Journal of Oral Health and Community Dentistry

Register      Login

VOLUME 16 , ISSUE 2 ( May-August, 2022 ) > List of Articles


Association of Depression and Excessive Daytime Sleepiness among Undergraduate Dental College Students in Chennai, India

Zoha Abdullah, RS Durgadevi, A Caroline Jerry, G Ganesh Kumar, Parvathy Premnath

Keywords : Dental students, Depression, Excessive daytime sleepiness, Insomnia, Sleep quality

Citation Information : Abdullah Z, Durgadevi R, Jerry AC, Kumar GG, Premnath P. Association of Depression and Excessive Daytime Sleepiness among Undergraduate Dental College Students in Chennai, India. J Oral Health Comm Dent 2022; 16 (2):87-93.

DOI: 10.5005/jp-journals-10062-0063A

License: CC BY-NC 4.0

Published Online: 13-09-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Introduction: Excessive daytime sleepiness (EDS) has become an emerging problem in 50% of college students. For healthcare students and professionals, the negative impact of EDS not only negatively affects the individual but also the safety and quality of care to the patients. The aim of the study was to investigate the prevalence of EDS among the dental students and to examine the correlation between risk factors and EDS in college students. Materials and methods: An online questionnaire (Google Form) with questions related to the sociodemographic characteristics, daytime sleepiness, depression, insomnia, and sedentary behaviors was distributed via online platforms. Data were collected and analyzed using SPSS software. Bivariate analysis (Chi-square test) was used to assess the association between independent variables with each of the main outcomes of interest. Independent t-test was done to compare continuous variables of interest between those with EDS and without EDS. Pearson correlation test was used to analyze the correlation between the variables. Results: A total of 170 students participated in the survey. The overall EDS prevalence was 72.4%. About 37.6% and 27% said they experience insomnia and had severe depression. There was a positive correlation between CESS score (EDS), depression, and insomnia score. Conclusion: Daytime sleepiness was highly prevalent among the college students in this study, and it was significantly associated with depression and insomnia among the college students.

