INTRODUCTION:

Mental health is widely regarded by pharmacy students as important, yet it remains under-recognised and often overlooked compared to physical health. Personal experiences with mental health challenges highlight its critical role in student well-being and success, underscoring the need to enhance education, awareness, and institutional support within pharmacy education.¹ Deeper learning in pharmacy education requires skilled educators to understand and challenge students, fostering higher cognitive development.² This involves applying strategies to enhance thinking, adapting instructional formats, and shaping students’ learning approaches. Educators should plan for cognitive growth throughout the pharmacy program and have a solid understanding of learners’ cognitive development.

Sleep is essential for overall health, brain function, and learning, yet its quality and duration can vary widely among individuals. Disrupted sleep patterns can lead to increased stress, reduced concentration, and difficulties in academic performance. Students, especially in demanding fields, often face the combined pressure of academic workload and poor sleep habits, which can create a cycle of fatigue, anxiety, and diminished focus. Research consistently shows that inadequate or poor-quality sleep not only affects mental well-being but also impairs the ability to retain information and perform well academically.^3-6 Understanding this link between stress, sleep, and concentration is key to promoting healthier habits and improving student outcomes^7-10.

In this study, we look beyond single-issue research to see the bigger picture of pharmacy students’ well-being. While past studies have examined stress, sleep habits, or concentration problems separately, few have explored how these factors connect and influence each other.^4,5,11 This study focuses on the combined effects of stress levels, sleep duration, sleep quality, trouble falling asleep, and patterns of concentration or distraction. By bringing these elements together, we aim to uncover links that isolated studies may have overlooked, offering a more complete understanding of the challenges pharmacy students face and how they can be better supported.¹⁵

The objectives are to assess the levels of stress among pharmacy students and examine their sleep habits, including sleep duration, sleep quality, and difficulties in falling asleep. Additional objectives include exploring patterns of concentration and identifying common sources of distraction. Finally, the study aims to analyze the interrelationships between stress, sleep variables, and concentration or distraction patterns to provide a comprehensive understanding of these factors.^12-14

METHODOLOGY:

Study Design:

This study adopted a cross-sectional survey design to assess the relationship between academic stress, sleep patterns, and cognitive focus among pharmacy students.

Study Population:

The study population consisted of 135 pharmacy students from Kamalakshi Pandurangan College of Pharmacy, Ayyampalayam, Tiruvannamalai, who participated in the survey to express their concerns about mental health.

Data Collection Tool:

Data were collected using a structured questionnaire prepared in Google Forms. The link was circulated to the pharmacy students via mobile phones for convenient access and response. The survey included items on academic stress, sleep patterns, cognitive focus, and suggestions for stress reduction strategies.

Questionnaire Sections:

1. Demographics:– age, gender, year of study.

2. Stress: assessed using the Perceived Stress Scale (PSS).

3. Sleep Quality: – measured using the Pittsburgh Sleep Quality Index (PSQI).

4. Concentration: evaluated using a short attention scale or Cognitive Failures Questionnaire (CFQ).

5. Coping Mechanisms: open-ended and multiple-choice questions on strategies students use to reduce academic stress (e.g., reduced workload, breaks, support services).

Data Analysis:

Data were analyzed using descriptive statistics (mean, percentages, frequencies) to summarize stress levels, sleep quality, concentration, and coping mechanisms. Correlation analysis was applied to explore relationships between academic stress, sleep, and concentration.

Ethical considerations:

Ethical clearance for this study was obtained from the Principal of Kamalakshi Pandurangan College of Pharmacy, Ayyampalayam, Tiruvannamalai. Participation was voluntary, informed consent was obtained from all students, and confidentiality of responses was maintained. The questionnaire did not collect personal identifiers such as names, thereby ensuring participants privacy and anonymity.

Data Analysis:

All survey responses were collected through Google Forms and exported to Google Sheets for analysis. As all responses were complete, no data cleaning was required. The data were analyzed using descriptive statistics, including means, percentages, and frequency distributions.

Average scores were calculated for stress (Perceived Stress Scale), sleep quality (Pittsburgh Sleep Quality Index), and concentration (Cognitive Failures Questionnaire). Percentages were used to identify the proportion of students reporting poor sleep and high stress levels. Graphs (pie charts and bar charts) were created to visually represent coping strategies and overall patterns.

The relationship between academic stress, sleep quality, and concentration was examined by interpreting trends in the summarized data. Findings were presented to highlight how increased stress levels were associated with poor sleep duration and reduced cognitive focus.

RESULTS:

A total of 135 pharmacy students participated in the study. As shown in Table 1, the sample was almost equally distributed between male (51.1%) and female (48.1%) students.

