JMIR Formative Research; Zahra Mousavi, Jocelyn Lai, Katharine Simon, Alexander P. Rivera, Asal Yunusova, Sirui Hu, Sina Labbaf, Salar Jafarlou, Nikil D. Dutt, Ramesh C. Jain, Amir M. Rahmani, Jessica L. Borelli; Published June 8, 2022; DOI: 10.2196/33964



Sleep disturbance is a transdiagnostic risk factor so prevalent among young adults it is considered a public health epidemic, exacerbated by the COVID-19 pandemic. Sleep may contribute to mental health via affect dynamics. Prior literature on contribution of sleep to affect is largely based on correlational studies or experiments that do not generalize to the daily lives of young adults. Furthermore, the literature examining the associations between sleep variability and affect dynamics remains scant.


In an ecologically valid context, using an intensive longitudinal design, we aimed to assess the daily and long-term associations between sleep patterns and affect dynamics among young adults during the COVID-19 pandemic.


College student participants (N=20, 65% female) wore an Oura ring continuously for 3-months to measure sleep patterns, such as average and variability in total sleep time (TST), wake after sleep onset (WASO), sleep efficiency (SE), and sleep onset latency (SOL), resulting in 1173 unique observations. We administered a daily ecological momentary assessment (EMA) using a mobile health app to evaluate positive (PA) and negative affect (NA), and COVID-worry once per day.


Participants with higher SOL, b= -1.09, SE=.36, p=.006, and TST, b= -.15, SE= .05, p=.008 on the prior day had lower PA the next day. Further, higher average TST across the 3-month period predicted lower average PA, b= -.36, SE= .12, p=.009. TST variability predicted higher affect variability across all affect domains. Specifically, higher variability in TST was associated higher PA variability, b=.09, SE= .03, p=.007, higher NA variability, b=.12, SE= .05, p=.03, and higher COVID-worry variability, b= .16, SE= .07, p= .04.


Fluctuating sleep patterns are associated with affect dynamics at daily and long-term scales. Low PA and affect variability may be potential pathways through which sleep has implications for mental health.