Academic Stress and Student Performance: The Mediating Role of Anxiety and the Moderating Influence of Sleep Quality (Published)
Academic stress is a critical determinant of students’ mental health and learning outcomes. Anxiety frequently acts as a mediating factor in this relationship, whereas sleep quality may moderate the extent to which stress impairs performance. Despite growing international evidence, little is known about these dynamics among Albanian university students. This study investigates the relationship between academic stress and student performance, focusing on the mediating role of anxiety and the moderating influence of sleep quality. A cross-sectional study was conducted among 116 students enrolled in public and private medical universities in Tirana. Data were collected using a structured online questionnaire, including the Perceived Stress Scale (PSS), Generalized Anxiety Disorder Scale (GAD-7), Pittsburgh Sleep Quality Index (PSQI), and the Sheehan Disability Scale (SDS). Descriptive statistics and regression-based mediation and moderation analyses were performed using SPSS v27.Higher perceived stress was significantly associated with lower academic performance (p < 0.05). Anxiety partially mediated this association, as students with moderate-to-severe anxiety reported greater academic impairment. Moreover, poor sleep quality amplified the negative effect of stress on performance. Female students and those in postgraduate programs exhibited higher anxiety and greater functional impairment. Anxiety mediates, and sleep quality moderates, the impact of academic stress on performance among Albanian medical students. These findings emphasize the need for institutional strategies such as psychological screening, counseling services, and stress-management training to enhance students’ well-being and academic outcomes.
Keywords: Academic Stress, Anxiety, Mediation, Moderation, Student Performance, sleep quality