Sleep quality and COVID-19-related stress in relation to mental health symptoms among Israeli and U.S. adults.

Abstract Objectives The COVID-19 virus has resulted not only in high rates of morbidity and mortality across the globe, but in widespread mental health problems and sleep disruption, likely as a result of pandemic-related stressors. The current study examines associations among COVID-related stress, sleep quality, and mental health. Design Cross-sectional data were collected via online surveys in May 2020. Participants were 2541 community adults ages 18-70 from Israel (N = 1969) and the U.S. (N = 572). Measurement Participants completed measures of COVID-related stress, sleep quality, and symptoms of anxiety, depression and adjustment disorder. Results Participants reported high rates of depression and anxiety symptoms, adjustment difficulties, and poor sleep quality. In both countries, COVID-related stressors were associated with both anxiety and depression, and these associations were mediated by sleep disturbances. Conclusions These results support the role of sleep in mental health difficulties. Widespread, accessible, evidence-based interventions are urgently needed to improve health and mental health and to promote resilience in preparation for future global crises.