A Cross-Sectional Estimate of the Determinants of Daytime Sleepiness Among Omani Nursing Students

Purpose: Daytime sleepiness and its impact on cognitive functioning, subjective fatigue and work tasks is gaining empirical significance among health science students. Nearly one third of nursing students endure daytime sleepiness (Huang, Yang, Wu, Liu, & Chen, 2014). Sleep disturbance among university students have been linked with stress (Benavente, Silva, Higashi, Guido, & Costa, 2014); increased technology use (Johansson, Petrisko, & Chasens, 2016); and consumption of addcitive beverages (Kaur & Singh, 2017). Sleep deficit in any form impacts academic performance (Abraham & Scaria, 2015), and health of nursing students (Menon, Karishma, & Mamatha, 2015). The persistence of this problem into the active professional life of nursing students can lead to major life threatening medical errors, compromise of patient safety and decisional regret (Scott, Arslanian-Engoren, & Engoren, 2014). The lack of studies on this region, was instrumental in the conduct of an empirical venture to determine the prevalence and determinants of daytime sleepiness among Omani nursing students.

Methods:

A cross-sectional research design was employed. The study was reviewed and approved by the Institutional Ethics and Research Committee. The Bachelor of Science nursing students, with an active registration status were included in the study. The questionnaire to identify the determinants of daytime sleepiness (personal, academic, and sleep related) was prepared by the researchers based on an extensive review of literature. The Epworth Sleepiness Scale (ESS) and Perceived Stress Scale (PSS) were used to assess daytime sleepiness and stress index, respectively. The normality of the data, required the use of parametric tests. Descriptive statistics (mean, median, standard deviation) and inferential statistics (two tailed independent ‘t’ test and ANOVA) were utilized to establish the statistical linking between the variables examined and their ESS scores.

Results:

The prevalence of daytime sleepiness was 57.4% (ESS > 10). Severe excessive daytime sleepiness (ESS > 16) was estimated at 12%. The nursing students’ ESS scores were significantly associated with use of stimulants, program study track, cohort, previous semester GPA, and sleep hours on the day before examination. A weak positive correlation was found between ESS scores and PSS scores. Greater stress is a barrier to adopting life style changes, and may indicate psychological imbalances which requires professional counseling. Hence the group surveyed can be easily trimmed to moderate their stimulant use, alleviate fears towards their first exposure to the clinical arena, forecast and plan their academic load, and to modulate their learning styles from memory to comprehension.

Conclusion:

The high prevalence of daytime sleepiness found among Omani nursing students reflects the need for awareness programs to magnify its predominance. The activation of universal preventive programs on sleep hygiene, and healthy sleep habits to prevent, predict and prescribe measures to eradicate daytime sleepiness is to be considered a priority. Additionally, further studies with prospective and experimental designs are required to establish cause-effect relationships. The effects of daytime sleepiness on psychological imbalances requires additional focused explorations. The preparedness of the educators in identifying and managing the determinants of daytime sleepiness is another critical area of investigation that demands urgent attention.