue : 6 | Page : CC05 - CC12 Full Version

Health Sciences Students’ Knowledge, Attitudes, and Awareness of the Effects of Sleep Quality on the Brain: A Cross-sectional Study


Published: June 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/69880.19478
Rana Alharthi, Rawan Alamri, Wafa Alqarni, Muhammad Anwar Khan, Raju Suresh Kumar

1. Intern, Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia. 2. Intern, Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia. 3. Intern, Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia. 4. Lecturer, Department of Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center (KAIMRC), Jeddah, Saudi Arabia. 5. Assistant Professor of Physiology, Department of Basic Sciences, College of Science and Health Profession

Correspondence Address :
Dr. Raju Suresh Kumar,
Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences and King Abdullah International Medical Research Center (KAIMRC), National Guard Health Affairs (NGHA), King Abdulaziz Medical City, Jeddah-21423, Makkah Province, Saudi Arabia.
E-mail: raju6712in@gmail.com

Abstract

Introduction: Sleep is a fundamental necessity for the human body, particularly for ensuring optimal brain function, and health science students are predisposed to experiencing lower-quality sleep than the general population.

Aim: To assess the knowledge, attitudes, and awareness of health science students regarding the influence of sleep quality on the brain.

Materials and Methods: This descriptive cross-sectional study included male and female students from diverse Colleges at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia, encompassing the College of Science and Health Professions, College of Medicine, College of Applied Medical Sciences, and College of Nursing. The study spanned one year, commencing in September 2022 and concluding in September 2023. It included 361 participants who completed a self-administered validated questionnaire. Participants were chosen through non probability consecutive sampling, and the questionnaire covered demographic characteristics, attitudes towards sleep quality, awareness of its importance, and knowledge of its impact on the brain. Data analysis encompassed descriptive statistics and inferential tests, including the Independent t-test, and Chi-square test with a significance level of p-value <0.05.

Results: Female students exhibited a higher likelihood of disagreeing (p-value=0.006) with the notion that sleep quality does not impact memory conversion compared to males. Additionally, a significant number of female students (p-value=0.009) acknowledged the correlation between anxiety and insomnia, which was not as prevalent among males. Among the participants, 66.8% were females, and 33.2% were males. Common presleep behaviours included avoiding tea/coffee (76.5%) and using smartphones before bedtime (90.6%). While awareness of sleep quality’s influence on memory recall was high (72.0%), comprehension of its connection with seizures in epilepsy was relatively lower.

Conclusion: This study underscores the significance of assessing attitudes, knowledge, and awareness regarding sleep quality among health science students. Notable gender variations were observed, with females demonstrating greater awareness of sleep’s impacts on memory and insomnia related to anxiety. Consequently, sleep education initiatives and fostering healthy sleep habits among students in health science disciplines are essential.

Keywords

Glymphatic system, Melatonin, Obesity, Sleep hygiene

Adequate sleep is now widely acknowledged as a critical factor in maintaining good mental, emotional, and physical health. Healthy sleep is defined by sufficient duration, favorable quality, suitable timing, and the absence of sleep-related disorders (1). Sleep consists of two major patterns: Rapid Eye Movement (REM) and Non Rapid Eye Movement (NREM) sleep. It is further subdivided into four sleep stages. The first stage is the lightest stage of sleep, lasting 1 to 5 minutes and characterised by muscle tone in the skeletal muscles. As the heart rate and body temperature drop, the individual enters the second stage of sleep, which lasts around 25 minutes. The third stage is deep sleep, which is tough for a person to wake up from. REM is the final sleep stage in which dreaming occurs (2). Scientific evidence suggests that REM sleep is associated with brain development (3). It has been reported that a lack of sleep can significantly impact mental performance, resulting in reduced alertness, impaired attention, and slower cognitive processing (4).

It is widely acknowledged that sleep timing can vary significantly from person to person due to intrinsic and external factors such as genetics, age, health state, school/work schedule, and lifestyle (5). According to recommendations from the National Sleep Foundation, United States adults between the ages of 18 and 64 years should aim for approximately seven to nine hours of sleep per night (6). Research has demonstrated that a lack of sleep can have numerous adverse effects on health, behaviour, mood, and academic performance, particularly during significant physical and emotional changes (7). Furthermore, the impact of sleep on brain health is substantial and manifests in unexpected ways. Lack of sleep not only affects memory and concentration in the short-term but also causes long-term neurological dysfunction (8).

