Public Health Among College Students: Sleep and Stress Amidst Finals

Written By: Yasmine Luong

When you picture a college student during finals, perhaps this particular image comes to mind. A bright computer light illuminates a hunched over college student in their dorm room, furiously typing away at their study guide. Their desk is littered with empty coffee cups and remains of instant ramen. Finals season is rife with students bragging about having less than two hours of sleep, the dark bags under their eyes somehow serving as a symbol of how hard they studied. Behind all this, there’s a more serious public health issue at hand – the rampant health issues of sleep deprivation and stress that drive students to take extreme actions for their academic success.

Stress During Finals 

Why do students tend to be more stressed during finals season? According to the 2015 National College Health Assessment, 32% of students experience even greater levels of stress in times surrounding final exams, supported by both psychological and physiological markers. [1] Beth Grampetro, health and wellness educator at the Office of Residence Life at Boston University, explains how it's due to fear stemming from not being prepared enough or not performing well, which in turn relates to a biological process known as “fight or flight.”[2] She details how frequent excessive stress leads to physical responses including “headaches, sleep disruptions, high blood pressure, upset stomach, and a worsening of any existing diseases.” [2] This stress can be difficult to navigate for all students, even with campus health resources and awareness of the issue. An additional point of consideration is how there is significant societal stigma and shame associated with asking for help, especially for male students.

The Relationship Between Sleep, Stress, and Academic Performance

A closer look at the interconnectedness between sleep, stress, and academic performance emphasizes how navigating stress and adequate sleep are key to improving academically. This contrasts the common idea of all-nighters that many college students partake in. A 2019 cross-sectional study of medical students in Saudi Arabia demonstrated that “poor sleep quality was significantly associated with elevated levels of stress.” [3] Based on 282 preclinical students’ responses on a questionnaire assessing academic performance, quality of sleep, and psychological distress, it was found that a “greater proportion of participants who had poor sleep quality reported distress compared to participants who did not have poor sleep quality (68.7% and 46.2%, respectively.) The prevalence of poor sleep quality also increased with each distress level.” [3] This study illustrates the relationship between the variables of sleep and stress, suggesting that sleep quality and stress are strongly connected with each other.

Another 2019 study of one hundred students in an introductory chemistry class found that “longer sleep duration, better sleep quality, and greater sleep consistency were associated with better academic performance.”[4] Through the measure of Fitbit sleep scores, they established that the sleep duration before the night of an exam wasn’t associated with a better test performance, but rather sleep duration and quality over the month before the exam was what mattered. These findings highlight how consistency of sleep over a long period of time has a correlation with better grades.

Both of these studies examine the relationships between sleep, stress, and academic performance. The key findings are that:

• Students tend to be more stressed during finals and exam season, which in turn is associated with poorer quality of sleep.

• Better academic performance is associated with three aspects of sleep: duration, quality, and consistency.

• Short-term longer sleep isn’t associated with a better test performance, but consistent, long, and quality sleep before an exam is.

Consequences

Shifting the focus to sleep deprivation, there are many negative effects that students experience from this ranging from emotional to psychological to physical. The National Library of Medicine states that among college students, 50% report daytime sleepiness and 70% attain insufficient sleep, resulting in impaired mood, learning skills, attention, and lower grade point averages. [5] A decrease in focus and memory build upon one another, reducing one’s ability to retain short-term knowledge and the ability to perform long-term memory functions like recall. Additionally, emotional consequences, increased irritability and anxiety, exacerbate problems with studying, and perpetuate a cycle of stress, lack of sleep, and poor academic performance. Cutting sleep short cuts REM sleep short, an essential stage in the sleep cycle that is associated with brain development and cognitive processing, where new information is committed to long-term memory. [6]

Additionally, the cost of poor sleep extends past academic performance and stress, as it has far-reaching consequences on one’s long-term health. Although college students may be able to pinpoint how sleep affects everyday functioning when it comes to the aforementioned ability to focus, learn, and study, not everyone is aware of the adverse effects of a lack of sleep that compounds over time. The Division of Sleep from Harvard Medical school shares that “a lack of sleep—especially on a regular basis—is associated with long-term health consequences, including chronic medical conditions like diabetes, high blood pressure, and heart disease, and that these conditions may lead to a shortened life expectancy.” [7] This connects with the previous 2019 study that emphasizes the importance of sleep consistency, consistent quality and longer duration sleep, in achieving higher grades, and even improving one’s physical, long-term health.

