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Xu T, Zhu D, Yu Z, Dang J, Schiöth H. Differentiating the relationships between traditional and new media use and sleep quality during the COVID-19 pandemic: roles of psychological distress and age. Front Psychol 2024; 15:1422004. [PMID: 38988378 PMCID: PMC11233781 DOI: 10.3389/fpsyg.2024.1422004] [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: 04/23/2024] [Accepted: 06/05/2024] [Indexed: 07/12/2024] Open
Abstract
Background Numerous studies have consistently demonstrated a decline in sleep quality during the COVID-19 pandemic. The primary objective of this study is to explore the impact of engaging with pertinent epidemic information through the media amid the COVID-19 crisis on individuals' sleep quality and the underlying mechanisms through which this influence operates. Methods An online cross-sectional study design was employed. A total of 1,063 British adults (36.2% males; M age = 38.85, SD age = 13.36, ranging from 18 to 77 years old) participated in the study and completed our questionnaires, which included media usage frequency during the pandemic, the 10-item Kessler Psychological Distress Scale (K10), the Insomnia Severity Index (ISI), and the Ten-item Personality Inventory (TIPI). Results Pearson's correlation analyses indicated that there was no significant correlation between COVID-19-related traditional media use (television, radio, newspaper) and psychological distress or sleep quality. However, exposure to information related to COVID-19 through new media use (Facebook, Tik Tok, Twitter) was correlated with greater psychological distress and poorer sleep quality. A moderated mediation analysis showed that psychological distress fully mediated the relationship between new media use and poor sleep, which was moderated by age, with the association between psychological distress and poor sleep quality being stronger among older adults. Conclusion Exposure to information of COVID-19 via new (but not traditional) media use deteriorated sleep quality through greater psychological distress, and this relationship was stronger among older adults.
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Affiliation(s)
- Tong Xu
- School of Education, Jianghan University, Wuhan, China
| | - Dongmei Zhu
- School of Education, Jianghan University, Wuhan, China
| | - Zhaoliang Yu
- Department of Psychology, School of Humanities and Social Sciences, Fuzhou University, Fuzhou, China
| | - Junhua Dang
- Institute of Social Psychology, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, China
| | - Helgi Schiöth
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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2
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Elder GJ, Santhi N, Robson AR, Alfonso-Miller P, Spiegelhalder K, Ellis JG. An online behavioral self-help intervention rapidly improves acute insomnia severity and subjective mood during the coronavirus disease-2019 pandemic: a stratified randomized controlled trial. Sleep 2024; 47:zsae059. [PMID: 38430544 PMCID: PMC11168762 DOI: 10.1093/sleep/zsae059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/20/2024] [Indexed: 03/04/2024] Open
Abstract
STUDY OBJECTIVES Stressful life events, such as the coronavirus disease-2019 (COVID-19) pandemic, can cause acute insomnia. Cognitive behavioral therapy for acute insomnia is effective but is both time and resource-intensive. This study investigated if an online behavioral self-help intervention, which has been successfully used alongside sleep restriction for acute insomnia, reduced insomnia severity and improved mood in acute insomnia. This study also assessed good sleepers to explore if a "sleep vaccination" approach was feasible. METHODS In this online stratified randomized controlled trial, 344 participants (103 good sleepers and 241 participants with DSM-5 acute insomnia) were randomized to receive the intervention/no intervention (good sleepers) or intervention/intervention after 28 days (poor sleepers). Insomnia severity was assessed using the ISI (primary outcome), and anxiety and depression using the GAD-7/PHQ-9 (secondary outcomes) at baseline, 1 week, 1 month, and 3-month follow-up. RESULTS In people with acute insomnia, relative to baseline, there were significant reductions in ISI (dz = 1.17), GAD-7 (dz = 0.70), and PHQ-9 (dz = 0.60) scores at 1-week follow-up. ISI, GAD-7, and PHQ-9 scores were significantly lower at all follow-up time points, relative to baseline. Subjective diary-derived sleep continuity was unaffected. No beneficial effects on sleep or mood were observed in good sleepers. CONCLUSIONS An online behavioral self-help intervention rapidly reduces acute insomnia severity (within 1 week), and benefits mood in people with acute insomnia. These beneficial effects are maintained up to 3 months later. Although the use of the intervention is feasible in good sleepers, their subjective sleep was unaffected. CLINICAL TRIAL REGISTRATION Testing an early online intervention for the treatment of disturbed sleep during the COVID-19 pandemic; prospectively registered at ISRCTN on 8 April 2020 (identifier: ISRCTN43900695).
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Affiliation(s)
- Greg J Elder
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | - Nayantara Santhi
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | - Amelia R Robson
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | | | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Medical Center - University of Freiburg, Freiburg, Germany
| | - Jason G Ellis
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
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3
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Rosenblum S, Cohen Elimelech O. Daily Functional Characteristics and Health Among Older Adults During COVID-19: A Structural Equation Modeling Approach. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241233430. [PMID: 38385207 PMCID: PMC10885779 DOI: 10.1177/00469580241233430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Within a few years, 1 in 6 people will be aged 60 years or older. Extreme situations, such as the COVID-19 crisis, constitute a challenge to older adults. However, the literature on the daily functional characteristics of older adults in the past and during the COVID-19 crisis and their relationships to their physical and mental health is scarce. This study aimed to examine the past and present daily functional factors associated with physical and mental health in older adults. Using an online platform, 204 Israelis aged 60 years and older reported their physical health symptoms and anxiety levels. They completed questionnaires about past (negative life events and childhood daily functional self-actualization) and present (adulthood daily functional self-actualization, functional cognition and sleep quality) factors. Structural equation modeling revealed correlations between functional cognition and childhood daily functional self-actualization (β = -.18) and anxiety (β = .15); adulthood daily functional self-actualization and past negative life events (β = -.18), anxiety (β = -.50), and physical symptoms (β = -16); and sleep quality and past childhood daily functional self-actualization (β = -.19), negative life events (β = .22), anxiety (β = .18), and physical symptoms (β = .40). These findings shed light on potential functional factors for older adults' health, indicating that these functional factors play a vital role in reducing health problems in later life.
