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The sudden COVID-19 pandemic and the uncertainty surrounding the virus has led to increased worry and fear. How this fear is associated with sleep remains unknown. Methods 419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked about agreement with statements endorsing beliefs that they were currently infected, that they would someday be infected, that they fear testing, and that they are worried about a family member becoming infected. They were asked to rate agreement with statements regarding changes to sleep during the pandemic. Ordinal logistic regressions with degree of agreement with statements about sleep changes were outcomes, agreement with statements about COVID infection beliefs as predictor, and age, sex, and race/ethnicity as covariates were examined. Results Those who believed they were infected were 65% less likely to be keeping a regular schedule (p=0.001), 61% less likely to report improved sleep (p=0.009), 2.9 times as likely to report worse sleep (p=0.001), 2.7 times as likely to report difficulty falling asleep (p=0.002), 2.1 times as likely to report sleep maintenance problems (p=0.03), 2.9 times as likely to report sleepiness (p=0.001). Those who believed they would be infected in the future were 83% less likely to report improved sleep (p=0.005), 7.49 times as likely to report worse sleep (p=0.001), 5.3 times as likely to report difficulty falling asleep (p=0.003), 4.1 times as likely to report sleep maintenance problems (p=0.01), and 5.7 times as likely to report sleepiness (0.003). Those that feared testing were 5.7 times as likely to report more sleepiness (p=0.03). Those that worried about family were 80% less likely to be keeping a regular schedule (p=0.01), 75% less likely to report improved sleep (p=0.02), 4.5 times as likely to report worse sleep (p=0.02), 4.5 times as likely to report sleep maintenance problems (p=0.01), and 8.3 times as likely to report sleepiness (p=0.001). Conclusion Those who believed they were infected reported worsening sleep, though the degree was even greater among those who anticipated infection for themselves or a family member. Worries about COVID-19 may result in more adverse impact on sleep than potential infection itself. Support (if any):

208 Sleep Disturbances During the COVID-19 Pandemic Associated with Worries and Fears About Possible Infection