Are you Lonesome Tonight? Ecological Momentary Assessment of Evening Loneliness, Worry, and Actigraphic Sleep in Adolescents

Objectives: This study aims to evaluate the association between ecological assessment experience of loneliness and nocturnal sleep in a sample of healthy adolescents and to investigate the potential mediating role of pre-sleep worry in this relationship. Methods: Each evening, participants completed an electronic diary including items assessing loneliness and worry. The time of diary administration was set on an individual basis to capture the actual pre-bed experience. Sleep parameters were assessed using actigraphy. Results: Analyses were conducted on 72 participants (53.9% boys; Mage = 15.65; SD = 1.32) and 535 nights. Multilevel structural equation modeling indicated that within person loneliness fluctuations over the assessment period predicted shorter sleep duration through the mediation of high pre-sleep worry (B = -1.634, p = .027); More specifically, at the within level, loneliness was significantly and positively related to worry (B = .131, p = .001), which in turn was negatively related to sleep duration (B = -12.502, p = .028). One step increase in loneliness-associated pre-sleep worry predicted a decrease of 12 minutes in sleep duration. The mediation path was not influenced by anxiety and gender differences in the adjusted analysis. Results on other sleep parameters were not significant. Conclusions: Findings suggest that adolescents' loneliness experienced at bedtime may influence sleep duration through worry. Sleep-promoting interventions in adolescents may benefit from targeting loneliness and pre-sleep cognitions.