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

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.