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Summary The coronavirus disease 2019 (COVID‐19) pandemic resulted in significant increases in insomnia, with up to 60% of people reporting increased insomnia. However, it is unclear whether exposure to risk factors for the virus or worries about COVID‐19 are more strongly associated with insomnia. Using a three‐part survey over the course of the first 6 months of the pandemic, we evaluated associations between COVID‐19 exposures, COVID‐19 worries, and insomnia. We hypothesised that COVID‐19‐related worries and exposure to risk of COVID‐19 would predict increases in insomnia. Participants ( N = 3,560) completed a survey at three time‐points indicating their exposures to COVID‐19 risk factors, COVID‐19‐related worries, and insomnia. COVID‐19 worry variables were consistently associated with greater insomnia severity, whereas COVID‐19 exposure variables were not. COVID‐19 worries decreased significantly over time, and there were significant interactions between change in COVID‐19 worries and change in insomnia severity over time. Individuals who experienced increases in COVID‐19 worries also experienced increases in insomnia severity. Changes in worry during the COVID‐19 pandemic were associated with changes in insomnia; worries about COVID‐19 were a more consistent predictor of insomnia than COVID‐19 exposures. Evidence‐based treatments targeting virus‐related worries may improve insomnia during this and future calamities.

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Background: Given that suicide ideation (SI) fluctuates drastically over short periods of time and is heterogenous across individuals, idiographic suicide research is warranted. In this pilot study, we used intensive ecological momentary assessment (EMA) to examine whether anxiety, depression, and PTSD symptoms on a given day predicted next-day SI on a person-to-person basis. Methods: PLWH (N = 10) with past-month SI completed daily randomly assessed ratings of suicidal urges using the Suicide-Visual Analogue Scale (S-VAS) and daily assessed ratings of anxiety, depression, and PTSD symptoms for 28 days. We used N = 1 Dynamic Structural Equation Modeling to test whether depression, anxiety or PTSD symptoms in the prior day predicted next-day S-VAS for each individual. Results: Across all participants, S-VAS on a given day was not predicted by prior-day anxiety, PTSD symptoms or S-VAS. In one participant, higher depression symptoms predicted lower next-day S-VAS. Conclusions: Daily-level data may be insufficient to predict near-term increases in suicide risk based on anxiety, depression, or PTSD symptoms in PLWH. These findings suggest the importance of finer-grained assessments (e.g., assessing suicide risk and its correlates multiple times per day) to better understand changes in suicide risk over time among PLWH.

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