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Introduction Medical students are undertaking an intense curriculum, the stress of which may cause or worsen insomnia and depressive symptoms. We aim to investigate factors which might affect the sleep of medical students, and how they currently manage their sleep. Methods A brief online survey was sent to medical students, consisting of validated questionnaires, and questions related to sleep management strategies. Results We recruited 828 participants—49.5% reported insomnia symptoms and 51.4% reported depressive symptoms. After adjusting for gender, ethnicity and age, depressive symptoms (Mild: odds ratio (OR) = 6.26; Moderate: OR = 18.13; Severe: OR = 15.57), and sleep hygiene (OR = 1.07) were associated with insomnia symptoms. Commonly endorsed strategies for sleep management by students were undertaking regular exercise (80.1%), having consistent sleep-wake time (71.3%), and limiting caffeine intake (70.3%). Few were willing to see a clinician (23.4%) or take medication (22.3%). Participants with insomnia symptoms were more likely to prefer limiting their alcohol intake (OR = 1.77), limiting daytime naps (OR = 1.5), seeing clinicians (OR = 1.86), and taking sleep medication (OR = 3.98), but less likely to prefer avoiding intense work (OR = 0.71) or minimizing using electronics (OR = 0.60) close to bedtime than those without insomnia symptoms. High sleep self-efficacy was associated with lower odds for having insomnia symptoms (OR = 0.74 (0.70, 0.77)). Discussion Self-reported insomnia and depression are common among medical students. Increased awareness and greater resources are needed to support the sleep health and emotional well-being of medical students.

Introduction Erectile dysfunction (ED) can lead to reduced sexual intimacy in men. The external penile prosthesis (EPP) is a device to help them participate in penetrative sex. Aim We investigate factors that may affect the willingness of individuals with ED to try an EPP and explore how the EPP could be presented most effectively to such patients to enhance their willingness to try an EPP. Methods Recruitment for this cross-sectional study occurred in-person and online. 147 participants (60.0 ± 14.3 years old; all experiencing self-reported ED) completed a survey containing both validated measures and questions specific to this study. The survey was open to English-speakers over the age of 18 who self-reported experiencing ED. Main Outcome Measure The primary outcome was participants’ willingness to try an EPP based on their level of knowledge about using the EPP. Secondary outcomes included the influence of the sexual function, sexual distress, ED history, age, relationship duration, sexual flexibility on willingness to try an EPP. We also collected feedback from participants’ on how and where they would like to be introduced to the EPP option. Results Most participants indicated a preference for being introduced to the EPP after trying some ED treatments (51.0%). Participants did not have strong preference regarding the setting where they were informed about the EPP. The majority however preferred having a sexual health therapist/counsellor (28.6%) or physician (25.9%) as the person introducing the EPP to them. Participants’ willingness to try the EPP increased with more information about the EPP presented to them (P < .001). Personalization of the EPP to match one's own penis was preferred by 38.7% of participants. Referring to this aid as an ‘external penile prosthesis’ was significantly more preferred over alternative labels, such as a “belted prosthetic phallus” or “strap-on dildo” (Ps < .001 for both). Multiple regression analyses showed that only sexual script flexibility was associated with the initial willingness to try an EPP (P < .01). Clinical Implications Clinicians should consider presenting the EPP to men with ED, who desire maintaining penetrative sexual intercourse with their partners. Strength and Limitations This is the first study to explore factors influencing the willingness to try an EPP. Further research is needed to establish the efficacy of EPPs for maintaining sexual activity and satisfaction in the real-life setting. Conclusion This study informs clinicians about effective ways to introduce the EPP to patients with ED who wish to maintain insertive/receptive sex.