Prevalence of Sleep Deprivation and Relation with Depressive Symptoms among Medical Residents in King Fahd University Hospital, Saudi Arabia
Open accessAbstract
OBJECTIVES: Sleep deprivation is common among medical residents of all specialties. This study aimed to determine the prevalence of sleep deprivation and depressive symptoms among medical residents in King Fahd University Hospital (KFUH) in Al Khobar, Saudi Arabia. Furthermore, the association between sleep deprivation, sleepiness and depressive symptoms was examined. METHODS: This cross-sectional study took place between February and April 2012 and involved 171 KFUH medical residents of different specialties. Data were collected using a specifically designed questionnaire eliciting demographic information, working hours and number of hours of sleep. In addition, validated Arabic versions of the Epworth Sleepiness Scale and the Beck Depression Inventory-2 (BDI-2) were used. RESULTS: The prevalence of acute sleep deprivation and chronic sleep deprivation among residents in KFUH was 85.9% and 63.2%, respectively. The prevalence of overall sleepiness was 52%; 43.3% reported being excessively sleepy in certain situations while 8.8% reported being excessively sleepy regardless of the situation. Based on the BDI-2, the prevalence of mild, moderate and severe depressive symptoms was 43.3%, 15.2% and 4.7%, respectively. Significant associations were found between sleep deprivation and depressive symptoms; depressive symptoms and sleepiness, and depressive symptoms and being a female resident. CONCLUSION: The vast majority of medical residents had acute sleep deprivation, with more than half suffering from chronic sleep deprivation. The number of hours and quality of sleep among the residents were strongly associated with depressive symptoms. New regulations are recommended regarding the number of working hours and night duties for medical residents. Further studies should assess these new regulations on a regular basis.
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Long and irregular working hours, irregular sleep schedules, and stress are main drivers associated with sleep disturbances among medical doctors.
“research has identified long and irregular working hours, irregular sleep schedules (52, 60, 61) and stress (48, 54, 58, 59, 62–64) as main drivers associated with sleep disturbances.”
Cites
A New Method for Measuring Daytime Sleepiness: The Epworth Sleepiness Scale
Johns, M. W. (1991) · Sleep · doi:10.1093/sleep/14.6.540 · Cited by 17,364 · see citing works
Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients
Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6703_13 · Cited by 5,965 · see citing works
Chervin, R. (2003) · Sleep Medicine · doi:10.1016/s1389-9457(03)00030-3 · Cited by 5,238 · see citing works
Reliability and factor analysis of the Epworth Sleepiness Scale.
Johns, M. (1992) · Sleep · doi:10.1093/sleep/15.4.376 · Cited by 2,193 · see citing works
Depressive Symptoms in Medical Students and Residents: A Multischool Study
Goebert, D., Thompson, D., Takeshita, J., Beach, C., Bryson, P., Ephgrave, K., Kent, A., Kunkel, M., Schechter, J., & Tate, J. (2009) · Academic Medicine · doi:10.1097/acm.0b013e31819391bb · Cited by 537 · see citing works
Cumulative effects of sleep restriction on daytime sleepiness.
Carskadon, M., & Dement, W. (1981) · Psychophysiology · doi:10.1111/j.1469-8986.1981.tb02921.x · Cited by 505 · see citing works
Rosen, I. M., Gimotty, P. A., Shea, J. A., & Bellini, L. M. (2006) · Academic Medicine · doi:10.1097/00001888-200601000-00020 · Cited by 495 · see citing works
Stress Management in Medical Education
Shapiro, S. L., Shapiro, D., & SCHWARTZ, G. E. R. (2000) · Academic Medicine · doi:10.1097/00001888-200007000-00023 · Cited by 413 · see citing works
Baldwin, D. C., & Daugherty, S. R. (2004) · Sleep · doi:10.1093/sleep/27.2.217 · Cited by 280 · see citing works
Surgeon Distress as Calibrated by Hours Worked and Nights on Call
Balch, C. M., Shanafelt, T. D., Dyrbye, L. N., Sloan, J. A., Russell, T., Béchamps, G. J., & Freischlag, J. A. (2010) · Journal of the American College of Surgeons · doi:10.1016/j.jamcollsurg.2010.06.393 · Cited by 217 · see citing works
Alansari, B. M. (2006) · Social Behavior and Personality An International Journal · doi:10.2224/sbp.2006.34.4.425 · Cited by 62 · see citing works
Sleep loss in resident physicians: the cause of medical errors?