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Puto G, Cybulski M, Kędziora-Kornatowska K, Doroszkiewicz H, Muszalik M. Sleep Quality in Older People: The Impact of Age, Professional Activity, Financial Situation, and Chronic Diseases During the SARS-CoV-2 Pandemic. Med Sci Monit 2023; 29:e941648. [PMID: 38083823 PMCID: PMC10725042 DOI: 10.12659/msm.941648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/26/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The SARS-CoV-2 pandemic negatively affected health and social life, notably deteriorating sleep quality in older adults. Studies report inconsistent findings on sleep disturbances during this period, influenced by various physiological, emotional, and sociodemographic factors. This study aimed to identify these determining factors. MATERIAL AND METHODS The study was conducted among 342 people 60 years of age or older participating in online classes of randomly selected Senior Clubs and the University of the Third Age in the southern regions of Poland. RESULTS Sleep problems (PSQI >5 points) were diagnosed in 250 subjects (83.6%). Logistic regression analysis showed that the quality of sleep significantly depends on: age, as people aged 66-70 were more likely to have better sleep quality than people aged 60-65 (OR=3.07), and those over 70 scored better than people aged 60-65 (OR=2.87); current job - employed people have a better chance of better sleep quality (OR=3.08) than unemployed people; financial situation, people assessing their financial situation as very good/good had a better chance of better sleep quality (OR=2.00) compared to people assessing their financial situation as very bad, bad/average; chronic diseases, people without chronic diseases had a chance of better sleep quality (OR=2.45) than people with chronic diseases. CONCLUSIONS Age, financial situation, current job, and chronic disease were the most important factors determining sleep quality in older people. The identification of factors affecting sleep quality can be used as important data to develop interventions and programs to improve sleep quality.
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Affiliation(s)
- Grażyna Puto
- Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland
| | - Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Białystok, Białystok, Poland
| | - Kornelia Kędziora-Kornatowska
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
| | | | - Marta Muszalik
- Department of Geriatrics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Bydgoszcz, Poland
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5
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Shaik L, Boike S, Ramar K, Subramanian S, Surani S. COVID-19 and Sleep Disturbances: A Literature Review of Clinical Evidence. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050818. [PMID: 37241050 DOI: 10.3390/medicina59050818] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 05/28/2023]
Abstract
The need for adequate good quality sleep to optimally function is well known. Over years, various physical, psychological, biological, and social factors have been investigated to understand their impact on sleep. However, understanding the etiological processes that are involved in causing sleep disturbances (SD) as impacted by stressful phases such as pandemics has not been well studied. Many such etiological and management strategies have surfaced during the latest "coronavirus disease of 2019 (COVID-19) pandemic. The occurrence of these SD in the infected and uninfected individuals poses a need to investigate factors linked to such occurrence during this phase. Some of such factors include stressful practices such as social distancing, masking, vaccines, and medications availability, changes in routines, and lifestyles. As the status of infection improved, a collective term for all the prolonged effects of COVID-19 after the resolution of the primary infection called the post-COVID-19 syndrome (PCS) surfaced. Apart from impacting sleep during the infectious phase, the aftereffects of this virus left an even greater impact during the PCS. Various mechanisms have been hypothesized to be linked to such SD during the PCS, but the available data are inconclusive. Further, the varied patterns of incidence of these SDs differed by many factors, such as age, gender, and geographical location, making clinical management even more challenging. This review elucidates the impact of coronavirus 2 (SARS-CoV-2) (COVID) disease on sleep health during the various phases of the COVID-19 pandemic. We also investigate different causal relationships, management strategies, and knowledge gaps related to SD during the COVID-19 pandemic.
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Affiliation(s)
- Likhita Shaik
- Department of Family Medicine, Hennepin Healthcare, Minneapolis, MN 55415, USA
| | - Sydney Boike
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA
| | | | | | - Salim Surani
- Department of Pulmonary, Critical Care and Sleep Medicine, Texas A&M University, College Station, TX 77843, USA
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6
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Elder GJ, Altena E, Palagini L, Ellis JG. Stress and the hypothalamic-pituitary-adrenal axis: How can the COVID-19 pandemic inform our understanding and treatment of acute insomnia? J Sleep Res 2023:e13842. [PMID: 36748346 DOI: 10.1111/jsr.13842] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 01/09/2023] [Accepted: 01/16/2023] [Indexed: 02/08/2023]
Abstract
Stress and sleep are very closely linked, and stressful life events can trigger acute insomnia. The ongoing COVID-19 pandemic is highly likely to represent one such stressful life event. Indeed, a wide range of cross-sectional studies demonstrate that the pandemic is associated with poor sleep and sleep disturbances. Given the high economic and health burden of insomnia disorder, strategies that can prevent and treat acute insomnia, and also prevent the transition from acute insomnia to insomnia disorder, are necessary. This narrative review outlines why the COVID-19 pandemic is a stressful life event, and why activation of the hypothalamic-pituitary-adrenal axis, as a biological marker of psychological stress, is likely to result in acute insomnia. Further, this review outlines how sleep disturbances might arise as a result of the COVID-19 pandemic, and why simultaneous hypothalamic-pituitary-adrenal axis measurement can inform the pathogenesis of acute insomnia. In particular, we focus on the cortisol awakening response as a marker of hypothalamic-pituitary-adrenal axis function, as cortisol is the end-product of the hypothalamic-pituitary-adrenal axis. From a research perspective, future opportunities include identifying individuals, or particular occupational or societal groups (e.g. frontline health staff), who are at high risk of developing acute insomnia, and intervening. From an acute insomnia treatment perspective, priorities include testing large-scale online behavioural interventions; examining if reducing the impact of stress is effective and, finally, assessing whether "sleep vaccination" can maintain good sleep health by preventing the occurrence of acute insomnia, by preventing the transition from acute insomnia to insomnia disorder.
