Chronotype, Daytime Sleepiness, and Related Factors Effects on Skipping Classroom among Medical Students in Tabuk
Background: Lecture attendance is very critical in medical practice. Good sleep hygiene is crucial for academic performance. Therefore, this research aimed to assess the relationship between daytime sleepiness and the chronotype, and skipping the classroom.
Methods: A cross-sectional study was conducted among medical Students in Tabuk from April 2022 to July 2022. Three hundred and thirty-four medical students were randomly selected. A standardized questionnaire based on the daytime sleepiness scale, morningness–eveningness questionnaire, and risk for skipping classrooms was used. The students detailed their sleeping habits for two weeks and then responded to the questionnaire distributed directly by the researchers who attended to solve any difficulties.
Results: Out of the 334 students,74.7% skipped the classroom last month. The most common reason for absence was the lecturer directly reading from the slide show (72.8%), followed by late lectures (67.8%), lecturers’ presentation skills (65.6%), and lack of interest (57.9%). Daytime sleepiness was evident in 40.1% of the students and was associated with skipping lectures (Wald, 3.86, P-value, 0.049, and 95% CI, 0.19–0.91). The majority were intermediate chronotypes (66.4%), followed by evening chronotypes (24.2%) with no association with skipping classrooms.
Conclusion: Skipping lectures is common among medical students in Tabuk City, Saudi Arabia; the causes were lecture timing, daytime sleepiness, and lecturers’ presentation skills. Most students were an intermediate chronotype that was not associated with classroom absence. Further larger multi-center studies are needed.
skipping classrooms, medical students, daytime sleepiness, chronotype, Saudi Arabia
 Bati, A. H., Mandiracioglu, A., Orgun, F., & Govsa, F. (2013). Why do students miss lectures? A study of lecture attendance amongst students of health science. Nurse Education Today, 33(6), 596–601. https://doi.org/10.1016/j.nedt.2012.07.010
 Skoglund, E., Fernandez, J., Sherer, J. T., Coyle, E. A., Garey, K. W., Fleming, M. L., & Sofjan, A. K. (2020). Using the theory of planned behavior to evaluate factors that influence pharmd students’ intention to attend lectures. American Journal of Pharmaceutical Education, 84(5), 7550. https://doi.org/10.5688/ajpe7550
 Irwin, N., Burnett, K. M., & McCarron, P. A. (2018). Association between attendance and overall academic performance on a module within a professional pharmacy degree. Currents in Pharmacy Teaching & Learning, 10(3), 396– 401. https://doi.org/10.1016/j.cptl.2017.11.008
 Hidayat, L., Vansal, S., Kim, E., Sullivan, M., & Salbu, R. (2012). Pharmacy student absenteeism and academic performance. American Journal of Pharmaceutical Education, 76(1), 8.
 Liu, B. (2020). The United States Medical Licensing Examination Step 1 is changing-US medical curricula should too. JMIR Medical Education, 6(2), e20182. https://doi.org/10.2196/20182
 Martin, J. S., Gaudreault, M. M., Perron, M., & Laberge, L. (2016). Chronotype, light exposure, sleep, and daytime functioning in high school students attending morning or afternoon school shifts: An actigraphic study. Journal of Biological Rhythms, 31(2), 205–217. https://doi.org/10.1177/0748730415625510
 Porcheret, K., Wald, L., Fritschi, L., Gerkema, M., Gordijn, M., Merrrow, M., Rajaratnam, S. M. W., Rock, D., Sletten, T. L., Warman, G., Wulff, K., Roenneberg, T., & Foster, R. G. (2018). Chronotype and environmental light exposure in a student population. Chronobiology International, 35(10), 1365– 1374. https://doi.org/10.1080/07420528.2018.1482556
 Mirghani, H. O. (2017). The effect of chronotype (morningness/eveningness) on medical students’ academic achievement in Sudan. Journal of Taibah University Medical Sciences, 12(6), 512–516. https://doi.org/10.1016/j.jtumed.2017.03.007
 Owens, J. A. (2001). Sleep loss and fatigue in medical training. Current Opinion in Pulmonary Medicine, 7, 411–418. https://doi.org/10.1097/00063198-200111000-00009
 Rique, G. L., Fernandes Filho, G. M., Ferreira, A. D., & de Sousa-Muñoz, R. L. (2014). Relationship between chronotype and quality of sleep in medical students at the Federal University of Paraiba, Brazil. Sleep Science, 7(2), 96– 102. https://doi.org/10.1016/j.slsci.2014.09.004
 Bakotic, M., Radosevic-Vidacek, B., & Koscec Bjelajac, A. (2017). Morningnesseveningness and daytime functioning in university students: The mediating role of sleep characteristics. Journal of Sleep Research, 26(2), 210– 218. https://doi.org/10.1111/jsr.12467
 American Academy of Sleep Medicine. (2014). International classification of sleep disorders (3rd ed.). American Academy of Sleep Medicine.
