Isabelle Merrony

University of Liverpool, United Kingdom

Is there an association between poor sleep and worsened mental health outcomes in medical students: a systematic

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Biography

Isabelle Merrony is a fourth-year medical student at the University of Liverpool with a strong interest in psychiatry and sexual health. She has gained extensive clinical experience through hospital placements in paediatrics, oncology, cardiology, obstetrics, gynaecology, and respiratory medicine, as well as working as a healthcare assistant on acute and COVID-19 wards. Isabelle has combined clinical work with leadership and organisational roles, including Charity Secretary for the University Sexual Health Society and Secretary for the Psychiatry Society. She completed a distinction-level research project on mental health in medical students and is actively involved in initiatives supporting people with severe mental illness. Bilingual in French and fluent in English, she is committed to patient-centred care, healthcare improvement, and developing her skills in mental health and sexual health.

Abstract

Background:

Medical students face significant academic and social pressures, often leading to poor sleep and mental health problems such as depression, anxiety, burnout and suicidal ideation. Despite growing awareness, the link between sleep disturbances and mental health outcomes remains unclear. Many studies are cross-sectional, rely on self-reported data and lack intervention or experimental research. This systematic review aims to assess the prevalence of sleep disturbance in medical students, examine its impact on mental health and identify gaps for future research and interventions.

Method:

Following PRISMA guidelines, searches were conducted in Scopus, PubMed and Web of Science, alongside hand searching and citation tracking. Sleep disturbances were measured using validated tools including the Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale. Mental health outcomes included depression, anxiety and burnout. Strengths and weaknesses of each study were appraised, and methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Tool. Thematic analysis was applied to compare findings across studies.

Result:

Seven studies met inclusion criteria, including one meta-analysis, one longitudinal study, one mixed-methods study and four cross-sectional studies. Four themes emerged: prevalence and impact of poor sleep, sleep and mental health, risk factors, and coping strategies. Jahrami reported 55% of participants experienced poor sleep, confirming high prevalence. Poor sleep was consistently associated with depression, anxiety and suicidal ideation. Most studies were cross-sectional and self-reported, limiting causal conclusions. Only Vollmer-Conna examined physiological mechanisms, highlighting the need for biological research. No studies tested interventions to improve sleep or mental health outcomes, revealing a clear research gap.

Conclusion:

Poor sleep is strongly associated with worsened mental health in medical students, highlighting the need for targeted interventions. Longitudinal, biological and interventional studies are required to establish causality and improve reliability. Medical schools should prioritise sleep education, workload management and mental health support to enhance wellbeing, academic performance and preparedness for future clinical practice.

Keywords:

Medical students; Sleep disturbance; Mental health; Depression; Anxiety; Burnout; Suicidal ideation; Sleep quality; Intervention; Systematic review