Sleep quality and anxiety among final-year medical interns during a family medicine clerkship: a cross-sectional study with implications for primary care training.
Çolak E & Şimşek E • BMC primary care • 2026
Poor sleep quality was common among medical interns during a Family Medicine clerkship and was associated with higher anxiety symptoms and self-reported concern about taking night shifts.
Key Findings
Results
Poor sleep quality was identified in the majority of medical interns studied.
59.4% of 219 participants were classified as having poor sleep quality based on the Pittsburgh Sleep Quality Index (PSQI).
The mean PSQI score was 6.59 ± 3.36 (scores above 5 are typically considered indicative of poor sleep quality).
The mean sleep duration reported was 6.73 hours.
The study was conducted at a single centre (Ankara Yıldırım Beyazıt University Faculty of Medicine) between June and September 2023.
Results
PSQI and Beck Anxiety Inventory (BAI) scores were positively correlated among medical interns.
The correlation coefficient between PSQI and BAI scores was r = 0.320, p < 0.001.
The mean BAI score was 9.63 ± 8.45.
This indicates that higher anxiety symptom levels were associated with poorer sleep quality.
Results
Higher BAI scores were independently associated with greater odds of poor sleep quality in multivariable logistic regression.
Each one-point increase in BAI score was associated with higher odds of poor sleep quality (OR = 1.075; 95% CI: 1.021–1.131; p = 0.006).
The model also included sex and self-reported concern about taking night shifts as covariates.
Participants with previously diagnosed psychiatric disorders or sleep disorders were excluded from the study.
Results
Self-reported concern about taking night shifts was independently associated with poor sleep quality.
Concern about taking night shifts was associated with 2.48-fold higher odds of poor sleep quality (OR = 2.483; 95% CI: 1.160–5.317; p = 0.019).
Night shift concern was identified alongside anxiety and sex as one of three significant predictors in the multivariable logistic regression model.
The study population consisted of final-year medical interns facing clinical responsibilities including night shifts, emergency department work, and direct patient care.
Results
Female sex was associated with lower odds of poor sleep quality compared with male sex, though this finding was less robust in sensitivity analyses.
Female sex was associated with an OR of 0.513 (95% CI: 0.265–0.994; p = 0.048) for poor sleep quality compared with male sex.
The authors note this finding 'was less robust in sensitivity analyses and should be considered exploratory.'
Sex was one of three variables retained in the final multivariable logistic regression model.
Methods
The study population consisted of 219 medical interns undertaking a Family Medicine clerkship, with participants excluded for pre-existing psychiatric or sleep disorders.
Data were collected using face-to-face questionnaires including a sociodemographic and lifestyle characteristics form, the PSQI, and the BAI.
The study was cross-sectional and single-centre, conducted over approximately four months (June–September 2023).
Participants with previously diagnosed psychiatric disorders or sleep disorders were excluded.
Descriptive statistics, comparative analyses, correlation analysis, and multivariable logistic regression were performed.
What This Means
This research examined sleep quality and anxiety levels among 219 final-year medical students (called interns) who were completing a Family Medicine rotation at a university hospital in Turkey. Using established questionnaires, the researchers found that nearly 60% of these interns had poor sleep quality, and on average they were sleeping only about 6.7 hours per night. Anxiety levels and sleep quality were meaningfully linked — interns with higher anxiety scores were more likely to report poor sleep.
The study also found that interns who were worried about taking night shifts were about 2.5 times more likely to have poor sleep quality, even after accounting for other factors. Male interns appeared more likely to report poor sleep than female interns, though the researchers caution this finding was not consistent across all their analyses. These results suggest that the stressors specific to clinical training — such as concerns about overnight shifts, patient care responsibilities, and career pressures — may contribute to sleep problems in this group.
This research suggests that sleep health and anxiety deserve attention within medical education and primary care training programs. However, because the study was cross-sectional (a snapshot in time), it cannot determine whether anxiety causes poor sleep, poor sleep worsens anxiety, or some other factor underlies both. The authors call for future intervention studies to test whether educational, screening, or support programs could improve the well-being of medical trainees and potentially influence how they approach sleep health in their future patients.
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Çolak E, Şimşek E. (2026). Sleep quality and anxiety among final-year medical interns during a family medicine clerkship: a cross-sectional study with implications for primary care training.. BMC primary care. https://doi.org/10.1186/s12875-026-03500-5