1073 How Do Daily Fluctuations in Stress, Anxiety, and Depression relate to Sleep in College Students?

Abstract Introduction College students face unique factors (e.g., academic and social demands, varied class schedules across days) that may put them at greater risk for mental health and sleep difficulties. Prior studies have shown that depression, anxiety, and stress are associated with sleep disturbances, but more studies utilizing repeated measures are needed to understand these relationships across more granular timescales. This study examined daily associations among stress, depression, anxiety, and sleep in college students. Methods 333 college students (Mage = 20 years, 54% Female, 81% Non-Hispanic/Latinx) from two universities in Tucson, AZ, and Corvallis, OR, completed 14-days of the Consensus Sleep Diary (CSD), Perceived Stress Scale-4 (PSS-4), Generalized Anxiety Disorder 2-item (GAD-2), and Patient Health Questionnaire-2 (PHQ-2). Multilevel models examined how stress (PSS-4 total), anxiety symptoms (GAD-2 total), and depression symptoms (PHQ-2 total) were associated with same-day sleep efficiency, duration, and timing. Results Between-person analyses revealed that, on average, students with greater depression reported lower sleep efficiency (β = −0.87, SE = 0.41, p = 0.037), while those with greater stress reported shorter sleep duration (β = −4.06, SE = 1.88, p = 0.031). Within-person analyses revealed that, when students experienced greater than usual anxiety symptoms, they reported worse sleep efficiency (β = −0.41, SE = 0.16, p = 0.010) and lower sleep duration (β = −4.20, SE = 1.85, p = 0.023) on the same day. When students experienced greater than usual stress, they reported shorter sleep duration (β = −2.07, SE = 0.94, p = 0.027). When students experienced greater than usual depressive symptoms, they reported longer sleep duration (β = 5.39, SE = 2.05, p = 0.009) and later sleep midpoint (β = 15.00, SE = 5.69, p = 0.009). Conclusion Results reveal that daily elevations in stress and anxiety are associated with shorter or less efficient sleep, whereas elevation in depressive symptoms is associated with longer and later sleep in college students. Findings extend past research by highlighting the utility of using repeated measurements to characterize the differential relationships among stress, anxiety, depression, and sleep in college students. Support (if any)