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Ta Z, Gilles AA, Parsinejad N, Egger MJ, Baron KG. Predicting the Persistence of Insomnia Symptoms during the COVID-19 Pandemic. Behav Sleep Med 2024; 22:433-445. [PMID: 38148617 DOI: 10.1080/15402002.2023.2298377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
OBJECTIVE The goal of this study is to evaluate the factors associated with vulnerability and course of insomnia longitudinally in the COVID-19 pandemic and examine differences between: (a) those who never demonstrated clinical insomnia symptoms, (b) those who demonstrated clinically elevated insomnia symptoms at 1 or 2 time points, and (c) those who demonstrated clinically elevated insomnia symptoms at all 3 time points. METHODS Participants (≥18 years old) completed measures of insomnia (ISI), depression (PHQ-8), anxiety (GAD-7), and pre-sleep arousal (PSAS) at 3 time points (baseline, 1 month, and 3 months). Data were analyzed using univariable odds ratios and multivariable multicategory logistic regression to determine demographic, psychological, and behavioral predictors of insomnia persistence. RESULTS A total of 129 participants completed all 3 assessments (70 female, age M = 44 years, SD = 16). We found that 40% (N = 51) never had insomnia symptoms, 33% (N = 42) reported transient insomnia symptoms (1 or 2 time points), and 28% (N = 36) reported persistent insomnia symptoms (all 3 time points). From the multivariable multicategory logistic analyses, pre-sleep arousal, gender, and income were significant predictors of insomnia persistence. CONCLUSIONS Findings indicate elevated insomnia symptoms were persistent in a substantial number of individuals throughout the pandemic. Results suggest additional insomnia and psychological interventions are needed to improve sleep and mental health.
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Affiliation(s)
- Zachary Ta
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
| | - Allyson A Gilles
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
| | - Nasim Parsinejad
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
| | - Marlene J Egger
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
| | - Kelly Glazer Baron
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT
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Yu BYM, Lam CS, Tam KYY, Cheung DST, Chen SC, Yeung WF. The Role of Insomnia and Exercise in COVID-19 Worries for Psychological Distress in Hong Kong Chinese: A Moderated Mediation Model. Behav Sleep Med 2024; 22:378-392. [PMID: 37842738 DOI: 10.1080/15402002.2023.2270095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
OBJECTIVE To examine the role of insomnia as a mediator between worrying and mental health and whether the association between worrying and insomnia is moderated by the levels of exercise frequency. METHODS A cross-sectional online survey was conducted during the fourth wave of the COVID-19 outbreak in Hong Kong (n = 988). Participants' insomnia, psychological distress, and exercise frequency were evaluated. A mediation analysis was performed to examine the direct effect of COVID-19 worries and their indirect effect through insomnia on psychological distress. RESULTS A significant indirect effect of COVID-19 worries through insomnia was found on psychological distress (beta = 0.18, SE = 0.02, 95% CI = 0.14-0.22, p < .001). The significant index of moderated mediation supported the moderating effect of exercise frequency on the indirect effect of COVID-19 worries on psychological distress (IMM = 0.06, SE = 0.02, 95% CI = 0.02-0.10, p = .006). The conditional indirect effects of insomnia on psychological distress were significant in individuals with mean and higher exercise frequency but not in those with lower exercise frequency. CONCLUSION COVID-19 worries increased psychological distress through the worsening of sleep, and such an array of COVID-19 worries on insomnia was moderated by exercise frequency. Engaging more frequent exercise could reduce insomnia in people with less COVID-19 worries.
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Affiliation(s)
- Branda Yee-Man Yu
- Department of Psychology, the University of Hong Kong, Hong Kong, SAR, China
| | - Chun Sing Lam
- School of Pharmacy, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Katy Yuen Yan Tam
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Shu Cheng Chen
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, China
| | - Wing Fai Yeung
- School of Nursing, the Hong Kong Polytechnic University, Hong Kong, SAR, China
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3
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Hoang HTX, Yeung WF, Truong QTM, Le CT, Bui ATM, Bui QV, Le QTL, Quach LH. Sleep quality among non-hospitalized COVID-19 survivors: a national cross-sectional study. Front Public Health 2024; 11:1281012. [PMID: 38375096 PMCID: PMC10875106 DOI: 10.3389/fpubh.2023.1281012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/28/2023] [Indexed: 02/21/2024] Open
Abstract
Objectives Insomnia is a common symptom after COVID-19 infection; however, its current evidence was among hospitalized COVID-19 patients. This study aimed to assess the prevalence of insomnia and identify its association with depression and anxiety among non-hospitalized COVID-19 recovered population. Methods We conducted a cross-sectional online survey of 1,056 COVID-19 survivors within 6 months of initial COVID-19 infection and retrieved did not require hospitalization. The Insomnia Severity Index, and Depression Anxiety and Stress Scale-14 were used. Multivariate logistic regression was used to examine the associations between depressive and anxiety score, and participants' insomnia level. Results The prevalence of insomnia was 76.1%, and among those, 22.8% of participants scored for severe insomnia. One third of participants reported worse sleep quality, shorter sleep duration, and harder to fall asleep, half reported more awaken nights after COVID-19 infection. Participants with depressive (OR 3.45; 95%CI 1.87-6.34) or anxiety (OR 3.93; 95%CI 2.52-6.13) had significantly higher odds of developing insomnia. Other risk factors of insomnia included pre-existing chronic conditions and higher education level, while COVID-19 symptoms and duration were not significantly associated. Conclusion Our study highlights the substantial burden of insomnia among non-hospitalized COVID-19 survivors and the significant association of depression and anxiety on the development of this long-term effect of COVID-19. These findings underscore the need for comprehensive interventions that address both sychological and sleeping health in this population.
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Affiliation(s)
| | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Cuc Thi Le
- Department of Nursing and Midwifery, Hanoi Medical University, Hanoi, Vietnam
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Anh Thi My Bui
- School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | | | - Linh Ha Quach
- Center for Ageing Research & Education, Duke-NUS Medical School, Singapore, Singapore
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Cheung DST, Yu BYM, Lam SC, Leung DYP, Chung KF, Ho FYY, Chen SC, Yeung WF. A longitudinal study on the change in sleep across three waves of the COVID-19 outbreaks in Hong Kong. Sleep Biol Rhythms 2024; 22:93-102. [PMID: 38476851 PMCID: PMC10899949 DOI: 10.1007/s41105-023-00486-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/19/2023] [Indexed: 03/14/2024]
Abstract
In the year 2020, Hong Kong experienced four COVID-19 epidemic waves. The present study aimed to examine the transition of sleep disturbances and explore its associated factors across the later three epidemic waves. Among the 1138 respondents who participated in an online survey at the second wave (T1, April 2020), 338 and 378 participants also completed a follow-up at the third (T2, August 2020) and fourth waves (T3, December 2020), respectively. Participants completed the Insomnia Severity Index and an investigator-designed questionnaire regarding potential factors associated with sleep change such as perceived risk of being infected, economic stress, and confidence in the government and health care professional. Sample of this study were mainly female (67.7%), married (50.3%), young adults (54.2%) with tertiary education (81.6%). Maintaining normal sleep was the most prevalent trajectory of sleep of all three waves (50.5%), followed by persistent insomnia (17.2%) and remitted insomnia (9.0%). Besides female, older-age and lower education level, the results showed that increment in worry about family being infected (adjusted risk ratio, RR = 1.28), perceived interference of daily lives (adjusted RR = 1.19), and economic distress (adjusted RR = 1.24) were significantly associated with the development of clinical insomnia during the three epidemic waves. These factors were also associated with worsening of other sleep parameters. Insomnia being persistent across the three waves of COVID-19 outbreaks was common. Increasing economic distress, daily interference, and worry about family members being infected were associated with an increasing risk of clinical insomnia across the three COVID-19 outbreaks. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00486-w.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Ka-Fai Chung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechic University, Hong Kong, Hong Kong SAR
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Musa S, Al-Dahshan A, Singh R. Prevalence of Obesity and Lifestyle Risk Factors Following Two Years' COVID-19 Related Service Closure at Wellness Center, Primary Health Care. Diabetes Metab Syndr Obes 2023; 16:3851-3868. [PMID: 38054038 PMCID: PMC10694276 DOI: 10.2147/dmso.s433978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/10/2023] [Indexed: 12/07/2023] Open
Abstract
Background COVID-19 lockdown has affected health behaviors and daily life in unprecedented ways. This study aimed to assess (i) the prevalence of lifestyle behaviors including physical activity, sedentary behavior, sleep, and stress levels during the COVID confinement, and (ii) evaluate anthropometric measures, body composition, cardiopulmonary and muscular endurance among regular Wellness Center attendees, following two years' service closure. Methods A cross-sectional study was undertaken between 1st June 2022 and 30th January 2023. A structured validated questionnaire was utilized to retrospectively collect data related to the closure period, and quantitative objective measurements were obtained at the time of data collection. Results A total of 100 adults with a mean age of 49.6 ± 10.5 years, mostly female (80%) and Qatari (76%) participated in the study. The results revealed high rates of low physical activity (47%), sedentary behavior (62%), poor sleep (58%), and stress levels (61% moderate and 5% high). Results also confirmed high prevalence of obesity (57%) marked by BMI and body circumferences, fat mass (34 ± 10.5 kg)/fat percentage (42.7 ± 7.2%) and muscle mass (20.6 ± 5.4 kg)/muscle percentage (25.4 ± 3.9%) above and below normal levels, respectively. The average cardiopulmonary (mean VO2 MAX was 15.5 ± 11 mL O2kg-1min-1) and muscular endurance (pushups per min 19 ± 8.9, L-sit 46 ± 35 secs, plank 42.7 ± 27.8 secs) were distinctly below normal levels for age and sex. Conclusion The findings indicate that physically active adults have experienced adverse lifestyle behaviors during the COVID-19 lockdown. Obesity, unfavorable body composition, low cardiopulmonary and muscular endurance were evident. More emphasis should be put on the development of targeted intervention strategies to promote positive lifestyle behaviors during any potential future crises.
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Affiliation(s)
- Sarah Musa
- Department of Preventative Health, Primary Health Care Corporation, Doha, Qatar
| | - Ayman Al-Dahshan
- Department of Medical Education, Hamad Medical Corporation, Doha, Qatar
| | - Rajvir Singh
- Department of Adult Cardiology, Heart Hospital Hamad Medical Corporation, Doha, Qatar
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Kumar M, Ali K, Sharma N, Sharma A, Jain M, Vats S, Kapoor G, Chahal A. Evaluation of Mental Health and Quality of Life among Indian Professionals Embarked as COVID-19 Survivors. J Lifestyle Med 2023; 13:66-72. [PMID: 37250276 PMCID: PMC10210969 DOI: 10.15280/jlm.2023.13.1.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/11/2023] [Accepted: 02/17/2023] [Indexed: 05/31/2023] Open
Abstract
Background Government guidelines for lockdown and quarantine measures impacted the daily lives and health of individuals amid the coronavirus disease 2019 (COVID-19) pandemic. The pandemic caused significant changes in the daily routine and lifestyles of individuals worldwide with the simultaneous emergence of mental health disorders. Stress caused by COVID-19 pandemic outbreaks and consequent social isolation significantly influenced the mental health and quality of life of professionals among Indian population. This study aimed to evaluate the mental health and quality of life among Indian professionals embarked as COVID-19 survivors. Methods A 20-item self-administered questionnaire was developed and circulated among the participants with the following domains: helplessness, apprehension, mood swing, physical activity, restlessness, insomnia, irritation, mental stress, and emotional instability to assess their mental health and quality of life. Results Of the total 322 participants, 73.6% of individuals experienced helplessness, 56.2% felt the need for counseling, 65.5% reported feeling irritated even over minor issues, 62.1% experienced negative thoughts during isolation, 76.5% experienced difficulty in falling asleep, and 71.9% felt restless during their course of illness. Conclusion The study concludes that mental health and quality of life among COVID-19 survivors was affected by sleep, physical activities, emotional instability, and job profile, as well as support from others, mood swings, and the need for counseling.
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Affiliation(s)
- Mohit Kumar
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Kamran Ali
- Department of Physiotherapy, School of Medical and Allied Sciences, GD Goenka University, Sohna, Haryana, India
| | - Nidhi Sharma
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Abhishek Sharma
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Mansi Jain
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Sakshi Vats
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
| | - Gaurav Kapoor
- Department of Physiotherapy, NIMS College of Physiotherapy and Occupational Therapy, NIMS University, Jaipur, Rajasthan, India
| | - Aksh Chahal
- Maharishi Markandeshwar Institute of Physiotherapy and Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India
- Department of Physiotherapy, School of Medical and Allied Health Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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Chen SC, Cheung TW, Yu BYM, Chan MY, Yeung WF, Li L. Improving Sleep with Far-Infrared-Emitting Pajamas: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3870. [PMID: 36900881 PMCID: PMC10002002 DOI: 10.3390/ijerph20053870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 02/17/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
Far infrared (FIR)-based clothing may alleviate sleep disturbance. This study aimed to explore the effects of FIR-emitting pajamas on sleep quality. This was a pilot randomized, sham-controlled trial. Forty subjects with poor sleep quality were randomized to FIR-emitting-pajamas and sham-pajamas groups in a 1:1 ratio. The primary outcome measure was the Pittsburgh Sleep Quality Index (PSQI). Other measures included the Insomnia Severity Index, and 7 day sleep diary, the Multidimensional Fatigue Inventory (MFI), the Hospital Anxiety and Depression Scale, the Epworth Sleepiness Scale, and the Satisfaction with Life Scale. Outcomes were measured at baseline and weeks 2, 4, and 6. Both groups showed within-group improvements in the PSQI score, but there was no significant difference between the two groups. However, FIR-emitting pajamas appeared to perform better than sham pajamas in reducing the MFI-physical score, with large effect sizes at three time points (dppc2 = 0.958, 0.841, 0.896); however, the differences were statistically insignificant. The intervention compliance was satisfactory. The effects of FIR-emitting pajamas on sleep quality were not superior to those in the control group. However, these pajamas may improve physical fatigue in adults with poor sleep quality, which warrants further exploration.
