(PS9-D81) Does Parental Accommodation Account for Associations Between Youth Anxiety and Sleep Hygiene?

Children and adolescents (youth) with anxiety disorders commonly report poor sleep health, including poor sleep hygiene practices. Nonetheless, little is known about variables that may explain this association. Sleep hygiene, characterized by behaviors and activities that influence the initiation and maintenance of sleep, can be influenced by rules and routines imposed by parents. Additionally, accommodation from parents is commonly reported by anxious youth. These behaviors help youth avoid or alleviate anxiety and may include co-sleeping, letting youth use electronics to avoid going to bed or to distract from worries, or leaving lights on. The current study tests a conceptual model where the associations between anxiety symptoms and poor sleep hygiene is accounted for by parental accommodation. Participants were 225 treatment-seeking youth (60.3% female, 84% Hispanic/Latino), ages 6-18 (M= 11.28, SD=2.98). Youth were asked to report on their symptoms of anxiety using the Screen for Child Anxiety and Related Emotional Disorders (SCARED), sleep hygiene practices using the Children’s Report of Sleep Patterns (CRSP), and parental accommodation using the Family Accommodation Scale for Anxiety (FASA). To examine our indirect effects model, we used PROCESS macro for SPSS version 27. Age and sex were included as covariates. The path between anxiety symptoms and family accommodation (path a) was significant and positive (b=1.88, p< .001). The path between family accommodation and sleep hygiene (path b) was also significant and positive (b=.2, p< .02). The direct effect of anxiety symptoms and sleep hygiene (path c’) was not significant. Finally, the indirect association between anxiety symptoms and sleep hygiene via family accommodation was statistically significant (b=.04, 95% CI [.006, .076]), such that higher levels of anxiety symptoms were associated with poor sleep hygiene through parental accommodation. These findings demonstrate that family accommodation partially accounts for the relationship between anxiety symptoms and sleep hygiene practices. Parents who accommodate to youth’s anxiety, which may include “giving in” to youth’s demands by co-sleeping with them, leaving the lights on, or letting them use electronics at bedtime, may be inadvertently contributing to youth’s poor sleep hygiene and maintaining poor sleep health. This, in turn, may maintain youth anxiety when parents are unable to meet youth’s demands or when youth are unable to self-soothe. Findings suggest that parental accommodation may be a promising treatment target for anxious youth with poor sleep hygiene.