Authors: Aryana Petti, Rhea Manohar, MPH; Yun Weisholtz, MD-PhD on behalf of the Gender Equity Task Force

College is often framed as a period of possibility, marked by new independence, intellectual growth, and the excitement of becoming who you are meant to be. Yet for many college women, this period is also marked by chronic stress, inadequate sleep, and mounting pressure to perform academically, socially, and personally. These stressors do not exist in isolation. Instead, stress and poor sleep form a mutually reinforcing cycle that places college women at increased risk for both mental and metabolic health consequences.

Large meta-analyses and cross-sectional studies consistently demonstrate moderate but meaningful associations between perceived stress, insomnia symptoms, and sleep disturbances among undergraduate students (Gardani et al., 2022). When stress disrupts sleep and insufficient sleep heightens stress reactivity, the downstream effects extend well beyond fatigue. Depression, anxiety, and disordered eating behaviors are more common in students experiencing chronic stress and poor sleep quality, compounding risks during an already vulnerable life transition (Priede et al., 2025; Montagni et al., 2020; Fruehwirth et al., 2023).

While academic stress affects all students, women consistently report higher perceived stress levels and greater vulnerability to its psychological effects (Graves et al., 2021; Barbayannis et al., 2022). Research suggests that women tend to experience higher baseline anxiety, neuroticism, and emotional stress responses. Ironically, these heightened stress responses may allow women to maintain academic performance through adaptive coping in the short term, but it comes at a cost (Benítez-Agudelo et al., 2025).

Over time, this sustained activation of stress pathways increases the risk of depression, anxiety disorders, and maladaptive coping behaviors. Emotional eating, irregular eating patterns, and poor sleep quality have been shown to mediate the relationship between stress and higher body mass index (BMI), particularly among female students (Du et al., 2022; Priede et al., 2025). In other words, stress does not simply coexist with mental and metabolic health challenges, but actively drives them.

The transition to college represents a critical window for mental and physical health trajectories. Stress experienced during this period is not transient for many students; perceived stress often mediates the relationship between external stressors, academic workload, financial insecurity, and family expectations, and the impact of these factors on worsening mental well-being (Slimmen et al., 2022). Without adequate support, stress-related patterns established during college can persist into adulthood, shaping long-term health outcomes. Importantly, these challenges are not failures of individual resilience. They reflect structural and cultural environments that normalize overwork, sleep deprivation, and self-sacrifice, particularly among high-achieving women.

Evidence indicates several protective factors that can meaningfully buffer the effects of stress and poor sleep. Social support, resilience, and self-control have been shown to moderate the relationships among stress, sleep quality, and mental health outcomes (Liu et al., 2023; Tafoya et al., 2023). This underscores the importance of campus-based interventions that go beyond crisis response.

Psychoeducation programs that normalize stress while teaching evidence-based coping strategies, resilience-building initiatives, and digital literacy tools that address sleep hygiene and mental health can improve outcomes at scale (Gardani et al., 2022; Graves et al., 2021). Equally important are peer-led communities and advocacy organizations that create spaces for connection, mentorship, and shared storytelling. These platforms validate lived experiences and remind college women that they are not alone in navigating systems that were not designed with their well-being in mind.

Addressing the intertwined mental and metabolic health challenges faced by college women requires a shift in how we define success and support in higher education. Sleep, stress, and health are not distractions from academic achievement; they are foundational to it. By investing in supportive environments, peer networks, and gender-responsive interventions, we can help ensure that college women are not simply surviving their education but emerging from it healthy, empowered, and heard.

References: 

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  2. Barbayannis, G., Bandari, M., Zheng, X., et al. (2022). Academic stress and mental well-being in college students: Correlations, affected groups, and COVID-19. Frontiers in Psychology, 13, 886344. https://doi.org/10.3389/fpsyg.2022.886344
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About the Authors

Aryana Petti, Undergraduate Student

Aryana Petti is a third-year Behavioral Neuroscience student at Northeastern University, preparing for a future career in medicine with a strong interest in psychiatry and nutrition. She is a clinical research coordinator for a sleep genetics lab in the Center for Genomic Medicine at Massachusetts General Hospital. She is a member of the AMWA Chapter at Northeastern and is the Design Director for her hip-hop-contemporary fusion dance team, Revolve. 

Rhea Manohar, MPH, MS3

Rhea Manohar is a third year medical student from St. George’s University. She has a Masters in Public Health with a concentration in Maternal and Child Health from George Washington University Milken Institute of Public Health and a Bachelors of Science in Microbiology & Immunology, and Public Health from the University of Miami. She served as Co-VP of OB/GYN Education for St. George’s University’s Women in Medicine chapter in St. George, Grenada where she developed hands-on workshops to further reproductive health issues and navigating challenging physician-patient communication scenarios. Prior to medical school, she was a Research Associate for Fors Marsh Group, where she led qualitative and quantitative public health research and campaign development for federal agencies (e.g., CDC, NIH, DHHS, CPSC). She is also a member of the Gender Equity Task Force of the American Medical Women’s Association. When she is not pursuing medicine, you can find her reading, exploring artistic passions, and spending time connecting with friends and family.

Yun Weisholtz, MD-PhD

Dr. Yun Weisholtz is a physician-scientist and advisor with a deep commitment to mentorship and advancing equity in medicine. She completed her undergraduate studies at Stanford University, where she double-majored in Biological Sciences and Chemistry, and spent a year in Germany as a Fulbright Scholar. She went on to enter the MD-PhD program in Neuroscience at Harvard Medical School and MIT, where she developed her passion for research, teaching, and mentoring. Dr. Weisholtz is a Physician Advisor with MedSchoolCoach and the founder of MD-PhD Advising, a consulting practice dedicated to helping students navigate the medical school and residency application process. Outside of work, she enjoys collecting Delft pottery from the Netherlands and spending time with her family and pets.