Sleep quality and anxiety among final-year medical interns during a family medicine clerkship: a cross-sectional study with implications for primary care training.

backgroundSleep problems and anxiety are common but often under-recognised concerns in primary care. Final-year medical interns, who are medical students undertaking their final year of supervised clinical training, represent an important group for sleep health research because they face clinical responsibilities and concerns related to night shifts, emergency department work, direct patient care, and career-related stressors. This study aimed to evaluate sleep quality and its association with anxiety among medical interns during a Family Medicine clerkship.

methodsThis single-centre cross-sectional study was conducted at Ankara Yıldırım Beyazıt University Faculty of Medicine between June 2023 and September 2023. Data were collected from medical interns during their Family Medicine clerkship. Participants with previously diagnosed psychiatric disorders or sleep disorders were excluded. Face-to-face questionnaires were used, including a sociodemographic and lifestyle characteristics form, the Pittsburgh Sleep Quality Index, and the Beck Anxiety Inventory. Descriptive statistics, comparative analyses, correlation analysis, and multivariable logistic regression analysis were performed to evaluate factors associated with poor sleep quality.

resultsA total of 219 medical interns were included. Poor sleep quality was identified in 59.4% of participants. The mean Pittsburgh Sleep Quality Index score was 6.59 ± 3.36, the mean sleep duration was 6.73 h, and the mean Beck Anxiety Inventory score was 9.63 ± 8.45. Pittsburgh Sleep Quality Index and Beck Anxiety Inventory scores were positively correlated (r = 0.320, p < 0.001). In the multivariable logistic regression model, higher BAI scores, sex, and self-reported concern about taking night shifts were associated with poor sleep quality. Each one-point increase in the BAI score was associated with higher odds of poor sleep quality (odds ratio [OR] = 1.075; 95% confidence interval [CI]: 1.021-1.131; p = 0.006), while self-reported concern about taking night shifts was associated with 2.48-fold higher odds (OR = 2.483; 95% CI: 1.160-5.317; p = 0.019). Female sex was associated with lower odds of poor sleep quality compared with male sex (OR = 0.513; 95% CI: 0.265-0.994; p = 0.048); however, this finding was less robust in sensitivity analyses and should be considered exploratory.

conclusionPoor sleep quality was common among medical interns and was associated with higher anxiety symptoms and self-reported concern about taking night shifts. These findings support consideration of sleep health and anxiety-related concerns within Family Medicine training. However, the cross-sectional design does not permit causal inference, and intervention studies are needed to determine whether educational, screening, or supportive approaches improve interns' well-being or future clinical practice.