Skipping Breakfast is Associated with Shorter Sleep Duration in Medical Students




Students Medical, Breakfast, Sleep Quali, Sleep Duration, Lifestyle, Circadian rhythm, Epidemiological study, Cross-sectional study, Health outcomes, Dietary habits, Educational interventions, Behavioral patterns, Sleep disturbances, Neurobehavioral function, Clinical assessment, PSQI, Modifiable factors, Public health, Self-reported data, Sleep


Background: Breakfast skipping is common in young adults, including medical students. Poor sleep quality is also common in medical students. Sleep quality and duration are important determinants of health and wellbeing. The aim of the study is to explore the novel association between medical students’ frequency of breakfast consumption with sleep quality and duration.

Methods: Year 3 medical students completed a survey at the end of 2018. Data collection included demographic information, the Pittsburgh Sleep Quality Index (PSQI) and breakfast consumption in the month before their end-of-year clinical assessment.

Results: The response rate for the survey was 76.6% (216/282). Forty-five percent of medical students skipped breakfast at least once in an average week and 56.9% of students had poor sleep quality (as defined by PSQI scores > 5). There was a statistically significant association between a higher frequency of breakfast skipping and shorter sleep duration (Kendall’s tau-b, P = 0.012). Regression analysis also showed that breakfast frequency had a statistically significant impact on sleep duration (P = 0.048).

Conclusion: Breakfast skipping is common in medical students. Furthermore, breakfast skipping is significantly associated with a shorter sleep duration. This knowledge could empower medical students to optimize their routines for better sleep and general health.


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O'Neil C, Byrd-Bredbenner C, Hayes D, Jana L, Klinger S, Stephenson-Martin S. The role of breakfast in health: definition and criteria for a quality breakfast. J Am Diet Assoc. 2014;114(12 Suppl):S8-26.

Deshmukh-Taskar P, Nicklas TA, Radcliffe JD, O'Neil CE, Liu Y. The relationship of breakfast skipping and type of breakfast consumed with overweight/obesity, abdominal obesity, other cardiometabolic risk factors and the metabolic syndrome in young adults. The National Health and Nutrition Examination Survey (NHANES): 1999–2006. Public Health Nutr. 2013;16(11):2073-82.

Qin L, Li J, Wang Y, Wang J, Xu J, Kaneko T. The effects of nocturnal life on endocrine circadian patterns in healthy adults. Life Sci. 2003;73(19):2467-75.

Sun J, Yi H, Liu Z, Wu Y, Bian J, Wu Y, et al. Factors associated with skipping breakfast among Inner Mongolia Medical students in China. BMC Public Health. 2013;13:42.

Javaid A, Munir I. Breakfast skipping and its effects on emotional and academic behaviour of a group of Saudi medical students. J Nutr Food Sci. 2018;8(6):1-4.

Ackuaku-Dogbe EM, Abaidoo B. Breakfast eating habits among medical students. Ghana Med J. 2014;48(2):66-70.

Girardeau G, Lopes-Dos-Santos V. Brain neural patterns and the memory function of sleep. Science. 2021;374(6567):560-4.

Peigneux P, Fogel S, Smith C. Memory Processing in Relation to Sleep. In: Kryger, M, Roth T, Dement WC, editors. Principles and Practice of Sleep Medicine. 6th ed. Elsevier; 2017:229-238.

Lewis PA, Knoblich G, Poe G. How Memory Replay in Sleep Boosts Creative Problem-Solving. Trends Cogn Sci. 2018;22(6):491-503.

Van Dongen HPA, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness: dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep. 2003;26(2):117-26.

Gruber R, Cassoff J. The interplay between sleep and emotion regulation: conceptual framework empirical evidence and future directions. Curr Psychiatry Rep. 2014;16(11):500.

Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rössler W. Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep. 2008;31(4):473-80.

Pigeon WR, Pinquart M, Conner K. Meta-analysis of sleep disturbance and suicidal thoughts and behaviors. J Clin Psychiatry. 2012;73(9):e1160-7.

Kecklund LG, Axelsson J. Health consequences of shift work and insufficient sleep. BMJ. 2016;355:i5210.

Falloon K, Bhoopatkar H, Moir F, Nakatsuji M, Wearn A. Sleep well to perform well: the association between sleep quality and medical student performance in a high-stakes clinical assessment. Sleep Adv. 2022;3(1):zpac019.

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.

Seoane HA, Moschetto L, Orliacq F, Orliacq J, Serrano E, Cazenave MI, et al. Sleep disruption in medicine students and its relationship with impaired academic performance: A systematic review and meta-analysis. Sleep Med Rev. 2020;53:101333.

