Stress, coping, resilience, and sleep during the COVID-19 pandemic: A representative survey study of US adults

Introduction The COVID-19 pandemic is a global health emergency resulting in widespread death and substantial disruption to daily life. Previous research has shown that novel disease outbreaks are associated with high stress levels and sleep impairments that lead to neuropsychiatric consequences. Therefore, it is vital to study both stress and protective factors such as coping and resilience that may hinder or help sleep quality during the COVID-19 pandemic. Further, as gender disparities exist in sleep quality, it is important to understand the relationship between pandemic-related stress, coping strategies, resilience, and sleep in bothgenders during the COVID-19 pandemic. Methods Our study examined how gender, stress, coping, and resilience were associated with sleep cross-sectionally during the COVID-19 pandemic in a representative sample of US adults (N = 393). Results Consistent with many recent studies, we found that worsened sleep quality in women compared to men persisted during the COVID-19 pandemic. Interestingly, pandemic-related stress was not significantly associated with sleep quality, but pandemicrelated coping was associated with sleep independent of robust controls and trait resilience. Conclusions Greater primary control engagement coping was associated with better sleep quality, while involuntary engagement coping was associated with poor sleep quality. Future research should extend the findings with actigraphy and explore ways to enhance beneficial coping and sleep health during pandemics.