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Affiliation(s)
- Greg J Elder
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | - Ellemarije Altena
- Institut de Neurosciences Cognitives et Intégratives d'Aquitaine-UMR 5287 CNRS, Team Neuroimaging and Human Cognition, Université de Bordeaux, Bordeaux, France
| | - Laura Palagini
- Department of Neuroscience and Rehabilitation, Psychiatric Section University of Ferrara, Ferrara, Italy.,Department of Clinical and Experimental Medicine, Psychiatric Section, University of Pisa, Azienda Ospedaliera Universitaria Pisana (AOUP), Pisa, Italy
| | - Jason G Ellis
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
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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] [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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8
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Natour N, Al-Tell M. Lifestyles of Palestinians during the COVID-19 pandemic: A cross-sectional study. Nutr Health 2022:2601060221137625. [PMID: 36352738 PMCID: PMC9659694 DOI: 10.1177/02601060221137625] [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] [Indexed: 06/16/2023]
Abstract
Background: Although the COVID-19 epidemic was linked to movement limitations and a sense of risk among the general public, changes in lifestyle and mental health were not examined among Palestinians. The study aimed to investigate changes in a group of Palestinians' lifestyles and mental health. Methodology: A translated questionnaire about demographics, mental health difficulties, and lifestyle choices was created using Google Forms and distributed over social media and academic platforms. SPSS 21 was used to analyze the data. Results: The participants' mean age was 25 9 years, 67% were women, and 47% were city dwellers. About 82% had a bachelor's degree. Infection with COVID-19 was present in 13% of study group, COVID-19 infection caused the death of a relative in 13% of study group, and commitment to limits was present in 14% of study group. Negative emotions like despair, hopelessness, and worry were extremely common. Despite eating a few fruits and vegetables and drinking a lot of soft beverages, study participants were generally active. Conclusion: The COVID-19 pandemic is associated with a negative impact on lifestyle and mental well-being.
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Affiliation(s)
- Nihal Natour
- Department of Public Health, School of Medicine, An-Najah National
University, Nablus, Palestine
| | - Mariam Al-Tell
- Department of Public Health, School of Medicine, An-Najah National
University, Nablus, Palestine
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9
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Chen J, Zhang SX, Yin A, Yáñez JA. Mental health symptoms during the COVID-19 pandemic in developing countries: A systematic review and meta-analysis. J Glob Health 2022; 12:05011. [PMID: 35604881 PMCID: PMC9126304 DOI: 10.7189/jogh.12.05011] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background This systematic review aims to 1) summarize the prevalence of anxiety, depression, distress, insomnia, and PTSD in the adult population during the first year of the COVID pandemic in developing countries and 2) uncover and highlight the uneven distribution of research on mental health in all developing countries across regions. Methods Several literature databases were systemically searched for meta-analyses published by September 22, 2021, on the prevalence rates of mental health symptoms in developing countries worldwide. We meta-analysed the raw data of the individual empirical results from the previous meta-analysis papers in developing countries in different regions. Results The prevalence rates of mental health symptoms were summarized based on 341 empirical studies with a total of 1 704 072 participants from 40 out of 167 developing countries in Africa, Asia (East, Southeast, South, and West), Europe, and Latin America. Comparatively, Africa (39%) and West Asia (35%) had the worse overall mental health symptoms, followed by Latin America (32%). The prevalence rates of overall mental health symptoms of medical students (38%), general adult students (30%), and frontline health care workers (HCWs) (27%) were higher than those of general HCWs (25%) and general populations (23%). Among five mental health symptoms, distress (29%) and depression (27%) were the most prevalent. Interestingly, people in the least developing countries suffered less than those in emergent and other developing countries. The various instruments employed lead to result heterogeneity, demonstrating the importance of using the well-established instruments with the standard cut-off points (eg, GAD-7, GAD-2, and DASS-21 for anxiety, PHQ-9 and DASS-21 for depression, and ISI for insomnia). Conclusions The research effort on mental health in developing countries during COVID-19 has been highly uneven in the scope of countries and mental health outcomes. This meta-analysis, the largest on this topic to date, shows that the mental health symptoms are highly prevalent yet differ across regions. The accumulated systematic evidence from this study can help enable the prioritization of mental health assistance efforts to allocate attention and resources across countries and regions.
