Associations between actigraphic and self-reported sleep and mental health in adolescents and young adults with cystic fibrosis

Objective To compare sleep and mental health outcomes in adolescents and young adults (AYA) with cystic fibrosis (CF) and healthy controls and to explore associations between sleep and mental health in CF. Methods In this cross-sectional study AYA with CF and healthy AYA aged 14–25 years completed 7 days/nights of actigraphy, the Pittsburgh Sleep Quality Index, PROMIS-Sleep Disturbance scale, PROMIS-Sleep-Related Impairment scale, State Trait Anxiety Inventory, and Center for Epidemiologic Studies Depression scale. For participants with CF, disease characteristics were collected from the Canadian Cystic Fibrosis Registry. Linear regression models were used to determine differences between groups and to examine associations between sleep and mental health outcomes. Results Eighty-six participants, 45 with CF (median age = 19 years, IQR = 6 years, 51.1% female, 82.2% on elexacaftor/tezacaftor/ivacaftor, ETI) and 41 healthy comparator participants (median age = 16 years, IQR = 4 years, 53.7% female) participated. No significant differences were found between groups in actigraphically measured sleep, self-reported sleep, or anxiety or depression symptoms. In participants with CF, poorer self-reported sleep quality was significantly associated with greater anxiety (p < .001) and depression symptoms (p < .001), but actigraphically measured sleep was not. Conclusions AYA with CF had comparable sleep, anxiety, and depression outcomes as their healthy peers. Only self-reported sleep had a significant relationship with mental health symptoms. These findings stress the importance of concurrent assessment of sleep and mental health in the clinical setting and may inform future longitudinal research. Better understanding relationships between sleep and mental health in AYA with CF could have a significant impact on well-being and quality of life.