701 Daily Associations Between Adolescent Sleep and Mental Health During the COVID-19 Pandemic

Abstract

Introduction: Sleep disturbances after a trauma forecast mental health difficulties such as post-traumatic stress symptoms (PTSS). COVID-19 has resulted in numerous stressors for youth (e.g., school closures, social isolation) that directly disrupt sleep and may have negative mental health consequences. However, investigations of sleep and adverse events in youth have primarily been limited to months or years after a trauma has occurred. How adolescent sleep patterns and mental health intersect during an ongoing adverse experience is unknown. Methods: Adolescents from the United States (N = 503; 80.9% female; 13-18 years) participated in an online daily diary study within 3 weeks after COVID-19 was declared a national emergency. Participants completed one week of twice daily reports (5406 observations) on their nightly sleep (sleep timing, sleep quality, sleep onset difficulties, and nightmares) and daytime mental health symptoms (COVID-19 PTSS, positive affect, negative affect, and loneliness). Results: Mixed models adjusting for age, sex, and socioeconomic status indicated that cyclical, bidirectional effects emerged, with daytime mental health symptoms predicting same-night sleep disturbances, and sleep disturbances predicting next-day mental health. Greater PTSS predicted sleep onset difficulties (Estimate = .02, SE = .004, t = 5.56 p .001) and sleep onset difficulties predicted nextday PTSS (Estimate = .35, SE = .17, t = 2.04, p .05). Greater daytime negative affect predicted greater nightmares (Estimate = .07, SE = .01, t = 4.97, p .001), and nightmares predicted marginally more nextday negative affect (Estimate = .07, SE = .04, t = 1.66, p = .09). PTSS (Estimate = .01, SE = .003, t = 3.47, p .001) and negative affect (Estimate = .05, SE = .03, t = 2.06, p .05) both predicted poorer sleep quality the following night. Conclusion: Findings suggest that mental health symptoms during the onset of the COVID-19 pandemic are associated with increased sleep disturbances. In turn, these sleep disturbances predict increased mental health symptoms. Overall, results provide a greater understanding of youth sleep patterns during COVID-19 and how sleep disturbances may inhibit resilience in the context of an ongoing stressor.