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Affiliation(s)
- Jiyao Chen
- College of Business, Oregon State University, Corvallis, Oregon, USA
| | - Stephen X Zhang
- Adelaide Business School, University of Adelaide, Adelaide, Australia
| | - Allen Yin
- School of Humanities, Southeast University, Nanjing, China
| | - Jaime A Yáñez
- Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima, Peru
- Gerencia Corporativa de Asuntos Científicos y Regulatorios, Teoma Global, Lima, Peru
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10
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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: 147] [Impact Index Per Article: 73.5] [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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11
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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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12
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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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13
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John B, Marath U, Valappil SP, Mathew D, Renjitha M. Sleep Pattern Changes and the Level of Fatigue Reported in a Community Sample of Adults During COVID-19 Pandemic. SLEEP AND VIGILANCE 2022; 6:297-312. [PMID: 35756155 PMCID: PMC9207167 DOI: 10.1007/s41782-022-00210-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 05/10/2022] [Accepted: 05/29/2022] [Indexed: 04/18/2023]
Abstract
PURPOSE The study aimed to (a) assess the sleep pattern changes and the level of fatigue among COVID positive adults (b) determine the association of sociodemographic and lifestyle factors (age, gender, marital status, occupation, income, exercise, nap, diet, and comorbidities) on sleep pattern and level of fatigue c) examine the relationship between sleep and fatigue, and between sleep problems, sleep quality and fatigue, among a community sample of COVID-19 affected adults. METHODS A non-experimental, descriptive, cross-sectional survey design was used. Participants were adults, between 18 and 63 years (n = 782), who tested positive for COVID-19 infection using RT-PCR or Antigen test, confined to home quarantine/under observation, and without any complications. Data was collected using the socio-demographic-sleep and related activity questionnaire, Fatigue Assessment Scale, and Sleep Quality Scale. RESULTS A majority of the participants reported either mild to moderate sleep quality problems (97.31%) and 377 of them (48.21%) reported fatigue levels. A significant association between sleep quality and fatigue with gender, and lifestyle factors such as sleep duration, food intake, napping, exercise pattern, and influence of COVID-19 on livelihood after being affected with COVID-19, and time of experiencing sleep problems after COVID-19 infection (all, p ˂ 0.01) were observed, as well as age with sleep quality. Poor sleep quality and fatigue were significantly correlated with each other, and also with sleep problems before being affected with COVID-19 (p = 0.000). CONCLUSIONS The study has shown that COVID-19 has an effect on an individual's demographic factors and a multitude of lifestyle factors, and highlights the need for post-COVID-19 monitoring even after recovery from the disease.
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Affiliation(s)
- Bindu John
- Community Health Nursing Department, Lisie College of Nursing, Lisie Medical and Educational Institutions, Kaloor, Ernakulam, District- 682018 Kerala India
| | - Usha Marath
- Lisie College of Nursing, Lisie Medical and Educational Institutions, Kaloor, Ernakulam, District-682018 Kerala India
| | - Sumathi Palghat Valappil
- Child Health Department, Lisie College of Nursing, Lisie Medical and Educational Institutions, Kaloor, Ernakulam, District-682018 Kerala India
| | - Deepa Mathew
- Medical Surgical Nursing Department, Lisie College of Nursing, Lisie Medical and Educational Institutions, Kaloor, Ernakulam, District-682018 Kerala India
| | - Mercy Renjitha
- Medical Surgical Nursing Department, Lisie College of Nursing, Lisie Medical and Educational Institutions, Kaloor, Ernakulam, District-682018 Kerala India
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14
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Karatel M, Bulut ZI, Sari EO, Pelin Z, Yakut Y. The profile of musculoskeletal pain and its associations with sleep quality and depression during the COVID-19 in Turkey. Korean J Pain 2022; 35:78-85. [PMID: 34966014 PMCID: PMC8728556 DOI: 10.3344/kjp.2022.35.1.78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/30/2021] [Accepted: 09/10/2021] [Indexed: 01/05/2023] Open
Abstract
Background The current pandemic has affected people’s health multidimensionally. This study aims to investigate musculoskeletal pain, sleep quality, depression levels, and their relationships in individuals belonging to different age groups during COVID-19 in Turkey. Methods A web-based self-administered survey that consisted of demographic questions, The Beck Depression Inventory (BDI), Pittsburgh Sleep Quality Index (PSQI), and scores of musculoskeletal pain was sent to participants. Pearson correlation analysis was used for determining the statistical relationship between variables. Results The study includes 1,778 participants. The highest percentage for mild, moderate, and severe pain was in the head (49.8%), back (15.5%), and head (11.5%), respectively. The PSQI-total had shown a weak correlation with pain levels in all body parts. The highest correlation for sleep quality and pain levels was between the PSQI-5 and lower back pain. There was a weak correlation between PSQI-2 and the BDI score, and a moderate correlation between the PSQI-1, PSQI-5, PSQI-7, PSQI-total, and BDI score. Pain in all body parts showed a weak correlation with depression level. Conclusions This study showed that musculoskeletal pain was varied in body parts with different intensities according to age groups in Turkey during the pandemic. The most common pain was in the head, back, and lower back. Headache was found correlated with the parameters of sleep quality. Pain of the head, neck, back, lower back, and shoulder were correlated with sleep latency. Sleep quality was associated with depression and musculoskeletal pain, while musculoskeletal pain was correlated with depression.
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Affiliation(s)
- Merve Karatel
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Zeynep Irem Bulut
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Erkin Oguz Sari
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Zerrin Pelin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Yavuz Yakut
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Hasan Kalyoncu University, Gaziantep, Turkey
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15
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Biondi F, Liparoti M, Lacetera A, Sorrentino P, Minino R. Risk factors for mental health in general population during SARS-COV2 pandemic: a systematic review. MIDDLE EAST CURRENT PSYCHIATRY, AIN SHAMS UNIVERSITY 2022; 29:85. [PMCID: PMC9552736 DOI: 10.1186/s43045-022-00251-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The COVID-19 pandemic and its social restrictions have affected mental health globally. This systematic review aims to analyze the psychological responses of the general population and its related sociodemographic risk factors, excluding the most vulnerable groups (e.g., healthcare workers, COVID-19 patients and survivors, pregnant women, people with chronic diseases or preexisting psychiatric disorders). A reproducible search from June 2020 to February 2021 was conducted on PubMed and Google Scholar, following the PRISMA guidelines. Papers that (1) considered the most at-risk populations, (2) did not report sociodemographic data, and (3) did not use validated scales were excluded from our analysis. Non-English papers and review articles were also excluded. Of 1116 papers identified, 25 were included for this review (n = 162,465). The main risk factors associated with the emergence of depression, anxiety, sleep disorders, post-traumatic stress disorder, and obsessive compulsive disorder were: female gender, younger and later age, high level of education, Latino origin, free marital status, living quarantine in a house with no outdoor, negative coping strategies, close proximity to positive cases, high concern about contracting COVID-19 and living in a most affected area. High income, physical activity, resilience, family support, and a high level of knowledge about COVID-19, seems to be protective factors against the onset of psychological symptoms. In a general population, COVID-19 restrictions are linked to risk factors for psychological disorders caused by gender and sociodemographic conditions. In this regard governments should pay more attention to the public’s mental health and its risk and protective factors.
