ABSTRACT
Introduction: Sleep quality is impacted by stress and disruptions in daily routine, both of which characterize the COVID-19 pandemic. The pandemic brought upon decreased social interactions, increased loneliness, and distress, particularly among persons living with a chronic disease and those who lost their job. The aims of the current study were to assess 1) whether chronic disease, unemployment, and access to physical contact were related to sleep quality during the COVID-19 pandemic, and 2) if COVID-19 health worry, work distress, and loneliness would act as specific mediators of each respective relationship. Method: Adults living in Florida (n=2,152;aged 47±18 years, 64% female) completed a Qualtrics survey in April-May 2020 (Wave 1). Participants (n=831) were reassessed one month later (Wave 2;May-June 2020). At Wave 1, participants reported presence of a chronic disease, employment status, opportunity for physical contact with someone they care about during the pandemic, COVID-19 health worry, work distress, and loneliness. At Wave 2, participants rated their quality of sleep and insomnia symptoms that were used to create a latent variable, sleep quality. Results: Using structural equation modeling, we found the presence of a chronic disease was associated with greater COVID health worry (β=0.06, p<.05) and unemployment was related to greater work distress (β=0.22,p<.001). Access to physical contact was directly associated with lower levels of loneliness (β=-0.29, p<.001). Loneliness, but not health worry or work distress, directly predicted worse sleep quality (β=-0.29, p<.001). Further, there was a significant indirect effect such that greater access to physical contact was associated with greater sleep quality via lower levels of loneliness (β=0.08,p < .001). While there were no direct effects of unemployment or access to physical contact on sleep quality, the presence of a chronic disease directly predicted worse sleep quality (β=-0.13, p =.001). Conclusion: As expected, adults living with a chronic disease had poorer sleep quality. Unexpectedly, health worry and work distress did not impact sleep;rather, loneliness was the sole psychosocial predictor of worse sleep quality. Interventions should target reducing loneliness by enhancing social engagement and encouraging safe physical contact to improve sleep problems during the ongoing pandemic.