Evaluation of the relationship of premenstrual syndrome with sleep quality and melatonin in medical students

Objective: Premenstrual syndrome (PMS) is a condition characterized by physical, behavioural and emotional symptoms that occur during the luteal phase of the menstrual cycle, with relief of symptoms with menstruation. PMS may affect daily activities, quality of life, school performance, social activities and sleep quality. In this study, we aimed to evaluate the relationship between premenstrual syndrome and sleep quality and melatonin in medical students with busy schedules and stressful exam periods. Materials and Methods: This study was approved by the decision numbered 2023/590 of the Ethics Committee of Selçuk University Faculty of Medicine at its meeting dated 19.12.2023. The study was conducted at Selçuk University Faculty of Medicine. The study population consisted of 174 medical students studying at Selçuk University Faculty of Medicine in the February-April period of the 2023-2024 academic year. The groups were formed by applying Premenstrual Syndrome Scale (PMSS) to the students studying between semesters I-VI. 87 PMS and 87 non-PMS students were included in the study. Sociodemographic data form and PSQI were administered to the participants to evaluate sleep quality. Blood samples taken from the students for melatonin levels were stored at -80oC until the study was performed. Melatonin levels were determined by ELISA method using the appropriate kit. Data were evaluated using Statistical Package for the Social Sciences (SPSS) version 25.0 statistical package program. Statistical significance was accepted as p<0.05. Results: A total of 174 students, 87 with PMS and 87 without PMS, were included in the study. The mean age of the students was 20.00 ± 1.66 years (18-23). The mean PMSS score of the students was 117.46±2.30 (58-206). Dysmenorrhea was more common in students with PMS and was statistically significant (p<0.001). 51.7% (n=90) of the students had good sleep quality and 48.3% (n=84) had poor sleep quality. Sleep quality was worse in the group with PMS compared to the group without PMS and was statistically significant (p<0.001). PSQI total and subcomponent scores were higher in the group with PMS compared to the group without PMS and were statistically significant (p<0.05). Melatonin value was lower and statistically significant in the group with PMS (p<0.001). There was a significant positive correlation between the participants' PSQI total score and PMSS total and subcomponent scores (p<0.05). Conclusion: This study shows that premenstrual syndrome negatively affects sleep quality. More frequent dysmenorrhea complaints, low melatonin levels and poor sleep quality were found in individuals with PMS. Therefore, it is important to provide students with information about strategies to cope with PMS and dysmenorrhea, to raise awareness about the importance of sleep hygiene, and to provide education that includes appropriate dietary and lifestyle changes to increase melatonin levels. These approaches will contribute to improving students' quality of life in both their academic and social lives. Keywords: Premenstrual syndrome, Medical students, Sleep quality, Melatonin