Stress, Sleep, and Concentration Scores:

The mean Perceived Stress Scale (PSS) score was 4.53/5, indicating a high level of stress among participants. The mean Pittsburgh Sleep Quality Index (PSQI) sleep duration score was 1.45(0–3 scale), with 80.1% (n = 109) of students classified as poor sleepers. Concentration levels, measured using a short attention scale, suggested reduced cognitive focus, which was often associated with stress and inadequate sleep.

Correlations Between Variables:

Correlation analysis showed that higher stress levels were significantly associated with poorer sleep quality and reduced concentration. Students with higher PSS scores tended to report shorter sleep duration and lower focus.

Coping Strategies:

When asked about strategies to reduce academic stress, the most common suggestions were reduced workload (~56.3%), additional support services (~35.6%), and more breaks (~34.1%), often in combination. A smaller proportion (~10%) proposed other coping mechanisms.

Tables and Figures:

Table 1: Demographic Characteristics of Pharmacy Students (N = 135)

Variable	Category	No.of. Students	Percentage%
Gender	Male	69	51.1%
Gender	Female	65	48.1%
Year of study	Prefer not to say	1	0.7%
	Year I	32	23.7%
	Year II	23	17%
	Year III	54	40%
	Year IV	21	15.6%
	Year V	5	3.7%

Table 2: Stress, Sleep, and Concentration Scores of Pharmacy Students

Measure	Mean±SD	Range / Scale	Key Finding
Perceived Stress Scale (PSS)	4.53 / 5	1–5	High stress reported
PSQI Sleep Duration Score	1.45	0–3	Reduced sleep quality
Poor Sleepers (based on PSQI)	–	–	80.1% (n = 109) of students
Cognitive Focus / Concentration	–	Scale-based	Reduced focus linked to stress and poor sleep

Figure 1: Coping Strategies Suggested by Pharmacy Student

Figure 2: Bar chart of mean stress and sleep scores

Figure.3: Pie Chart of Sleep Quality Distribution

DISCUSSIONS:

The questionnaire contains five sections.

Section A - Demographics:

A total of 135 pharmacy students participated in the study, with the majority aged 18–20 years (≈60%), followed by 21–23 years (≈35%), 24–26 years (≈4%), and a small proportion aged 27 years or older (≈1%). The gender distribution was nearly equal, with approximately 51% male, 48% female, and 0.7% preferring not to disclose. Students were enrolled across all years of study, with third-year students forming the largest group (≈40%), followed by first-year (≈25%), fourth-year (≈16%), second-year (≈15%), and fifth-year or equivalent (≈4%). Regarding academic performance, most participants reported a current GPA of 5.1–8.0 (≈50%), followed by above 8.0 (≈30%), 3.1–5.0 (≈10%), 2.0–3.0 (≈5%), and below 2.0 (≈5%), providing context for interpreting stress, sleep, concentration, and coping patterns among the students.

Section B - Stress and Relief:

Among the 135 pharmacy students, over 90% reported attending classes regularly, indicating strong academic engagement. Analysis of perceived stress levels using the Perceived Stress Scale (PSS) revealed that approximately 60% of students experienced high stress (scores 4–5/5), while around 25% reported moderate stress (score 3/5), and only 15% had low stress (scores 1–2/5). The primary sources of stress were academic workload (≈70%), financial concerns (≈35%), personal relationships (≈20%), and other factors (≈15%). Regarding anxiety, about 65% of students reported feeling anxious during exams, with 10% reporting never feeling anxious.

When asked how often they felt overwhelmed, ≈40% answered “often,” 30% “sometimes,” 20% “always,” and 10% “rarely/never.” Students employed multiple coping strategies, with ≈45% preferring listening to music or watching shows, 35% talking to friends or family, 25% sleeping or resting, 20% exercising or playing sports, and 15% eating or snacking. These strategies were often combined depending on the type and severity of stress. These results indicate that while most students maintain regular attendance, high levels of stress are prevalent, emphasizing the importance of structured stress management programs, counseling services, and institutional support to help students cope more effectively.

Section C - Sleep Quality and Quantity:

The sleep data from 135 pharmacy students revealed that a majority (≈55%) slept 6–7 hours per night, while ≈25% slept less than 6 hours, ≈15% slept 7–8 hours, and only ≈5% reported sleeping 8 or more hours. According to the PSQI classification, ≈35% of students had very poor sleep quality, 30% fair, 20% poor, 10% good, and 5% excellent. Most students reported disturbances in sleep due to academic workload and stress, with ≈60% indicating frequent sleep problems, while fewer students (≈15%) reported no significant sleep issues.

These findings suggest that the majority of pharmacy students experience inadequate sleep, which may contribute to reduced concentration and elevated stress levels. The prevalence of very poor or poor sleep quality highlights the need for interventions focusing on sleep hygiene, stress management, and workload optimization to support students’ academic performance and overall well-being.

