228 The Association of Prior Mental Health Conditions with COVID-19-related Sleep Changes

Introduction: Among persons with mental health conditions, the impact of the COVID-19 pandemic on sleep health is underexplored. The present study investigated whether sleep changes related to the COVID-19 pandemic differed among individuals with mood and/or anxiety disorders compared to individuals without these disorders. Methods: A 25-minute online survey, distributed globally to adults aged >18y through social media advertising from 5/28/2020- 7/10/2020, examined the association of mental health diagnoses with COVID-19 related sleep changes. Participants reported prior history of mood and anxiety disorders, and pre-COVID-19 and current sleep patterns including bedtime, wake time, total sleep time (TST), sleep efficiency (SE:[TST/time in bed∗100%], and nightmare frequency/wk. ANOVA models comparing mental health disorder groups (no diagnoses, mood disorders, anxiety disorders, mood and anxiety disorders) on mean differences in sleep changes were conducted. Results: Among 1,048 participants, 71.5% reported no prior mood and/or anxiety disorders9.3% reported anxiety disorders only, 4.3% reported prior mood disorders only, and 14.9% reported both mood and anxiety disorders. There were significant group differences in total sleep time (F (3,670)=4.6, p=0.003) and sleep efficiency (F (3,670) =2.8, p=0.038) such that individuals with both mood and anxiety disorders experienced greater decreases in total sleep time (Mean Difference: 39.0min, SE=13.0) and sleep efficiency (Mean Difference=3.8%, SE=1.6) compared to individuals without any mood or anxiety disorders. In addition, the model for nightmare frequency per week was significant (F(3,654)=5.6, p=0.001) such that individuals with both anxiety and mood disorders (Mean Difference=1.1, SE=0.4) and individuals with mood disorders only (Mean Difference=1.1, SE=0.4) reported greater increases in nightmare frequency compared to participants without any mood or anxiety disorders. There were no group differences in bedtime and wake time. Conclusion: Among a global sample, COVID-19 pandemic-related sleep health significantly worsened among individuals with prior mood and anxiety disorders relative to individuals without these disorders.