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

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.