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Affiliation(s)
- Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Tin-Wai Cheung
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR 999077, China
| | - Mei-Yan Chan
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Li Li
- School of Fashion and Textiles, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
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Cheung T, Lam JYT, Fong KH, Cheng CPW, Ho A, Sittlington J, Xiang YT, Li TMH. Evaluating the Efficacy of Electrical Vestibular Stimulation (VeNS) on Insomnia Adults: Study Protocol of a Double-Blinded, Randomized, Sham-Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3577. [PMID: 36834268 PMCID: PMC9964781 DOI: 10.3390/ijerph20043577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/27/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Insomnia is a common health problem in the general population. There are different ways to improve sleeping habits and quality of sleep; however, there is no clinical trial using transdermal neurostimulation to treat individuals with symptoms of insomnia in Asia. This gives us the impetus to execute the first study in Asia which aims to evaluate the efficacy of Electrical Vestibular Stimulation (VeNS) on individuals with insomnia in Hong Kong. This study proposes a two-armed, double-blinded, randomized, sham-controlled trial including the active VeNS and sham VeNS group. Both groups will be measured at baseline (T1), immediately after the intervention (T2), and at the 1-month (T3) and 3-month follow-up (T4). A total of 60 community-dwelling adults aged 18 to 60 years, with insomnia symptoms will be recruited in this study. All subjects will be computer randomized into either the active VeNS group or the sham VeNS group on a 1:1 ratio. All subjects in each group will receive twenty 30-min VeNS sessions during weekdays, which will be completed in a 4-week period. Baseline measurements and post-VeNS evaluation of the psychological outcomes (i.e., insomnia severity, sleep quality and quality of life) will also be conducted on all participants. The 1-month and 3-month follow-up period will be used to assess the short-and long-term sustainability of the VeNS intervention. For statistical analysis, a mixed model will be used to analyze the repeated measures data. Missing data will be managed by multiple imputations. The level of significance will be set to p < 0.05. Significance of the study: The results of this study will be used to determine whether this VeNS device can be considered as a self-help technological device to reduce the severity of insomnia in the community setting. We registered this clinical trial with the Clinical trial government, identifier: NCT04452981.
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Affiliation(s)
- Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- The Mental Health Research Centre, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Joyce Yuen Ting Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Kwan Hin Fong
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Alex Ho
- Integrated Services for Persons with Disabilities, Christian Family Service Centre, Hong Kong SAR, China
| | - Julie Sittlington
- School of Biomedical Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Yu-Tao Xiang
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macau SAR, China
| | - Tim Man Ho Li
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kosendiak AA, Adamczak B, Kontek S, Kuźnik Z, Roman M, Gostkowski M, Niedziółka A. Level of Physical Activity, Sleep Quality and Use of Personal Protective Equipment of Students at Wroclaw Medical University during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2406. [PMID: 36767774 PMCID: PMC9915195 DOI: 10.3390/ijerph20032406] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
The study was conducted in October 2020 and March 2021 among Wroclaw Medical University students of different years and faculties. The objective of the study was to establish the relationship between some determinants, such as gender and the levels of physical activity, and the quality of sleep of medical students during the pandemic. Ultimately, 696 responses from October and 652 from March were included. To determine the level of physical activity, the International Physical Activity Questionnaire (IPAQ) was used, and for sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used. The findings pointed to a higher Total MET m/w (metabolic equivalent of task in minutes a week) in men compared to women in both study periods (2020: 1845.8 to 1542.5, p = 0.009; 2021: 2040.7 to 1826.6, p = 0.025). This was mainly due to a higher Vigorous Exercises MET m/w in men (2020: 837.3 to 635.8, p = 0.008; 2021: 773.3 to 490.3, p = 0.0006). Moreover, women had a lower quality of sleep resulting from problems in Habitual Sleep Efficiency, Sleep Disturbances, and Daytime Dysfunctions. An adequate level of physical activity and a good night's rest are the fundaments of health; therefore, it is necessary to determine the causes of their deficiencies in order that we can counteract them.
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Affiliation(s)
| | - Bartosz Adamczak
- Student Scientific Association, Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Sylwiusz Kontek
- Student Scientific Association, Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Zofia Kuźnik
- Student Scientific Association, Department of Physical Education and Sport, Wroclaw Medical University, 51-601 Wroclaw, Poland
| | - Michał Roman
- Warsaw University of Life Sciences, Institute of Economics and Finance, Nowoursynowska 166, 02-787 Warsaw, Poland
| | - Michał Gostkowski
- Department of Econometrics and Statistics, Warsaw University of Life Sciences, Institute of Economics and Finance, Nowoursynowska 166, 02-787 Warsaw, Poland
| | - Arkadiusz Niedziółka
- Faculty of Agriculture and Economics, University of Agriculture in Krakow, 31-120 Krakow, Poland
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Abuhammad S, Alzoubi KH, Khabour OF, Hamaideh S, Khasawneh B. Sleep quality and sleep patterns among recovered individuals during post-COVID-19 among Jordanian: A cross-sectional national study. Medicine (Baltimore) 2023; 102:e32737. [PMID: 36701736 PMCID: PMC9857545 DOI: 10.1097/md.0000000000032737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 01/04/2023] [Indexed: 01/27/2023] Open
Abstract
This study aims to investigate sleep patterns and quality in patients who had SARS-CoV-2 (COVID-19) infection and to determine the sleep quality and pattern among patients. A cross-sectional design was used to assess sleeping patterns during the post-COVID-19 era for recovered individuals from April 1st, 2022, to June 1st, 2022. The participants had to meet the following requirements: both genders, ages 18 to 70, and previously infected with COVID-19. The prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was 834 (40.6%), and the prevalence of disturbance in sleep quality was 1308 (63.6%). Lower economic status and younger ages in twenties and thirties experienced more disturbances in sleep patterns than other older ages. Many predictors were determined the quality of sleep. These predictors were age (B = .105, P = .00), income (B = .05, P = .035) and educational level (B = .20, P = .006). To sum up, our study found that the prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was moderate, and the prevalence of disturbance in sleep quality was high. The predictors of quality of sleep were age, income, and educational level. Practitioners should be trained to evaluate and manage sleep disturbances, as this comprehensive approach has the potential to reduce mental distress and prevent the consequences of sleep disturbances.
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Affiliation(s)
- Sawsan Abuhammad
- Department of Maternal and Child Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Omar F Khabour
- Dept. of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Shaher Hamaideh
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
| | - Basheer Khasawneh
- Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Melegari MG, Ferri R, Giallonardo M, Donfrancesco R, Bruni O. Changes in sleep duration and disturbances during Covid-19 lockdown and internalizing-externalizing behaviors in children with attention deficit hyperactivity disorders. Sleep Med 2023; 101:183-189. [PMID: 36402003 PMCID: PMC9637012 DOI: 10.1016/j.sleep.2022.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 10/15/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To examine how changes in sleep patterns and sleep problems occurring between the pre-pandemic and the Covid-19 lockdown period influenced mood-behavioral functioning of children with Attention Deficit Hyperactivity Disorder (ADHD). METHODS Parents of 992 children with ADHD (85.4% boys, mean age: 11.52 years, SD = 3.17), recruited from the Italian ADHD family association, completed a modified version of the Sleep Disturbance Scale for Children and filled out 11 emotional behavioral items selected from the Child Behavior Checklist (CBCL) 6-18 questionnaire. Subgroups identified based on sleep duration changes ("maintained", "increased", "reduced") and of sleep problems during lockdown ("onset", "remission", "maintained", "no sleep problem") were analyzed to evaluate the association with internalizing and externalizing scores. RESULTS Sleep duration showed no or low influence on internalizing and externalizing behaviors after control for age, sex, and socioeconomic status. Patients with ADHD with "no sleep problem" showed significant lower scores in internalizing and externalizing behaviors than those who "maintained" or had "onset" of different sleep problems. The effect sizes were higher for internalizing than externalizing behaviors. Lower internalizing scores were found in those who remitted difficulty in falling asleep, daytime sleepiness, nightmares, vs. the "maintained" or "onset" groups and those who remitted hypnic jerks vs. the "onset" group. Children with ADHD who "maintained" sleep terrors reported higher internalizing and mainly externalizing scores than the other groups. CONCLUSION Sleep problems negatively influence daytime functioning of patients with ADHD. but mood and behavioral domains show different susceptibility to the changes of sleep problems, and different vulnerability to specific sleep problems.
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Affiliation(s)
- Maria Grazia Melegari
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy; Consortium Humanitas, Lumsa University, Rome, Italy.
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Troina, Italy.
| | - Martina Giallonardo
- Independent Researcher (previously at Department of Developmental and Social Psychology) Sapienza University, Rome, Italy.
| | | | - Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University, Rome, Italy.
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12
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Scarpelli S, Zagaria A, Ratti PL, Albano A, Fazio V, Musetti A, Varallo G, Castelnuovo G, Plazzi G, Franceschini C. Subjective sleep alterations in healthy subjects worldwide during COVID-19 pandemic: A systematic review, meta-analysis and meta-regression. Sleep Med 2022; 100:89-102. [PMID: 36029756 PMCID: PMC9364714 DOI: 10.1016/j.sleep.2022.07.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/04/2022] [Accepted: 07/18/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVE We conducted a systematic review and meta-analysis to provide an update on sleep quality in different world areas and better characterize subjective sleep alterations during the COVID-19 pandemic. Considering gender distribution and specific pandemic-related parameters, we also intend to identify significant predictors of sleep problems. METHODS Six electronic databases were searched from December 2019 to November 2021 for studies investigating sleep during COVID-19 employing the Pittsburgh Sleep Quality Index, the Medical Outcomes Study Sleep, the Insomnia Severity Index or the Epworth Sleepiness Scale. Random-effects models were implemented to estimate the pooled raw means of subjective sleep alterations. Also, we considered the role of several pandemic-related parameters (i.e., days from the first COVID-19 case, government stringency index, new cases for a million people, new deaths for a million people) by means of meta-regression analyses. RESULTS A total of 139 studies were selected. The pooled mean of the global Pittsburgh Sleep Quality Index score (PSQIgen) was 6.73 (95% CI, 6.61-6.85). The insomnia severity index score was reported from 50 studies with a pooled mean of 8.44 (95% CI, 7.53-9.26). Subgroup analyses confirmed that most subcategories had poor sleep quality and subclinical insomnia. Meta-regressions showed that PSQIgen was predicted by days from the first COVID-19 case and government restrictions with a negative slope and by female gender with a positive slope. The government stringency index was positively correlated with the direct subjective evaluation of sleep quality. CONCLUSIONS We found an overall impaired sleep and widespread subthreshold insomnia during the COVID-19 pandemic. The female percentage seems to be the best predictor of impaired sleep quality, consistently to the available literature. Noteworthy, sleep alterations were inversely associated with governmental restrictions and decreased during the pandemic. Our results give a contribution to critically orienting further studies on sleep since COVID-19 pandemic.
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Affiliation(s)
- Serena Scarpelli
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Andrea Zagaria
- Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Italy
| | - Pietro-Luca Ratti
- Neurocenter of Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland and Al Centro del Sonno, Venice, Italy
| | - Antonio Albano
- Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma, Italy
| | - Vincenzo Fazio
- Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Giorgia Varallo
- Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma, Italy
| | - Gianluca Castelnuovo
- Department of Psychology, Catholic University of Milan, Milan, Italy; Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Christian Franceschini
- Department of Medicine and Surgery, Faculty of Medicine and Surgery, University of Parma, Italy.
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13
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AlRasheed MM, Fekih-Romdhane F, Jahrami H, Pires GN, Saif Z, Alenezi AF, Humood A, Chen W, Dai H, Bragazzi N, Pandi-Perumal SR, BaHammam AS, Vitiello MV. The prevalence and severity of insomnia symptoms during COVID-19: A global systematic review and individual participant data meta-analysis. Sleep Med 2022; 100:7-23. [PMID: 36030616 PMCID: PMC9359588 DOI: 10.1016/j.sleep.2022.06.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/20/2022] [Accepted: 06/24/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION There have been no previous meta-analytic studies that have looked at the prevalence of insomnia symptoms in different COVID-19 groups using a single assessment instrument to evaluate insomnia symptoms while maintaining data homogeneity. The current review's associated goal is to undertake an individual participant data (IPD) analysis to further investigate past meta-analyses, a method that has been shown to be more robust than standard meta-analyses. MEETHODS Only studies that used the Insomnia Severity Index (ISI) to assess insomnia are used in this analysis. The IPDMA was performed and registered in PROSPERO in compliance with the PRISMA IPD Statement (CRD42021275817). From November 2019 to August 2021, researchers explored seventeen databases and six preprint services for relevant studies. RESULTS The pooled estimate of insomnia symptoms (subthreshold and clinically significant) was 52.57%. An estimated 16.66% of the population suffered from clinically significant insomnia, of which 13.75% suffered from moderate insomnia, and 2.50% suffered from severe insomnia. The different populations' grouping had no statistically significant differences in the prevalence of insomnia symptoms. Insomnia symptoms did not appear to be associated with age or sex. CONCLUSION Our findings imply that the COVID-19 pandemic is linked to a significant rise in subthreshold insomnia symptoms, but not to moderate or severe insomnia. Educating people from all walks of life about the importance of sleep and the risk of acquiring insomnia symptoms during this or future pandemics should be a top concern.
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Affiliation(s)
- Maha M AlRasheed
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; Princess Noura bint Abdul Rahman University, Riyadh, Saudi Arabia.
