Academic Impairment From Sleep Difficulties: The Role of Substance Use, Psychological Distress, and Loneliness in U.S. College Students

Sleep-related academic impairment is a common issue among college students and may be influenced by psychological and behavioral health factors. This study used cross-sectional data from the Spring 2021 American College Health Association-National College Health Assessment III (ACHA-NCHA III) to examine whether psychological distress, loneliness, and substance use were associated with academic impairment due to sleep difficulties among U.S. college students aged 18–24 ( N = 798). Logistic regression showed that psychological distress, loneliness, and elevated risk scores for alcohol and cannabis use were significantly associated with sleep-related academic impairment. Tobacco use was marginally associated. Demographic factors did not show significant associations. These findings suggest that mental health and substance use are important, intersecting contributors to academic impairment linked by sleep problems. Interventions that address mental health, reduce substance use risk, and promote healthy sleep may be particularly beneficial in improving academic outcomes and overall student well-being on college campuses.