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Affiliation(s)
- Francesca Biondi
- Institute for Diagnosis and Care, Hermitage Capodimonte, Naples, Italy
| | - Marianna Liparoti
- grid.7841.aDepartment of Social and Developmental Psychology, University of Rome “Sapienza”, Rome, Italy
| | - Angelica Lacetera
- Institute for Diagnosis and Care, Hermitage Capodimonte, Naples, Italy
| | - Pierpaolo Sorrentino
- grid.5399.60000 0001 2176 4817Institut de Neuroscience Des Systemès, Aix-Marseille University, Marseille, France
| | - Roberta Minino
- grid.17682.3a0000 0001 0111 3566Department of Motor Sciences and Wellness, University of Naples “Parthenope”, Naples, Italy
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16
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Testing an early online intervention for the treatment of disturbed sleep during the COVID-19 pandemic in self-reported good and poor sleepers (Sleep COVID-19): study protocol for a randomised controlled trial. Trials 2021; 22:913. [PMID: 34895327 PMCID: PMC8665855 DOI: 10.1186/s13063-021-05888-0] [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: 09/10/2021] [Accepted: 11/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background Theoretical models of insomnia suggest that stressful life events, such as the COVID-19 pandemic, can cause acute insomnia (short-term disruptions to sleep). Early interventions may prevent short-term sleep problems from progressing to insomnia disorder. Although cognitive behavioural therapy for insomnia (CBT-I) is effective in treating insomnia disorder, this can be time and resource-intensive. Further, online interventions can be used to deliver treatment to a large number of individuals. The objective of this study is to investigate if an online behavioural intervention, in the form of a leaflet, which has been successfully used alongside CBT-I for acute insomnia, can reduce symptoms of acute insomnia in poor sleepers. Methods A total of 124 self-reported good and poor sleepers will be enrolled in an online stratified randomised controlled trial. After baseline assessments (T1), participants will complete a 1-week pre-intervention sleep monitoring period (T2) where they will complete daily sleep-diaries. Poor sleepers (n = 62) will be randomly allocated to an invention or wait-list group, where they will receive the intervention (T3), or will do so after a 28-day delay. Good sleepers (n = 62) will be randomly assigned to an intervention or no intervention group. All participants will complete a 1-week post intervention sleep monitoring period using daily sleep diaries (T4). Participants will be followed up at 1 week (T5), 1 month (T6) and 3 months (T7) post intervention. The primary outcome measure will be insomnia severity, measured using the Insomnia Severity Index. Secondary outcome measures will include subjective mood and subjective sleep continuity, measured using sleep diaries. Data will be analysed using an intention-to-treat approach. Discussion It is expected that this online intervention will reduce symptoms of acute insomnia in self-reported short-term poor sleepers, and will also prevent the transition to poor sleep in good sleepers. We expect that this will demonstrate the feasibility of online interventions for the treatment and prevention of acute insomnia. Specific advantages of online approaches include the low cost, ease of administration and increased availability of treatment, relative to face-to-face therapy. Trial registration ISRCTN43900695 (Prospectively registered 8th of April 2020).
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17
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Zhang QQ, Li L, Zhong BL. Prevalence of Insomnia Symptoms in Older Chinese Adults During the COVID-19 Pandemic: A Meta-Analysis. Front Med (Lausanne) 2021; 8:779914. [PMID: 34869501 PMCID: PMC8634335 DOI: 10.3389/fmed.2021.779914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 10/12/2021] [Indexed: 11/29/2022] Open
Abstract
Background: The ongoing COVID-19 pandemic has disproportionately affected the sleep health of older adults, but the limited number of studies on insomnia symptoms of older Chinese adults differed in terms of screener of insomnia, sample size, and prevalence, making mental health planning for this population difficult. This meta-analysis estimated the prevalence of insomnia symptoms in older Chinese adults during the COVID-19 pandemic. Methods: Both Chinese (CNKI, Wanfang, VIP) and English (PubMed, EmBase, PsycInfo) databases were systematically searched to identify cross-sectional studies containing data on the prevalence of insomnia symptoms in older Chinese adults during the pandemic. Risk of bias (RoB) of included studies was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Results: Nine studies with a total of 27,207 older Chinese adults were included. RoB scores of these studies ranged between zero and six. The pooled prevalence rates of insomnia symptoms and moderate and severe insomnia symptoms were 24.6% [95% confidence interval (CI): 19.5–30.5%] and 11.1% (95% CI: 7.2–16.9%), respectively. In subgroup analysis, significantly higher prevalence rates were observed in studies defining insomnia symptoms as “Insomnia Severity Index (ISI) ≥ 8” than in those defining them as “ISI ≥ 15” (32.6 vs. 15.6%, P < 0.001) and in older adults living in the COVID-19 epicenter than in those living in other places (35.2 vs. 23.3%, P = 0.006). Conclusion: Nearly one out of every four older Chinese adults suffered from insomnia symptoms during the pandemic. Mental health services for this population during the pandemic should include supportive activities aimed at improving mental well-being, periodic assessment of insomnia symptoms, and psychiatric assessment and treatment when necessary.
