Psychosocial and Family Factors Associated With Sleep Quality Among Undergraduate Medical Students in Ho Chi Minh City: A Cross-Sectional Study

Abstract Objective To determine the prevalence of sleep quality and identify factors independently associated with poor sleep quality among undergraduate medical students in Ho Chi Minh City, Vietnam. Design Cross-sectional study. Setting The study was conducted during the year 2025 at the University of Medicine and Pharmacy at Ho Chi Minh City, a major medical training institution in Vietnam. Participants A total of 846 undergraduate medical students from the Doctor of Preventive Medicine and Traditional Medicine programs participated in the study. The median age was 22 years, and 66.0% were female. Outcome measures Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). A global score greater than 5 was defined as poor sleep quality. Multivariable logistic regression analysis was employed to identify psychosocial, family, and behavioral factors independently associated with poor sleep quality. Results The prevalence of poor sleep quality among the participants was 44.09%. In the multivariable model, bullying or abuse showed the strongest association with poor sleep (aOR = 4.86, 95% CI 2.60 to 9.08, p < 0.001). Poor sleep quality was also significantly associated with family problems (aOR = 1.91, 95% CI 1.32 to 2.77), serious illness (aOR = 2.01, 95% CI 1.01 to 4.00), and smoking (aOR = 3.94, 95% CI 1.02 to 15.25). Furthermore, diminishing family cohesion was a critical predictor, with students reporting no family bonding having over threefold higher odds of poor sleep (aOR = 3.21, 95% CI 1.20 to 8.57). Conversely, having parents in manual occupations, such as fathers as workers (aOR = 0.58) or mothers as farmers (aOR = 0.62), appeared to be protective. Conclusions Poor sleep quality is highly prevalent among medical students in Ho Chi Minh City, influenced by a complex interplay of academic rigor and systemic stressors in the post COVID 19 era. Psychosocial stressors, particularly interpersonal trauma and family dysfunction, serve as dominant determinants independent of traditional lifestyle factors. These results suggest that university health services should prioritize trauma informed mental health screenings and systemic interventions to support the well being of the future healthcare workforce.