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| - There are concerns that both the experience of adversities during the COVID-19 pandemic and worries about experiencing adversities will have substantial and lasting effects on physical and mental health. One pathway through which both experience of and worries about adversity may impact health is through effects on sleep. Psychosocial stress can reduce sleep length and increase sleep disturbance, which can in turn reduce individuals ability to cope and respond to stressors, and worsen health outcomes. Therefore this study explored whether either worries about adversities during the pandemic or the experience of adversities were associated with impaired sleep. We used data from 45,109 adults in the COVID-19 Social Study assessed weekly from 01/04/2020-11/05/2020 in the UK during the pandemic. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. We used random-effect within-between models that automatically account for all time-invariant confounders. Both the total number of adversity experiences and total number of adversity worries were associated with lower quality sleep. Each additional experience was associated with a 1.17 (95% CI = 1.11, 1.24) times higher odds of poor quality sleep while each additional worry was associated with a 1.20 (95% CI = 1.17, 1.23) times higher odds of poor quality sleep. When considering specific experiences and worries, all worries and experiences were significantly related to poorer quality sleep except experiences relating to employment and finances. Having a larger social network offered some buffering effects on associations but there was limited further evidence of moderation by social or psychiatric factors. Results suggest that poor sleep may be a mechanism by which adversities are affecting mental health and highlight the importance of interventions that seek to reassure individuals and support adaptive coping strategies during the pandemic.
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