KRAMER, M. L. (2010) · Frontiers in Neurology · doi:10.3389/fneur.2010.00128 · Cited by 48 · see citing works
An Evaluation of Mood States among First-Year Residents
Kirsling, R. A., Kochar, M., & Chan, C. H. (1989) · Psychological Reports · doi:10.2466/pr0.1989.65.2.355 · Cited by 45 · see citing works
Wada, K., Yoshikawa, T., Goto, T., Hirai, A., Matsushima, E., Nakashima, Y., Akaho, R., Kido, M., & Hosaka, T. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-127 · Cited by 34 · see citing works
[Validation of the Arabic Version of the Epworth Sleepiness Scale: Multicentre study].
Riachy, M., Juvelikian, G., Sleilaty, G., et al. (2012) · Revue des maladies respiratoires · doi:10.1016/j.rmr.2011.12.017 · Cited by 14
Effect of On-Call Related Sleep Deprivation on Physicians’ Mood and Level of Alertness
Wali, S., Abushanab, L., Quotah, K., et al. (2011) · doi:10.1378/chest.1117573 · Cited by 2
Flagged first, then by citations
6 of the 22 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Mata, D. A., Ramos, M. A., Bansal, N., Khan, R., Guille, C., Di Angelantonio, E., & Sen, S. (2015) · JAMA · doi:10.1001/jama.2015.15845 · Cited by 1,255 · see citing works
Prevalence of Depression and Depressive Symptoms Among Resident Physicians
Mata, D. A., Ramos, M. A., Bansal, N., Khan, R., Guille, C., Angelantonio, E. D., & Sen, S. (2016) · Survey of Anesthesiology · doi:10.1097/sa.0000000000000237 · Cited by 12 · see citing works
“Oriel et al,33 2004 United States NR Family medicine 1-4 185 Mean (range), 33 (26-57) 87 (47.”
Sunjaya, D. K., Herawati, D. M. D., & Siregar, A. Y. M. (2021) · BMC Public Health · doi:10.1186/s12889-021-10299-6 · Cited by 112 · see citing works
“argued that moderate to severe depressive symptoms prevalence in doctors are approximately 20% [41].”
BackgroundThe Impact of the COVID-19 Pandemic on Students’ Mental Health and Sleep in Saudi Arabia
Alyoubi, A., Halstead, E. J., Zambelli, Z., & Dimitriou, D. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18179344 · Cited by 94 · see citing works
“Medical students in Saudi Arabia who reported sleep disruption and insomnia, also had a higher level of depression, anxiety, and stress prior to the pandemic [25,47].”
BackgroundAlami, Y. Z., Ghanim, B. T., & Zyoud, S. H. (2018) · Journal of Occupational Medicine and Toxicology · doi:10.1186/s12995-018-0203-z · Cited by 52 · see citing works
Almarzouki, A. F., Mandili, R. L., Salloom, J., Kamal, L. K., Alharthi, O. H., Alharthi, S., Khayyat, N., & Baglagel, A. M. (2022) · Brain Sciences · doi:10.3390/brainsci12111525 · Cited by 60 · see citing works
“Previous work has demonstrated that sleep quality is correlated with mental health both locally and worldwide [25,54,55].”
BackgroundChang, Q., Xia, Y., Bai, S., Zhang, X., Liu, Y., Yao, D., Xu, X., & Zhao, Y. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.564815 · Cited by 44 · see citing works
Assessment of Physician Well-being, Part One: Burnout and Other Negative States
Lall, M. D., Gaeta, T. J., Chung, A. S., Dehon, E. E., Malcolm, W., Ross, A. S., Way, D. P., Weichenthal, L. A., & Himelfarb, N. T. (2019) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2019.1.39665 · Cited by 42 · see citing works
Sleep Deprivation and Depression : A bi-directional association
Al-Abri, M. (2015) · Sultan Qaboos University medical journal · doi:10.18295/2075-0528.1646 · Cited by 45 · see citing works
Night shift work in resident physicians: does it affect mood states and cognitive levels?
