Heart Rate Variability and Stress Levels among Undergraduate Medical Students

Abstract

Background: Medical students are frequently exposed to academic, emotional, and psychological stress, which can adversely affect autonomic nervous system function. Heart Rate Variability (HRV) is a reliable, non-invasive indicator of autonomic balance and can be used to objectively assess physiological responses to stress. This study aimed to evaluate the association between heart rate variability and perceived stress among undergraduate medical students. Materials and Methods: A cross-sectional observational study was conducted among 150 undergraduate medical students in the Department of Physiology, Mediciti Institute of Medical Sciences, Ghanpur. Perceived stress was assessed using the Perceived Stress Scale (PSS-10), and HRV was recorded under standardized resting conditions. Time-domain parameters (SDNN and RMSSD) and the frequency-domain parameter (LF/HF ratio) were analyzed. Statistical analysis was performed using SPSS version 25.0, with p < 0.05 considered statistically significant. Results: The mean age of the participants was 20.8 ± 1.5 years, and 54.0% were females. Moderate stress was observed in 62.0% of students, while 24.0% experienced high stress. SDNN and RMSSD decreased significantly with increasing stress levels, whereas the LF/HF ratio increased significantly (p < 0.001). Perceived stress showed a significant negative correlation with SDNN (r = −0.42) and RMSSD (r = −0.39), and a positive correlation with the LF/HF ratio (r = 0.36, p = 0.002). Conclusion: Higher perceived stress was significantly associated with reduced heart rate variability, indicating impaired autonomic function among undergraduate medical students. Early stress identification and targeted interventions may improve autonomic health and psychological well-being. Keywords Heart Rate Variability; Stress; Perceived Stress Scale; SDNN; RMSSD; LF/HF Ratio; Undergraduate Medical Students; Autonomic Nervous System.