Digital Companions for Academic Stress and Sleep Quality: A Conceptual Review and Developing Study with Primary Care Implications

Post-secondary students continue to report high levels of academic stress, sleep disruption, and difficulty accessing timely mental-health support, all of which intersect with primary care. Artificial Intelligence (AI) companion chatbots are increasingly used by young adults because of their continuous availability and conversational design. Early digital mental-health research suggests these tools may support short-term mood regulation, coping, and perceived emotional support, although concerns remain regarding privacy, misinformation, and emotional over-reliance. This conceptual review examines current evidence on AI companion chatbots in relation to academic stress, student well-being, and early mental-health support pathways connected to primary care, while identifying key gaps and risks informing a developing master’s research study by Matthews. The review synthesizes literature across AI companions/chatbots, digital mental-health interventions, academic stress, and emerging student-use patterns, including evidence related to AI-mediated emotional support, stress regulation, academic self-efficacy, and foundational digital mental-health interventions demonstrating short-term improvements in mood and stress outcomes. Literature addressing risks, including privacy concerns, accuracy limitations, and emotional dependency, was also incorporated.Findings from the conceptual review informed the design of a developing quantitative study examining how students perceive and use AI companion chatbots for stress management, sleep, coping, and help-seeking behaviors. Planned data collection includes pre- and post-surveys assessing academic stress, coping, sleep quality, and perceived well-being, alongside exploratory use of Matthews’ (2025) AI Companion Usage (AICU) Index to capture interaction patterns, motivations, and perceived relational qualities with AI companions. Exploratory analyses will examine differences across demographic and baseline stress groups, as well as relationships between AI companion engagement and well-being outcomes. Together, the conceptual review and developing study highlight the need for institutional and governmental guidance on the ethical, safe, and evidence-informed use of AI companion chatbots within student mental-health pathways connected to primary care. As these technologies become more common across post-secondary and commercial settings, policies addressing privacy, data governance, accuracy standards, and boundaries of emotional support will be essential to ensure AI technologies support student well-being safely and equitably.Keywords: Artificial Intelligence (AI); chatbots; companions; digital mental health; academic stress; sleep quality; conceptual review