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Psychiatry Department "Ibn Omrane", Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain; Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | | | | | - Ahmad F Alenezi
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ali Humood
- Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Wen Chen
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, 361000, China
| | - Haijiang Dai
- Department of Cardiology, The Third Xiangya Hospital, Central South University, Changsha, 410013, China
| | - Nicola Bragazzi
- Department of Mathematics and Statistics, Laboratory for Industrial and Applied Mathematics (LIAM), York University, Toronto, Canada
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada; Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Riyadh, 11324, Saudi Arabia; The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Michael V Vitiello
- Psychiatry & Behavioral Sciences, Gerontology & Geriatric Medicine, and Biobehavioral Nursing, University of Washington, Seattle, WA, 98 l 95-6560, USA
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Alharbi HF, Barakat H. Effect of COVID-19 Pandemic on Dietary Habits and Sleep Quality Applying the Pittsburgh Sleep Quality Index in Adult Saudi Population: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191911925. [PMID: 36231232 PMCID: PMC9565782 DOI: 10.3390/ijerph191911925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/15/2022] [Accepted: 09/18/2022] [Indexed: 06/12/2023]
Abstract
The study aimed to evaluate the possible correlations between sleep quality and dietary habits in a population of Saudi during the COVID-19 pandemic. Exactly 444 adults completed a web-based cross-sectional study using an electronic questionnaire. Results indicate a significant difference between body mass index (BMI) and bad sleep quality. Smoking is linked to bad sleep quality. Both genders affected by coronavirus had a substantially bad quality compared to non-affected. An association between the degree of craving for sugar and bad sleep quality was found. In addition, there was a statistical difference between males and females who crave sugar very often in bad sleep quality. The result of sleep latency in males was 35.83%, who suffered from a severe sleep disorder, while 41.18% were female. The sleep duration was 65.00%, and 53.90% of males and females slept between 6 and 7 h per day. Sleep efficiency, measured according to the Pittsburgh questionnaire protocol, was measured in percentages, where a value of less than 65.00% is considered the lowest sleep efficiency. Females had a lower sleep efficiency of 25.49% compared to males (13.33%). These differences were statistically significant (p = 0.03). In conclusion, quality and sleep duration were impaired during the COVID-19 pandemic, and the observed changes were associated with diet.
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Affiliation(s)
- Hend F. Alharbi
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 51452, Saudi Arabia
| | - Hassan Barakat
- Department of Food Science and Human Nutrition, College of Agriculture and Veterinary Medicine, Qassim University, Buraydah 51452, Saudi Arabia
- Food Technology Department, Faculty of Agriculture, Benha University, Moshtohor 13736, Egypt
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15
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Subrata SA. Holistic care of patients with diabetic foot ulcers during the COVID-19 era: integration of Henderson's Need Theory. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S38-S49. [PMID: 35980928 DOI: 10.12968/bjon.2022.31.15.s38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The COVID-19 pandemic has inhibited the practice of diabetic foot ulcer care, particularly in the community. Comprehensive theory-based nursing care is needed to prevent further complications. Unfortunately, a study combining theory with nursing care in diabetic foot ulcer care has not been explored. When caring for patients with diabetic foot ulcers, who are also at increased risk of severe complications from COVID-19, it is important to take a holistic view of the patient and consider all of their needs and the factors affecting them. Henderson's Need Theory and the 14 basic needs contained within it was chosen to be integrated in the care of patients with diabetic foot ulcers during the pandemic, with the hope that the findings will help nurses to optimise care in both hospital-based and community practice.
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Affiliation(s)
- Sumarno Adi Subrata
- Nursing Lecturer, Center of Research and Community Empowerment (LPPM)/Wound Study Center (WOSCE), Universitas Muhammadiyah Magelang, Indonesia
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16
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Kantor J, Kantor BN, Fortgang RG, Pace-Schott EF. Sleep Quality Impairment Is Associated With Pandemic Attitudes During the Coronavirus Disease 2019 (COVID-19) Circuit Breaker Lockdown in England: A Cross-Sectional Study. Front Public Health 2022; 10:819231. [PMID: 35910875 PMCID: PMC9334795 DOI: 10.3389/fpubh.2022.819231] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesThe COVID-19 pandemic has been associated with sleep quality impairment and psychological distress, and the general public has responded to the pandemic and quarantine requirements in a variety of ways. We aimed to investigate whether sleep quality is low during a short-term (circuit break) quarantine restriction, and whether sleep quality is associated with respondents' overall attitudes to the pandemic using a validated scale.Design and SettingOnline cross-sectional study in England in November 2020.ParticipantsThe study included 502 respondents over the age of 18.MeasurementsSleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and pandemic attitudes were assessed using the Oxford Pandemic Attitudes Scale–COVID-19 (OPAS-C), a validated 20-item, 7-domain scale that assesses pandemic-related stress, fear, loneliness, sense of community, sense of exaggerated concern, non-pharmaceutical interventions, and vaccine hesitancy. Unadjusted and multivariable logistic regression odds ratios of association were assessed between the dependent variable of poor sleep quality (PSQI>5) and risk factors, including OPAS-C score, age, sex, educational status, and income.ResultsThe mean (SD) PSQI score was 7.62 (3.49). Overall, 68.9% of respondents met criteria for poor sleep quality using the PSQI cutoff of >5. The mean (SD) OPAS-C score was 60.3 (9.1). There was a significantly increased odds of poor sleep quality in the highest vs. lowest OPAS-C quartiles (OR 4.94, 95% CI [2.67, 9.13], p < 0.0001). Age, sex, income, political leaning, employment status, and education attainment were not associated with poor sleep quality.ConclusionsMore than two-thirds of respondents met criteria for poor sleep quality. The odds of poor sleep quality increased in a dose-response relationship with pandemic attitudes (such as higher levels of pandemic-related stress, fear, or loneliness). The association between poor sleep quality and pandemic attitudes suggests opportunities for public health and sleep medicine interventions, and highlights the need for further research.
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Affiliation(s)
- Jonathan Kantor
- Center for Global Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
- Florida Center for Dermatology, St Augustine, FL, United States
- *Correspondence: Jonathan Kantor
| | | | | | - Edward F. Pace-Schott
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, MA, United States
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17
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Yu BYM, Lam JCS, Lam SC, Li Y, Chen S, Lam MY, Yeung WF. COVID-19 vaccine hesitancy and resistance in an urban Chinese population of Hong Kong: a cross-sectional study. Hum Vaccin Immunother 2022; 18:2072144. [PMID: 35612813 PMCID: PMC9359377 DOI: 10.1080/21645515.2022.2072144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vaccine hesitancy against COVID-19 is prevalent. This study aimed to identify the factors associated with COVID-19 vaccination compliance among adults in Hong Kong. An online survey was conducted during an early stage of community-based COVID-19 vaccination campaign in Hong Kong. The questionnaire consisted of vaccine status, sociodemographic information, risk perception of being infected by COVID-19, and exposure to confirmed COVID cases, as well as items on sleep and mental health. The association between these variables and vaccine hesitancy was analyzed. Among the 883 participants (67.5% females, 54.5% aged 18–39), 30.6% had low vaccine hesitancy, 27.4% had high vaccine hesitancy, and 27.5% had vaccine rejection. The likelihood of having high vaccine hesitancy was higher among young (adjusted odds ratio [aOR] = 2.99; 95% confidence interval [CI]: 1.23–7.30) and middle-aged respondents (aOR = 2.99; 95% CI: 1.07–5.47) than among old respondents. Moreover, those who were married (aOR = 0.51; 95% CI: 0.29–0.88), had a full-time job (aOR = 0.55; 95% CI: 0.29–0.88), and had a greater confidence in the government (aOR = 0.68; 95% CI: 0.54–0.86) were less likely to exhibit vaccine hesitancy. Our findings showed that the prevalence of vaccine hesitancy and vaccine resistance were high. Policy makers need specific strategies to target those who may have a high risk of vaccine hesitancy and resistance.
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Affiliation(s)
- Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Jason Chun-Sing Lam
- School of Pharmacy, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong SAR, China
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Shucheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Mei Yuk Lam
- Department of Medical Science, Tung Wah College, Hong Kong SAR, China
| | - Wing-Fai Yeung
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
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18
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Zhang J, Zhang X, Zhang K, Lu X, Yuan G, Yang H, Guo H, Zhu Z, Wang T, Hao J, Sun Y, Su P, Yang L, Zhang Z. An updated of meta-analysis on the relationship between mobile phone addiction and sleep disorder. J Affect Disord 2022; 305:94-101. [PMID: 35149136 DOI: 10.1016/j.jad.2022.02.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 02/07/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND To conduct a meta-analysis to quantitatively assess the association between mobile phone addiction (MPA) and sleep disorder (SD) by reviewing current evidence from observational studies. METHODS The meta-analysis was conducted by searching Pubmed, Embase, Scopus, and Web of science using a retrieval strategy related to MPA and SD. Pooled Odds ratios and Pearson's correlation coefficients were calculated by R software using a random effects model. RESULTS 29 studies including a total of 20041 participants were identified. We found that MPA was significantly associated with an increased risk of adolescents having SD (OR = 2.25, 95%CI= 1.72-2.94). Additionally, the findings also demonstrated that weak-to-moderate positive correlations were found between MPA and SD (summary r = 0.30, 95%CI= 0.25-0.34). The meta-regression analysis and subgroup analysis suggested that the geographic location and the measurement of MPA might be the sources of heterogeneity, and the robustness of the findings was confirmed by sensitivity analysis. LIMITATIONS The information collected was self-reported, and the recall bias was inevitable. CONCLUSIONS This study updated the findings of the association between MPA and SD from the previous reviews and was also the first meta-analysis to assess the association between MPA and SD using Odds Radios and correlation coefficients concurrently. The result of this study re-emphasized that paying more attention to the public health concerns of MPA and SD is needed in the future, whether implementation more relevant researches or developing targeted policies.
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Affiliation(s)
- Jianghui Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Xueqing Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Kexin Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Xiaoyan Lu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Guojing Yuan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Huayu Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Haiyun Guo
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Zhihui Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Tianli Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Jiahu Hao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Puyu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Linsheng Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China
| | - Zhihua Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui 230032, China.
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Jahrami HA, Alhaj OA, Humood AM, Alenezi AF, Fekih-Romdhane F, AlRasheed MM, Saif ZQ, Bragazzi NL, Pandi-Perumal SR, BaHammam AS, Vitiello MV. Sleep disturbances during the COVID-19 pandemic: A systematic review, meta-analysis, and meta-regression. Sleep Med Rev 2022; 62:101591. [PMID: 35131664 PMCID: PMC8782754 DOI: 10.1016/j.smrv.2022.101591] [Citation(s) in RCA: 157] [Impact Index Per Article: 78.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/15/2021] [Accepted: 01/11/2022] [Indexed: 02/07/2023]
Abstract
This systematic review and meta-analysis evaluated the extent of sleep disturbances during the COVID-19 pandemic. Eleven databases and six preprint repositories were searched for the period from November 1, 2019, to July 15, 2021. The DerSimonian and Laird method was used to develop random-effect meta-analyses. Two hundred and fifty studies comprising 493,475 participants from 49 countries were included. During COVID-19, the estimated global prevalence of sleep disturbances was 40.49% [37.56; 43.48%]. Bayesian meta-analysis revealed an odds of 0.68 [0.59; 0.77] which translates to a rate of approximately 41%. This provides reassurance that the estimated rate using classical meta-analysis is robust. Six major populations were identified; the estimated prevalence of sleep problem was 52.39% [41.69; 62.88%] among patients infected with COVID-19, 45.96% [36.90; 55.30%] among children and adolescents, 42.47% [37.95; 47.12%] among healthcare workers, 41.50% [32.98; 50.56%] among special populations with healthcare needs, 41.16% [28.76; 54.79%] among university students, and 36.73% [32.32; 41.38%] among the general population. Sleep disturbances were higher during lockdown compared to no lockdown, 42.49% versus 37.97%. Four in every ten individuals reported a sleep problem during the COVID-19 pandemic. Patients infected with the disease, children, and adolescents appeared to be the most affected groups.
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Affiliation(s)
- Haitham A Jahrami
- Ministry of Health, Bahrain; College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain.
| | - Omar A Alhaj
- Department of Nutrition, Faculty of Pharmacy and Medical Science, University of Petra, Amman, Jordan
| | - Ali M Humood
- College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain
| | - Ahmad F Alenezi
- College of Medicine and Medical Sciences, Arabian Gulf University, Bahrain
| | - Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Psychiatry Department "Ibn Omrane", Tunisia; Tunis El Manar University, Faculty of Medicine of Tunis, Tunisia
| | - Maha M AlRasheed
- Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, Toronto, Canada
| | - Seithikurippu R Pandi-Perumal
- Somnogen Canada Inc., College Street, Toronto, Canada; Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, Tamil Nadu, India
| | - Ahmed S BaHammam
- Department of Medicine, College of Medicine, University Sleep Disorders Center, King Saud University, Saudi Arabia; The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh, Saudi Arabia
| | - Michael V Vitiello
- Psychiatry & Behavioral Sciences, Gerontology & Geriatric Medicine, and Biobehavioral Nursing, University of Washington, Seattle, WA 98195-6560, United States
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20
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Zhan N, Zhang Y, Xie D, Geng F. The associations of parental COVID-19 related worries, lifestyles, and insomnia with child insomnia during the COVID-19 outbreak. J Sleep Res 2022; 31:e13590. [PMID: 35362217 PMCID: PMC9115149 DOI: 10.1111/jsr.13590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/13/2022] [Accepted: 03/06/2022] [Indexed: 11/29/2022]
Abstract
The impacts of the Coronavirus Disease 2019 (COVID‐19) pandemic on sleep health have been studied extensively. However, little is known about sleep problems within the family system during the pandemic. This study aimed to examine the influence of the COVID‐19 pandemic on insomnia in both adults and children, and to explore whether parental COVID‐19 related worries, lifestyles, and insomnia were associated with child insomnia. A total of 1355 parent–child dyads (39.2% fathers, mean age 38.37 years, SD = 5.34; 52.7% boys, mean age 12.47 years, SD = 1.67) were recruited from Jiangxi province in China from 4 to 18 February 2020. Data on insomnia, COVID‐19 related worries, physical activity, and screen time were collected using online questionnaires. Path analysis showed that COVID‐19 related worries and screen time were positively associated with insomnia in both parents and children; while children's physical activity was negatively related to children's insomnia. Parents' insomnia, COVID‐19 related worries, physical activity, and screen time were positively associated with children's insomnia, COVID‐19 related worries, physical activity, and screen time, respectively. Bootstrap tests showed that parents' worries were positively associated with children's insomnia via parents' insomnia and children's worries; parents' physical activity was negatively associated with children's insomnia via children's physical activity, parents' screen time was positively associated with children's insomnia via parents' insomnia and children's screen time. Both parental and child sleep are affected by the pandemic. Parental insomnia, stress reaction, and lifestyles contribute to child insomnia. Child sleep health may be maintained or improved by family bonds, home exercise, and sleep schedules.