Sleep deprivation has been reported to result in brain activity alterations in self-control, suppression, judgement and decision-making (9). A study using functional Magnetic Resonance Imaging (fMRI) on sleep-deprived healthy individuals found that a lack of sleep led to decreased working memory function (10). In a meta-analysis conducted by Schmid D et al., the importance of sleep in the consolidation of motor memories among healthy human volunteers was underscored (11). Lack of sleep, whether in quantity or quality, is linked to difficulty controlling appetite, leading to obesity, metabolic syndrome, diabetes, or hypertension later in life (12). Additionally, being overweight or obese increases the likelihood of having sleep disorders, including obstructive sleep apnoea, driving to oxidative stress and systemic inflammation where the circadian clock is days regulated, eventually worsening sleep quality (12),(13).

Health science students are particularly susceptible to poor sleep, especially among the general population (14). Due to their long study and high-class hours, clinical internship, high academic pressure, night work shift, emotional stress, lifestyle decisions, and frequent use of social media (14). Reports suggest that adolescents in Saudi Arabia have shorter sleep durations than those in the United Kingdom, possibly due to poor sleep hygiene (15). The community must acknowledge the significance of sleep quality to tackle this issue effectively (16). There is a lack of literature exploring health science students’ awareness, knowledge, and attitude towards the quality of their sleep and its influence on brain function. This study aims to assess the knowledge, attitudes, and awareness of the impact of sleep quality on the brain among health sciences students at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia.

Material and Methods

This descriptive cross-sectional study focuses on male and female students enrolled in various colleges at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia. The study includes students from the College of Science and Health Professions (COSHP), College of Medicine (COM), College of Applied Medical Sciences (CAMS), and College of Nursing (CON). The study lasted a year, starting in September 2022 and concluding in September 2023. Approval from the Institutional Review Board (IRB) was granted for the study, which included the questionnaire survey and consent forms (Study number SP22J/129/08). The survey was accessible online from January to April 2023.

Inclusion criteria: Male and female health sciences students, who were enrolled in various colleges at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia during the study period were included in the study.

Exclusion criteria: Students from universities apart from King Saud bin Abdulaziz University for Health Sciences were excluded from the study.

Sample size: Using Raosoft® software, the sample size for the study was determined to be 342 students, with a confidence level of 95%, a response distribution of 50%, and a margin of error of ±5%. Participants were chosen through a non probability consecutive sampling method. However, 361 participants participated in the survey.

An ensemble of independent subject experts scrutinized the content validity of the questions, whereas a group of medical education specialists evaluated the questionnaire’s face validity. The questionnaire’s reliability was assessed by conducting a pilot survey with 35 individuals outside the study population. The reliability coefficient Cronbach’s alpha (α=0.92) was computed.

This survey was conducted online among study participants after obtaining informed consent from each participant. To mitigate acquiescence bias, a mix of positively and negatively worded items in the questionnaire were used. Reverse scoring was employed for negatively worded items in the questionnaire to ensure respondents’ attentiveness to the content of the questions rather than consistently choosing the same response option. Subsequently, following data collection, the scores for the reverse-scored items were reverted to match the scoring of the remaining questionnaire items.

The questionnaire comprised four sections:

Section 1 focusing on demographic characteristics, featuring four questions;

Section 2 addressing the attitudes of health science students towards sleep quality, containing 13 questions;

Section 3 examining the awareness of health science students regarding the significance of sleep quality, consisting of 13 questions; and

Section 4 exploring the knowledge of health science students regarding the significance of sleep quality and its impact on the brain, encompassing 12 questions.

Sections 1 and 2 consisted of closed-ended questions. Sections 3 and 4 employed a five-point Likert scale, structured from “strongly disagree” to “strongly agree”. These two sections have been measured as numerical variables to simplify the presentation and understanding of the readers, so a higher percentage meant higher agreement among the respondents.

The questionnaire was disseminated using a Google survey form and shared online via WhatsApp and email. The study aimed to collect data on health science students’ attitudes, knowledge, and awareness, with these variables considered dependent factors. Independent factors included gender, academic year, and college.

