Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries

Du, Chen; Zan, Megan Chong Hueh; Cho, Min Jung; Fenton, Jenifer I.; Hsiao, Pao Ying; Hsiao, Richard; Keaver, Laura; Lai, Chang-Chi; Lee, HeeSoon; Ludy, Mary-Jon; Shen, Wan; Swee, Winnie Chee Siew; Thrivikraman, Jyothi; Tseng, Kuo-Wei; Tseng, Wei-Chin; Tucker, Robin M.

doi:10.3390/clockssleep2030025

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Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries

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Winnie Chee Siew Swee

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Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI 48824, USA

Division of Nutrition and Dietetics, International Medical University, Kuala Lumpur 57000, Malaysia

Global Public Health, Leiden University College, 2595 DG The Hague, The Netherlands

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Department of Food and Nutrition, Indiana University of Pennsylvania, Indiana, PA 15705, USA

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Department of Kinesiology, Health, and Sport Science, Indiana University of Pennsylvania, Indiana, PA 15705, USA

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Department of Health and Nutritional Science, Institute of Technology Sligo, F91 YW50 Sligo, Ireland

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Department of Exercise and Health Sciences, University of Taipei, Taipei, Taiwan

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Department of Human Services, Bowling Green State University, Bowling Green, OH 43403, USA

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Department of Public & Allied Health, Bowling Green State University, Bowling Green, OH 43403, USA

Author to whom correspondence should be addressed.

Clocks & Sleep 2020, 2(3), 334-353; https://doi.org/10.3390/clockssleep2030025

Received: 6 July 2020 / Revised: 22 July 2020 / Accepted: 5 August 2020 / Published: 11 August 2020

(This article belongs to the Special Issue Sleep, Rhythms, and Mental Health)

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Abstract

High levels of perceived stress and anxiety among university students are a global concern and are known to negatively influence sleep. However, few studies have explored how stress response styles, like psychological resilience and rumination, might alter these relationships. Using validated tools, perceived stress, anxiety, stress response styles, and sleep behaviors of undergraduate and graduate students from seven countries during the height of the COVID-19 pandemic were characterized in order to examine the relationships between these factors using mediation and moderation analyses. Students enrolled in universities in China, Ireland, Malaysia, Taiwan, South Korea, the Netherlands, and the United States were recruited in May 2020. A total of 2254 students completed this cross-sectional study. Perceived stress and anxiety were negatively associated with sleep quality through the mediation of rumination. Increased psychological resilience weakened the relationships between perceived stress and anxiety on sleep quality. The majority of students reported that COVID-19 negatively influenced their mental health and sleep quality but not sleep duration. Based on these results, university students would likely benefit from sleep education and mental health promotion programs that include trainings to increase psychological resilience and reduce rumination, particularly during times of increased stress. View Full-Text

Keywords: COVID-19; sleep; stress; anxiety; rumination; psychological resilience; university students

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MDPI and ACS Style

Du, C.; Zan, M.C.H.; Cho, M.J.; Fenton, J.I.; Hsiao, P.Y.; Hsiao, R.; Keaver, L.; Lai, C.-C.; Lee, H.; Ludy, M.-J.; Shen, W.; Swee, W.C.S.; Thrivikraman, J.; Tseng, K.-W.; Tseng, W.-C.; Tucker, R.M. Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries. Clocks & Sleep 2020, 2, 334-353. https://doi.org/10.3390/clockssleep2030025

AMA Style

Du C, Zan MCH, Cho MJ, Fenton JI, Hsiao PY, Hsiao R, Keaver L, Lai C-C, Lee H, Ludy M-J, Shen W, Swee WCS, Thrivikraman J, Tseng K-W, Tseng W-C, Tucker RM. Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries. Clocks & Sleep. 2020; 2(3):334-353. https://doi.org/10.3390/clockssleep2030025

Chicago/Turabian Style

Du, Chen, Megan C.H. Zan, Min J. Cho, Jenifer I. Fenton, Pao Y. Hsiao, Richard Hsiao, Laura Keaver, Chang-Chi Lai, HeeSoon Lee, Mary-Jon Ludy, Wan Shen, Winnie C.S. Swee, Jyothi Thrivikraman, Kuo-Wei Tseng, Wei-Chin Tseng, and Robin M. Tucker. 2020. "Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries" Clocks & Sleep 2, no. 3: 334-353. https://doi.org/10.3390/clockssleep2030025

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Increased Resilience Weakens the Relationship between Perceived Stress and Anxiety on Sleep Quality: A Moderated Mediation Analysis of Higher Education Students from 7 Countries

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