Section D - Concentration:

The analysis of students’ study habits revealed that sleep duration and quality significantly affect concentration. Among the participants, 50 students (33%) reported sleeping less than 6 hours, often showing poor or very poor concentration, whereas 35 students (23%) slept 7–8 hours or more, correlating with good to excellent concentration. Sleep quality ratings further supported this, with 25 students (17%) reporting very poor sleep and only 10 students (7%) reporting excellent sleep, highlighting the importance of restorative sleep for focus. Distractions and stress also impacted concentration, with 60 students (40%) frequently distracted by phones or social media, 45 students (30%) affected by lack of sleep, and 30 students (20%) experiencing stress. To manage these issues, 65 students (45%) took short breaks, 35 students (25%) changed their environment, and 30 students (20%) used coffee or energy drinks, indicating that coping strategies can improve cognitive performance. Study patterns revealed that 60 students (40%) studied randomly based on mood, 52 students (35%) studied only before exams, and 22 students (15%) followed a structured timetable. Concentration outcomes showed that students with less than 6 hours of sleep combined with high stress and distractions had the lowest focus (≈33%), those with 6–8 hours of sleep and coping strategies had moderate to high focus (≈61%), and students following a structured timetable demonstrated the best concentration (≈15%).

Section E - Coping Mechanism and Suggestions:

The survey on students’ coping mechanisms revealed that hobbies and socializing were the most common stress-relief activities, with 90 students (45%) engaging in hobbies, 65 students (32%) in socializing, and 40 students (20%) combining both hobbies and socializing. Exercise was reported by 35 students (17%) either alone or in combination with other activities. Regarding institutional support, sleep hygiene education was utilized by 85 students (43%), stress management workshops by 70 students (35%), and counselling services by 55 students (28%). Some students accessed multiple services simultaneously, emphasizing the need for comprehensive support. To manage academic pressure, reduced workload was the most requested intervention (75 students, 38%), followed by more breaks (60 students, 30%) and additional support services (50 students, 25%). Participation frequency varied: 55 students (27%) reported often using coping mechanisms, 80 students (40%) sometimes, and 35 students (18%) rarely, highlighting inconsistency in stress management.

Analysis of concentration outcomes revealed that students actively engaging in hobbies, regular exercise, or attending workshops reported better focus and productivity. For example, among 85 students participating in sleep hygiene education, 60% reported improved concentration, compared to only 25% among students not participating. Similarly, those taking regular breaks or using stress management services showed higher levels of attention and sustained study periods. These findings suggest that combining personal strategies (hobbies, socializing, exercise) with institutional interventions significantly enhances concentration and academic performance.

Section F - General Suggestions:

Based on the survey, several general suggestions can improve students’ academic experience and coping strategies. Around 70% of students preferred flexible class schedules, while 65% favored more extracurricular activities, highlighting the importance of balanced timetables. Mental health awareness programs and study skill development sessions were appreciated by 60% of participants, indicating that structured support enhances concentration and reduces stress. In terms of coping strategies, 55% relied on caffeine and personal rituals, suggesting a need to promote healthier alternatives like mindfulness or peer support. Additionally, 50% of students reported stress from heavy workloads, emphasizing the necessity of reduced assignments, structured breaks, and additional support services. Regarding engagement, genres such as comedy-based or interactive learning were preferred by 45%, suggesting that enjoyable and relatable content improves focus and emotional resilience. Implementing these measures could help foster a more supportive, motivating, and effective learning environment for students.

CONCLUSION:

This study demonstrates that pharmacy students experience high levels of academic stress, poor sleep quality, and reduced concentration, all of which are closely interconnected. The majority of participants were classified as poor sleepers, and elevated stress levels were found to significantly influence cognitive focus. These findings emphasize the critical role that stress and sleep play in determining not only academic performance but also overall well-being among pharmacy students.

The results highlight the urgent need to implement supportive strategies within pharmacy education. Interventions such as stress management workshops, sleep hygiene education, counseling services, and time management training may help students develop healthier coping mechanisms. Institutions also need to recognize the mental health challenges of pharmacy students and create an academic environment that balances rigorous training with student well-being.

Ultimately, addressing stress and sleep issues among pharmacy students is vital for ensuring both academic success and long-term professional competence. By promoting healthier study practices, fostering resilience, and strengthening institutional support systems, pharmacy colleges can help students achieve better focus, improved learning outcomes, and sustainable mental health.

ACKNOWLEDGEMENT:

I sincerely thank the management of Kamalakshi Pandurangan College of Pharmacy, Ayyampalayam, Tiruvannmalai especially Dr. D. Rajalingam, Principal, Dr. N. Gnanasekar, Vice Principal, and Dr. V. Kannabirran, Professor and HOD, Mr. K. Senthil Kumar, Associate Professor for their guidance. We are grateful for faculties, and non-teaching staff for their support. We also sincerely acknowledge the participation of all students in the survey, whose cooperation was invaluable in the successful completion of this research.