Statistical Analysis

Data were initially recorded in an Excel spreadsheet and subsequently imported into Statistical Package for Social Sciences (SPSS) version 20.0 (IBM, Chicago, Illinois, USA) for analysis. Descriptive analysis was performed using frequency and percentage calculations for categorical variables such as gender and city of residence. Likert scale responses to the questionnaire were computed with percentages in descriptive presentation, while the mean was used to compare the outcomes. The analysis involved conducting Chi-square tests and Independent t-tests to explore gender variations in responses whenever applicable. A significance threshold below 0.05 was deemed statistically significant.

Results

A total of 361 students from King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia, were involved in the study. They filled out a survey questionnaire, and their demographic information is detailed in (Table/Fig 1). Among the participants, 241 were identified as female (66.8%), while 120 were male (33.2%).

The study unveiled that students maintained an average nightly sleep duration of 6.1 hours (Table/Fig 2). Notably, 168 (46.5%) of participants rarely experienced nocturnal awakenings, yet 254 (70.4%) reported feeling drowsy during the daytime. Most students refrained from consuming tea or coffee before bedtime 276 (76.5%) and avoided smoking shisha/cigarettes 331 (91.7%). Moreover, only 122 (33.8%) of students maintained a consistent physical exercise regimen. Regarding presleep habits, many participants did not engage in activities such as listening to music 316 (87.5%) or keeping bedroom lights on while sleeping 305 (84.5%). A significant portion 327 (90.6%) of respondents acknowledged using their phones before bedtime. In comparison, 247(68.4%) reported having difficulty waking up in the morning.

In the awareness segment, among 361 participants, 260 (72.0%) strongly affirmed the significance of sleep quality for memory recall (Table/Fig 3). Furthermore, approximately 120 (33.2%) strongly agreed that the blue light emitted from devices disrupts sleep quality, while 145 (40.2%) acknowledged that consuming caffeine before sleeping reduces total sleep time. Moreover, 168 (46.5%) participants concurred that individuals with insomnia are more likely to suffer from anxiety. However, 114 (31.6%) participants did not agree to the question concerning association between lack of sleep and high obesity risk.

In the knowledge section, among the 361 participants, 215 (59.6%) expressed neutrality concerning the association between overusing sleeping pills and dementia (Table/Fig 4). Regarding sleep-related health issues, 154 (42.7%) agreed, and 147 (40.7%) strongly agreed that lack of sleep contributes to migraines and tension headaches. Furthermore, 133 (36.8%) strongly agreed, and 100 (27.7%) agreed that melatonin plays a role in regulating sleep. Additionally, 143 (39.6%) agreed, and 87 (24.1%) strongly agreed that insufficient sleep leads to amygdala activation, potentially causing mood disorders. In addressing negative questions within the questionnaire, participants demonstrated a good understanding regarding the statement “Poor sleep quality does not increase the risk of Alzheimer’s disease,” with 63 (17.5%) strongly disagreeing and 112 (31.0%) disagreeing. Similarly, for the statement “Sleep deprivation does not negatively affect working memory,” 95 (26.3%) strongly disagreed, and 160 (44.3%) disagreed. However, regarding the negative statement “Poor sleep quality will not trigger seizures in people with epilepsy,” only 30 (8.3%) of participants exhibited a good comprehension of this question.

When analysing the questionnaire data, an independent t-test was conducted to examine gender differences in study participants’ responses. A notable proportion of female students (p-value=0.006) disagreed with the assertion that sleep quality is inconsequential for converting short-term memory into long-term memory compared to males (Table/Fig 5). Furthermore, a significant number of female students (p-value=0.009) strongly agreed that anxiety could be a contributing factor to insomnia, in contrast to males.

When comparing gender differences in the knowledge section of the questionnaire (Table/Fig 6), no significant differences were observed in knowledge levels between male and female students.

In the gender comparison conducted in (Table/Fig 7) notable differences emerged between male and female participants. The findings indicate that a higher proportion of males (31.7%) compared to females (19.9%) reported not waking up during sleep, showing a significant difference (p-value <0.001). A larger percentage of females (71.0%) reported not engaging in physical exercise compared to males (56.7%) (p-value=0.007). More females (20.3%) reported sleeping with bedroom lights on compared to males (5.8%) (p<0.001). A higher proportion of females (73.0%) reported difficulty waking up compared to males (59.2%) (p-value=0.008).