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Affiliation(s)
- Nalan Zhan
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Yeqing Zhang
- School of Psychology, Jiangxi Normal University, Nanchang, China
| | - Dongjie Xie
- Hangzhou College of Preschool Teacher Education, Zhejiang Normal University, Jinhua, China
| | - Fulei Geng
- School of Psychology, Jiangxi Normal University, Nanchang, China
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21
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Neculicioiu VS, Colosi IA, Costache C, Sevastre-Berghian A, Clichici S. Time to Sleep?-A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:3497. [PMID: 35329184 PMCID: PMC8954484 DOI: 10.3390/ijerph19063497] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/10/2022] [Accepted: 03/14/2022] [Indexed: 02/06/2023]
Abstract
Sleep is intrinsically tied to mental and overall health. Short sleep duration accompanies the modern lifestyle, possibly reaching epidemic proportions. The pandemic and subsequent lockdowns determined a fundamental shift in the modern lifestyle and had profound effects on sleep and mental health. This paper aims to provide an overview of the relationship between sleep, mental health and COVID-19. Contrasting outcomes on sleep health have been highlighted by most reports during the pandemic in the general population. Consequently, while longer sleep durations have been reported, this change was accompanied by decreases in sleep quality and altered sleep timing. Furthermore, an increased impact of sleep deficiencies and mental health burden was generally reported in health care workers as compared with the adult general population. Although not among the most frequent symptoms during the acute or persistent phase, an increased prevalence of sleep deficiencies has been reported in patients with acute and long COVID. The importance of sleep in immune regulation is well known. Consequently, sleep deficiencies may influence multiple aspects of COVID-19, such as the risk, severity, and prognosis of the infection and even vaccine response.
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Affiliation(s)
- Vlad Sever Neculicioiu
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
| | - Ioana Alina Colosi
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
| | - Carmen Costache
- Department of Microbiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (I.A.C.); (C.C.)
| | - Alexandra Sevastre-Berghian
- Department of Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.S.-B.); (S.C.)
| | - Simona Clichici
- Department of Physiology, “Iuliu Hatieganu” University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania; (A.S.-B.); (S.C.)
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22
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O'Hora KP, Osorno RA, Sadeghi-Bahmani D, Lopez M, Morehouse A, Kim JP, Manber R, Goldstein-Piekarski AN. Viability of an Early Sleep Intervention to Mitigate Poor Sleep and Improve Well-being in the COVID-19 Pandemic: Protocol for a Feasibility Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e34409. [PMID: 34995204 PMCID: PMC8923148 DOI: 10.2196/34409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/07/2021] [Accepted: 12/18/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has led to drastic increases in the prevalence and severity of insomnia symptoms. These increases in insomnia complaints have been paralleled by significant decreases in well-being, including increased symptoms of depression, anxiety, and suicidality and decreased quality of life. However, the efficacy and impact of early treatment of insomnia symptoms on future sleep and well-being remain unknown. OBJECTIVE Here, we present the framework and protocol for a novel feasibility, pilot study that aims to investigate whether a brief telehealth insomnia intervention targeting new insomnia that developed during the pandemic prevents deterioration of well-being, including symptoms of insomnia, depression, anxiety, suicidality, and quality of life. METHODS The protocol details a 2-arm randomized controlled feasibility trial to investigate the efficacy of a brief, telehealth-delivered, early treatment of insomnia and evaluate its potential to prevent deterioration of well-being. Participants with clinically significant insomnia symptoms that began during the pandemic were randomized to either a treatment group or a 28-week waitlist control group. Treatment consists of 4 telehealth sessions of cognitive behavioral therapy for insomnia (CBT-I) delivered over 5 weeks. All participants will complete assessments of insomnia symptom severity, well-being, and daily habits checklist at baseline (week 0) and at weeks 1-6, 12, 28, and 56. RESULTS The trial began enrollment on June 3, 2020 and closed enrollment on June 17, 2021. As of October 2021, 49 participants had been randomized to either immediate treatment or a 28-week waitlist; 23 participants were still active in the protocol. CONCLUSIONS To our knowledge, this protocol would represent the first study to test an early sleep intervention for improving insomnia that emerged during the COVID-19 pandemic. The findings of this feasibility study could provide information about the utility of CBT-I for symptoms that emerge in the context of other stressors before they develop a chronic course and deepen understanding of the relationship between sleep and well-being. TRIAL REGISTRATION ClinicalTrials.gov NCT04409743; https://clinicaltrials.gov/ct2/show/NCT04409743. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/34409.
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Affiliation(s)
| | - Raquel A Osorno
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Dena Sadeghi-Bahmani
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.,Department of Psychology, Stanford University, Stanford, CA, United States
| | - Mateo Lopez
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Allison Morehouse
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Jane P Kim
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Rachel Manber
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Andrea N Goldstein-Piekarski
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States.,Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, United States
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23
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Li Y, Chen B, Hong Z, Sun Q, Dai Y, Basta M, Tang X, Qin Q. Insomnia symptoms during the early and late stages of the COVID-19 pandemic in China: a systematic review and meta-analysis. Sleep Med 2022; 91:262-272. [PMID: 34732293 PMCID: PMC8479411 DOI: 10.1016/j.sleep.2021.09.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 09/19/2021] [Accepted: 09/19/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND Evidence suggests that the outbreak of the coronavirus disease 2019 (COVID-19) and the prevention/control measures for COVID-19 may cause insomnia during the acute phase of COVID-19 pandemic in China. However, it is unclear whether insomnia sustains during the later phases of the pandemic. METHODS We searched PubMed/Medline, EMBASE, PsycINFO and China National Knowledge Infrastructure from the 27th December 2019 to the 2nd February 2021. As early stage studies on COVID-19 pandemic in China were defined as those conducted prior to April 1st, 2020, while late stage studies were those conducted after April 1st, 2020. RESULTS A total of 98 studies with 193,889 participants were included. The pooled prevalence of insomnia symptoms among all populations was 39.1% (95% CI 36.2-42.0%); the pooled prevalence of insomnia symptoms during the early and late stages of COVID-19 in China were 37.0% (95% CI 34.1-39.9%) and 41.8% (95% CI 33.6-50.0%), respectively. Importantly, there was no significant difference regarding the prevalence of insomnia symptoms between the early and late stages of COVID-19. Meta-regression showed that healthcare workers, COVID-19 patients, patients with chronic medical conditions and patients with mental disorders had a higher prevalence of insomnia symptoms compared to the general population. This association remained significant in healthcare workers and patients with chronic medical conditions after adjusting for age, gender, areas of high or low prevalence of COVID-19 cases, anxiety and depression. CONCLUSIONS Over one third of our sample present insomnia symptoms during the early stage of COVID-19 pandemic in China. Interestingly, prevalence of insomnia symptoms sustains high during the late stage of the pandemic despite the control of the disease and the amelioration of its adverse effects. Our findings suggest that insomnia symptoms related to COVID-19 appear to persist of over time.
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Affiliation(s)
- Yun Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Baixin Chen
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Zhuoting Hong
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Qimeng Sun
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Yanyuan Dai
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, China; Sleep Medicine Center, Shantou University Medical College, Shantou, China
| | - Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Xiangdong Tang
- Sleep Medicine Center, Translational Neuroscience Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingsong Qin
- Laboratory of Human Virology and Oncology, Shantou University Medical College, Shantou, China
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24
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Bourmistrova NW, Solomon T, Braude P, Strawbridge R, Carter B. Long-term effects of COVID-19 on mental health: A systematic review. J Affect Disord 2022; 299:118-125. [PMID: 34798148 PMCID: PMC8758130 DOI: 10.1016/j.jad.2021.11.031] [Citation(s) in RCA: 139] [Impact Index Per Article: 69.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 10/26/2021] [Accepted: 11/13/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Acute effects of COVID-19 can be life-threatening. Alterations in mental health during the active infection have been documented, but the long-term consequences are less clear. METHOD A systematic review was undertaken to investigate the effect of COVID-19 infection on long-term mental health outcomes. Three databases [PubMed, Medline (Ovid) and Cochrane library] were searched between 1st October 2019 and 29th August 2021 with additional hand searching to identify all published studies reporting symptoms of generalised anxiety, depression, post-traumatic stress disorder (PTSD), or sleep disturbance in participants at least one month after COVID-19 infection. The prevalence and mean symptom score of each were assessed. RESULTS Eight hundred and eighty five studies were found, of which 33 were included in the review involving a total of 6743 participants. The studies' risk of bias were typically fair quality. The median study age of participants was 57.8 years (IQR 49.3-60.7), with 63.0% male (IQR 57.0%-73.0%). Participants typically experienced no or mild symptoms of long-term anxiety (GAD-7, STAI-S, HADS) and depression (PHQ-9, BDI, PHQ-2, HADS). Prevalence varied depending on the measurement tool. Sleep disturbances (primarily insomnia) were most commonly reported as mild. PTSD prevalence was similar to anxiety and depression. CONCLUSION The overall effect of the pandemic has been linked with worsening psychiatric symptoms. However, the long-term effect from direct COVID-19 infection has been associated with no or mild symptoms. Studies exhibited the long-term prevalence of anxiety, depression, PTSD, and sleep disturbances to be comparable to general population levels.
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Affiliation(s)
- Nicole Wallbridge Bourmistrova
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Tomas Solomon
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom
| | - Philip Braude
- North Bristol NHS Trust, Bristol, Northern Ireland, United Kingdom
| | - Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, PO74, King's College London, De Crespigny Park, London, Northern Ireland SE5 8AZ, United Kingdom,National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust, London, Northern Ireland SE5 8AZ, United Kingdom
| | - Ben Carter
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London SE5 8AF, United Kingdom.
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25
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Tanioka K, Kayaba M, Tomishima S, Komada Y, Inoue Y. Changes in sleep behavior, sleep problems, and psychological distress/health-related quality of life of young Japanese individuals before and during the COVID-19 pandemic. Chronobiol Int 2022; 39:781-791. [PMID: 35139703 DOI: 10.1080/07420528.2022.2034839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Social restrictions during the coronavirus disease (COVID-19) pandemic have impacted sleep behavior and sleep problems, and their related daytime functioning in young adults. However, no studies have examined such changes in young individuals from countries with mild infection intensity and social restrictions. Therefore, we focused on sleep behaviors and sleep issues in young people in Japan. This study was conducted before and after the pandemic (October 2019 and May 2020, respectively). In total, 2,222 (1,371 students and 851 workers) individuals participated and completed anonymous Web-based questionnaires concerning demographic characteristics, sleep behaviors, sleep problems using the Japanese version of the Epworth Sleepiness Scale (JESS) and the Athens Insomnia Scale (AIS-J), psychological distress using the Japanese version of the Kessler Psychological Distress Scale, and health-related quality of life (HRQoL) evaluated with the Short Form-8 (SF-8). A significantly delayed sleep phase was observed in the second survey compared to the first (p < .001) and was more pronounced in students than in workers (p < .001). The total sleep time, social jetlag degree, and JESS, AIS-J, and SF-8 scores were significantly improved after the pandemic (p < .001, p < .001, p < .001, p < .001, p < .05, and p < .001, respectively). Careful monitoring of whether these modest changes can lead to adjustment concerns is needed.
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Affiliation(s)
- Kosuke Tanioka
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Momoko Kayaba
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | | | - Yoko Komada
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Liberal Arts, Meiji Pharmaceutical University, Tokyo, Japan
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.,Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
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26
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Liu Y, Wang X, Sun P, Zhang Q, Zhang C, Shen Y, Wang S, Ma J, Wang G. Sleep disturbance and anxiety symptom among public during the second wave of COVID-19 in Beijing: A web-based cross-sectional survey. J Affect Disord 2022; 298:80-85. [PMID: 34728284 PMCID: PMC8556681 DOI: 10.1016/j.jad.2021.10.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/25/2021] [Accepted: 10/23/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The global coronavirus disease 2019 (COVID-19) epidemic has significantly impacted people's lives. This study aimed to examine the influence of the unexpected second wave of COVID-19 on sleep quality and anxiety of Chinese residents in Beijing in June 2020, compared with the initial outbreak at the beginning of 2020, and to investigate the associated factors. METHODS Using a web-based cross-sectional survey, we collected data from 1,511 participants. assessed with demographic information, sleep quality and anxiety symptoms. The participants were asked to compare their recent sleep and sleep during the first outbreak. The Zung's Self-rating Anxiety Scale (SAS) was used to assess their current insomnia severity. Multivariable logistic regression models were used to analyze the association between COVID-19 epidemic and risk of sleep disturbance and anxiety symptom. RESULTS The overall prevalence of sleep disturbance and anxiety symptoms were 50.8% and 15.3% respectively. People had significantly shorter sleep duration during the second wave of COVID-19(7.3 ± 1.3) h than the first outbreak (7.5 ± 1.4)h (p < 0.001). During the second outbreak, people were less concerned about infection and more concerned about financial stress and occupational inferference. Beijing residents did not have significant differences in sleep disturbance and anxiety compared with other regions, nor were occupations and nucleic acid testing associated risk factors. Home quarantine, health administrators, history of insomnia and anxiety-depression were significantly associated with sleep disturbance. Female gender, home quarantine, history of insomnia and anxiety-depression were significantly associated with anxiety. CONCLUSION High prevalence of sleep disturbance and depression symptom was common during the second wave of COVID-19 crisis in Beijing. Home quarantine and previous history of insomnia and anxiety-depressive risk factors were associated with sleep disturbance and anxiety. Female gender was impacting predictor of anxiety. We need continuous assessment of the sleep quality and anxiety symptoms of this epidemic.