Costa, C., Mondello, S., Micali, E., Indelicato, G., Licciardello, A. A., Vitale, E., Briguglio, G., Teodoro, M., & Fenga, C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.03.139 · Cited by 64 · see citing works
Marzouk, M., Ouanes-Besbes, L., Ouanes, I., Hammouda, Z., Dachraoui, F., & Abroug, F. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-020655 · Cited by 79 · see citing works
“Moreover, in a cross-sectional study conducted among residents of various specialties in Saudi Arabia, the prevalence of moderate to severe depressive symptoms was around 20%.(17) Resident physicians share the same known causes of depression with the general population: physical health, lifestyle, marital status, hist…”
BackgroundPrevalence of and risk factors for poor sleep quality among residents in training in KSA
AlSaif, H. I. (2018) · Journal of Taibah University Medical Sciences · doi:10.1016/j.jtumed.2018.11.007 · Cited by 29 · see citing works
“They inquired on the number of sleeping hours over the last week but did not investigate other domains of sleep quality.(8) Given the various negative effects of poor sleep quality in residents on patient care and safety and on residents’ learning capacity and mental health, residents’ sleep quality should be assessed…”
BackgroundMethodKanmogne, G. D., Qiu, F., Ntone, F. E., Fonsah, J. Y., Njamnshi, D. M., Kuate, C. T., Doh, R. F., Kengne, A. P., Tagny, C. T., Nchindap, E., et al. (2017) · PLoS ONE · doi:10.1371/journal.pone.0171956 · Cited by 29 · see citing works
Yaghmour, A., Alesa, A., Anbarserry, E., Binmerdah, M. A., Alharbi, A., Housawi, A. A., Almehdar, M. H., Lytra, H., Alsaywid, B. S., & Lytras, D. M. (2021) · Healthcare · doi:10.3390/healthcare9020160 · Cited by 28 · see citing works
“For instance, 43% medical residents working in the eastern region of Saudi Arabia reported as suffering from depression [29].”
BackgroundDabbagh, R., Alwatban, L., Alrubaiaan, M., Alharbi, S., Aldahkil, S., AlMuteb, M., Alsahli, N., & Almutairi, R. (2022) · Medical Teacher · doi:10.1080/0142159x.2022.2139669 · Cited by 30 · see citing works
Tareke, S. A., Lelisho, M. E., Hassen, S. S., Seid, A. A., Jemal, S. S., Teshale, B. M., Wotale, T. W., & Pandey, B. K. (2022) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-021-01195-1 · Cited by 97 · see citing works
The Correlation Between Night Shift Work Schedules, Sleep Quality, and Depression Symptoms
Alreshidi, S. M., & Rayani, A. M. (2023) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s421092 · Cited by 23 · see citing works
Cheng, J., Zhao, X., Qiu, J. H., Jiang, Y., Ren, J., Sun, S.-Y., Wang, R., & Su, C. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.01.014 · Cited by 24 · see citing works
Prevalence and Predictors of Depression Among Medical Residents in Western Saudi Arabia
Alshardi, A., & Farahat, F. M. (2019) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-019-09667-7 · Cited by 34 · see citing works
“A high prevalence was observed among general surgery, urology, internal medicine, and neurology residents (Al-Maddah et al., 2015).”
BackgroundResultInfluentialEffects of Changes in Environmental Color Chroma on Heart Rate Variability and Stress by Gender
Oh, J., & Park, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095711 · Cited by 24 · see citing works
Elhadi, M., Khaled, A., Malek, A. B., El-Azhari, A. E.-A., Gwea, A. Z., Zaid, A., Elturki, S. M., Aburgegah, A., Ageila, M. A. K. A., Alhadi, A., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-039382 · Cited by 20 · see citing works
Microsurgical Performance After Sleep Interruption: A NeuroTouch Simulator Study
Micko, A. S. G., Knopp, K., Knosp, E., & Wolfsberger, S. (2017) · World Neurosurgery · doi:10.1016/j.wneu.2017.06.142 · Cited by 14 · see citing works
Ayuob, N., Sindi, A., & Eldeek, B. (2016) · doi:10.18203/2320-6012.ijrms20160322 · Cited by 12
Kamali, M., Moosazadeh, M., Azizi, M., Ghasemian, R., Reskati, M. H., & Elyasi, F. (2021) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12213 · Cited by 7 · see citing works
Study of Mental Health Status of the Resident Physicians in China During the COVID-19 Pandemic
Jia, S., Zhao, Y., Liu, J.-Q., Guo, X., Chen, M., Zhou, S., & Zhou, J.-L. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.764638 · Cited by 8 · see citing works
Bahnassy, A., Saeed, A., Almatham, K. I., et al. (2018) · doi:10.4172/0032-745x.1000317 · Cited by 7
“Worldwide, including KSA, several studies addressed stress among medical residents in different disciplines [8-16].”
