Sleep medicine education and knowledge among medical students in selected Saudi Medical Schools

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Abstract

Background

Limited information is available regarding sleep medicine education worldwide. Nevertheless, medical education has been blamed for the under-recognition of sleep disorders among physicians. This study was designed to assess the knowledge of Saudi undergraduate medical students about sleep and sleep disorders and the prevalence of education on sleep medicine in medical schools as well as to identify the obstacles to providing such education.

Methods

We surveyed medical schools that were established more than 10 years ago, asking fourth- and fifth-year medical students (men and women) to participate. Seven medical schools were selected. To assess knowledge on sleep and sleep disorders, we used the Assessment of Sleep Knowledge in Medical Education (ASKME) Survey, which is a validated 30-item questionnaire. The participants were separated into two groups: those who scored ≥60% and those who scored <60%. To assess the number of teaching hours dedicated to sleep medicine in the undergraduate curricula, the organizers of the major courses on sleep disorders were contacted to obtain the curricula for those courses and to determine the obstacles to education.

Results

A total of 348 students completed the survey (54.9% male). Among the participants, 27.7% had a specific interest in sleep medicine. More than 80% of the study sample had rated their knowledge in sleep medicine as below average. Only 4.6% of the respondents correctly answered ≥60% of the questions. There was no difference in the scores of the respondents with regard to university, gender, grade-point average (GPA) or student academic levels. Only five universities provided data on sleep medicine education. The time spent teaching sleep medicine in the surveyed medical schools ranged from 0-8 hours with a mean of 2.6 ±2.6 hours. Identified obstacles included the following: (1) sleep medicine has a lower priority in the curriculum (53%) and (2) time constraints do not allow the incorporation of sleep medicine topics in the curriculum (47%).

Conclusions

Medical students in the surveyed institutions possess poor knowledge regarding sleep medicine, which reflects the weak level of education in this field of medicine. To improve the recognition of sleep disorders among practicing physicians, medical schools must provide adequate sleep medicine education.

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Most cited references 28

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Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort.

Terry Young, Laurel Ann Finn, Paul Peppard … (2008)

Sleep-disordered breathing (SDB) is a treatable but markedly under-diagnosed condition of frequent breathing pauses during sleep. SDB is linked to incident cardiovascular disease, stroke, and other morbidity. However, the risk of mortality with untreated SDB, determined by polysomnography screening, in the general population has not been established. An 18-year mortality follow-up was conducted on the population-based Wisconsin Sleep Cohort sample (n = 1522), assessed at baseline for SDB with polysomnography, the clinical diagnostic standard. SDB was described by the number of apnea and hypopnea episodes/hour of sleep; cutpoints at 5, 15 and 30 identified mild, moderate, and severe SDB, respectively. Cox proportional hazards regression was used to estimate all-cause and cardiovascular mortality risks, adjusted for potential confounding factors, associated with SDB severity levels. All-cause mortality risk, adjusted for age, sex, BMI, and other factors was significantly increased with SDB severity. The adjusted hazard ratio (HR, 95% CI) for all-cause mortality with severe versus no SDB was 3.0 (1.4,6.3). After excluding persons who had used CPAP treatment (n = 126), the adjusted HR (95% CI) for all-cause mortality with severe versus no SDB was 3.8 (1.6,9.0); the adjusted HR (95% CI) for cardiovascular mortality was 5.2 (1.4,19.2). Results were unchanged after accounting for daytime sleepiness. Our findings of a significant, high mortality risk with untreated SDB, independent of age, sex, and BMI underscore the need for heightened clinical recognition and treatment of SDB, indicated by frequent episodes of apnea and hypopnea, irrespective of symptoms of sleepiness.

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Prevalence of symptoms and risk of sleep apnea in middle-aged Saudi males in primary care.