Li L, Wang Y, Wang S, Zhang L, Li L, X D, et al. Prevalence of sleep disturbances in Chinese university students: a comprehensive meta-analysis. J Sleep Res. 2018;27(3):e12648.

Rao W, Li W, Qi H, Hong L, Chen C, Li C, et al. Sleep quality in medical students: a comprehensive meta-analysis of observational studies. Sleep Breath. 2020;24(3):1151-65.

Kant AK, Graubard BI. Association of self-reported sleep duration with eating behaviors of American adults: NHANES 2005–2010. Am J Clin Nutr. 2014;100(3):938-47.

Kim S, DeRoo LA, Sandler DP. Eating patterns and nutritional characteristics associated with sleep duration. Public Health Nutr. 2011;14(5):889-95.

Gill S, Panda S. A amartphone app reveals erratic diurnal eating patterns in humans that can be modulated for health benefits. Cell Metab. 2015;22(5):789-98.

Garaulet M, Gómez-Abellán P. Timing of food intake and obesity: A novel association. Physiol Behav. 2014;134:44-50.

Moir F, Patten B, Yielder J, Sohn CS, Maser B, Frank E. Trends in medical students’ health over 5 years: Does a wellbeing curriculum make a difference? Int J Soc Psychiatry. 2023;69(3):675-88.

Gwin JA, Leidy HJ. Breakfast consumption augments appetite, eating behavior, and exploratory markers of sleep quality compared with skipping breakfast in healthy young adults. Curr Dev Nutr. 2018;2(11):nzy074.

Reutrakul S, Hood MM, Crowley SJ, Morgan MK, Teodori M, Knutson KL. The relationship between breakfast skipping, chronotype, and glycemic control in type 2 diabetes. Chronobiol Int. 2014;31(1):64-71.

Xu S, Akioma M, Yuan Z. Relationship between circadian rhythm and brain cognitive functions. Front Optoelectron. 2021;14(3):278-87.

Smith RP, Easson C, Lyle SM, Kapoor R, Donnelly CP, Davidson EJ, et al. Gut microbiome diversity is associated with sleep physiology in humans. PLoS One. 2019;14(10): e0222394.

Berry SE, Valdes AM, Drew DA, Asnicar F, Mazidid M, Wolf J, et al. Human postprandial responses to food and potential for precision nutrition. Nat Med. 2020;26(6):964–73.

Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. Meta-analysis of relation of skipping breakfast with heart disease. Am J Cardiol. 2019;124(6):978-86.

Rong S, Snetselaar LG, Xu G, Sun Y, Liu B, Wallace RB, et al. Association of skipping breakfast with cardiovascular and all-cause mortality. J Am Coll Cardiol. 2019;73(16):2025-32.

Witbracht M, Keim NL, Forester S, Widaman A, Laugero K. Female breakfast skippers display a disrupted cortisol rhythm and elevated blood pressure. Physiol Behav. 2015;140:215-21.

Park S, Rim SJ, Lee JH. Associations between dietary behaviours and perceived physical and mental health status among Korean adolescents. Nutr Diet. 2018;75(5):488-93.

Sichieri, R, Everhart JE, Roth H. A prospective study of hospitalization with gallstone disease among women: role of dietary factors, fasting period, and dieting. Am J Public Health. 1991;81(7):880-4.

de Cabo R, Mattson MP. Effects of Intermittent Fasting on Health, Aging, and Disease. N Engl J Med. 2019;381(26):2541-51.

Lowe DA, Wu N, Rohdin-Bibby L, Moore AH, Kelly N, Liu YE et al. Effects of time-restricted eating on weight loss and other metabolic parameters in women and men with overweight and obesity. JAMA Intern Med. 2020;180(11):1491-9.

The image depicts a tired-looking medical professional, likely a student or resident, resting their head on their hands with a weary expression. Surrounding them are symbols of time and exhaustion: a large clock showing different times, an alarm clock, and a crescent moon indicating nighttime. In front of the person is a plate with a donut and a cup of coffee, suggesting a quick, possibly unhealthy meal. The background includes calming elements like leaves, and a heartbeat line, emphasizing the stress and fatigue associated with demanding medical schedules. The overall color scheme is soft, with shades of blue and green, highlighting a somber and reflective mood.


2024-06-12 — Updated on 2024-07-09

How to Cite

Bhoopatkar, H., Sharma, S., Moir, F., Nakatsuji, M., Wearn, A., & Falloon, K. (2024). Skipping Breakfast is Associated with Shorter Sleep Duration in Medical Students. International Journal of Medical Students, 12(2), 178–184.