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Affiliation(s)
- Yanan Liu
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China
| | - Xi Wang
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China
| | - Pengfei Sun
- Department of Cardiology, Peking University First Hospital, Beijing, China
| | - Qi Zhang
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China
| | - Cheng Zhang
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China
| | - Yane Shen
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China
| | - Shixuan Wang
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China
| | - Jing Ma
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China.
| | - Guangfa Wang
- Department of Pulmonary and critical care medicine, Peking University First Hospital, Beijing, China
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27
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Zhang SX, Chen RZ, Xu W, Yin A, Dong RK, Chen BZ, Delios AY, Miller S, McIntyre RS, Ye W, Wan X. A Systematic Review and Meta-Analysis of Symptoms of Anxiety, Depression, and Insomnia in Spain in the COVID-19 Crisis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:1018. [PMID: 35055841 PMCID: PMC8775436 DOI: 10.3390/ijerph19021018] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 11/08/2021] [Accepted: 11/29/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND General population, frontline healthcare workers (HCWs), and adult students in Spain are at risk of anxiety, depression, and insomnia symptoms during the COVID-19 crisis. A meta-analysis of the individual studies on these symptoms would provide systematic evidence to aid policymakers and researchers in focusing on prevalence, risk, and best interventions. OBJECTIVE This paper aims to be the first meta-analysis and systematic review to calculate the prevalence of anxiety, depression, and insomnia symptoms in Spain's adult population (general population, frontline healthcare workers (HCWs), and adult students) during the Covid-19 epidemic. METHOD Random-effect meta-analysis was used to estimate the prevalence of anxiety, depression, and insomnia. RESULTS The meta-analysis includes 28 studies with 38 individual samples in Spain. The pooled prevalence of anxiety symptoms in 22 studies comprising a sample population of 82,024 was 20% (95% CI: 15-25%), that of depression symptoms in 22 articles with a total sample comprising 82,890 individuals was 22% (95% CI: 18-28%), and that of insomnia symptoms in three articles with a sample population of 745 was 57% (95% CI: 48-66%. CONCLUSIONS The accumulative evidence reveals that adults in Spain suffered higher prevalence rates of mental symptoms during the COVID-19 crisis, with a significantly higher rate relative to other countries such as China. Our synthesis also reveals a relative lack of studies on frontline and general HCWs in Spain.
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Affiliation(s)
- Stephen X. Zhang
- Faculty of Professions, University of Adelaide, Adelaide, SA 5005, Australia;
| | | | - Wen Xu
- Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo 315100, China;
| | - Allen Yin
- School of Humanities, Southeast University, Nanjing 211189, China;
| | - Rebecca Kechen Dong
- Business School, University of South Australia, Adelaide, SA 5001, Australia;
| | - Bryan Z. Chen
- Faculty of Professions, University of Adelaide, Adelaide, SA 5005, Australia;
| | | | - Saylor Miller
- College of Business, Oregon State University, Corvallis, OR 97330, USA;
| | - Roger S. McIntyre
- Mood Symptoms Psychopharmacology Unit (MDPU), Department of Psychiatry, University of Toronto, Toronto, ON M5T 2S8, Canada;
| | - Wenping Ye
- Department of Business Administration, School of Management, Jinan University, Guangzhou 510632, China;
| | - Xue Wan
- School of Economics and Management, Tongji University, Shanghai 200092, China;
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28
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Morin CM, Vézina-Im LA, Ivers H, Micoulaud-Franchi JA, Philip P, Lamy M, Savard J. Prevalent, incident, and persistent insomnia in a population-based cohort tested before (2018) and during the first-wave of COVID-19 pandemic (2020). Sleep 2022; 45:zsab258. [PMID: 34698868 PMCID: PMC8574325 DOI: 10.1093/sleep/zsab258] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/24/2021] [Indexed: 11/26/2022] Open
Abstract
STUDY OBJECTIVES High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018). METHODS Data were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April to May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments. RESULTS The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% 2 years later. There was a significant worsening of sleep quality, fatigue, anxiety, and depression (all ps < .005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress. CONCLUSIONS The COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the COVID-19.
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Affiliation(s)
- Charles M Morin
- École de psychologie et Centre d’étude des troubles du sommeil, Université Laval, Québec,Canada
- Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Lydi-Anne Vézina-Im
- École de psychologie et Centre d’étude des troubles du sommeil, Université Laval, Québec,Canada
- Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Hans Ivers
- École de psychologie et Centre d’étude des troubles du sommeil, Université Laval, Québec,Canada
- Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Jean-Arthur Micoulaud-Franchi
- Service de médecine universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
- Université de Bordeaux, SANPSY USR 3413, Bordeaux,France
| | - Pierre Philip
- Service de médecine universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon, Bordeaux, France
- Université de Bordeaux, SANPSY USR 3413, Bordeaux,France
| | - Manon Lamy
- École de psychologie et Centre d’étude des troubles du sommeil, Université Laval, Québec,Canada
- Centre de recherche CERVO/BRAIN Research Center, Québec, Canada
| | - Josée Savard
- École de psychologie et Centre d’étude des troubles du sommeil, Université Laval, Québec,Canada
- Centre de recherche du CHU de Québec, Québec, Canada
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29
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Preserving mental well-being and engagement of students in Philippine virtual classrooms during the COVID-19 crisis: Insights from a Filipino educator. Asian J Psychiatr 2022; 67:102915. [PMID: 34773802 DOI: 10.1016/j.ajp.2021.102915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 10/28/2021] [Indexed: 11/21/2022]
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30
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Subjective sleep quality before and during the COVID-19 pandemic in a Brazilian rural population. Sleep Health 2021; 8:167-174. [PMID: 34924345 PMCID: PMC8675050 DOI: 10.1016/j.sleh.2021.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 11/02/2021] [Accepted: 11/12/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Prior studies have examined sleep during the coronavirus disease 2019 (COVID-19) pandemic, but have few compared sleep measured both during and prior to COVID. We examined the impact of the COVID-19 pandemic on subjective sleep quality in general and separately by gender and age (<50 vs. ≥50 years). Further, we compared sleep quality between those who did and did not follow quarantine orders. METHODS This sample is from the Baependi Heart Study, a family-based cohort of adults in South-eastern Brazil. Longitudinal data were from 417 individuals who completed the Pittsburgh Sleep Quality Index (PSQI) twice: between January 2010 and September 2014 (pre-COVID) and during the COVID-19 stay-at-home order March-June, 2020. Cross-sectional analysis included 800 participants. RESULTS Mean (±SD) PSQI scores were significantly higher during than before COVID-19 (5.7 ± 3.8 vs. 5.0 ± 3.3, p < .01). This increase was significant among women and among adults ≥50 years but not in men or younger adults. The significant increase in PSQI was only observed in those who quarantined during COVID-19 (5.9 ±3.7 vs. 5.2 ±3.4, p < .01) and not those who did not quarantine (5.0 ± 3.7 vs. 4.5 ± 3, p = .12). In cross-sectional analyses, individuals who quarantined had higher PSQI scores than nonquarantined individuals (6.1 ± 3.9 vs. 5.0 ± 3.5, p < .01). The quarantine status-dependent differences were significant for women (6.4 ± 4 vs. 5.2 ± 3.7, p < .01) and older adults (6.6 ± 0.1 vs. 5.5 ± 3.3, p = .04). Differences by quarantine status were attenuated after adjusting for age and gender. CONCLUSIONS Subjective sleep quality declined during the COVID-19 pandemic, particularly among women, older adults, and those compliant to quarantine orders.
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Cervera-Martínez J, Atienza-Carbonell B, Mota JC, Bobes-Bascarán T, Crespo-Facorro B, Esteban C, García-Portilla MP, Gomes-da-Costa S, González-Pinto A, Jaén-Moreno MJ, Sarramea F, Vieta E, Zorrilla I, Tabarés-Seisdedos R, Kapczinski F, De Boni RB, Balanzá-Martínez V. Lifestyle changes and mental health during the COVID-19 pandemic: A repeated, cross-sectional web survey. J Affect Disord 2021; 295:173-182. [PMID: 34469856 PMCID: PMC8418875 DOI: 10.1016/j.jad.2021.08.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 08/06/2021] [Accepted: 08/18/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND This study aimed to compare self-reported changes on lifestyle behaviors during two phases of the COVID-19 pandemic in Spain, and to evaluate clinical and sociodemographic factors associated with lifestyles. METHODS Two cross-sectional web surveys were conducted during lockdown (April 15-May 15, 2020) and seven months later (November 16-December 16, 2020). Lifestyle behaviors were self-reported by a multidimensional scale (SMILE-C). Two separate samples of respondents were analyzed. A multivariate regression model was performed to evaluate the association of SMILE-C scores with demographic and clinical variables. RESULTS The sample comprised, 3412 participants from the first survey (S1) and in the S1 and 3635 from the second (S2). SMILE-C score decreased across surveys (p < 0.001). The rates of positive screenings for depression and anxiety were similar between the surveys, whereas those for alcohol abuse decreased (p < 0.001). Most participants in S2 reported that their lifestyle had not changed compared to those before the pandemic. Variables independently associated with an unhealthier lifestyle were working as an essential worker, lower educational level, previous mental disease, worse self-rated health, totally/moderate changes on diet, sleep or social support, as well as positive screenings for alcohol abuse, anxiety and depression. LIMITATIONS The cross-sectional design and recruitment by non-probabilistic methods limit inferring causality and the external validity of the results. CONCLUSIONS Overall lifestyle worsened seven months after the lockdown in Spain. Several demographic and clinical factors were associated with lifestyle scores. The contribution of common mental disorders to unhealthier lifestyles should be considered in order to prevent the negative impact of the pandemic.
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Affiliation(s)
- Jose Cervera-Martínez
- Hospital de Denia-Marina Salud, Alicante, Spain; Department of Medicine, University of Valencia, Valencia, Spain
| | | | - Jurema C Mota
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Teresa Bobes-Bascarán
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Servicio de Salud del Principado de Asturias (SESPA), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Psychology, University of Oviedo, Oviedo, Spain
| | - Benedicto Crespo-Facorro
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital Universitario Virgen del Rocío, IBIS, Seville, Spain; University of Sevilla, Seville, Spain
| | | | - María Paz García-Portilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Servicio de Salud del Principado de Asturias (SESPA), Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain
| | - Susana Gomes-da-Costa
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital Universitario de Alava. BIOARABA, UPV-EHU, Vitoria, Spain
| | - M José Jaén-Moreno
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Departamento de Ciencias Morfológicas y Sociosanitarias, Universidad de Córdoba, Córdoba, Spain
| | - Fernando Sarramea
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Córdoba, Spain; Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, Barcelona, Catalonia, Spain
| | - Iñaki Zorrilla
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Hospital Universitario de Alava. BIOARABA, UPV-EHU, Vitoria, Spain
| | - Rafael Tabarés-Seisdedos
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Medicine, Teaching Unit of Psychiatry and Psychological Medicine, University of Valencia, Blasco Ibáñez, 15, Valencia 46010, Spain
| | - Flavio Kapczinski
- Departament of Psychiatry and Behavioral Neurosciences, McMaster University, Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada; Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, RS, Brazil
| | - Raquel B De Boni
- Institute of Scientific and Technological Communication and Information in Health (ICICT), Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil
| | - Vicent Balanzá-Martínez
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Medicine, Teaching Unit of Psychiatry and Psychological Medicine, University of Valencia, Blasco Ibáñez, 15, Valencia 46010, Spain.
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In-Depth Characterization of Sleep Patterns Among People with Insomnia During the Pandemic of COVID-19. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:157-163. [PMID: 34765232 PMCID: PMC8551896 DOI: 10.12865/chsj.47.02.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/12/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND The effects of the COVID-19 pandemic on sleep duration and insomnia have been well studied in different studies. However, there is no study available on the characteristics of insomnia during the pandemic. This study aimed to evaluate the characteristics of insomnia experienced by the general Iranian population during the COVID-19 pandemic. METHODS A cross-sectional community-based study was designed. We designed an online questionnaire and sent it to Iranian people via available social platforms. The questionnaire contained questions on the socio-demographic characteristics of the participants. We used Fear of COVID-19 scale (FCV-19), Insomnia Severity Index (ISI), Patient Health Questionnaire-2 (PHQ-2), and Generalized Anxiety Disorder Scale-2 (GAD-2) for detailed characterization of insomnia and its symptoms. RESULTS In total, 675 people with insomnia with the mean age of 40.28 years (SD=11.15) participated in our study. Prevalence of difficulty initiating sleep (DIS), difficulty maintaining sleep (DMS), and early morning awakening (EMA) were 91.4%, 86.7%, and 77%, respectively. DIS, DMS, and EMA were more common in people with depression and anxiety. FCV-19 score was higher in those with more severe types of DIS, DMS, and EMA (P<0.001). FCV-19 was a risk factor for all patterns of insomnia (OR=1.19, 1.12, 1.02 for DIS, DMS, and EMA, respectively). CONCLUSION Fear of COVID-19 is a major contributing factor to insomnia patterns. Investigation of COVID-19 fear in people with insomnia and the addition of attributed relieving or management strategies to conventional management of insomnia are reasonable approaches to improve the sleep condition of people in the pandemic.