Ahmed BaHammam, H Sayer, Abdulaziz BinSaeed … (2008)

The prevalence of obstructive sleep apnea OSA has not been assessed in Saudi Arabia. We aimed to assess the prevalence of individuals who were at risk of OSA in a sample of middle-aged Saudi males, using the Berlin questionnaire at primary care settings. The study was conducted at King Khalid University and King Fahd National Guard primary health care clinics in Riyadh, Kingdom of Saudi Arabia between December 2005 and March 2006. Berlin Questionnaire was administered by trained medical students to consecutive Saudi male patients in the age group 30-65 years attending the primary health care clinics, after explaining the procedure of the study. Based on the data collected and defined criteria, patients were stratified into high risk and low risk according to responses. Five hundred and seventy-eight middle-aged Saudi males with a mean age of 45.02 +/- 9.3 year were surveyed in this study. Snoring was present in 52.3%, and breathing pauses more than once per week was noticed in 11.3%. Based on the Berlin questionnaire stratification for risk of OSA, 33.3% were considered as high risk patients for OSA. The occurrence of daytime tiredness >once/week was reported by 35.5%. The prevalence of snoring and risk for OSA is similar to that reported in the US. In primary care setting, one in 3 middle-aged Saudi males is at risk for OSA.

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Sleep education in medical school curriculum: a glimpse across countries.

Jodi Mindell, Alex Bartle, Norrashidah Wahab … (2011)

The objective of this study was to assess the prevalence of education about sleep and sleep disorders in medical school education and to identify barriers to providing such education. Surveys were sent to 409 medical schools across 12 countries (Australia, India, Indonesia, Japan, Malaysia, New Zealand, Singapore, South Korea, Thailand, United States, Canada and Viet Nam). Overall, the response rate was 25.9%, ranging from 0% in some countries (India) to 100% in other countries (New Zealand and Singapore). Overall, the average amount of time spent on sleep education is just under 2.5h, with 27% responding that their medical school provides no sleep education. Three countries (Indonesia, Malaysia, and Viet Nam) provide no education, and only Australia and the United States/Canada provide more than 3h of education. Paediatric topics were covered for a mere 17 min compared to over 2h on adult-related topics. These results suggest that there continues to be very limited coverage of sleep in medical school education despite an incredible increase in acknowledgement of the importance of sleep and need for recognition of sleep disorders by physicians. Copyright Â© 2011 Elsevier B.V. All rights reserved.

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Author and article information

Contributors

Abdulellah Almohaya

Abdulaziz Qrmli

Naeif Almagal

Khaled Alamri

Salman Bahammam

Mashhour Al-Enizi

Atif Alanazi

Aljohara S Almeneessier

Munir M Sharif

Ahmed S BaHammam

Journal

Journal ID (nlm-ta): BMC Med Educ

Journal ID (iso-abbrev): BMC Med Educ

Title: BMC Medical Education

Publisher: BioMed Central

ISSN (Electronic): 1472-6920

Publication date Collection: 2013

Publication date (Electronic): 27 September 2013

Volume: 13

Page: 133

Affiliations

[1 ]University Sleep Disorders Center, College of Medicine, King Saud University, Box 225503, Riyadh 11324, Saudi Arabia

[2 ]College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

[3 ]Family Medicine Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia

[4 ]National Plan for Science and Technology, King Saud University, Riyadh, Saudi Arabia

Article

Publisher ID: 1472-6920-13-133

DOI: 10.1186/1472-6920-13-133

PMC ID: 3849688

PubMed ID: 24070217

SO-VID: f5a93e4d-f8ca-4e48-8722-43810e0f1222

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

History

Date received : 11 June 2013

Date accepted : 24 September 2013

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Sleep medicine education and knowledge among medical students in selected Saudi Medical Schools

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Abstract

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Most cited references 28

Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort.

Prevalence of symptoms and risk of sleep apnea in middle-aged Saudi males in primary care.

Sleep education in medical school curriculum: a glimpse across countries.

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