Additive Effects of Sleep Loss, Psychological Distress and Physical Inactivity on Cognitive Failures in Young Adults

Young adults frequently report cognitive complaints often attributed to sleep loss alone. However, subjective cognitive functioning is shaped by broader lifestyle and affective factors. Cross-sectional data were analyzed from 530 young adults (mean age 22.1 +/- 2.3 years) to examine the independent, interactive, and cumulative associations of short sleep duration, low physical activity, and psychological distress with everyday cognitive failures. Cognitive failures were strongly associated with sleep duration, physical activity, sleep quality, and distress in univariate analyses. However, hierarchical regression revealed that psychological distress, poor sleep quality, and short sleep duration were the dominant independent correlates of cognitive failures, collectively explaining a substantial proportion of variance in Cognitive Failures Questionnaire scores (R-squared = 0.585, p < 0.001). In contrast, the apparent protective effect of physical activity was not observed after adjustment for sleep and distress (p = 0.976), and no significant sleep-by-physical activity interaction was observed. Further, cumulative risk modeling demonstrated a robust dose-dependent relationship, with cognitive failures increasing progressively as behavioral and psychological risk factors accumulated (p < 0.001). Individuals exposed to all three risk factors exhibited more than double the cognitive failure burden observed in individuals with no risk factors. These results indicate that the cognitive burden in young adults can best be described by an additive increase of behavioral and psychological risk factors as a function of the co-occurrence, rather than by the presence of compensatory effects of lifestyle risk factors. Interventions aimed at preserving cognitive function may therefore benefit from simultaneously targeting sleep health and psychological well-being rather than relying on physical activity alone to offset cognitive burden.