Sleep Quality, Perceived Stress, and Symptoms of Anxiety and Depression among Medical Students

Background: Medical and allied students experience high academic demands ,irregular schedules ,and early clinical exposure ,which are commonly associated with poor sleep quality, elevated perceived stress , and symptoms of depression and anxiety , potentially compromising learning and wellbeing . Methods: A narrative review with targeted literature identification was performed using major biomedical databases and publisher platforms. We focused on studies of medical/healthcare students that used validated instruments for sleep quality and stress (e.g., PSQI, PSS-10) and mental health symptoms (e.g., PHQ-9, GAD-7). Evidence was synthesized across three domains: (i) prevalence of poor sleep and psychological symptoms, (ii) associations between sleep/stress and depression/anxiety, and (iii) implications for screening and preventive interventions in student populations. Results: Consistent cross-sectional evidence indicates a high burden of poor sleep quality among medical students, with systematic reviews suggesting that approximately half of medical students may report poor sleep quality depending on region and measurement approach. Across studies, poorer sleep quality and higher perceived stress show robust, positive associations with depressive and anxiety symptoms. These relationships persist in many multivariable models that adjust for demographic and lifestyle factors, although causal direction cannot be inferred due to cross-sectional designs and self-report measures. Conclusion: The convergent evidence supports routine screening for sleep problems and perceived stress in student health services and the implementation of scalable prevention strategies (sleep hygiene education, stress-management programs, and stepped-care referral pathways). Future research should prioritize longitudinal designs and intervention trials to clarify causal mechanisms and effective program components.