0918 Elevated stress during the first-year of medical school negatively impacts sleep quality

Abstract Introduction Poor sleep health is widespread within healthcare and is notoriously neglected during residency; however, little is known about sleep quality during the pre-clinical years of medical school. Stress contributes to poor sleep quality and is commonplace in medical education. This study sought to understand how stress impacts sleep among first-year medical students. Methods A one-time, 130-item survey was distributed to the first-year medical school class three months into the first semester. Quantitative and open-text questions sought to understand student demographics, mental health, sleep quality, and sleep-related behaviors, beliefs, and knowledge. Highly prevalent anxiety was defined as feeling nervous/anxious/on edge for more than half of the days during the previous two weeks. Odds ratios (OR) include 95% confidence intervals and were determined using binary logistic regression. Statistical significance was considered a p-value ≤0.05. Results 138 of the 209 students (66%) in the first-year medical school class completed the survey. Demographics mirrored those of the whole class: 46% male, 54% female, and average age 23.5. Short sleep was prevalent with a mean (standard deviation) sleep time of 6.85 (0.86) hours. Additionally, more than three-quarters reported suboptimal sleep: 56% rated quality as average, and 21% rated quality as poor/very poor. 33% of respondents reported difficulty falling asleep at least once per week. A lack of restorative sleep was also common: 38% felt that sleep was rarely or never refreshing. Over half of respondents (51%) attributed poor sleep to either stress or school, and 29% of students reported elevated or highly prevalent anxiety. Elevated anxiety predicted suboptimal sleep quality (OR 14.67, 1.70-126.76, p=0.015) and a lack of restorative sleep (OR 6.00, 1.52-23.71, p=0.011). Similarly, suboptimal sleep quality was associated with highly prevalent anxiety (OR 44.0, 4.62-418.93, p< 0.001) and difficulty falling asleep (OR 4.14, 1.76-9.75, p=0.001). Conclusion Poor sleep and stress are both prevalent during the first year of medical school, with students directly linking stress from their academic workload to impaired sleep quality and insufficient sleep duration. Due to the pervasiveness of stress within medical education, future interventions should help students improve their sleep during both low and high stress time periods. Support (if any)