Discussion

The objective of this study was to assess the knowledge, attitude, and awareness of health science students about the impact of sleep quality on the brain. The results revealed that the average nightly sleep duration of the participants was 6.1 hours, and many reported experiencing daytime drowsiness. While most of them avoided consuming tea or coffee before going to bed, the usage of mobile phones before sleeping was quite common. The participants had mixed knowledge levels when it came to sleep-related health issues and negative statements. Notably, gender differences were observed, especially in their attitudes towards memory conversion and the link between anxiety and insomnia, with females expressing stronger views.

The mean night time sleep duration of the study participants was six hours, which is one hour less than the optimal range of 7-9 hours, as reported in a previous study conducted by the National Sleep Foundation of the United States (6). A notably higher number of individuals reported experiencing drowsiness in the afternoon, suggesting an indication of poor sleep quality. Previous studies have suggested a link between increased smartphone usage among adolescents and a decline in sleep quality, along with associated issues such as daytime drowsiness, insomnia, inadequate sleep duration, and delayed onset of sleep (17),(18).

According to the research findings, most students (90.6%) of the surveyed population tend to use their smartphones before going to bed. Despite being aware of the adverse effects of blue light emitted by cell phones on sleep quality, participants exhibited a contrary behaviour by engaging with their phones shortly before going to sleep. Using electronic devices at night has been linked to poor sleep quality. An average of five hours of smartphone usage is associated with insomnia and decreased sleep duration (17). Studies have shown that exposure to screen light reduces melatonin levels, suppressing the desire to fall asleep before bedtime (19). Exposure to electronic device screens delays sleep onset, reduces REM sleep, and suppresses melatonin secretion (19). The exposure to blue light emitted by electronic devices before bedtime could have reduced melatonin production, potentially impacting the study participants’ sleep quality. It has been documented that heightened daytime sleepiness correlates with poor sleep quality (20). In this study, 70.4% of the participants reported experiencing heightened daytime sleepiness (Table/Fig 2). This observation could establish a connection between increased daytime sleepiness and poor sleep quality. The data analysis of the questionnaire revealed a clear comprehension among participants regarding melatonin’s role in regulating the sleep-wake cycle. Moreover, the study findings indicated that 85% of students demonstrated insufficient sleep habits, frequently compensating for weekday sleep deficits by extending their weekend sleep duration. Furthermore, both organic and pharmacological supplements can impact sleep hygiene. However, participants showed a significant lack of awareness regarding the potential risks associated with the misuse of hypnotic medications such as benzodiazepines, which may result in severe side-effects (21). To elaborate, benzodiazepine toxicity can cause various Central Nervous System (CNS) effects, particularly at higher doses. Additionally, it can lead to overdose, withdrawal symptoms due to physiological dependence, and the development of sedative-hypnotic use disorder (21). Likewise, 76.5% of students involved in this study stated that they refrained from consuming coffee or tea within one hour before bedtime. This finding contrasts with a study conducted in Saudi Arabia, where most individuals consumed caffeine primarily in the morning rather than at night (22).

The present research delves into the connection between exercise and sleep hygiene, an aspect that is often neglected. In this study, a notable percentage of students (66.2%) stated their lack of physical activity, echoing findings from a previous study conducted in Saudi Arabia (23), which linked poor sleep quality with physical inactivity among students. The study participants shared the same level of knowledge as those in the previous study, who were also unaware of the positive effects physical exercise can have in improving sleep quality. An earlier investigation discovered that listening to music can enhance subjective sleep quality across all age groups, improving sleep (24). Nonetheless, 87.5% of students in this study concurred that they do not listen to music before bedtime. This study indicates that nearly half of the students had limited knowledge concerning the correlation between sleep duration and strokes, as well as the connection between inadequate sleep and a heightened risk of obesity. It has been reported that poor sleep quality can lead to an increased risk of obesity (1). Reduced sleep duration increases the risk of obesity and stroke in individuals with hypertension and diabetes mellitus (25). In addition to stroke, individuals with epilepsy experience poorer sleep quality than those without, which significantly lowers their quality of life and may trigger seizures (26). However, the participants in this study had diminished views about the causal relationship between poor sleep quality and seizures.