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Affiliation(s)
- Qian-Qian Zhang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Lan Li
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Bao-Liang Zhong
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
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18
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Amicucci G, Salfi F, D’Atri A, Viselli L, Ferrara M. The Differential Impact of COVID-19 Lockdown on Sleep Quality, Insomnia, Depression, Stress, and Anxiety among Late Adolescents and Elderly in Italy. Brain Sci 2021; 11:1336. [PMID: 34679402 PMCID: PMC8533758 DOI: 10.3390/brainsci11101336] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 10/05/2021] [Accepted: 10/07/2021] [Indexed: 12/17/2022] Open
Abstract
The restraining measures due to the COVID-19 outbreak deeply affected the general population's sleep health and psychological status. The current literature proposes young and older people as two particularly at-risk groups. However, the differential impact of the lockdown period in these specific age categories needs to be disentangled. Through a web-based survey adopting validated questionnaires, we evaluated and compared sleep quality/habits, insomnia, perceived stress, depression, and anxiety symptoms of Italian late adolescents (n = 670; mean age ± SD, 19.38 ± 0.74, 18-20 years) and elderly (n = 253; 68.18 ± 2.79, 65-75 years). Young respondents reported more severe insomnia symptoms, worse subjective sleep quality, longer sleep latency, higher daytime dysfunction, and a more prevalent disruption of sleep habits (bedtime, get-up time, nap) than the elderly. On the other hand, older participants showed shorter sleep duration, lower habitual sleep efficiency, and greater use of sleep medications. Finally, the younger population displayed higher levels of depression and perceived stress. Our findings indicate that the lockdown period had more pervasive repercussions on sleep and the mental health of late adolescents. The implementation of supportive strategies is encouraged for this vulnerable population group.
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Affiliation(s)
- Giulia Amicucci
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.A.); (F.S.); (A.D.); (L.V.)
- Department of Psychology, “Sapienza” University of Rome, 00185 Rome, Italy
| | - Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.A.); (F.S.); (A.D.); (L.V.)
| | - Aurora D’Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.A.); (F.S.); (A.D.); (L.V.)
| | - Lorenzo Viselli
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.A.); (F.S.); (A.D.); (L.V.)
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (G.A.); (F.S.); (A.D.); (L.V.)
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19
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KG, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2021; 126:276-359. [PMID: 34489050 DOI: 10.1016/j.prosdent.2021.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 11/26/2022]
Abstract
The Scientific Investigation Committee of the American Academy of Restorative Dentistry offers this review of the 2020 professional literature in restorative dentistry to inform busy dentists regarding noteworthy scientific and clinical progress over the past year. Each member of the committee brings discipline-specific expertise to this work to cover this broad topic. Specific subject areas addressed include prosthodontics; periodontics, alveolar bone, and peri-implant tissues; implant dentistry; dental materials and therapeutics; occlusion and temporomandibular disorders (TMDs); sleep-related breathing disorders; oral medicine and oral and maxillofacial surgery; and dental caries and cariology. The authors focused their efforts on reporting information likely to influence day-to-day dental treatment decisions with a keen eye on future trends in the profession. With the tremendous volume of dentistry and related literature being published today, this review cannot possibly be comprehensive. The purpose is to update interested readers and provide important resource material for those interested in pursuing greater detail. It remains our intent to assist colleagues in navigating the extensive volume of important information being published annually. It is our hope that readers find this work useful in successfully managing the dental patients they encounter.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, Chair and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor, Department of Comprehensive Oral Health, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Frederick Eichmiller
- Vice President and Science Officer, Delta Dental of Wisconsin, Stevens Point, Wis
| | | | - Jean-Pierre Albouy
- Assistant Professor of Prosthodontics, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin G Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, Md; Private practice, Baltimore, Md
| | - Matthias Troeltzsch
- Associate Professor, Department of Oral and Maxillofacial Surgery, Ludwig-Maximilians University of Munich, Munich, Germany; Private practice, Ansbach, Germany
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20
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Madrid-Valero JJ, Bowling N, Vafeiadou A, Buysse DJ, Banissy MJ, Gregory AM. Sleep in adults from the UK during the first few months of the coronavirus outbreak. J Sleep Res 2021; 31:e13465. [PMID: 34453464 DOI: 10.1111/jsr.13465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 07/21/2021] [Accepted: 07/28/2021] [Indexed: 01/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) outbreak emerged at the end of 2019 and quickly spread around the world. Measures to counter COVID-19, including social distancing and lockdowns, created an unusual situation that had the potential to impact a variety of behaviours, including sleep, which is crucial for health and well-being. Data were obtained through an online survey. The total sample comprised 19,482 participants from the UK. Participants were asked several questions regarding sleep quality and quantity. Each participant completed the questionnaires once during a data collection period spanning January 20 to March 31, 2020. Data provided by different participants during different weeks (spanning time-periods just before COVID-19 was identified in the UK and during the early weeks following its arrival) were compared using analysis of variance tests and regressions. Regression analyses controlling for age, sex and ethnicity revealed significant associations of small magnitude between date of survey completion and sleep quality, sleep latency, number of awakenings and composite score of poor sleep quality. These analyses also indicated small increases in eveningness tendency as the study progressed. There was no change in sleep duration or time spent awake at night. The COVID-19 outbreak did not appear to impact negatively sleep in a substantial manner during the early stages in the UK. The small increases in sleep quality variables (except for time spent awake at night and sleep duration) and eveningness are nonetheless of interest. Further research is needed to understand how best to provide support to those most in need of a good night's sleep during this unprecedented time.
