Depression and Anxiety Mediate the Association between Sleep Quality and Self-Rated Health in Healthcare Students.

OBJECTIVES: This study aimed to investigate factors associated with sleep quality in healthcare students and to determine whether depressive and anxiety symptoms may explain some of the associations between sleep quality and self-rated health. STUDY DESIGN: This is a cross-sectional study at wave one. METHODS: A total of 637 healthcare students were recruited via a stratified random sampling method in Hangzhou, China. The Sleep Quality Questionnaire (SQQ) and the four-item Patient Health Questionnaire (PHQ-4) were used to assess sleep quality and depressive and anxiety symptoms, respectively. Self-rated health was assessed via a self-developed questionnaire of both physical and psychological health. Structural equation modeling was used to examine the direct and indirect effects of sleep quality on self-rated health through depressive and anxiety symptoms. RESULTS: Students engaged in part-time employment (p = 0.022), with poor perceived employment prospects (p = 0.009), and who did not participate in recreational sports (p = 0.008) had worse sleep quality. Structural equation modeling revealed a significant total effect of sleep quality on self-rated health (b = 0.592, p < 0.001), a significant direct effect of both sleep quality and depressive and anxiety symptoms on self-rated health (b = 0.277, 95% CI: 0.032-0.522), and a significant indirect effect of sleep quality on self-rated health through depressive and anxiety symptoms (b = 0.315, 95% CI: 0.174-0.457). CONCLUSIONS: Depressive and anxiety symptoms partially explain the association between sleep quality and self-rated health. Intervening upon sleep quality, depressive, and anxiety symptoms may bolster the self-rated health of healthcare students.

Lifestyle Factors and Sleep Health across the Lifespan.

Sleep health, operationalized as a multidimensional construct consisting of sleep regularity, satisfaction, alertness, timing, efficiency, and duration, is an emerging concept in the field of sleep medicine which warrants further investigation. The purpose of the present study was to: (1) compare sleep health across the lifespan, (2) determine lifestyle factors associated with sleep health, and (3) examine whether lifestyle factors associated with sleep health varied between and within age groups. Participants consisted of 3284 individuals (Mean age = 42.70; 45% male) who participated in a cross-sectional online survey of sleep and health. Sleep health was measured using the RU-SATED scale, while demographic and lifestyle factors (e.g., daily social media use, sedentary activity, fast food consumption, etc.) were all self-reported. Sleep health was the highest among older adults (M = 8.09) followed by middle-aged (M = 7.65) and younger adults (M = 7.16). Across age groups, fast-food consumption, daily regularity, and daily TV, social media, or internet use were all negatively correlated with sleep health (ps < 0.05). Few differences in the association between lifestyle factors and sleep health across age groups were found. Overall, these findings may help to inform sleep health promotion efforts by targeting the most pertinent lifestyle factors for promoting sleep health.

Insomnia symptoms during the COVID-19 pandemic: an examination of biopsychosocial moderators.

OBJECTIVE/BACKGROUND: Healthy sleep is vital for physical and psychological health, and poor sleep can result in a myriad of negative physical and psychological outcomes. Insomnia symptoms often manifest as a result of acute life stressors or changes, and COVID-19 experiences may be one such stressor. Other known predisposing factors to insomnia may moderate the impact of COVID-19 experiences on sleep. The present study aimed to determine current levels of insomnia severity in a US sample, to investigate the relation of COVID-19 experiences to insomnia symptoms, and to determine which individuals are most susceptible to this association. METHODS: Data were drawn from a larger online survey investigating sleep and health outcomes across the lifespan. COVID-19 experiences were assessed with the exposure and impact subscales of the CAIR Pandemic Impact Questionnaire (C-PIQ). The Insomnia Severity Index (ISI) measured insomnia symptoms. Biological, psychological, and social moderators were measured using other brief self-report measures. RESULTS: Insomnia symptoms prevalence was as follows: moderate-to-severe symptoms (25.5%), subthreshold symptoms (37.7%), and no symptoms (36.7%). Individuals' COVID-19 experiences significantly predicted insomnia symptom severity [F(1,997) = 472.92, p < 0.001, R2 = 0.32]. This association was moderated by race, anxiety symptoms, depressive symptoms, physical somatization, and social loneliness, but not age, gender, or education. CONCLUSIONS: Although negative experiences with COVID-19 are associated with worse insomnia symptoms, this relationship is not the same for everyone.