Somnolencia diurna y rendimiento académico de estudiantes de medicina de una Universidad Pública colombiana

Abstract

Introducción: el sueño es una función fisiológica importante para el adecuado funcionamiento físico, sicológico, cognoscitivo e intelectual. La somnolencia diurna excesiva de tipo moderada o grave es un disturbio del sueño y su presencia en estudiantes de medicina, pudiese repercutir en el rendimiento académico. Objetivo: establecer la prevalencia de somnolencia diurna normal y patológica en estudiantes de pregrado de medicina. Metodología: estudio de corte transversal prospectivo. Se incluyeron estudiantes de pregrado de medicina de la Universidad de Cartagena, Colombia, en el segundo periodo académico del año 2011. Se les aplicó un formulario para recolección de información socio demográfico, académica y la escala de Epworth para evaluar somnolencia diurna. A mayor puntuación mayor somnolencia diurna. La participación fue voluntaria y anónima, escogiéndose una muestra estratificada por sexo y semestre. Los datos fueron analizados con Epi-Info 3.5.1. Valor de p<0.05 fue considerado estadísticamente significativo. Resultados: 210 estudiantes de medicina llenaron completamente los formularios. Edad media 19.7±2.0. El 51.0% [IC95%: 44.0-57.9%] femenino y 49.0% [IC95%: 42.156.0%] masculino. El 69% [IC95%: 62.3-75.2%] procedente de Cartagena y el restante 31% [IC95%: 24.8-37.7%] de distintas provincias. El 53.8% [IC95%: 49.8%-60.7%] con vida sexual activa. El promedio académico de toda la población de estudiantes fue 3.8±0.28. El 31.4% [IC95%: 25.2%-38.2%] con notas altas, 50.5% [IC95%: 43.5%57.4%] notas medias y el 18.1% [IC95%: 13.1%-24.0%] notas regulares. No tuvieron somnolencia diurna anormal el 19.0% [IC95%: 14.0%-25.0%], el 21.4% [IC95%: 16.1%-27.0%] presentaron excesiva somnolencia diurna leve, el 49.0% [IC95%: 42.1%56.0%] moderada y el 10.5% [IC95%: 6.7%-15.4%] grave. El 60% de los estudiantes tenía somnolencia diurna patológica. La puntuación promedio de la escala de Epworth en la población fue 10.6±3.7. Se observó diferencia significativa de somnolencia diurna según estado nutricional. La puntuación promedio de la escala en estudiantes de bajo peso fue 9.1±3.1, peso normal 10.6±3.7, sobrepeso 11.5±3.9 y obesidad 5.5±2.1 (p=0.03). También se observó diferencia significativa según actividad sexual, 11.3±3.9 en estudiantes con actividad y 9.7±3.3 en los que no tenían (p=0.002). No se encontró diferencia significativa en la severidad de la somnolencia diurna según el rango de notas ni por nivel de formación. Conclusiones: se observó que seis de cada diez estudiantes presentaban somnolencia diurna moderada o grave. No se encontraron diferencias en la severidad de la somnolencia diurna según el rendimiento académico

Introduction: Sleep is an important physiological function for the adequate physical, psychological, cognitive and intellectual performance. Excessive daytime sleepiness classified as moderate or severe is a sleep disorder and its presence in medical students could affect in the academic performance. Objective: Establish the prevalence of normal and pathological daytime sleepiness in medical students. Methods: Prospective and cross-sectional study. Medical students of Medicine of the Universidad de Cartagena, Colombia in the second academic period of 2011 were included. A survey for the compilation of socio-demographic and academic data and the Epworth Scale for the assessment of daytime sleepiness were applied. The higher the score indicates higher daytime sleepiness of the respondent. The participation was voluntary and anonymous. A stratified sample by gender and semester was chosen. Data analysis was performed using the EPI-INFO statistical program (Version 3.5.1). A p value < 0.05 was considered as statistically significant. Results: 210 medical students filled completely the surveys. The mean age was 19.7±2.0 years. 51.0% [CI 95%: 44.0-57.9%] were women and 49.0% [CI95%: 42.1-56.0%] were men. 69% [CI95%: 62.3-75.2%] came from Cartagena and the remaining 31% [CI95%: 24.8-37.7%] came from different provinces. 53.8% [CI95%: 49.8%-60.7%] had sexually active life. The academic mean of all population of students was 3.8±0.28. 31.4% [CI95%: 25.2%-38.2%] had high grades, 50.5% [CI95%: 43.5%-57.4%] had average grades and 18.1% [CI95%: 13.1%-24.0%] had regular grades. 19.0% [IC95%: 14.0%-25.0%] did not have abnormal daytime sleepiness, 21.4% [CI95%: 16.1%27.0%] had mild daytime sleepiness, 49.0% [CI95%: 42.1%-56.0%] moderate daytime sleepiness and 10.5% [CI95%: 6.7%-15.4%] had severe daytime sleepiness. 60% of the students had pathological daytime sleepiness. The average score of Epworth scale in the population was 10.6±3.7. Significant difference of diurnal somnolence according to the nutritional status was observed. The average score of the scale in students with low weight was 9.1±3.1, normal weight 10.6±3.7, overweight 11.5±3.9 and obesity 5.5±2.1 (p=0.03). Also a significant difference according to the sexual activity was observed, 11.3±3.9 in students with sexual activity and 9.7±3.3 in those without it (p=0.002). There was not found significant difference in the severity of daytime sleepiness according to the range of grades and the academic level. Conclusions: It was observed that six of each ten students presented excessive daytime sleepiness classified as moderate or severe. There were not found differences in the severity of the diurnal somnolence according to the academic performance.