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Lin SY, Chung KKH. Risk Perception, Perception of Collective Efficacy and Sleep Quality in Chinese Adults during COVID-19 Pandemic in Hong Kong: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111533. [PMID: 34770053 PMCID: PMC8583171 DOI: 10.3390/ijerph182111533] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/28/2021] [Accepted: 10/31/2021] [Indexed: 12/20/2022]
Abstract
Background: Only a few studies have studied the link between risk perception and sleep in the context of the COVID-19 pandemic. The purpose of our study is to propose and test a theoretical model to understand the relationships between COVID-19 risk appraisals—risk perception and perception of collective coordinated defense (PCCD) in particular—and subjective sleep quality in Chinese adults in Hong Kong during the COVID-19 pandemic. COVID-19-related fear and rumination were examined as potential mediators of the relationships. Methods: Data were collected using a self-report online questionnaire from a convenience sample of 224 Chinese adults during the fourth wave of the COVID-19 pandemic in Hong Kong. Results: Risk perception and PCCD were found to predict poor sleep quality. Mediation analysis showed that both fear and rumination mediated the relationship between risk perception and sleep quality, whereas only fear mediated the relationship between PCCD and sleep quality. The model was an excellent fit to the data and accounted for 44% of the variance in sleep quality in Chinese adults. This study indicated that both perception of high risks of contracting COVID-19 and anticipations of collective disease preventive efforts had adverse effects on subjective sleep quality via increasing COVID-19-related fear. Conclusions: These findings underscore the need for addressing sleep problems induced by psychological consequences of the pandemic. While policy makers often deliver public messaging campaigns that frame disease prevention as a collective goal, developing evidence-based coping strategies to combat COVID-19 adverse impacts on psychological health is equally important.
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Affiliation(s)
- Shiang-Yi Lin
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong, China;
- Division of Social Science, Hong Kong University of Science and Technology, Kowloon, Hong Kong, China
| | - Kevin Kien Hoa Chung
- Department of Early Childhood Education, The Education University of Hong Kong, Tai Po, Hong Kong, China;
- Centre for Child and Family Science, The Education University of Hong Kong, Tai Po, Hong Kong, China
- Correspondence: ; Tel.: +852-29487760
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Sultan I, Alobaidi RA, Sewaid KK, Bader MU, Almuwallad NT, Mohammed RA. Assessment of the Effect of the COVID-19 Pandemic on the Lifestyle of the Population in Saudi Arabia: A Cross-Sectional Online Survey Study. Cureus 2021; 13:e19796. [PMID: 34956785 PMCID: PMC8692506 DOI: 10.7759/cureus.19796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2021] [Indexed: 12/23/2022] Open
Abstract
Background The coronavirus (COVID-19) pandemic has created an unprecedented problem in people's lives around the world. Lockdown measures altered the routine lifestyle aspects of people including diet, exercise, sleep, stress, smoking, job status, recreation, and application of modern technologies. Understanding the lifestyle profile of individuals could help in designing effective interventions to minimize the risk factors of COVID-19-related health problems. Objectives The aim of this research is to investigate the lifestyle changes among adults living in Saudi Arabia (SA) during the COVID-19 pandemic. Methods A cross-sectional survey study was done to investigate the lifestyle changes during the COVID-19 pandemic in Saudi Arabia from August to September 2020. A pre-designed questionnaire was used for data collection and distributed online through social media. The questionnaire included items about sleep patterns, dietary habits, physical activity, employment status, recreation activities, use of social media, and screen time before and during the pandemic. Results A total of 338 adults with a median age of 40 years participated in the study. During the pandemic, employment, smoking decreased significantly (53.3 vs. 55.6%, p<0.001 & 15.7% vs. 18.3%, p=0.049) with significant increases in daily intake of fruits or vegetables (47% to 60.2%, p<0.001), caffeinated beverages (seven or more times caffeine, 3% vs. 0.9%, p<0.001), and water (more than eight water cups daily, 18.4 vs. 11.9, p<0.001). Overweight group increased significantly from 28.5% to 32% (p=0.009). Sleeping more than nine hours increased significantly from 8.3% to 21.8% (p<0.001) with increasing sleeping aids from 11.6% to 15.7% (p<0.001). Both the screen and the social media times increased significantly for six or more hours daily (14.8% vs. 35.3% and 9.5% vs. 28.2% respectively, p=<0.001 for both). There were significant decreases in socialization (91.4% vs. 37.8%) and fast food (71.98% vs. 47.04%), and increases in physically inactivity (19% vs. 5.3%) and stress (90.8% vs. 85.2%) (p<0.001 for all). Most participants perceived stress during the pandemic (307, 90.8%). Conclusion There were remarkable behavioral changes in all aspects of the lifestyle of the participants living in SA during the COVID-19 pandemic with some positive effects on smoking and dietary habits. However, negative changes included unemployment, physical inactivity, sleep disturbances, social isolation, and excessive weight gain. There is a need to study the possible consequences of such changes on the future population health in SA.
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Affiliation(s)
- Intessar Sultan
- Internal Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Roba A Alobaidi
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Khulood K Sewaid
- Medicine and Surgery, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Maryam U Bader
- Family Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Norah T Almuwallad
- Medical Education and Simulation, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Rehab A Mohammed
- Internal Medicine, Faculty of Girls, Al-Azhar University, Cairo, EGY
- Internal Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
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Lam CS, Yu BYM, Cheung DST, Cheung T, Lam SC, Chung KF, Ho FYY, Yeung WF. Sleep and Mood Disturbances during the COVID-19 Outbreak in an Urban Chinese Population in Hong Kong: A Longitudinal Study of the Second and Third Waves of the Outbreak. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168444. [PMID: 34444192 PMCID: PMC8392420 DOI: 10.3390/ijerph18168444] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 08/03/2021] [Accepted: 08/05/2021] [Indexed: 11/21/2022]
Abstract
In response to the worsening situation of the COVID pandemic, this follow-up study aimed to assess the impact of the “third wave” of the outbreak on sleep and mood disturbances among Hong Kong citizens. A total of 339 respondents included in our last study during the second wave (4–11 August 2020) joined this survey (response rate = 51.1%). The questionnaire collected data on sleep conditions, mood, stress, and risk perception. The sleep quality and mood status were assessed using the Insomnia Severity Index (ISI), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9. The weighted prevalence of insomnia, anxiety, and depression was 33.6%, 15.3%, and 22.0%, respectively. Compared with the last survey, five out of six sleep parameters significantly worsened despite the lack of difference in the ISI score. The GAD-7 score was significantly lower. Old-aged adults were less likely to maintain good sleep quality compared with middle-aged adults (adjusted OR = 4.03, 95% CI: 1.04–15.73). Respondents without psychiatric disorder were more likely to be anxiety-free across the two time points (adjusted OR = 7.12, 95% CI: 1.33–38.03). One-third of Hong Kong people reported poor sleeping quality in the third wave of the COVID-19 outbreak. Policy-makers need to propose a contingent plan to allocate mental health resources to vulnerable subpopulations.
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Affiliation(s)
- Chun Sing Lam
- Faculty of Medicine, School of Pharmacy, The Chinese University of Hong Kong, Hong Kong, China;
| | - Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong, China;
| | - Denise Shuk Ting Cheung
- Li Ka Shing Faculty of Medicine, School of Nursing, The University of Hong Kong, Hong Kong, China;
| | - Teris Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China;
| | | | - Ka-Fai Chung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, China;
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China;
- Correspondence:
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Kim DM, Bang YR, Kim JH, Park JH. The Prevalence of Depression, Anxiety and Associated Factors among the General Public during COVID-19 Pandemic: a Cross-sectional Study in Korea. J Korean Med Sci 2021; 36:e214. [PMID: 34313037 PMCID: PMC8313395 DOI: 10.3346/jkms.2021.36.e214] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/19/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Since its first case confirmed on January 20, 2020, Korea has been through three waves of the COVID-19 pandemic. Fears of the fourth wave persist as new cases continue to emerge. In such unpredictable times, the mental well-being of people is of crucial importance. This study examined the levels of depression and anxiety and their predictors among the Korean general public in Busan, Korea, during the COVID-19 pandemic. METHODS We conducted a cross-sectional study via a self-reported questionnaire administered to 2,288 adult residents (aged 19-60 years) of Busan, Korea. Participants' depression and anxiety were assessed using the Korean version of the Patient Health Questionnaire-4 (PHQ-4), which consists of PHQ-2 and Generalized Anxiety Disorder-2 (GAD-2), with the cutoff score of 3. RESULTS The mean age of the participants was 39.71 years. COVID-19 had several psychosocial impacts on people. It was revealed that 80.3% had restrictions in outside activities, 47.3% reported financial difficulties, and 53.6% had a fear of death or fatal outcome when infected with COVID-19. We performed logistic regression analysis to identify the factors associated with depression and anxiety. A total of 30.7% participants were classified as at risk of depression based on cutoff score of 3 on PHQ-2. Logistic regression analysis revealed that changes in sleep pattern due to COVID-19 were most strongly associated with depression, followed by restrictions in outside activities due to social distancing and increased family conflicts due to COVID-19. Also, 22.6% participants were classified as at risk of anxiety based on a cutoff score of 3 on GAD-2. Analysis revealed that changes in sleep pattern due to COVID-19 were most strongly associated with anxiety, followed by spending a lot of time searching for COVID-19-related information and having a fear of death or fatal outcome when infected with COVID-19. CONCLUSION The results are alarming; 30.7% had a PHQ-2 score of 3 or higher, indicating depression, and 22.6% had a GAD-2 score of 3 or higher, indicating anxiety. Changes in sleep pattern had the strongest association with both depression and anxiety. Our results can be used to formulate mental health policies tailored to the context of the city. Our findings suggest the high prevalence of depression and anxiety in the society during the COVID-19 pandemic, which places growing importance on early intervention for mental health problems during these times.
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Affiliation(s)
- Dong Min Kim
- Department of Psychiatry, Dong-A University Hospital, Busan, Korea
| | - Young Rong Bang
- Department of Psychiatry, Dong-A University Hospital, Busan, Korea
| | - Joon Hee Kim
- Busan Regional Mental Health Welfare Center, Busan, Korea
| | - Jae Hong Park
- Department of Psychiatry, Dong-A University Hospital, Busan, Korea
- Busan Regional Mental Health Welfare Center, Busan, Korea.
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Li X, Cai Q, Jia Z, Zhou Y, Liu L, Zhou Y, Zhang B, Ren L, Tang Y. The correlation between mental health status, sleep quality, and inflammatory markers, virus negative conversion time among patients confirmed with 2019-nCoV during the COVID-19 outbreak in China: An observational study. Medicine (Baltimore) 2021; 100:e26520. [PMID: 34232185 PMCID: PMC8270605 DOI: 10.1097/md.0000000000026520] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023] Open
Abstract
The 2019 coronavirus disease (COVID-19) has spread to the whole world. Psychological and sleep problems among confirmed patients have drawn extensive attention which may be highly related to immune function and inflammatory responses of people. The aim of this study is to examine the correlation of mental health status, sleep quality, and inflammatory markers, virus negative conversion time (NCT) among confirmed patients during the COVID-19 outbreak.A cross-sectional survey was conducted in this study. Data from 66 patients assessed with demographic information, anxious symptom, depressive symptom, stress, and sleep quality were collected using a smartphone-based questionnaire platform and then clinical characteristics and laboratory indicators were collected using case review.Nearly 30% of the participants reported depression, anxiety, perceived pressure, and poor sleep quality. Compared with the group without depression, neutrophil count, and ratio of neutrophil count to lymphocyte count (NLR) in the depression disorder group were increased (P = .028, 0.043). There was also a significant difference in NLR and NCT between the anxiety group and the non-anxiety group (P = .021, .024). Similarly, compared with the good sleep quality group, NLR in the poor sleep quality group was increased (P = .011). Correlation analysis indicated that Self-Rating Depression Scale score was positively related to neutrophil count and NLR (r = 0.366, 0.330, P = .016, .031). The total score of Pittsburgh Sleep Quality Index (PSQI) was negatively related to lymphocyte count (r = -0.317, P = .049), and the sleep disturbance as 1 of the 7 dimensions of PSQI scale was positively correlated with NCT and NLR (r = 0.370, 0.340, P = .020, .034).In our study, confirmed patients were prone to have psychological and sleep problems. The level of inflammation in patients with psychological and sleep problems was higher than that in patients without corresponding problems. The inflammatory level increased with the increase of Self-Rating Depression Scale score, and the lymphocyte count decreased with the increase of the PSQI score. NCT was prolonged in the anxiety group and sleep disturbance was positively correlated with NCT.
