Academic stress and anxiety are prevalent among medical students and significantly affect their mental health and academic performance. However, limited research exists on these dynamics within the context of Albanian medical education, where institutional mental health support is still evolving. This study examines the relationships between academic stress, anxiety, and sleep quality, and their combined effects on academic performance and well-being among Albanian medical students.

Existing evidence indicates that stress and anxiety impair cognitive functions such as attention, memory, and decision-making, leading to reduced academic outcomes and increased risk of burnout. Poor sleep quality further intensifies these effects, contributing to emotional dysregulation, fatigue, and decreased resilience. Anxiety is considered a key mechanism linking academic stress to poorer performance, while sleep quality may either buffer or worsen this relationship.

Additionally, prolonged stress and anxiety can hinder professional identity formation by reducing confidence, engagement, and the development of essential clinical competencies. These challenges were amplified during the COVID-19 pandemic due to disruptions in learning and clinical training. This study seeks to address the research gap in Albania by providing insights into how stress, anxiety, and sleep interact, with the aim of informing interventions that enhance student well-being and academic success.