Background: Sleep is one of the basic needs of human beings and is important to their health. Medicine is one of the most
stressful fields of education because of its highly demanding professional and academic requirements, and psychological
stress and poor sleep are highly prevalent in resident and fellowship training; however, they are not well documented and
have not yet been taken seriously.
Objective: This study aimed to determine the prevalence of poor sleep and associated factors in resident and fellowship training in Rajavithi Hospital, a tertiary referral hospital in Bangkok, Thailand.
Material and Method: This cross-sectional study was conducted between June and August 2015. The two hundred and fourteen participants were all residents or fellows in the academic year 2015. The data were collected using: 1) Demographics; 2) Suanprung stress test-20 items (SPST-20) modified by the Department of Mental Health, Ministry of Public Health, Thailand; 3) Health behavior; and 4) a Thai version of the Pittsburgh Sleep Quality Index (T-PSQI) questionnaire (score >5 indicates poor sleep). Binary logistic regression was used to identify factors associated with poor sleep status. This study was reviewed and approved by the ethics committee, Rajavithi Hospital.
Results: Most of the participants were female with mean age (+SD) of 28.87+2.55 years (range 25-41 years). Subjects
studying in the 1st, 2nd and 3rd year accounted for 48.1%, 32.2% and 19.7% respectively, and 36.9% of participants were
involved in shift work. The mean + SD of SPST-20 scores was 15.57+8.27, and the prevalence of poor sleep quality was 54.7%. Factors associated with poor sleep were shifting work schedule (OR 2.10, 95% CI 1.07-4.12, p = 0.031) and raised
stress score (OR 1.15, 95% CI 1.09-1.21, p<0.001). Those who had poor sleep quality stated that the activities they pursued to relieve this condition were social media (42.0%), followed by reading books (32.4%) and watching television (16.8%). Only a few poor sleepers used sleeping pills (6.4%).
Conclusion: There was a high prevalence of poor sleep quality, and factors associated with this were shifting work schedule and higher stress scores. Proper interventions should be made in the form of recommendations of measures to help to relieve sleep problems.

Keywords: Sleep, Pittsburgh Sleep Quality Index, Residents, Fellows