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Affiliation(s)
- Xixi Li
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Quan Cai
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Ziyi Jia
- Department of Emergency, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yifang Zhou
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Linzi Liu
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yuning Zhou
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Baoyan Zhang
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Luyu Ren
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yanqing Tang
- Department of Geriatric Medicine, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
- Department of Psychiatry, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
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Lee LYK, Chan ICW, Wong OPM, Ng YHY, Ng CKY, Chan MHW, Ng JKC, Koo HHT, Lam ST, Chu ACW, Wong RYS, Leung HPY, Pun ALC. Reuse of face masks among adults in Hong Kong during the COVID-19 pandemic. BMC Public Health 2021; 21:1267. [PMID: 34187439 PMCID: PMC8240770 DOI: 10.1186/s12889-021-11346-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background During the COVID-19 pandemic, over 99% of adults in Hong Kong use face masks in public. With the limited supply of face masks in the market and the uncertainty about the future development of COVID-19, reusing face masks is a legitimate way to reduce usage. Although this practice is not recommended, reusing face masks is common in Hong Kong. This study aimed to examine the practice of reusing face masks among adults in Hong Kong during the COVID-19 pandemic and its association with their health beliefs toward this health crisis. Methods A cross-sectional descriptive study was conducted. A quota sample of 1000 adults was recruited in Hong Kong in April 2020. Guided by the Health Belief Model, the subjects were invited to answer questions on their practice of reusing face masks and health beliefs toward COVID-19 through telephone interview. Their practice on reuse, storage, and decontamination of used face masks were summarized by descriptive statistics. The difference in health beliefs between the subjects who reused and did not reuse face masks was examined by conducting an independent t test. The association between health beliefs and reuse of face masks was determined by conducting a logistic regression analysis. Results One-third (n = 345, 35.4%) of the subjects reused face masks in an average of 2.5 days. Among them, 207 subjects stored and 115 subjects decontaminated their used face masks by using various methods. The subjects who reused face masks significantly perceived having inadequate face masks (t = 3.905; p < 0.001). Having a higher level of perception of having inadequate face masks increased the likelihood of reusing face masks (OR = 0.784; CI 95%: 0.659–0.934; p = 0.006). Conclusion Despite having 90 face masks in stock, the adults who reused face masks significantly perceived that they had inadequate face masks. Concerted effort of health care professionals, community organizations, and the government will improve individuals’ practice in use of face masks and alleviate their actual and perceived feeling of having inadequate face masks, which lead them to reuse.
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Affiliation(s)
- Linda Yin-King Lee
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong.
| | - Issac Chun-Wing Chan
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Owen Pak-Man Wong
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Yaki Hoi-Ying Ng
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Crystal Kit-Ying Ng
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Max Hin-Wa Chan
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Joe Ka-Chun Ng
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Hailey Hei-Tung Koo
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Suk-Ting Lam
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Ada Cho-Wai Chu
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Rachel Yuen-Shan Wong
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Heidi Po-Ying Leung
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
| | - Angel Lok-Ching Pun
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Kowloon, Hong Kong
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Zhu W, Fang Y, Bai ZL, Li NN, Zhao JY, Hu Z. Effect of Emerging Major Infectious Diseases on Sleep Quality of Medical Workers: Findings from Medical Workers Providing Support During the COVID-19 Pandemic. Med Sci Monit 2021; 27:e931881. [PMID: 34117207 PMCID: PMC8207954 DOI: 10.12659/msm.931881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) outbreak has exerted immense pressure on medical systems in China and abroad. This study aimed to compare the sleep quality of medical personnel conscripted to the Wuhan Union Cancer Centre to offer support during the early stages of the COVID-19 pandemic to the sleep quality of those who remained at Anhui Medical University Hospital and to determine the role of interventions in improving sleep quality. Material/Methods Questionnaires were completed by 369 individuals who were conscripted to support Wuhan (N=137) and others who were not (the control group; N=232). The Pittsburgh Sleep Quality Index (PSQI) was used to measure the duration and quality of sleep. The Anhui Provincial Health Commission organized a comprehensive intervention, consisting of physical-psychological-social dimensions, over the course of 2 weeks. Results Only 34.21% of the Wuhan support workers reported better sleep quality, as opposed to the 55.60% of the control group at stage 1 (t/χ2=14.005, P<.001). Furthermore, despite the Wuhan support group being more prone to poor sleep quality, their sleep quality significantly improved after the interventions. Conclusions The findings from this study showed that medical staff who were conscripted to offer support during the early stages of the COVID-19 pandemic suffered from impaired quality of sleep. The use of questionnaire-based sleep assessments may provide individualized approaches to supporting medical personnel during future epidemics and pandemics. Furthermore, our results indicate that relevant interventions can significantly improve sleep quality, while a prolonged break after interventions does not affect sleep quality.
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Affiliation(s)
- Wen Zhu
- Graduate Student Affairs Office, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Yue Fang
- First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Zhong-Liang Bai
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Nian-Nian Li
- Department of Business Administration, School of Management, University of Science and Technology of China, Hefei, Anhui, China (mainland)
| | - Jia-Yun Zhao
- Graduate Student Affairs Office, First Affiliated Hospital, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Zhi Hu
- Department of Health Services Management, School of Health Services Management, Anhui Medical University, Hefei, Anhui, China (mainland)
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Poor Sleep Quality and Its Relationship with Individual Characteristics, Personal Experiences and Mental Health during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116030. [PMID: 34205195 PMCID: PMC8200012 DOI: 10.3390/ijerph18116030] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023]
Abstract
While the COVID-19 has dramatically altered our lifestyle and sleep practices, the links between sleep, individual characteristics, personal experiences and mental health during the pandemic require further examination. This cross-sectional, multi-methods study examined differences in language used to describe personal experiences, and mental health, based on sleep quality during the early stages of the pandemic. N = 1745 participants (mean age 42.97 ± 14.46 years) from 63 countries responded to the survey. Sleep quality was assessed using the Pittsburgh Sleep Quality Index and mental health was examined using the Patient Health Questionnaire-9, the State Trait Anxiety Inventory, the Perceived Stress Scale and the UCLA-Loneliness Scale. Quantitative analysis of qualitative, language content of personal experiences was conducted using free-text responses and comments to a question on the survey. Almost 50% of the participants reported poor sleep quality, which was linked to a more negative emotional tone and greater mentions of money or finance related words. Good sleepers reported more positive emotional tone in their experiences. Greater reports of clinical state anxiety, moderate depression and moderate stress were observed in poor sleepers, even after accounting for demographics and pandemic-related factors such as loneliness, financial concerns and risk of contracting COVID-19 disease. Results from this study highlight an urgent need for sleep-related public health interventions. Practitioner education, sleep screening for those with mental health conditions, and encouraging people to adopt digital tools may help to reduce the burden of poor sleep on mental health. While the pandemic itself is a stressful and uncertain time, improving sleep can support positive emotion regulation, improving mood and consequential action.
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Alimoradi Z, Broström A, Tsang HW, Griffiths MD, Haghayegh S, Ohayon MM, Lin CY, Pakpour AH. Sleep problems during COVID-19 pandemic and its' association to psychological distress: A systematic review and meta-analysis. EClinicalMedicine 2021; 36:100916. [PMID: 34131640 PMCID: PMC8192091 DOI: 10.1016/j.eclinm.2021.100916] [Citation(s) in RCA: 191] [Impact Index Per Article: 63.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The emerging novel coronavirus disease 2019 (COVID-19) has become one of the leading cause of deaths worldwide in 2020. The present systematic review and meta-analysis estimated the magnitude of sleep problems during the COVID-19 pandemic and its relationship with psychological distress. METHODS Five academic databases (Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and Embase) were searched. Observational studies including case-control studies and cross-sectional studies were included if relevant data relationships were reported (i.e., sleep assessed utilizing the Pittsburgh Sleep Quality Index or Insomnia Severity Index). All the studies were English, peer-reviewed papers published between December 2019 and February 2021. PROSPERO registration number: CRD42020181644. FINDINGS 168 cross-sectional, four case-control, and five longitudinal design papers comprising 345,270 participants from 39 countries were identified. The corrected pooled estimated prevalence of sleep problems were 31% among healthcare professionals, 18% among the general population, and 57% among COVID-19 patients (all p-values < 0.05). Sleep problems were associated with depression among healthcare professionals, the general population, and COVID-19 patients, with Fisher's Z scores of -0.28, -0.30, and -0.36, respectively. Sleep problems were positively (and moderately) associated with anxiety among healthcare professionals, the general population, and COVID-19 patients, with Fisher's z scores of 0.55, 0.48, and 0.49, respectively. INTERPRETATION Sleep problems appear to have been common during the ongoing COVID-19 pandemic. Moreover, sleep problems were found to be associated with higher levels of psychological distress. With the use of effective programs treating sleep problems, psychological distress may be reduced. Vice versa, the use of effective programs treating psychological distress, sleep problems may be reduced. FUNDING The present study received no funding.
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Affiliation(s)
- Zainab Alimoradi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden
| | - Hector W.H. Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Mark D. Griffiths
- International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, UK
| | - Shahab Haghayegh
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Maurice M. Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, CA, USA
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University
| | - Amir H. Pakpour
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Torrente FM, López PL, Comandé D, Ailan D, Fernandez Nievas SE, Robertson L, Ciapponi A. Remote non-pharmacologic interventions for sleep problems in healthcare workers during the COVID-19 pandemic. Hippokratia 2021. [DOI: 10.1002/14651858.cd015132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Fernando Manuel Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
| | - Pablo Luis López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
| | - Daniel Comandé
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
| | - Delfina Ailan
- Psychiatry and Cognitive Psychotherapy; Institute of Cognitive Neurology (INECO); Buenos Aires Argentina
| | - Simon E Fernandez Nievas
- Quality and Patient Safety; Institute for Clinical Effectiveness and Health Policy; Buenos Aires Argentina
| | - Lindsay Robertson
- Cochrane Common Mental Disorders; University of York; York UK
- Centre for Reviews and Dissemination; University of York; York UK
| | - Agustín Ciapponi
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
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Jantzen R, Noisel N, Camilleri-Broët S, Labbé C, Malliard TD, Payette Y, Broët P. Epidemiological characteristics of the COVID-19 spring outbreak in Quebec, Canada: a population-based study. BMC Infect Dis 2021; 21:435. [PMID: 33971843 PMCID: PMC8107425 DOI: 10.1186/s12879-021-06002-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 03/22/2021] [Indexed: 01/08/2023] Open
Abstract
Background By mid-July 2020, more than 108,000 COVID-19 cases had been diagnosed in Canada with more than half in the province of Quebec. In this context, we launched a study to analyze the epidemiological characteristics and the socio-economic impact of the spring outbreak in the population. Method We conducted an online survey of the participants of the CARTaGENE population-based cohort, composed of middle-aged and older adults. We collected information on socio-demographic, lifestyle, health condition, COVID-19 related symptoms and COVID-19 testing. We studied the association between these factors and two outcomes: the status of having been tested for SARS-CoV-2 and the status of having received a positive test. These associations were measured with univariate and multivariate analyses using a hybrid tree-based regression model. Results Among the 8,129 respondents from the CARTaGENE cohort, 649 were tested for COVID-19 and 41 were positive. Medical workers and individuals having a contact with a COVID-19 patient had the highest probabilities of being tested (32% and 42.4%, respectively) and of being positive (17.2% and 13.0%, respectively) among those tested. Approximately 8% of the participants declared that they have experienced at least one of the four COVID-19 related symptoms chosen by the Public Health authorities (fever, cough, dyspnea, anosmia) but were not tested. Results from the tree-based model analyses adjusted on exposure factors showed that the combination of dyspnea, dry cough and fever was highly associated with being tested whereas anosmia, fever, and headache were the most discriminant factors for having a positive test among those tested. During the spring outbreak, more than one third of the participants have experienced a decrease in access to health services. There were gender and age differences in the socio-economic and emotional impacts of the pandemic. Conclusion We have shown some discrepancies between the symptoms associated with being tested and being positive. In particular, the anosmia is a major discriminant symptom for positivity whereas ear-nose-throat symptoms seem not to be COVID-19 related. The results also emphasize the need of increasing the accessibility of testing for the general population. Supplementary Information The online version contains supplementary material available at (10.1186/s12879-021-06002-0).
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Affiliation(s)
- Rodolphe Jantzen
- CARTaGENE, CHU Ste-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, H3T1C5, Canada. .,Université de Montréal, Montréal, Canada.
| | - Nolwenn Noisel
- CARTaGENE, CHU Ste-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, H3T1C5, Canada.,Université de Montréal, Montréal, Canada
| | | | - Catherine Labbé
- CARTaGENE, CHU Ste-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, H3T1C5, Canada
| | - Thibault de Malliard
- CARTaGENE, CHU Ste-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, H3T1C5, Canada
| | - Yves Payette
- CARTaGENE, CHU Ste-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, H3T1C5, Canada
| | - Philippe Broët
- CARTaGENE, CHU Ste-Justine Research Center, 3175 Chemin de la Côte-Sainte-Catherine, Montréal, H3T1C5, Canada.,Université de Montréal, Montréal, Canada.,Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, 94807, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Paris-Sud, Hôpital Paul Brousse, 12 Avenue Paul Vaillant Couturier, Villejuif, 94807, France
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López PL, Torrente FM, Comandé D, Ailan D, Fernandez Nievas SE, Robertson L, Ciapponi A. Remote non-pharmacologic interventions for sleep problems in adults during the COVID-19 pandemic. Hippokratia 2021. [DOI: 10.1002/14651858.cd015051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Pablo Luis López
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
| | - Fernando Manuel Torrente
- Laboratory of Psychopathology Research, Institute of Cognitive and Translational Neuroscience (INCyT); CONICET, INECO Foundation, Favaloro University; Buenos Aires Argentina
| | - Daniel Comandé
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
| | - Delfina Ailan
- Psychiatry and Cognitive Psychotherapy; Institute of Cognitive Neurology (INECO); Buenos Aires Argentina
| | - Simon E Fernandez Nievas
- Quality and Patient Safety; Institute for Clinical Effectiveness and Health Policy; Buenos Aires Argentina
| | - Lindsay Robertson
- Cochrane Common Mental Disorders; University of York; York UK
- Centre for Reviews and Dissemination; University of York; York UK
| | - Agustín Ciapponi
- Argentine Cochrane Centre; Instituto de Efectividad Clínica y Sanitaria (IECS-CONICET); Buenos Aires Argentina
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Al Naamani Z, Gormley K, Noble H, Santin O, Al Maqbali M. Fatigue, anxiety, depression and sleep quality in patients undergoing haemodialysis. BMC Nephrol 2021; 22:157. [PMID: 33910523 PMCID: PMC8080199 DOI: 10.1186/s12882-021-02349-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 04/08/2021] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Patients undergoing haemodialysis may experience troubling symptoms such as fatigue, anxiety, depression and sleep quality, which may affect their quality of life. The main objective of this study is to determine the prevalence of fatigue, anxiety, depression and sleep quality among patients receiving haemodialysis during the coronavirus disease 2019 (COVID-19) pandemic, and to explore the contributing predictors. METHODS A cross-sectional and descriptive correlational design using Qualtrics software was performed. Data were collected using the Functional Assessment of Cancer Therapy-Fatigue (FACT-F), the Hospital Anxiety and Depression Scale (HADS) and the Pittsburgh Sleep Quality Index (PSQI). Logistic regression analyses were used to explore the predictors that were associated with fatigue, anxiety, depression and sleep quality. RESULTS Of the 123 patients undergoing haemodialysis who participated, 53.7% (n = 66) reported fatigue, 43.9% (n = 54) reported anxiety, 33.3% (n = 41) reported depression and 56.9% (n = 70) reported poor sleep. Fatigue, anxiety and sleep quality (P < .05) were significantly associated with being female, and whether family members or relatives were suspected or confirmed with COVID-19. Logistic regression showed that being within the age group 31-40, having a secondary education level, anxiety, depression and sleep quality were the main predictors affecting the fatigue group. CONCLUSION Fatigue, anxiety, depression and sleep quality are significant problems for patients receiving haemodialysis during the COVID-19 pandemic. Appropriate interventions to monitor and reduce fatigue, psychological problems and sleep quality amongst these patients are needed. This can help to strengthen preparations for responding to possible future outbreaks or pandemics of infectious diseases for patients receiving haemodialysis.
