0684 Improving Psychological Distress for Better Sleep During the Covid-19 Pandemic: Analyses of Data From a Pilot Randomized Controlled Trial

Abstract

Abstract Introduction Psychological distress has been associated with sleep problems. Emerging evidence suggests positive psychological well-being is associated with better sleep. However, most of these studies are cross-sectional and do not provide information on the effect that changes in psychological outcomes have on sleep. The aim of this secondary analysis was to test whether changes in distress and well-being following a 7-week intervention to improve sleep and mental health were associated with changes in sleep among adults reporting poor sleep quality (Pittsburgh Sleep Quality Index [PSQI]>5) and moderate distress (Perceived Stress Scale [PSS]≥14) during the COVID-19 pandemic. Methods Thirty individuals (age 40.7±12.9y, 80% female, 50% racial/ethnic minority) completed a pilot study testing a well-being and sleep hygiene intervention vs. sleep hygiene alone. Questionnaires were administered at baseline and post-intervention to assess distress (PSS and the Symptom Questionnaire), well-being (Psychological Well-Being scales), and sleep (PSQI and Insomnia Severity Index). A sleep diary was administered to collect information on total sleep time (TST), variability in TST, sleep onset latency, wake time after sleep onset, bedtime, and variability in bedtime. Change scores were calculated for each variable as the difference between post-intervention and baseline. Separate linear regression models were estimated with psychological variables as predictors and sleep variables as outcomes. Analyses were adjusted for intervention group, baseline scores of predictors and outcomes, age, and sex. Results Reductions in anxiety were associated with improvements in insomnia (B=0.6±0.2 (SE), p=0.008) and TST (B=-10.1±3.5, p=0.009); reductions in depression, somatization, and hostility were each associated with improvements in sleep quality (B=0.2±0.1, p=0.007), TST (B=-10.3±4.5, p=0.03), and earlier bedtime (B=8.8±3.0, p=0.008), respectively; and reductions in perceived stress were associated with improvements in sleep quality (B=0.2±0.1, p=0.005) and insomnia (B=0.3±0.1, p=0.02). No associations were found between changes in well-being and sleep. Conclusion Our findings suggest that reductions in distress following well-being and sleep hygiene or sleep hygiene alone interventions predict improvements in sleep. Focusing interventions on improving distress may be relevant to ameliorate sleep quality in the context of psychological distress. The association between well-being and sleep should be further delineated to determine the role of well-being in sleep promotion. Support (If Any)