Sleep Quality, Physical Activity, and Academic Performance Among Medical Students in Sudan During Armed Conflict: A Cross-Sectional Study
Sleep Quality, Physical Activity, and Academic Performance Among Medical Students in Sudan During Armed Conflict: A Cross-Sectional Study
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Date
2026
Authors
Anfal Yousif Ishag Adam
Mohab Ahmed Abdalla
Mohammed Khalid Abdullah
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Publisher
Napata College
Abstract
Background: Medical students are exposed to high academic demands that can negatively affect
sleep quality and physical activity, both of which are important for cognitive performance. These
challenges may be exacerbated during periods of conflict, such as the ongoing war in Sudan.
This study aimed to assess the association between sleep quality, physical activity, and academic
performance among medical students in Sudan during the war period (2023–2025).
Methods: A cross-sectional study was conducted among 203 medical students from five Sudanese
universities. Data were collected using an online self-administered questionnaire, including the
Pittsburgh Sleep Quality Index (PSQI) to assess sleep quality, the short form of the International
Physical Activity Questionnaire (IPAQ-SF) for physical activity, and self-reported academic
performance. Descriptive and inferential statistics were performed using SPSS to examine
associations between sleep quality, physical activity, and academic performance. Ethical approval
and informed consent were obtained prior to participation.
Results: A total of 203 medical students participated, with over half reporting declined academic
performance during the conflict. The mean PSQI score was 8.15 ± 3.70, indicating poor sleep
quality, while 46.8% had high physical activity levels. Sleep quality was significantly associated
with age, residency, socioeconomic status, and all academic performance measures (p < 0.05). In
contrast, physical activity showed no significant association with academic performance.
Regression analysis identified sleep quality as a significant predictor of academic performance (β
= -0.373, p < 0.001), whereas physical activity was not. A weak positive correlation was observed
between physical activity and poorer sleep (r = 0.166, p = 0.018).
Conclusion: Poor sleep quality was highly prevalent among medical students in this conflict
affected setting and was strongly associated with lower academic performance, while physical
activity showed no significant direct effect. These findings underscore the critical role of sleep in
supporting cognitive function and academic success, highlighting the need for interventions that
promote healthy sleep habits in medical student populations.
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Napata College