Moreover, the study showed that students were well-informed about the impact of obstructive sleep apnoea on sleep quality. Obstructive sleep apnoea reportedly alters patients’ circadian clocks, which are strongly associated with glucose regulation (13). Research has documented insomnia as a predictive factor for anxiety (27), and participants in this study exhibited a notable awareness of this relationship. Interestingly, female participants showed significantly higher awareness compared to males in this regard. Research has shown that insufficient sleep not only impacts short-term memory and concentration but also leads to long-term neurological dysfunction (8). While examining this study’s findings, it was evident that female participants displayed a higher level of awareness regarding the significance of good sleep quality for memory recall than males.

There is a reciprocal relationship between migraines, tension headaches, and sleep disturbances. This indicates that headaches can cause sleep problems and vice versa (28). Moreover, the current study found that participants acknowledged the correlation between inadequate sleep and migraines and tension headaches. The prevalence of sleep deprivation in today’s fast-paced society has emerged as a significant health concern. Given its profound effects on brain function, it can lead to severe implications for ones overall health. This was supported by an increasing volume of research demonstrating the crucial role of sleep in facilitating the glymphatic system’s function, which is responsible for removing metabolic waste products from the CNS (29). The fact that the glymphatic system is more active during regular sleep than during alertness suggests that sleep is necessary for cleaning the brain (29). Notably, the students participating in this research are aware of these effects. One study highlighted the crucial role of the amygdala in sleep and emotional regulation (30). The participants in this study exhibited a strong understanding of this association.

When comparing attitudes by gender, a higher percentage of females reported a lack of participation in physical exercise compared to males, and a greater proportion of females reported difficulty waking up compared to males. Exercise has been reported to improve sleep quality (31). Research has suggested that physical activity and sleep quality may be influenced by various mechanisms, including the release of endorphins that can potentially lower stress and anxiety levels, resulting in increased relaxation and better sleep (32). More female participants in this study reported sleeping with bedroom lights on compared to males. A recent study highlighted a link between bedroom light exposure and reduced sleep efficiency (33). Understanding the influence of bedroom light on sleep quality is crucial.

This study highlights the significance of addressing sleep quality among health science students through customised sleep education initiatives. Tailored interventions based on gender may be necessary to cater to the varying attitudes towards sleep. Additionally, filling knowledge gaps regarding the impact of sleep on brain function could enable students to make well-informed decisions about their sleep habits, ultimately enhancing their overall wellbeing. Future research could focus on evaluating the effectiveness of customised sleep education interventions for health science students while tracking changes in sleep quality over time. Diversifying participant samples across universities and regions would improve generalisability, while comparative studies across cultures could shed light on cultural influences on sleep behaviours. Exploring the long-term effects of improved sleep on academic performance and mental health outcomes among health science students could aid in developing comprehensive wellness programs to promote healthy sleep habits in this population.

Limitation(s)

A constraint of this study lies in its dependence on self-reported data, potentially leading to response bias and inaccuracies. Furthermore, the cross-sectional design hinders the establishment of causal relationships between variables. Moreover, the study’s sample was confined to a single university in Jeddah, Saudi Arabia, potentially restricting the applicability of the results to broader populations. Subsequent studies could consider longitudinal designs and include a more diverse range of participants to enhance the reliability and generalisability of the results.

Conclusion

This study examined the knowledge, attitudes, and awareness regarding the impact of sleep quality on the brain among health sciences students at King Saud bin Abdulaziz University for Health Sciences in Jeddah, Saudi Arabia. The findings highlight the significance of improving sleep quality among these students, indicating notable knowledge disparities and varied attitudes, especially among females, who demonstrate greater awareness in certain areas. Gender distinctions were evident in participants’ attitudes toward sleep, emphasising the importance of tailored sleep education programs addressing gender-specific issues. Such initiatives offer potential for enhancing students’ overall well-being and academic performance.

Acknowledgement

The authors express their sincere gratitude to everyone who participated in this study. Authors also thank the officials and staff of KAIMRC and KSAU-HS for their invaluable assistance and support throughout this research endeavour.

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DOI and Others

DOI: 10.7860/JCDR/2024/69880.19478

Date of Submission: Feb 01, 2024
Date of Peer Review: Feb 21, 2024
Date of Acceptance: Apr 26, 2024
Date of Publishing: Jun 01, 2024

AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA

PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Feb 02, 2024
• Manual Googling: Apr 22, 2024
• iThenticate Software: Apr 24, 2024 (9%)

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