PDF Share
  1. Harikiran AG, Srinagesh J, Nagesh KS, et al. Perceived sources of stress amongst final year dental under graduate students in a dental teaching institution at Bangalore, India: A cross sectional study. Indian J Dent Res 2012;23(3):331–336. DOI: 10.4103/0970-9290.102218.
  2. Schmitter M, Liedl M, Beck J, et al. Chronic stress in medical and dental education. Med Teach 2008;30(1):97–99. DOI: 10.1080/01421590701769571.
  3. Alzahem AM, van der Molen HT, Alaujan AH, et al. Stress amongst dental students: A systematic review. Eur J Dent Educ 2011;15(1): 8–18. DOI: 10.1111/j.1600-0579.2010.00640.x.
  4. Cooper CL, Baglioni AJ. A structural model approach toward the development of a theory of the link between stress and mental health. Br J Med Psychol 1988;61 (Pt 1):87–102. DOI: 10.1111/j.2044-8341.1988.tb02767.x.
  5. Prasad M, Patthi BR, Singla A, et al. Assessment of anxiety and depression among dental practitioners: an exploratory cross-sectional study. J Clin Diagn Res 2017;11(10):ZC01–ZC04.
  6. Rada RE, Johnson-Leong C. Stress, burnout, anxiety and depression among dentists. J Am Dent Assoc 2004;135(6):788–794. DOI: 10.14219/jada.archive.2004.0279.
  7. Nair MKC, Paul MK, John R. Prevalence of depression among adolescents. Indian J Pediatr 2004;71(6):523–524. DOI: 10.1007/BF02724294.
  8. Sabbarwal B, Puranik MP, Sowmya KR. Prevalence of depressive symptoms and associated factors among dental students: A cross sectional study. J Global Oral Health 2019;2(1):16–22. DOI: 10.25259/JGOH_30_2019.
  9. Takayama Y, Miura E, Miura K, et al. Condition of depressive symptoms among Japanese dental students. Odontology 2011;99(2):179–187. DOI: 10.1007/s10266-011-0005-6.
  10. Pagnin D, de Queiroz V, Carvalho YTMS, et al. The relation between burnout and sleep disorders in medical students. Acad Psychiatry 2014;38(4):438–444. DOI: 10.1007/s40596-014-0093-z.
  11. Roehrs T, Shore E, Papineau K, et al. A two-week sleep extension in sleepy normals. Sleep 1996;19(7):576–582. PMID: 8899937.
  12. Riemann D, Voderholzer U. Primary insomnia: A risk factor to develop depression? J Affect Disord 2003;76(1–3):255–259. DOI: 10.1016/s0165-0327(02)00072-1.
  13. Söderström M, Jeding K, Ekstedt M, et al. Insufficient sleep predicts clinical burnout. J Occup Health Psychol 2012;17(2):175–183. DOI: 10.1037/a0027518.
  14. Oginska H, Pokorski J. Fatigue and mood correlates of sleep length in three age-social groups: School children, students, and employees. Chronobiol Int 2006;23(6):1317–1328. DOI: 10.1080/07420520601089349.
  15. Tsou MT, Chang BCC. Association of Depression and Excessive Daytime Sleepiness among Sleep-Deprived College Freshmen in Northern Taiwan. Int J Environ Res Public Health 2019;16(17):3148. DOI: 10.3390/ijerph16173148.
  16. Melamed S, Oksenberg A. Excessive daytime sleepiness and risk of occupational injuries in non-shift daytime workers. Sleep 2002;25(3):315–322. DOI: 10.1093/sleep/25.3.315.
  17. Joo S, Shin C, Kim J, et al. Prevalence and correlates of excessive daytime sleepiness in high school students in Korea. Psychiatry Clin Neurosci 2005;59(4):433–440. DOI: 10.1111/j.1440-1819.2005.01396.x.
  18. Gibson ES, Powles ACP, Thabane L, et al. “Sleepiness” is serious in adolescence: two surveys of 3235 Canadian students. BMC Public Health 2006;6:116. DOI: 10.1186/1471-2458-6-116.
  19. Hangouche AJE, Jniene A, Aboudrar S, et al. Relationship between poor quality sleep, excessive daytime sleepiness and low academic performance in medical students. Adv Med Educ Pract 2018;9: 631–638. DOI: 10.2147/AMEP.S162350.
  20. Gaultney JF. The prevalence of sleep disorders in college students: Impact on academic performance. J Am Coll Health 2010;59(2):91–97. DOI: 10.1080/07448481.2010.483708.
  21. Angelin TJ, Mota KR, dos Santos Júnior VE, et al. Evaluation of sleep quality and daytime sleepiness in dentistry students. Pesqui Bras Odontopediatria Clín Integr 2020;20:e0003. DOI: 10.1590/pboci.2020.122.
  22. Johns MW. A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep 1991;14(6):540–545. DOI: 10.1093/sleep/14.6.540.
  23. Lee MB, Lee YJ, Yen LL, et al. Reliability and validity of using a Brief Psychiatric Symptom Rating Scale in clinical practice. J Formos Med Assoc 1990;89(12):1081–1087. PMID: 1982678.
  24. Soldatos CR, Dikeos DG, Paparrigopoulos TJ. Athens Insomnia Scale: Validation of an instrument based on ICD-10 criteria. J Psychosom Res 2000;48(6):555–560. DOI: 10.1016/s0022-3999(00)00095-7.
  25. Elagra MI, Rayyan MR, Alnemer OA, et al. Sleep quality among dental students and its association with academic performance. J Int Soc Prev Community Dent 2016;6(4):296–301. DOI: 10.4103/2231-0762.186788.
  26. Aravinth H, Dhanraj M, Jain A. Prevalence of sleep disorder among dental students – A questionnaire study. Drug Invention Today 2018;10(12):2434–2440. ISSN: 0975-7619.
  27. Periyasamy Y, Priyadarshoni SP, Jayashri P. Prevalence of sleep disorder among dental students and correlation with oral hygiene status – A cross-sectional study. Drug Invention Today 2019; 11(2):7.
  28. Alhajj MN, Khader Y, Murad AH, et al. Perceived sources of stress amongst dental students: A multicountry study. Eur J Dent Educ 2018;22(4):258–271. DOI: 10.1111/eje.12350.
