ArticleBMC medical education2026
Lifestyle behaviors during exam periods and their association with academic performance among Palestinian medical students: a cross-sectional study.
Article in BMC medical education, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMedical students often face significant psychological and lifestyle challenges during examination periods, including sleep disruption, increased caffeine intake, altered dietary habits, low physical activity, and higher tobacco use. These behaviors may influence academic performance, yet evidence remains inconsistent.
methodsA cross-sectional study was conducted from April to October 2025 among 403 medical students from five universities in Palestine. Data were collected via an Arabic-language, self-administered online questionnaire covering sociodemographic, dietary and beverage habits, smoking, sleep, and physical activity. Academic performance was self-reported for the last two semesters. Statistical analysis included correlation, Mann-Whitney U, and regression models to assess relationships between lifestyle behaviors and academic performance.
resultsParticipants reported low sleep duration (< 7 h/day: 89.3%) and low physical activity (19.1%). Caffeine intake was moderate, with most students consuming ≤ 1 cup/day of traditional or instant coffee. Waterpipe smoking was more prevalent than cigarette or e-cigarette use and increased during exams. Regression analysis revealed small but significant negative associations between traditional coffee and tea consumption and average grades. Other dietary habits, energy drinks, sleep, and exercise were not significantly associated with average grades. Waterpipe use was unexpectedly positively associated with average grades, likely due to confounding factors.
conclusionExamination periods are associated with unhealthy behaviors among medical students, particularly increased caffeine and tobacco use, short sleep, and low physical activity. Among these, only coffee and tea consumption showed a small negative impact on academic performance.
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