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Affiliation(s)
- Juan J Madrid-Valero
- Department of Health Psychology, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | | | | | - Daniel J Buysse
- Department of Psychiatry and Center for Sleep and Circadian Science, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michael J Banissy
- Department of Psychology, Goldsmiths, University of London, London, UK.,School of Psychological Science, University of Bristol, Bristol, UK
| | - Alice M Gregory
- Department of Psychology, Goldsmiths, University of London, London, UK
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21
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Alimoradi Z, Gozal D, Tsang HWH, Lin CY, Broström A, Ohayon MM, Pakpour AH. Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis. J Sleep Res 2021; 31:e13432. [PMID: 34245055 PMCID: PMC8420603 DOI: 10.1111/jsr.13432] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/13/2021] [Accepted: 06/16/2021] [Indexed: 02/05/2023]
Abstract
The outbreak of the novel coronavirus disease 2019 (COVID‐19) changed lifestyles worldwide and subsequently induced individuals’ sleep problems. Sleep problems have been demonstrated by scattered evidence among the current literature on COVID‐19; however, little is known regarding the synthesised prevalence of sleep problems (i.e. insomnia symptoms and poor sleep quality) for males and females separately. The present systematic review and meta‐analysis aimed to answer the important question regarding prevalence of sleep problems during the COVID‐19 outbreak period between genders. Using the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guideline and Newcastle–Ottawa Scale checklist, relevant studies with satisfactory methodological quality searched for in five academic databases (Scopus, PubMed Central, ProQuest, Web of Science , and EMBASE) were included and analysed. The protocol of the project was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identification code CRD42020181644). A total of 54 papers (N = 67,722) in the female subgroup and 45 papers (N = 45,718) in the male subgroup were pooled in the meta‐analysis. The corrected pooled estimated prevalence of sleep problems was 24% (95% confidence interval [CI] 19%–29%) for female participants and 27% (95% CI 24%–30%) for male participants. Although in both gender subgroups, patients with COVID‐19, health professionals and general population showed the highest prevalence of sleep problems, it did not reach statistical significance. Based on multivariable meta‐regression, both gender groups had higher prevalence of sleep problems during the lockdown period. Therefore, healthcare providers should pay attention to the sleep problems and take appropriate preventive action.
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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
| | - David Gozal
- Department of Child Health and the Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, USA
| | - Hector W H Tsang
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Anders Broström
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Maurice M Ohayon
- Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, Palo Alto, CA, USA
| | - 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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22
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Salfi F, Lauriola M, D'Atri A, Amicucci G, Viselli L, Tempesta D, Ferrara M. Demographic, psychological, chronobiological, and work-related predictors of sleep disturbances during the COVID-19 lockdown in Italy. Sci Rep 2021; 11:11416. [PMID: 34075173 PMCID: PMC8169862 DOI: 10.1038/s41598-021-90993-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/17/2021] [Indexed: 11/24/2022] Open
Abstract
The first COVID-19 contagion wave caused unprecedented restraining measures worldwide. In Italy, a period of generalized lockdown involving home confinement of the entire population was imposed for almost two months (9 March-3 May 2020). The present is the most extensive investigation aimed to unravel the demographic, psychological, chronobiological, and work-related predictors of sleep disturbances throughout the pandemic emergency. A total of 13,989 Italians completed a web-based survey during the confinement period (25 March-3 May). We collected demographic and lockdown-related work changes information, and we evaluated sleep quality, insomnia and depression symptoms, chronotype, perceived stress, and anxiety using validated questionnaires. The majority of the respondents reported a negative impact of confinement on their sleep and a delayed sleep phase. We highlighted an alarming prevalence of sleep disturbances during the lockdown. Main predictors of sleep disturbances identified by regression models were: female gender, advanced age, being a healthcare worker, living in southern Italy, confinement duration, and a higher level of depression, stress, and anxiety. The evening chronotype emerged as a vulnerability factor, while morning-type individuals showed a lower predisposition to sleep and psychological problems. Finally, working from home was associated with less severe sleep disturbances. Besides confirming the role of specific demographic and psychological factors in developing sleep disorders during the COVID-19 pandemic, we propose that circadian typologies could react differently to a particular period of reduced social jetlag. Moreover, our results suggest that working from home could play a protective role against the development of sleep disturbances during the current pandemic emergency.
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Affiliation(s)
- Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, Coppito, AQ, Italy
| | - Marco Lauriola
- Department of Social and Developmental Psychology, Sapienza University of Rome, Rome, Italy
| | - Aurora D'Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, Coppito, AQ, Italy
| | - Giulia Amicucci
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, Coppito, AQ, Italy
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Lorenzo Viselli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, Coppito, AQ, Italy
| | - Daniela Tempesta
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, Coppito, AQ, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, Via Vetoio (Coppito 2), 67100, Coppito, AQ, Italy.
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23
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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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24
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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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25
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Li W, Zhang H, Zhang C, Luo J, Wang H, Wu H, Zhu Y, Cui H, Wang J, Li H, Zhu Z, Xu Y, Li C. The Prevalence of Psychological Status During the COVID-19 Epidemic in China: A Systemic Review and Meta-Analysis. Front Psychol 2021; 12:614964. [PMID: 34017278 PMCID: PMC8129549 DOI: 10.3389/fpsyg.2021.614964] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/24/2021] [Indexed: 12/12/2022] Open
Abstract
The COVID-19 is creating panic among people around the world and is causing a huge public mental health crisis. Large numbers of observational studies focused on the prevalence of psychological problems during the COVID-19 pandemic were published. It is essential to conduct a meta-analysis of the prevalence of different psychological statuses to insight the psychological reactions of general population during the COVID-19 epidemic in China. Sixty six observational studies about the psychological statuses of people during the COVID-19 were included, searching up to 1 December 2020. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to evaluate the quality of the included studies. OpenMeta[Analyst] was used for the data analysis. High prevalence of acute stress and fear symptoms were observed in the early period of the epidemic. Additionally, anxiety and depression symptoms continued at a high prevalence rate during the epidemic. It should alert the lasting mental health problems and the risk of post-traumatic stress disorder and other mental disorders. Systematic Review Registration: PROSPERO CRD 42020171485.
