ABSTRACT
Aims: QOL has become an important outcome variable for research studies, including children and adolescents. Examining the relationships between QOL and its predictors are a critical way to understand and improve QOL. Good sleep hygiene is essential to maintain optimal physical and psychological development and functioning. Behavioral sleep problems have been linked with poor academic performance and decreased QOL. This study provides the opportunity to examine HRQOL longitudinally in a sample of adolescents receiving mental health services and impacted by multiple disasters (hurricanes, earthquakes, and COVID-19). We examine these associations and post-pandemic impact. Method(s): Adolescents (12-18 years) were evaluated with the AQOL-MHS. It evaluates QOL in three domains (Emotional Regulation (ER), Self-Concept (SC), and Social Context (SoC). 228 caretaker-child dyads participated in a total of 4 assessments that span over a 2-year period. Sleep problems (SP) were assessed by the Child Sleep Habits Questionnaire. Data across time was included in the analysis to examine linear time trends. Three models were examined;A includes main effects of time, sleep problems and interaction, B controls for sex, age, and includes internalizing disorders and ADHD, C removes ADHD. Result(s): Half of our sample reported having a sleep problem and 49.3% were scored as having a psychiatric disorder, 29.1% had both. No differences were observed by sex or age. Having a sleep problem was significantly associated with having a mental diagnosis (p <= 0.01), PTSD (p <= 0.01) and worse overall QOL (p <= 0.006). SP by time interaction models were not significant. In bivariate analyses, ADHD was associated with sleep problems (p <= 0.04) but not in multivariate analyses. Having an internalizing disorder was a strong predictor of QOL, overall and for all sub-scales (p <= 0.001). Conclusion(s): The current study highlights the associations between sleep problems and QOL. Sleep problems were mostly associated with the Self-Concept domain. Those with sleep problems at baseline showed no improvement in QOL across time. Post-pandemic use of electronic devices has increased, and their use has shown adverse sleep outcomes. Parents should be aware of these associations and their implications. Clinicians should address sleep problems to achieve holistic improvement in adolescents' psychiatric symptoms and QOL.