Relating Sleep, Stress, and Academic Performance Among a Cohort of Professional School Students
Authors: Alarcon Fortepiani Lourdes , Jaballas Alexis , Rios Dede , Franklin Cynthia , Fortenberry Sandra , Valdes Matt 
Published: May 2024

Academic achievement in health professions has been shown to be associated with internal motivation and active learning. While attendance to lectures, small group instruction, and time management have an impact; non-academic factors such as family support, sleep deprivation and stress can also affect academic success. Individuals experience physiological changes when encountering stress. Previous studies have demonstrated that high levels of stress, typically associated with increases in cortisol, can lead to detrimental effects on sleep patterns and academic performance, including impaired memory and diffculty concentrating. High levels of cortisol can have a negative impact on sleep, increasing light sleep and frequent wakings, which can in turn decrease academic performance. However, it is unclear whether physiological stress levels can affect sleep pattern and academic performance. Therefore, the purpose of this study was to examine how physiological stress levels relate to sleep patterns and academic performance among a cohort of professional school students. We hypothesized that elevated stress levels lead to decreased academic performance and a rise in irregular sleep patterns. Thus, during the summer semester of 2023, a longitudinal study was conducted, involving 22 optometry school students (OPT III) enrolled in a minimum of 19 credit hours. We measured academic performance, based on the participants' semester grade point average and sleep patterns using wrist-based accelerometers (MiBand 7, Beijing, China), while cortisol levels were measured through saliva samples collected at the study's onset, midpoint, and conclusion over a 30 day period. Exclusion criteria included individuals who were pregnant, nursing, or caring for a newborn. The study protocol received IRB approval (5059-9201). Data collection and analysis were performed using Google Sheets (Mountain View, CA) and XLMiner Analysis Tookpak (Incline Village, NV). We observed that cortisol levels were initially at their lowest during the study's onset (0.218 ug/dL), and subsequently increased for the midpoint and end of the study (0.279 ug/dL and 0.241 ug/dL, respectively). However, these fluctuations did not achieve statistical significance, with p-values of 0.08 and 0.24, respectively. The subjects exhibiting increased variation in “mid-sleep waking” displayed elevated levels of cortisol (r = 0.560, p = 0.007), indicating a significant positive association between mid-sleep waking and cortisol levels. Furthermore, we observed a positive relationship between weekday deep and light sleep and academic performance (r = 0.477, p = 0.025 and r = 0.454, p = 0.034, respectively). Our findings suggest that a moderate amount of stress may enhance performance through potentially increased focus and motivation and emphasizes the potential role that deep and light sleep play in cognitive functions and memory. Furtehrmore, promoting healthy sleep habits and maintaining a consistent sleep schedule may contribute to improved academic outcomes. However, based on the potential associations between sleep patterns, cortisol levels, and academic performance, further exploration into the complex interplay between these factors is needed. NIH/NEI T35 Training Grant [T35EY032441]. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.