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The COVID-19 pandemic has caused widespread disruption and stress for people of all ages and circumstances around the world. This study investigates the relationship between general and specific stressors and various dimensions of sleep health. Methods A sample of N=419 US adults completed online surveys about sleep and COVID-19 experiences. Participants were asked whether they experienced increased general, financial, food, housing, family and relationship stress due to the COVID-19 pandemic. They were also asked whether they experienced a more regular schedule, improved sleep, worsened sleep, more early insomnia, more middle-of-the-night insomnia, more daytime sleepiness, and more naps due to the COVID-19 pandemic. Ordinal logistic regressions with sleep change as outcome and stress variable as predictor were adjusted for age, sex, and race/ethnicity. Results COVID-19-related general, financial, food, housing, family, and relationship stress were all associated with a decreased likelihood of maintaining a more regular schedule (oOR=0.52-0.67, all p&amp;lt;0.001) and improved sleep (oOR=0.56-0.67, all p&amp;lt;0.001). They were also all associated with a greater likelihood of worsened sleep (oOR=1.48-2.41, all p&amp;lt;0.001), early insomnia (oOR=1.63-1.85, all p&amp;lt;0.001), middle-of-the-night insomnia (oOR=1.40-2.00, all p&amp;lt;0.001), and daytime sleepiness (oOR=1.58-2.07, all p&amp;lt;0.001). Increased napping was also associated with more COVID-related financial, food, and housing stress (oOR=1.33-1.55, all p&amp;lt;0.005). Conclusion Regular sleep schedules can be disrupted by stressors directly, or by the anxiety that so often accompanies stress. Stressed individuals may experience increased difficulty falling asleep, or more nighttime arousals, or find themselves waking up earlier than usual, all as a result of ruminating thoughts, stress-induced nightmares, or outside disturbances. Disruption to sleep at night often results in increased daytime sleepiness and fatigue, with a higher chance of napping. This study reports the significant association of some of these with COVID-19 pandemic-related stress. More individuals now find themselves working from home with greater flexibility in their schedules, but this has not necessarily led to better sleep. The impact of the pandemic on various health outcomes as a result of stress is still to be revealed. Support (if any):

211 Pandemic-Related Sleep Changes Associated with COVID-Related General, Financial, Food, Housing, Family and Relationship Stress