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Affiliation(s)
| | - Kevin Gormley
- College of Nursing and Midwifery, Mohammed Bin Rashid University of Medicine and Health Science, Dubai, UAE
| | - Helen Noble
- School of Nursing and Midwifery, Queens's University Belfast, Belfast, UK
| | - Olinda Santin
- School of Nursing and Midwifery, Queens's University Belfast, Belfast, UK
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Alharbi AS, Alshahrani SM, Alsaadi MM, AL-Jahdali HH, Wali SO, BaHammam AS. Sleep quality and insomnia during the COVID-19 lockdown among the Saudi public: A cross-sectional study. Saudi Med J 2021; 42:384-390. [PMID: 33795493 PMCID: PMC8128641 DOI: 10.15537/smj.2021.42.4.20200735] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 03/11/2021] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES To measure the Saudi population's sleep quality during the lockdown of COVID-19. METHODS An internet-based questionnaire that was performed during the lockdown of the COVID-19 pandemic among the Saudi population over 2 weeks from April 1 to April 15, 2020. We used the instant messaging application WhatsApp and Twitter to reach the targeted population. Saudi citizens and non-Saudi residents who can read and understand the questionnaire were recruited. Data were analyzed using Stata and SPSS. RESULTS A total of 790 responses were included. The majority of participants were the Saudi population 735 (92.9%). The prevalence of insomnia and poor sleep quality were 54.4% and 55.5%, respectively. Saudi citizenship was associated with longer sleep duration (p=0.031). Female gender and being married were associated with worse global PSQI, sleep quality, sleep distribution, sleep latency, and daytime dysfunction. CONCLUSION Our findings showed that during the COVID-19 pandemic, the Saudi population had a high prevalence of insomnia and poor sleep quality. Routine monitoring of the psychological impact of life-threatening outbreaks and the adoption of effective early mental health actions should be considered.
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Affiliation(s)
- Adel S. Alharbi
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
- Address correspondence and reprint request to: Dr. Adel S. Alharbi, Department of Pediatrics, Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense, Riyadh, Kingdom of Saudi Arabia. E-mail: ORCID ID: http://orcid.org/0000-0001-7974-4026
| | - Sultan M. Alshahrani
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Muslim M. Alsaadi
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Hamdan H. AL-Jahdali
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Siraj O. Wali
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
| | - Ahmed S. BaHammam
- From the Department of Pediatrics (Alharbi), Pediatric Sleep Disorders Center, Prince Sultan Military City, Ministry of Defense; from the Department of Neurosciences (Alshahrani), King Abdullah bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University; from the Department of Pediatrics (Alsaadi), from the National Plan for Science and Technology (BaHammam), College of Medicine & King Khalid University Hospital; from the University Sleep Disorders Center (BaHammam), Department of Medicine, College of Medicine, King Saud University; from the Department of Medicine (AL-Jahdali), Sleep Disorder Center, King Saud Bin Abdulaziz for Health Sciences, Riyadh; and from the Sleep Medicine and Research Center (Wali), King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.
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Becker SP, Dvorsky MR, Breaux R, Cusick CN, Taylor KP, Langberg JM. Prospective Examination of Adolescent Sleep Patterns and Behaviors Before and During COVID-19. Sleep 2021; 44:6149938. [PMID: 33631014 PMCID: PMC7928571 DOI: 10.1093/sleep/zsab054] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/19/2021] [Indexed: 12/19/2022] Open
Abstract
Study Objectives To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD. Methods Participants were 122 adolescents (ages 15–17; 61% male; 48% with ADHD). Parents reported on adolescents’ sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019 to February 2020) and during (May–June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19. Results Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19. Conclusions COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.
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Affiliation(s)
- Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Melissa R Dvorsky
- Division of Psychology and Behavioral Health, Children's National Hospital, Washington, DC, USA
| | - Rosanna Breaux
- Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | - Caroline N Cusick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Katherine P Taylor
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
| | - Joshua M Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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Effects of COVID-19 pandemic and lockdown on lifestyle and mental health of students: A retrospective study from Karachi,Pakistan. ANNALES MEDICO-PSYCHOLOGIQUES 2021; 180:S29-S37. [PMID: 33612842 PMCID: PMC7883721 DOI: 10.1016/j.amp.2021.02.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/10/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Due to the COVID-19 pandemic, many countries imposed lockdowns on their citizens in an attempt to contain the disease. Pakistan is one of these countries. A government mandated lockdown can have mitigating psychological effects on young adults, out of which a large fraction is made up of students. This study aims to investigate the correlations between changes in sleep pattern, perception of time, and digital media usage. Furthermore, it explores the impact of these changes on the mental health of students of different educational levels. METHODS This cross-sectional study was conducted via a web-based questionnaire, from March 24 to April 26, 2020. The survey was targeted at students and 251 responses were obtained. It was a 5-section long questionnaire. The first section inquired about demographics of participants. Each of the other 4 section were devoted to changes in sleep pattern, perception of time flow, digital media usage and mental health status of students. Close ended questions with multiple choice responses, dichotomous, interval and 4-point Likert scales were used in the construction of the survey questionnaire. Chi square, T-tests multinomial and binary logistic regression were used as primary statistical tests. All data were analyzed using Statistical Package for Social Science (SPSS) version 23.0 (IBM Corp., Armonk, NY). RESULTS Out of 251 adolescents that participated in our study, the majority (70.2%) were females. The mean age of the participants was 19.40+/- 1.62 years. Two-thirds of the respondents did not have much trouble falling asleep (66.5%). The analysis found no significant association between longer sleep periods and procrastination level (p = 0.054). Nearly three-fourths (72.9%) of our participants felt that getting through quarantine would have been more difficult if they did not have any electronic gadgets. Of these, a majority (85.8%) had a general feeling of tiredness and lacked motivation (p = 0.023). Additionally, a large number of students (69.7%) had reported that time is seemingly moving faster. A significant relationship between increased usage of electronic items and longer sleep periods was also noted (p = 0.005). With respect to the level of education statistically significant values were noted for alarm use both before and after quarantine began (p = 0.021 and p = 0.004, respectively). Further analysis showed that there was a significant difference in the median difference of time spent on social media before the outbreak (3.0+/-32.46) and time spent on social media after the outbreak (6.0+/-3.52) in a single day (p=0.000). CONCLUSIONS Our research has revealed that due to the lockdown imposed by the government in response to COVID-19, the sleeping patterns of the students was affected the most. Our findings show that the increase in use of social media applications led to a widespread increase in the length of sleep, worsening of sleep habits (people sleeping at much later hours than usual), and a general feeling of tiredness. A general lack of recollection regarding what day of the week it was, as well as a change in the perceived flow of time were also notable. All these findings indicate the decline in mental health of students due to the lockdown. Promoting better sleep routines, minimizing the use of digital media, and encouragement of students to take up more hobbies could collectively improve the health and mood of students in self quarantine.
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Bruni O, Malorgio E, Doria M, Finotti E, Spruyt K, Melegari MG, Villa MP, Ferri R. Changes in sleep patterns and disturbances in children and adolescents in Italy during the Covid-19 outbreak. Sleep Med 2021; 91:166-174. [PMID: 33618965 PMCID: PMC7871805 DOI: 10.1016/j.sleep.2021.02.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/09/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023]
Abstract
Objective To examine the impact of home confinement during the COVID-19 pandemic on the sleep patterns and sleep disturbances in Italian children and adolescents. Methods Participants completed an anonymous online survey, shared via social media and targeting children and adolescents aged 1–18 years, subdivided into age groups: 1–3, 4–5, 6–12, and 13–18 years. Caregivers completed a modified version of the Sleep Disturbance Scale for Children (SDSC), along with demographic information. Results The final sample consisted of 4314 subjects: 2217 males (50.4%) and 2097 females (49.6%). Age group distribution was: 1–3 years 1263 (29.3%), 4–5 years 893 (20.7%), 6–12 years 1848 (42.8%) and 13–18 years 310 (7.2%). We found a significant delay in bedtime and risetime in all age groups. School-age children and adolescents experienced the most significant delay: weekday bedtime ≥23 was reported by 28.4% of 6- to 12-year-old children during lockdown vs. 0.9% before and by 63.5% vs. 12.3% of 13- to 18-year-old adolescents. Risetime was also delayed with most subjects waking up after 8 in all age groups and sleep duration increased in all groups but not in the younger group. The screen time (excluding online lessons) boosted during the lockdown, mainly in older children but also in younger children. Sleep disorders increased in all groups but not in adolescents. Younger groups had an increased prevalence of difficulty falling asleep, anxiety at bedtime, night awakenings, nightmares and sleep terrors. Conclusion Our study demonstrates that confinement due to COVID-19 determined a big delay in sleep/wake schedule of children in all age groups as well as an increase of sleep disturbances in all groups but adolescents.
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Affiliation(s)
- Oliviero Bruni
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy.
| | - Emanuela Malorgio
- Italian Federation of Primary Care Pediatricians (Federazione Italiana Medici Pediatri, FIMP), Expert on Sleep Disorders AIMS, Torino, Italy
| | - Mattia Doria
- Italian Federation of Primary Care Pediatricians (Federazione Italiana Medici Pediatri, FIMP), Venice, Italy
| | - Elena Finotti
- Department of Rehabilitation, Child and Adolescent Neuropsychiatry Unit, ULSS 6, Vicenza, Italy
| | - Karen Spruyt
- Lyon Neuroscience Research Center, INSERM U1028-CNRS UMR 5292, University Claude Bernard, School of Medicine, Lyon, France
| | - Maria Grazia Melegari
- Department of Developmental and Social Psychology, Sapienza University of Rome, Italy
| | - Maria Pia Villa
- Chair of Pediatrics, NESMOS Department, Sapienza University, Sant'Andrea Hospital, Rome, Italy
| | - Raffaele Ferri
- Sleep Research Centre, Oasi Research Institute - IRCCS, Troina, Italy
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Maestro-Gonzalez A, Sánchez-Zaballos M, Mosteiro-Díaz MP, Zuazua-Rico D. Quality of sleep among social media users during the lockdown period due to COVID-19 in Spain. Sleep Med 2021; 80:210-215. [PMID: 33607556 PMCID: PMC9188780 DOI: 10.1016/j.sleep.2021.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 12/01/2020] [Accepted: 01/26/2021] [Indexed: 11/06/2022]
Abstract
Aims To analyse the quality of sleep of the Spanish population during the lockdown due to COVID-19. Design Cross-sectional descriptive study using a web based survey design. Methods Pittsburgh Sleep Quality Index questionnaire and sociodemographic, occupational, health and sleep quality variables were used to collect data during the first month of the lockdown period due to COVID-19 (March–April 2020). A snowball sampling was carried out, where participants were asked to disseminate and distribute the questionnaire among their own profiles in social networks. Results A representative sample of 5220 participants aged ≥18 years old took part in the study. The global PSQI score was 8.17 points (SD 4.43). A statistical association was found between the global PSQI score and several of the variables collected. Findings show that the quality of sleep was worse among women (p < 0.001), single participants (p 0.02), those working in rotating shifts (p < 0.001), on-site workers (p < 0.001), and people diagnosed with COVID-19 or who had someone in their environment diagnosed with the virus (p < 0.001). Conclusion Findings show that the Spanish population has experienced poor quality of sleep during the lockdown period. Being a woman, working in rotating shifts, having suffered from COVID-19 or having someone close suffering from COVID-19, being unemployed or being affected by a Temporary Redundancy Scheme, as well as spending long hours in bed were associated with poorer sleep quality. On the contrary, being older and sleeping longer hours were associated with a better sleep quality.
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Affiliation(s)
- Alba Maestro-Gonzalez
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marta Sánchez-Zaballos
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain.
| | | | - David Zuazua-Rico
- Faculty of Medicine and Health Sciences, University of Oviedo, Hospital Universitario Central de Asturias, Oviedo, Spain
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