Sleep quality and psychological distress among Bangladeshi medical students: Prevalence, predictors, and sex-institutional differences

Poor s leep quality and psychological distress are common in medical students worldwide. Understanding the relationship between sleep quality and psychological distress is crucial for enhancing student well-being and academic achievement. This study aimed to assess the prevalence and influencing factors of poor sleep quality and psychological distress among Bangladeshi medical students, and to explore sex and institutional differences. A cross-sectional study was conducted among 378 medical students using a structured questionnaire. Data were collected using the Depression, Anxiety, and Stress Scale (DASS-21) and the Pittsburgh Sleep Quality Index (PSQI). Statistical analyses including confirmatory factor analysis (CFA), independent samples t -tests, and a bivariate test of association were conducted. The prevalence rates of poor sleep quality (67.2 %), depression (55.8 %), anxiety (58.7 %), and stress (38.6 %) were significantly high among medical students in Bangladesh. The CFA test recommended a three-factor model for DASS-21 and a two-factor model for PSQI. A moderately positive association was found between sleep quality and depression, anxiety, and stress. Independent samples t -tests showed that male students reported lower PSQI and DASS-21 scores. Additionally, depression (AOR = 2.61, 95 % CI: 1.37–4.99) and stress (AOR = 2.77, 95 % CI: 1.25–6.14) were found as the most significant predictors of sleep quality. Psychological distress, excessive time spent on social media, and online games negatively influence sleep quality, while being a male, smoking, and having career-building opportunities positively influence sleep quality. Interventions aimed at reducing stress and promoting healthy sleep practices are urgently needed within medical institutions. • High prevalence of poor sleep (67.2 %) was found among Bangladeshi medical students. • Depression and stress were the strongest predictors of poor sleep. • Female students reported worse sleep and higher psychological distress. • Excessive screen time was linked to six times higher odds of poor sleep. • Private medical students showed higher depression and anxiety.