Bidirectional Relations Between Sleep and Emotional Distress in College Students: Loneliness as a Moderator

Abstract

Mental health symptoms are of increasing concern among college students in the United States and are often associated with insufficient sleep. However, the predictive relations between sleep and mental health are not well understood. The present study examined the daily, bidirectional associations between multiple sleep variables (subjective rating of morning restedness, objective measurement of nighttime sleep minutes) and college students’ feelings of emotional distress. Self-reported loneliness was assessed as a moderator of these bidirectional relations. Participants were 101 undergraduate students (80% women) attending a liberal arts college in the northeastern United States. Students wore an actigraph to monitor nighttime sleep minutes across four weeknights (Monday–Thursday). They self-reported loneliness on the first day of the study and completed daily electronic assessments regarding restedness and emotional distress (worry, stress) each day for the remainder of the week. Multilevel modeling analyses demonstrated that greater restedness was predictive of less worry and stress that day. Further, the associations between better sleep (more rested, more nighttime sleep minutes) and less distress were stronger for less lonely students. In contrast, none of the distress indices were directly predictive of next-day restedness or nighttime sleep minutes, though one significant interaction demonstrated that the association between less worry and feeling more rested the next day was stronger for students who reported low compared to high loneliness. Together, the results point to sleep as a stronger influence on emotional distress than the reverse pathway and may suggest that social connection facilitates the positive influence of good sleep on student mental health.

Keywords:

• Bidirectional
• daily diary
• mental health
• rested
• sleep minutes

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclosure statement

The authors have no conflicts of interest to declare.

Notes

1 To address the possibility that participants with substantial amounts of missing sleep information were affecting the results, we re-ran all study analyses, excluding individuals who were missing 2 or more nights of actigraphy or sleep diary data. The pattern of results was very similar and thus we followed Bagley et al. (2015) in retaining all cases regardless of number of days of available sleep data to increase power.

2 The second set of models did not detect any significant relations between loneliness and the sleep variables, but given that loneliness was significantly correlated with both worry and stress, it is possible a suppressor effect could be evident when loneliness and each of these variables were simultaneously entered as predictors in the models. To test this possibility, we conducted additional analyses in which separate models were run for loneliness predicting each of the sleep variables, without worry or stress in the models. Loneliness was not a significant predictor of either sleep variable, making it unlikely that a suppressor effect was operative.

Additional information

Notes on contributors

Lauren E. Philbrook

Lauren E. Philbrook is an assistant professor in the Psychological and Brain Sciences department at Colgate University. Her research examines multiple layers of contextual influences on youth sleep, as well as how sleep intersects with other bioregulatory processes in the prediction of developmental outcomes.

Grace E. Macdonald-Gagnon

Grace Macdonald-Gagnon is a research assistant in the Psychiatry department at Yale University. She completed her Bachelor of Arts degree in Psychological Science from Colgate University. Her research interests are in various domains including anxiety disorders, addictive behaviors, and emotional processes