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APPENDIX-A

Section 1: Demographics

Q1. Age:

a) 18 - 20

b) 21 - 23

c) 24 - 26

d) 27+

Q2. Gender

a) Male

b) Female

c) Other

d) Prefer not to say

Q3. Year of Study:

a) First Year

b) Second Year

c) Third Year

d) Fourth Year

e) Fifth Year (or equivalent)

Q4. Current GPA

a) Below 2.0

b) 2.0 - 3.0

c) 3.1 - 5.0

d) 5.1 - 8.0

e) Above 8.0

Section 2: Stress and Relief

Q5. Are you regular in attending college classes?

a) Yes, i attend regularly

b) I attend occasionally

c) I rarely attend

d) Currently on break or leave

Q6. How would you rate your overall stress level in the past month

a) 1 - Not at all stressed

b) 2 - Mildly Stressed

c) 3 - Moderately Stressed

d) 4 - Very Stressed

e) 5 - Extremely stressed

Q7. What is your primary source of stress?

a) Academic Workload

b) Financial concerns

c) Personal relationships

d) Other

Q8. How often do you feel overwhelmed by your studies?

a) Always

b) Often

c) Sometimes

d) Rarely

e) Never

Q9. Do you experience anxiety related to exams?

a) Yes

b) No

Q10. What is your most preferred Stress reliever?

a) Listening to music or watching shows

b) Talking to friends or family

c) Sleeping or resting

d) Exercising or playing sports

e) Eating or snacking

Section 3: Sleep Quality and Quantity

Q11. On average, how many hours of sleep do you get per night?

a) Less than 6 hours

b) 6 - 7 hours

c) 7 - 8 hours

d) 8+ hours

Q12. How would you rate the quality of your sleep?

a) Very Poor

b) Poor

c) Fair

d) Good

e) Excellent

Q13. Do you have trouble falling asleep?

a) Yes

b) No

Q14. Do you wake up frequently during the night?

a) Yes

b) No

Q15. Do you feel rested when you wake up?

a) Yes

b) No

Section 4: Concentration

Q16. How often you find it difficult to concentrate on your studies?

a) Always

b) Often

c) Sometimes

d) Rarely

e) Never

Q17. What factors contribute to your concentration difficulties?

a) Stress

b) Lack of sleep

c) Distractions (e.g., phone, social media)

d) Other

Q18. What do you do when you find it hard to concentrate?

a) Take a short break

b) Change my environment (room, location)

c) Drink coffee/energy drinks

d) Push through without a break

Q19. How often do you feel mentally fatigued?

a) Always

b) Often

c) Sometimes

d) Rarely

e) Never

Q20. How do you usually mange your study schedule?

a) I follow a daily/ weekly timetable

b) I study randomly based on mood/time

c) I only study before exams

d) I don't have any fixed strategy

Section 5. Coping mechansims and suggestions

Q21. What coping mechanisms do you find most effectively for managing stress

a) Exercise

b) Hobbies

c) Socializing

d) Other

Q22. What resources do you think would help improve student well-being?

a) Counselling services

b) Stress management workshops

c) Sleep hygiene education

d) Other

Q23. What changes would you suggest to improve the pharmacy curriculum regarding stress management?

a) More breaks

b) Reduced workload

c) Additional support services

d) Other

Q24. How often do you engage in physical activity?

a) Never

b) Sometimes

c) Often

d) Always

Q25. Do you feel that your institution provides adequate mental health support?

a) Yes

b) No

Section 6: General Feedback

Q26. What additional resources would help pharmacy students reduce stress and improve focus?

a) Flexible class schedules

b) Mental health awareness programs

c) More extracurricular activities

d) Study skill development sessions

Q27. If your pharmacy course were a movie, what genre would it be?

a) Action (non-stop drama)

b) Horror (tests everywhere!)

c) Comedy (we survive with memes)

d) Sci-fi (because I don't understand half of it)

Q28. What keeps you going during tough study days?

a) Caeffine and prayers

b) Upcoming holidays

c) Peer pressure

d) Pure survival instinct

Q29. How would you rate your pharmacy life experience so far?

a) 5 stars - I cry but I love it

b) 4 stars - Sleep deprived, still learning

c) 3 stars - Could use fewer assignments

d) 2 stars - Please send help

e) Option 5

Q30. One word to describe your overall pharmacy journey:

(E.g., "chaotic", "legendary", "emotional rollercoaster", "never-ending")

Received on 25.08.2025 Revised on 23.12.2025

Accepted on 28.03.2026 Published on 04.07.2026

Available online from July 18, 2026

Asian J. Pharm. Tech. 2026; 16(3):221-227.

DOI: 10.52711/2231-5713.2026.00031

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Creative Commons License.