# Association Between Physical Activity Levels and Sleep Quality Among Saudi Board Trainees: A Cross-Sectional Study

## TL;DR

This study found that anxiety and depression are the main factors linked to poor sleep among Saudi medical residents, while physical activity does not significantly improve sleep quality.

## Contribution

The study identifies anxiety and depression as the strongest predictors of poor sleep quality among Saudi board trainees, despite initial associations with physical activity.

## Key findings

- 51.5% of Saudi board trainees experience poor sleep quality.
- Anxiety and depression are independently associated with poor sleep quality.
- Physical activity is not independently linked to better sleep quality after adjusting for other factors.

## Abstract

Background

Medical residency training is associated with high workload, psychological stress, and irregular sleep schedules, all of which may negatively affect sleep quality and mental well-being. Although physical activity is known to improve sleep and psychological health, limited evidence exists regarding its independent association with sleep quality among Saudi board trainees.

Aim

This study aimed to estimate the prevalence of poor sleep quality and identify its predictors among Saudi board trainees.

Methods

This cross-sectional survey study used an online, self-administered questionnaire that covered participants’ demographics and personal characteristics. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), physical activity was evaluated using the short form of the International Physical Activity Questionnaire (IPAQ-SF), and anxiety and depression were screened using the four-item Patient Health Questionnaire (PHQ-4). Logistic regression models were applied to identify factors associated with poor sleep quality.

Results

The prevalence of poor sleep quality was 51.5% (101/196). Univariable logistic regression analysis revealed that several factors were significantly associated with increased odds of poor sleep quality, including being a junior resident (OR: 1.188, 95% CI: 1.032-1.366, p=0.017), use of sedative medications (OR: 1.640, 95% CI: 1.327-2.027, p<0.001), anxiety (OR: 1.482, 95% CI: 1.148-1.913, p=0.003), depression (OR: 1.495, 95% CI: 1.104-2.024, p=0.010), and mixed anxiety and depression (OR: 1.757, 95% CI: 1.482-2.083, p<0.001). However, in the multivariable logistic regression model, only the use of sedative medications and the presence of anxiety and/or depression remained independently associated with poor sleep quality. Residency level and physical activity did not retain statistical significance.

Conclusions

Anxiety and depression emerged as the most significant factors associated with poor sleep quality among Saudi residency trainees. Although physical activity initially appeared protective, it was not independently associated with sleep quality after adjusting for other relevant variables. Further research is needed to better understand the underlying mechanisms and consequences of anxiety and depression to guide strategies for improving sleep and well-being among Saudi residents.