BackgroundResultInfluentialDepressive symptoms and correlates among village doctors in China
Gu, L., Chu, J., Zhen-biao, Q., & Jia, C.-X. (2017) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2017.07.004 · Cited by 8 · see citing works
Risk of fatigue among anesthesia residents in Saudi Arabia
Arab, A. A., & Khayyat, H. Y. (2017) · Saudi Medical Journal · doi:10.15537/smj.2017.3.17511 · Cited by 8 · see citing works
Sadeghi-Bahmani, D., Rigotti, V., Stanga, Z., Lang, U. E., Blais, R. K., Kelley, M. L., & Brand, S. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1390636 · Cited by 6 · see citing works
Daher, A. M., Burud, I. A. S., Subair, M., Mushahar, L., & Xin, L. J. (2024) · PLoS ONE · doi:10.1371/journal.pone.0306574 · Cited by 6 · see citing works
Amin, M. H. J., Elmahi, M. A. M. E., Fadlalmoula, G. A. A. G. A., Amin, J. H. J., Alrabee, N. H. K., Awad, M. H., omer, Z. Y. M., Dayyeh, N. T. I. A., Abdalkareem, N. A. H., Ahmed, E. M. O. M. S., et al. (2024) · Sleep Science and Practice · doi:10.1186/s41606-024-00104-9 · Cited by 5 · see citing works
Daubry, T. M. E., Nwogueze, B. C., Toloyai, P.-E. Y., & Moke, E. G. (2024) · Sleep Science · doi:10.1055/s-0043-1778013 · Cited by 4 · see citing works
“63 Our fi ndings were contrary to the fi ndings of Al-Maddah et al. 64 that chronic rather than acute sleep deprivation may result in depression.”
ResultHameed, T. K., Dubayee, M. S. A., Masuadi, E., Al‐Anzi, F., & Asmary, N. A. A. (2021) · Journal of Taibah University Medical Sciences · doi:10.1016/j.jtumed.2021.05.003 · Cited by 5 · see citing works
“In one of the previously mentioned studies conducted in Eastern KSA, the overall prevalence of sleepiness was reported to be 52%.(8) More recently, in a study of the residents of Saudi Commission for Health Specialties’ programs, a very high proportion of residents (86.”
InfluentialDepressive Symptoms among Plastic Surgery Residents
Andejani, D. F., Alissa, S. I., & Al-Qattan, M. M. (2017) · Plastic & Reconstructive Surgery Global Open · doi:10.1097/gox.0000000000001516 · Cited by 5 · see citing works
Kim, J., Yoon, J., & Kim, S. (2015) · Journal of Korean Society of Occupational and Environmental Hygiene · doi:10.15269/jksoeh.2015.25.2.236 · Cited by 6 · see citing works
“예를 들 어, 사우디아라비아의 레지던트 171명을 대상으로 수면부족과 우울증 사이의 연관성을 조사한 연구는 주당 40~76시간 근무한 집단에서는 13.4%, 77~90시 간 근무한 집단에서는 28.4%가 우울증상을 가지고 있는 것으로 보고했다(Al-Maddah et al., 2015).”
InfluentialMental Health Issues among Physicians in Saudi Arabia: A Scoping Review
Ram, D., & Alharbi, H. Y. (2025) · Saudi Journal of Medicine and Medical Sciences · doi:10.4103/sjmms.sjmms_128_25 · Cited by 3 · see citing works
A Meta-Analytical Comparison of Depression Prevalence in GCC Countries
Camia, C., & Alhallami, A. O. (2023) · Current Research in Ecological and Social Psychology · doi:10.1016/j.cresp.2023.100149 · Cited by 3 · see citing works
Alshammari, S., & Alrishan, M. (2020) · Journal of Family and Community Medicine · doi:10.4103/jfcm.jfcm_9_20 · Cited by 3 · see citing works
“[12] A local study conducted in King Fahad University Hospital found that 63% of medical residents were sleep deprived.[13] The prevalence of SD among Saudi adults was estimated as 33%.”
BackgroundAyuob, N., Bahumdain, S. Z., AL-Najei, Z. A., et al. (2015) · doi:10.5455/jcme.20151222112334 · Cited by 4
“When it came to the reasons for selecting medicine as a profession, in the current study, a willingness to help patients and an interest in the medical field were the most common among the senior students, and this was in agreement with some previous studies [12-14).”
