Is the association between sleep and internalizing symptoms mediated by student and parent-related pressures?

Abstract

Objectives: Inadequate sleep has been afforded relatively little attention, despite known declines over adolescence, a critical period for the onset of mental ill-health. There remains a need for population-level longitudinal studies to better understand links with internalizing symptoms and in managing relevant pressures among adolescents. We examined the bidirectional relationships between sleep and depression and anxiety symptoms, and whether the relationships are mediated by school- and parent-related pressures. Measures: We used 2-year linked prospective data from 25,722 Canadian secondary school students that participated in the COMPASS study in the 2017-18 and 2018-19 school years. Path analysis models tested autoregressive and cross-lagged relationships between sleep duration and depression and anxiety symptoms. Bootstrap method of indirect effects was used to test school and parent pressures as mediators. Results: Results supported the hypothesized bi-directional relationships between sleep duration and depression and anxiety symptoms across one year. Shorter sleep predicted greater internalizing symptoms, and vice versa. In females, both parental and school pressures mediated the association between sleep duration and depression and anxiety symptoms, and in the reverse direction, parental but not school pressures mediated the association between depression and sleep. In males, school pressures mediated the association between sleep and depression symptoms. Conclusions: This study provides new insights into the nature and directionality of associations between sleep and internalizing symptoms over time and differences by sex. Results further strengthen calls that short sleep should be taken seriously. Interventions promoting regular sleep schedules in adolescence may help mitigate risk for stress-related psychopathology.