BMC Med Educ. 2026 Jun 4. doi: 10.1186/s12909-026-09591-z. Online ahead of print.
ABSTRACT
BACKGROUND: Medical students often face significant psychological and lifestyle challenges during examination periods, including sleep disruption, increased caffeine intake, altered dietary habits, low physical activity, and higher tobacco use. These behaviors may influence academic performance, yet evidence remains inconsistent.
METHODS: A cross-sectional study was conducted from April to October 2025 among 403 medical students from five universities in Palestine. Data were collected via an Arabic-language, self-administered online questionnaire covering sociodemographic, dietary and beverage habits, smoking, sleep, and physical activity. Academic performance was self-reported for the last two semesters. Statistical analysis included correlation, Mann-Whitney U, and regression models to assess relationships between lifestyle behaviors and academic performance.
RESULTS: Participants reported low sleep duration (< 7 h/day: 89.3%) and low physical activity (19.1%). Caffeine intake was moderate, with most students consuming ≤ 1 cup/day of traditional or instant coffee. Waterpipe smoking was more prevalent than cigarette or e-cigarette use and increased during exams. Regression analysis revealed small but significant negative associations between traditional coffee and tea consumption and average grades. Other dietary habits, energy drinks, sleep, and exercise were not significantly associated with average grades. Waterpipe use was unexpectedly positively associated with average grades, likely due to confounding factors.
CONCLUSION: Examination periods are associated with unhealthy behaviors among medical students, particularly increased caffeine and tobacco use, short sleep, and low physical activity. Among these, only coffee and tea consumption showed a small negative impact on academic performance.
PMID:42243807 | DOI:10.1186/s12909-026-09591-z
