EXAMINING THE ASSOCIATION OF TRAIT SLEEP REACTIVITY WITH CHANGES IN SLEEP, DEPRESSION, AND ANXIETY IN THE COVID-19 PANDEMIC

Abstract Introduction Sleep Reactivity (SR), a trait-like tendency for stressful events to trigger sleep disturbances, is an established diathesis for insomnia and depression. However, no studies to date have examined SR in the context of the COVID-19 pandemic and it’s related restrictions. Thus, the goal of this analysis is to test whether SR confers a vulnerability for greater sleep and mood symptoms due to the stress of COVID-19 and it’s related restrictions. We hypothesized that (1) The onset of the pandemic will trigger greater increases in insomnia symptoms in highly sleep reactive individuals. 2) Sleep-reactive individuals would experience reduced recovery of insomnia, anxiety, and depression symptoms over the course of the pandemic. Methods SR, insomnia, anxiety, and depressive symptoms were assessed by the Ford Insomnia Response to Stress Test (FIRST), Insomnia Severity Index (ISI), Beck Anxiety Inventory (BAI), and Beck Depression Inventory (BDI II), respectively, at two time points (early-pandemic, 6-month follow-up). Additionally, participants retrospectively reported ISI prior to the pandemic. N = 253 adults from Stanford’s COVID-19 Pandemic Sleep Study (April-November 2020) provided baseline insomnia measures, and were excluded if they reported pre-pandemic clinical insomnia (ISI >10). Ranked-correlation tests were used to test the current hypotheses. Paired t-tests were used to evaluate changes in mean insomnia, depression, and anxiety scores. Covariates included essential worker status, sex, and age. Results ISI after COVID-19 was significantly higher than retrospective, pre-pandemic ISI (t = 8.2, d = 0.55, p < 0.0001). However, SR was not significantly correlated with the pandemic-related increase in ISI (ρ = 0.07, p = 0.34). Depression significantly increased after 6-months (t = 2.0, d = 0.27, p = 0.047), whereas anxiety did not (t = 1.7, d = 0.26, p = 0.10). Neither changes in depression nor anxiety were predicted by SR (Depression: ρ = 0.15, p = 0.32; Anxiety: ρ = -0.13, p = 0.40). Conclusion Insomnia and depression, but not anxiety, increased with the onset of the pandemic. However, trait SR was not a predisposing factor for pandemic-related sleep and mood changes. This is the first analysis examining SR as a risk factor for insomnia and mood symptoms in the pandemic. Support (If Any)