ResultPrevalence of Depression and Burnout among Family Medicine Residents in Riyadh City, Saudi Arabia
AlNahedh, A., BinRusayyis, A., Al-Tannir, M. A., & AlFayyad, I. (2023) · Health Psychology Research · doi:10.52965/001c.90620 · Cited by 2 · see citing works
Pandey, D., Hasan, A., Pandey, B. K., Lelisho, M. E., George, A. S., & Shahul, A. (2023) · CSI Transactions on ICT · doi:10.1007/s40012-023-00383-0 · Cited by 30 · see citing works
“Sleep disruption increased melancholy, anxiety, and stress in Saudi medical students before the outbreak [56, 66].”
BackgroundDanasekaran, R., Syed, R., Natarajan, S. B., et al. (2025) · International Journal of Occupational Safety and Health · doi:10.3126/ijosh.v15i3.69186 · Cited by 1
“29 The living conditions and work to establish causality between psychological morbidity and its risk factors.”
Alonezan, A., Alobidan, A., Alkahmous, A., Alhumaid, N. A., & Abahussain, R. (2025) · Sleep Science and Practice · doi:10.1186/s41606-025-00149-4 · Cited by 1 · see citing works
“However, these studies do not focus specifically on resident physicians, even though they are more prone to sleep problems [18, 35].”
Alsaleem, M. A., Wasili, F. M. J., & Alsaleem, S. A. (2022) · King Khalid University Journal of Health Sciences · doi:10.4103/kkujhs.kkujhs_24_22 · Cited by 1 · see citing works
Sleep Disturbances Among Adult Patients with Mood Disorders: A Saudi Cross-Sectional Study
Almadani, A., Alghamdi, A., Alsalman, F. S., Alghanim, A. J., Hashim, R. T., Binbakhit, A. I., Alkulyah, A., Almutairi, R., Alfarhan, L., Muhnna, A. K., et al. (2026) · Nature and Science of Sleep · doi:10.2147/nss.s576765
“The multivariate analysis revealed that younger adults (18–25) experienced significantly greater sleep effort than the 46–55 age group.”
de Carvalho, D. B. M., Martins, R. R., Flôr, J. S. M., Martins, W. N. D., Beltrão, S. M. V., & Maluf, F. (2025) · Health Residencies Journal - HRJ · doi:10.51723/hrj.v6i32.1160
The impact of remote working on sleep quality in otolaryngology
Mowat, A. J., Ang, T., Sturges, P., & Jervis, S. (2024) · Journal of Laryngology and Voice · doi:10.4103/jlv.jlv_7_24
Consequences of sleep deprivation among nurses at critical care units in Al-Najaf city
Hassan, A. J., Khudhair, F. W., & Mahdi, A. (2022) · International Journal of Health Sciences · doi:10.53730/ijhs.v6ns6.10419
ASSOCIATION OF DEPRESSION, ANXIETY AND STRESS WITH QUALITY OF SLEEP AMONG DPT STUDENTS OF ZCRS
Zafar, B., Amir, F., & Ali, S. W. (2019) · Pakistan Journal of Rehabilitation · doi:10.36283/pjr.zu.8.1/008
- Authors
- Al-Maddah, E. M., Al-Dabal, B. K., & Khalil, M. S.
- Affiliations
- King Fahd Hospital of the University (SA)
- Imam Abdulrahman Bin Faisal University (SA)
- Venue
- Sultan Qaboos University Medical Journal
- Publisher
- Sultan Qaboos University
- Published
- 2015-01-21
- Volume
- 15
- Issue
- 1
- Pages
- 78-84
- ISSN
- 2075-051X (ISSN-L)
- 2075-0528
- PMC
- PMC4318611
- OpenAlex
- W2330566766
- Cited by
- 44
- References
- 22
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 4 · 2023: 4 · 2022: 6 · 2021: 7 · 2020: 3 · 2019: 3 · 2018: 3 · 2017: 5 · 2016: 1 · 2015: 3
- FWCI
- 6.03
- Type
- journal article
- Language
- en
- Open access
- diamond
- doi.org
- Licence
- cc-by
- Locations
- Sultan Qaboos University medical journal (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- sleep deprivation, depressive symptoms, medical residents, sleepiness, acute sleep deprivation, chronic sleep deprivation, working hours, night duty, gender differences, residency training
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