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ORIGINAL RESEARCH article

Front. Psychol.
Sec. Health Psychology
Volume 16 - 2025 | doi: 10.3389/fpsyg.2025.1512416
This article is part of the Research Topic The Interplay of Stress, Health, and Well-being: Unraveling the Psychological and Physiological Processes - Volume II View all 28 articles

The Indirect Effect of Sleep Quality on Stress-Related Psychosocial Outcomes in Adolescents: An Investigation Across Genders

Provisionally accepted
Camila Koike Camila Koike 1Bridget Nestor Bridget Nestor 1Andreas Michael Baumer Andreas Michael Baumer 2Joe Kossowsky Joe Kossowsky 1*
  • 1 Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, United States
  • 2 Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zürich, Zürich, Switzerland

The final, formatted version of the article will be published soon.

    Background: Sleep is foundational for adolescent psychosocial outcomes though often compromised by normative developmental changes and external factors. Methods: This cross-sectional study examined sleep quality as a mechanism linking stress and psychosocial outcomes and explored gender differences. Results: Adolescents (N=236; Mean=15.66; SD=1.07, 46.19% female) completed self-report measures assessing sleep quality and psychosocial outcomes. Structural equation modeling was used to test the potential mediating effect of sleep quality on associations between stress and psychosocial outcomes. Results indicated sleep quality accounted for 82.0% of the total effect of stress on school functioning (ꞵ=-0.45, p<0.001) and 61.9% of the total effect of stress on pain (ꞵ=0.14, p<0.001). A larger indirect effect of sleep quality on school functioning (ꞵdiff=-0.27, p=0.006) emerged for boys than girls, and the effect of sleep quality on pain was significant only for girls (ꞵ=0.20, p=0.003, 65.0% of total effect). Conclusion: Sleep quality explained a large proportion of the cross-sectional association between stress and school functioning and pain. Sleep quality represents a modifiable transdiagnostic pathway that may buffer the effects of stress in adolescence.

    Keywords: sleep quality, stress, adolescents, indirect effect, Genders, psychosocial, psychological

    Received: 16 Oct 2024; Accepted: 03 Jan 2025.

    Copyright: © 2025 Koike, Nestor, Baumer and Kossowsky. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Joe Kossowsky, Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, United States

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