  29. Jahrami H, Alshomili H, Almannai N, et al. Predictors of excessive daytime sleepiness in medical students: A meta-regression. Clocks Sleep 2019;1(2):209–219. DOI: 10.3390/clockssleep1020018.
  30. Huang CF, Yang LY, Wu LM, et al. Determinants of daytime sleepiness in first-year nursing students: A questionnaire survey. Nurse Educ Today 2014;34(6):1048–1053. DOI: 10.1016/j.nedt.2013.11.005.
  31. Siddalingaiah HS, Chaudhuri A, Chandrakala D, et al. Excessive daytime sleepiness and its determinants: Do they have a pattern with study semesters among postgraduate medical resident doctors? Int J Commun Med Public Health 2017;5(1):382–389. DOI: 10.18203/2394-6040.ijcmph20175818.
  32. Aldrin A, Ganapathy D, Sasanka LK. Insomnia among the dental college students. IJPR 2020;12(4). Available from: = 17550.
  33. Basu M, Saha SK, Majumder S, et al. A study on sleeping pattern among undergraduate medical students of a Tertiary Care Teaching Hospital of Kolkata. IJMEDPH 2019;9(4):118–124. DOI: 10.5530/ijmedph.2019.4.26.
  34. Cooper CL, Watts J, Kelly M. Job satisfaction, mental health, and job stressors among general dental practitioners in the UK. Br Dent J 1987;162(2):77–81. DOI: 10.1038/sj.bdj.4806030.
  35. Nezam S, Golwara A, Jha PC, et al. Comparison of prevalence of depression among medical, dental, and engineering students in Patna using Beck's Depression Inventory II: A cross-sectional study. J Family Med Prim Care 2020;9(6):3005–3009. DOI: 10.4103/jfmpc.jfmpc_294_20.
  36. Basudan S, Binanzan N, Alhassan A. Depression, anxiety and stress in dental students. Int J Med Educ 2017;8:179–186. DOI: 10.5116/ijme.5910.b961.
  37. Laurence B, Williams C, Eiland D. Depressive symptoms, stress, and social support among dental students at a historically black college and university. J Am Coll Health 2009;58(1):56–63. DOI: 10.3200/JACH.58.1.56-63.
  38. Dagnew B, Andualem Z, Dagne H. Excessive daytime sleepiness and its predictors among medical and health science students of University of Gondar, Northwest Ethiopia: Institution-based cross-sectional study. Health Qual Life Outcomes 2020;18. Available from:
  39. Dinis J, Bragança M. Quality of sleep and depression in college students: A systematic review. Sleep Sci 2018;11(4):290–301. DOI: 10.5935/1984-0063.20180045.
  40. Shen Y, Meng F, Tan SN, et al. Excessive daytime sleepiness in medical students of Hunan province: Prevalence, correlates, and its relationship with suicidal behaviors. J Affect Disord 2019;255:90–95. DOI: 10.1016/j.jad.2019.05.036.
  41. Zailinawati AH, Teng CL, Chung YC, et al. Daytime sleepiness and sleep quality among Malaysian medical students. Med J Malaysia 2009;64(2):108–110. PMID: 20058567.
  42. Bhanawat N, Maheshwari V, Joshi G, et al. A study of association between depression and sself-esteem among dental students of Udaipur. Int J Orofacial Res 2017;2(2):57–60. DOI: 10.4103/ijofr.ijofr_15_17.
  43. Sravani A, Doshi D, Kulkarni S, et al. Depression, anxiety, and stress among undergraduate dental students in Hyderabad City, Telangana, India: A cross-sectional study. J Indian Assoc Public Health Dent 2018;16(1):26–29. DOI: 10.4103/jiaphd.jiaphd_10_17.
  44. Azad MC, Fraser K, Rumana N, et al. Sleep disturbances among medical students: A global perspective. J Clin Sleep Med 2015;11(1): 69–74. DOI: 10.5664/jcsm.4370.
  45. de Castro Corrêa C, de Oliveira FK, Pizzamiglio DS, et al. Sleep quality in medical students: a comparison across the various phases of the medical course. J Bras Pneumol 2017;43(4):285–289. DOI: 10.1590/S1806-37562016000000178.
  46. Van den Bulck J. Television viewing, computer game playing, and internet use and self-reported time to bed and time out of bed in secondary-school children. Sleep 2004;27(1):101–104. DOI: 10.1093/sleep/27.1.101.
  47. Choi K, Son H, Park M, et al. Internet overuse and excessive daytime sleepiness in adolescents. Psychiatry Clin Neurosci 2009;63(4): 455–462. DOI: 10.1111/j.1440-1819.2009.01925.x.
  48. Lin PH, Lee YC, Chen KL, et al. The relationship between sleep quality and internet addiction among female college students. Front Neurosci 2019;13:599. DOI: 10.3389/fnins.2019.00599.
  49. Bediwy AS, Mansour YM, Abo Ali EA. Excessive daytime sleepiness among patients with metabolic syndrome. Egyptian J Chest Dis Tuberc 2016;65(1):259–263. DOI: 10.1016/j.ejcdt.2015.08.010.
  50. Khandelwal D, Dutta D, Chittawar S, et al. Sleep disorders in type 2 diabetes. Indian J Endocrinol Metab 2017;21(5):758–761. DOI: 10.4103/ijem.IJEM_156_17.
  51. Bixler EO, Vgontzas AN, Lin H-M, et al. Excessive daytime sleepiness in a general population sample: The role of sleep apnea, age, obesity, diabetes, and depression. J Clin Endocrinol Metab 2005;90(8): 4510–4515. DOI: 10.1210/jc.2005-0035.
  52. Millman RP, Working Group on Sleepiness in Adolescents/Young Adults, AAP Committee on Adolescence. Excessive sleepiness in adolescents and young adults: Causes, consequences, and treatment strategies. Pediatrics 2005;115(6):1774–1786. DOI: 10.1542/peds.2005-0772.
  53. Hein M, Lanquart J-P, Loas G, et al. Prevalence and risk factors of excessive daytime sleepiness in insomnia sufferers: A study with 1311 individuals. J Psychosom Res 2017;103:63–69. DOI: 10.1016/j.jpsychores.2017.10.004.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.