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Ashraf A’aqoulah,1,2 Tamer Abusido,1– 3 Abdulmajeed Alfadhel,2,3 Farah Kalmey,2,4 Raghib Abusaris2,5 1Department of Health Systems Management, College of Public Health, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 2King Abdullah International Medical Research Center, Riyadh, Saudi Arabia; 3Department of Pediatric, Pediatric Pulmonology Division, King Abdullah Specialized Children Hospital, Riyadh, Saudi Arabia; 4Department of English, College of Science and Health Professions, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; 5Department of Epidemiology and Biostatistics, College of Public Health, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaCorrespondence: Ashraf A’aqoulah, Email Aqoulaha@ksau-hs.edu.saBackground: Adequate sleep is essential for physicians to maintain alertness, accuracy, and emotional stability in clinical care. However, no studies focused solely on physicians, particularly in Saudi Arabia.Objective: To determine the prevalence and determinants of sleep quality among physicians in tertiary care centers in Saudi Arabia.Methods: A cross-sectional survey was conducted between January and March 2025 using the validated Pittsburgh Sleep Quality Index (PSQI). Demographic, occupational, and lifestyle data were obtained through an electronic questionnaire. Poor sleep quality was defined as a global PSQI score > 5. Bivariate analyses used the chi-square test, and multivariable logistic regression estimated adjusted odds ratios (aOR) with 95% confidence intervals (CI).Results: A total of 412 physicians participated (61% male; 72% aged 20– 39 years). The mean PSQI score was 8.6 ± 3.1 (median = 8), and 75.2% (95% CI: 71.1– 79.4) of physicians were classified as poor sleepers. Shift work (aOR 2.58, 95% CI 1.61– 4.13) and on-call duties (aOR 1.76, 1.12– 2.76) significantly increased the odds of poor sleep. Later, bedtimes (1:00– 3:00 AM; aOR 3.12, 1.98– 4.91), prolonged daytime naps (> 30 min; aOR 2.95, 1.65– 5.26), and screen use before sleep (aOR 1.67, 1.08– 2.61) were also associated with poorer sleep quality. Being married (aOR 0.47, 0.33– 0.69), having children (aOR 0.51, 0.32– 0.81), and avoiding caffeine ≥ 6 hours before bedtime (aOR 0.50, 0.27– 0.90) were protective.Conclusion: This study highlights a high prevalence of poor sleep quality among physicians working in tertiary care centers in Saudi Arabia, driven by occupational and behavioral factors. Behavioral changes and institutional measures promoting regulated work schedules and improved sleep hygiene are essential to mitigate sleep-related risks and enhance physician well-being.Keywords: sleep quality, PSQI, physicians, Saudi Arabia, shift work