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

## TL;DR

This study shows that sleep quality strongly influences how stress affects school performance and pain in teens, with some differences between boys and girls.

## Contribution

The study identifies sleep quality as a key modifiable pathway linking stress to psychosocial outcomes in adolescents, with gender-specific effects.

## Key findings

- Sleep quality mediates 78.4% of the effect of stress on school functioning in adolescents.
- Sleep quality mediates 54.2% of the effect of stress on pain in adolescents.
- The indirect effect of sleep quality on pain is significant only for girls.

## Abstract

Sleep is foundational for adolescent psychosocial outcomes though often compromised by normative developmental changes and external factors. This cross-sectional study examined sleep quality as a mechanism linking stress and psychosocial outcomes and explored gender differences. Adolescents (N = 246; Mage=15.8; 46.3% female) completed self-report measures assessing sleep quality and psychosocial outcomes. Structural equation modeling results indicated sleep quality accounted for 78.4% of the total effect of stress on school functioning (b=−0.45, p < 0.001) and 54.2% of the total effect of stress on pain (b = 0.14, p = 0.002). A larger indirect effect of sleep quality on school functioning (b=−0.26, p = 0.016) emerged for boys than girls, and the effect of sleep quality on pain was significant only for girls (b = 0.18, p < 0.001, 69.6% of total effect). Sleep quality explained a large proportion of the effect of stress on school functioning and pain. Sleep quality represents a modifiable transdiagnostic pathway that may buffer the effects of stress in adolescence.