 Johns, M. W. (1991). A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep, 14, 540545. https://doi.org/10.1093/sleep/14.6.540
 Bahmamm, A. S., Alaseem, A. M., Alzakri, A. A., Alminessier, A. S., & Sharif, M. M. (2012). The relationship between sleep and wake habits and academic performance in medical students; A cross-sectional study. BMC Medical Education, 12, 61. https://doi.org/10.1186/1472-6920-12-61
 Alamoudi, W. A., Alhelo, A. F., Almazrooa, S. A., Felemban, O. M., Binmadi, N. O., Alhindi, N. A., Ali, S. A., Akeel, S. K., Alhamed, S. A., Mansour, G. M., & Mawardi, H. H.. (2021). Why do students skip classroom lectures: A single dental school report. BMC Medical Education, 21(1), 388. 10.1186/s12909-021-02824-3. Erratum in: BMC Medical Education, 21(1), 427.
 Mustafa, T., Farooq, Z., Asad, Z., Amjad, R., Badar, I., Chaudhry, A. M., Khan, M. A., & Rafique, F. (2014). Lectures in medical education: What students think? Journal of Ayub Medical College, Abbottabad, 26(1), 21–25. Erratum in: Journal of Ayub Medical College, Abbottabad, 26(2).
 Emahiser, J., Nguyen, J., Vanier, C., & Sadik, A. (2021). Study of live lecture attendance, student perceptions and expectations. Medical Science Educator, 31(2), 697–707.
 El Hangouche, A. J., Jniene, A., Aboudrar, S., Errguig, L., Rkain, H., Cherti, M., & Dakka, T. (2018). Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students. Advances in Medical Education and Practice, 9(9), 631–638. https://doi.org/10.2147/AMEP.S162350
 Al-Zahrani, J. M., Aldossari, K. K., Abdulmajeed, I., Al-Ghamdi, S. H., Al-Shamrani, A. M., & Al-Qahtani, N. S. (2016). Daytime sleepiness and academic performance among Arab medical students. Journal of Thoracic Disease, 8(2), AB006.
 Jahrami, H., Alshomili, H., Almannai, N., Althani, N., Aloffi, A., Algahtani, H., Brown, C. A. (2019). Predictors of excessive daytime sleepiness in medical students: A metaregression. Clocks & Sleep, 1(2), 209–219.
 Alqudah, M., Balousha, S. A. M., Balusha, A. A. K., Al-U’dat, D. G., Saadeh, R., Alrabadi, N., & Alzoubi, K. (2022). Daytime sleepiness among medical colleges’ students in Jordan: Impact on academic performance. Sleep Disorders, 2022, 7925926. https://doi.org/10.1155/2022/7925926
 Abdulghani, H. M., Alrowais, N. A., Bin-Saad, N. S., Al-Subaie, N. M., Haji, A. M., & Alhaqwi, A. I (2012). Sleep disorder among medical students: relationship to their academic performance. Medical Teacher, 34(1), S37–S41.
 Dutra da Silva, R. C., Garcez, A., Pattussi, M. P., & Olinto, M. T. A. (2022). Prevalence and factors associated with excessive and severe daytime sleepiness among healthcare university students in the Brazilian Midwest. Journal of Sleep Research, 31(3), e13524. https://doi.org/10.1111/jsr.13524
 Shimura, A., Hideo, S., Takaesu, Y., Nomura, R., Komada, Y., & Inoue, T. (2018). Comprehensive assessment of the impact of life habits on sleep disturbance, chronotype, and daytime sleepiness among high-school students. Sleep Medicine, 44, 12–18. https://doi.org/10.1016/j.sleep.2017.10.011
 Tan, M. N., Mevsim, V., Pozlu Cifci, M., Sayan, H., Ercan, A. E., Ergin, O. F., Oksuz, U., & Ensari, S. (2020). Who is happier among preclinical medical students: The impact of chronotype preference. Chronobiology International, 37(8), 1163– 1172. https://doi.org/10.1080/07420528.2020.1761373
 Li, T., Xie, Y., Tao, S., Yang, Y., Xu, H., Zou, L., Tao, F., & Wu, X. (2020). Chronotype, sleep, and depressive symptoms among Chinese college students: A cross-sectional study. Frontiers in Neurology, 11, 592825. https://doi.org/10.3389/fneur.2020.592825
 Kolomeichuk, S. N., Randler, C., Morozov, A. V., Gubin, D. G., & Drake, C. L. (2021). Social Jetlag and Excessive Daytime Sleepiness from a sample of Russian children and adolescents. Nature and Science of Sleep, 13, 729– 737. https://doi.org/10.2147/NSS.S290895
 Desalegn, A. A., Berhan, A., & Berhan, Y. (2014). Absenteeism among medical and health science undergraduate students at Hawassa University, Ethiopia. BMC Medical Education, 14, 81.
 Azab, E., Saksena, Y., Alghanem, T., Midle, J. B., Molgaard, K., Albright, S., & Karimbux, N. (2016). Relationship among dental Students’ class lecture attendance, use of online resources, and performance. Journal of Dental Education, 80(4), 452–458. https://doi.org/10.1002/j.0022-0337.2016.80.4.tb06103.x
 Alghamdi, A. Y. K., Albarkati, B., Alrehili, O., & Salih, M (2016). Prevalence causes and impacts of absenteeism among medical students at UQU. Education 6(1):9–12.