What Can You Do

Through an exploration of stress during finals, the relationship between stress, academic performance, and sleep, and the consequences of sleep deprivation, there is the pressing message that sleep is an essential part of our lives that should not be neglected, especially during finals season among college students. From this conclusion, what can be done to ensure fair sleep and to alleviate stress?

Alvin Mantey, a mental health expert studying at University of Cincinnati, suggests preparing well to alleviate anxiety, as it tends to build up in the presence of loss of control and a sense of inadequacy. He also advises to be honest with yourself and actively committing to relaxation including sleeping in, spending time with friends, and taking the night off. He advocates for stress management, which “ will set you up to be resilient during the challenges and even place you in positions to help people you know who go through similar challenges” and to reach out to professors or counseling services, either personal or made available by the school and get the help you need.” [8]

More specifically to improve sleep: exercising daily, limiting caffeine and alcohol intake that could disrupt sleep quality, stopping electronic usage an hour before bed, and optimizing your sleep environment to be cool, dark and quiet. [6] These tips can help supplement a regular sleep schedule and the above tips about stress relief, all contributing to better academic success and improved wellbeing during stressful exams.

References:

1. Koschel, Tessa L, et al. “Examining the Impact of a University-Driven Exercise Programming Event on End-of-Semester Stress in Students.” International Journal of Exercise Science, vol. 10, no. 5, 1 Jan. 2017, pp. 754–763, https://doi.org/10.70252/vlvy9105. Accessed 16 Oct. 2024.

2. “Fear of Finals | BU Today.” Boston University, www.bu.edu/articles/2006/fear-of-finals/.

3. Alotaibi, Abdullah D., et al. “The Relationship between Sleep Quality, Stress, and Academic Performance among Medical Students.” Journal of Family & Community Medicine, vol. 27, no. 1, 13 Jan. 2020, pp. 23–28, journals.lww.com/jfcm/fulltext/2020/27010/the_relationship_between_sleep_quality,_stre ss,.4.aspx, https://doi.org/10.4103/jfcm.JFCM_132_19.

4. Okano, Kana, et al. “Sleep Quality, Duration, and Consistency Are Associated with Better Academic Performance in College Students.” Npj Science of Learning, vol. 4, no. 16, 1 Oct. 2019, www.nature.com/articles/s41539-019-0055-z, https://doi.org/10.1038/s41539-019-0055-z.

5. Cusack, Taylor. “How Sleep Impacts Your Studies.” Www.isu.edu, Idaho State University, www.isu.edu/cob/blog/articles/how-sleep-impacts-your-studies.html.

6. Ryan, Tom. “Why Sleep Can Help You Ace Your Final Exams.” Sleep Foundation, 13 May 2021, www.sleepfoundation.org/school-and-sleep/final-exams-and-sleep.

7. Division of Sleep Medicine at Harvard Medical School. “Why Sleep Matters: Consequences of Sleep Deficiency.” Sleep.hms.harvard.edu, 1 Oct. 2021, sleep.hms.harvard.edu/education-training/public-education/sleep-and-health-education-program/sleep-health-education-45.

8. “Tips for Coping with the Stress of Finals Week.” Msj.edu, 2025, www.msj.edu/news/2025/04/Tips%20for%20Coping-with%20the-Stress-of%20Finals-Week.html. Accessed 18 Nov. 2025.