Factors Associated With Insomnia Among Medical Students Across Latin America During the COVID-19 Pandemic: A Multicenter 2020 Benchmark Study

The COVID-19 pandemic disrupted medical education and mental health. This multicenter study examined factors associated with insomnia among medical students from 13 Latin American countries during the first pandemic wave. A cross-sectional analytical study was conducted using an online questionnaire. Insomnia was measured with the Insomnia Severity Index. Exposures included physical activity, eating disorder symptoms, burnout, resilience, smoking and alcohol risk, and sociodemographic, educational, and clinical variables. Prevalence ratios with 95% confidence intervals were estimated through regression. Among 2,019 students, the prevalence of insomnia symptoms according to the ISI cutoff was 46.9% (95% CI: 44.7–49.1). Higher prevalence was observed among students who reported being a son or daughter within their family, those with relatives diagnosed or deceased from COVID-19, prior mental health problems, eating disorder symptoms, or smoking risk. Lower prevalence was found among seventh-year students, those with children, those perceiving the pandemic as serious, and students reporting high physical activity or resilience. Almost half of medical students screened positive for insomnia symptoms during the early pandemic. Family COVID-19 impact, prior mental health problems, eating disorder symptoms, and smoking risk were associated factors, while advanced training level, parenthood, physical activity, and resilience were associated with a lower prevalence of insomnia symptoms. These findings provide evidence for sleep health in Latin American medical students and may guide post-pandemic comparisons and interventions.