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Affiliation(s)
- Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huijuan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Caidi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinjing Luo
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hongyan Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wu
- Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yikang Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Chinese Academy of Science Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Science, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Li
- Shanghai Clinical Research Center for Mental Health, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhuoying Zhu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Yifeng Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Chinese Academy of Science Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Science, Shanghai, China
- Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, China
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26
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Trabelsi K, Ammar A, Masmoudi L, Boukhris O, Chtourou H, Bouaziz B, Brach M, Bentlage E, How D, Ahmed M, Mueller P, Mueller N, Hsouna H, Elghoul Y, Romdhani M, Hammouda O, Paineiras-Domingos LL, Braakman-Jansen A, Wrede C, Bastoni S, Pernambuco CS, Mataruna-Dos-Santos LJ, Taheri M, Irandoust K, Bragazzi NL, Strahler J, Washif JA, Andreeva A, Bailey SJ, Acton J, Mitchell E, Bott NT, Gargouri F, Chaari L, Batatia H, Khoshnami SC, Samara E, Zisi V, Sankar P, Ahmed WN, Ali GM, Abdelkarim O, Jarraya M, Abed KE, Moalla W, Souissi N, Aloui A, Souissi N, Gemert-Pijnen LV, Riemann BL, Riemann L, Delhey J, Gómez-Raja J, Epstein M, Sanderman R, Schulz S, Jerg A, Al-Horani R, Mansi T, Dergaa I, Jmail M, Barbosa F, Ferreira-Santos F, Šimunič B, Pišot R, Pišot S, Gaggioli A, Steinacker J, Zmijewski P, Apfelbacher C, Glenn JM, Khacharem A, Clark CC, Saad HB, Chamari K, Driss T, Hoekelmann A. Sleep Quality and Physical Activity as Predictors of Mental Wellbeing Variance in Older Adults during COVID-19 Lockdown: ECLB COVID-19 International Online Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4329. [PMID: 33921852 PMCID: PMC8073845 DOI: 10.3390/ijerph18084329] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/15/2021] [Accepted: 04/16/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The COVID-19 lockdown could engender disruption to lifestyle behaviors, thus impairing mental wellbeing in the general population. This study investigated whether sociodemographic variables, changes in physical activity, and sleep quality from pre- to during lockdown were predictors of change in mental wellbeing in quarantined older adults. METHODS A 12-week international online survey was launched in 14 languages on 6 April 2020. Forty-one research institutions from Europe, Western-Asia, North-Africa, and the Americas, promoted the survey. The survey was presented in a differential format with questions related to responses "pre" and "during" the lockdown period. Participants responded to the Short Warwick-Edinburgh Mental Wellbeing Scale, the Pittsburgh Sleep Quality Index (PSQI) questionnaire, and the short form of the International Physical Activity Questionnaire. RESULTS Replies from older adults (aged >55 years, n = 517), mainly from Europe (50.1%), Western-Asia (6.8%), America (30%), and North-Africa (9.3%) were analyzed. The COVID-19 lockdown led to significantly decreased mental wellbeing, sleep quality, and total physical activity energy expenditure levels (all p < 0.001). Regression analysis showed that the change in total PSQI score and total physical activity energy expenditure (F(2, 514) = 66.41 p < 0.001) were significant predictors of the decrease in mental wellbeing from pre- to during lockdown (p < 0.001, R2: 0.20). CONCLUSION COVID-19 lockdown deleteriously affected physical activity and sleep patterns. Furthermore, change in the total PSQI score and total physical activity energy expenditure were significant predictors for the decrease in mental wellbeing.
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Affiliation(s)
- Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia
| | - Achraf Ammar
- Institute of Sport Science, Otto-Von-Guericke University, 39106 Magdeburg, Germany;
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, 92000 Nanterre, France;
| | - Liwa Masmoudi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia
| | - Omar Boukhris
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (A.A.); (N.S.)
| | - Hamdi Chtourou
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (A.A.); (N.S.)
| | - Bassem Bouaziz
- Multimedia InfoRmation Systems and Advanced Computing Laboratory (MIRACL), Higher Institute of Computer Science and Multimedia of Sfax, University of Sfax, Sfax 3000, Tunisia; (B.B.); (F.G.)
| | - Michael Brach
- Institute of Sport and Exercise Sciences, University of Münster, 48149 Münster, Germany; (M.B.); (E.B.); (D.H.); (M.A.)
| | - Ellen Bentlage
- Institute of Sport and Exercise Sciences, University of Münster, 48149 Münster, Germany; (M.B.); (E.B.); (D.H.); (M.A.)
| | - Daniella How
- Institute of Sport and Exercise Sciences, University of Münster, 48149 Münster, Germany; (M.B.); (E.B.); (D.H.); (M.A.)
| | - Mona Ahmed
- Institute of Sport and Exercise Sciences, University of Münster, 48149 Münster, Germany; (M.B.); (E.B.); (D.H.); (M.A.)
| | - Patrick Mueller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany; (P.M.); (N.M.)
- Department of Neurology, Medical Faculty, Otto-Von-Guericke University, 39120 Magdeburg, Germany
| | - Notger Mueller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), 39120 Magdeburg, Germany; (P.M.); (N.M.)
- Department of Neurology, Medical Faculty, Otto-Von-Guericke University, 39120 Magdeburg, Germany
| | - Hsen Hsouna
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (A.A.); (N.S.)
| | - Yousri Elghoul
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax 3000, Tunisia
| | - Mohamed Romdhani
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (A.A.); (N.S.)
| | - Omar Hammouda
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, 92000 Nanterre, France;
| | - Laisa Liane Paineiras-Domingos
- Programa de Pós-graduação em Ciências Médicas, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro 20550-170, Brazil;
- Departamento de Fisioterapia, Faculdade Bezerra de Araújo, Rio de Janeiro 23052-180, Brazil
| | - Annemarie Braakman-Jansen
- Department of Psychology, Health & Technology, University of Twente, 7522 Enschede, The Netherlands; (A.B.-J.); (C.W.); (S.B.); (L.V.G.-P.)
| | - Christian Wrede
- Department of Psychology, Health & Technology, University of Twente, 7522 Enschede, The Netherlands; (A.B.-J.); (C.W.); (S.B.); (L.V.G.-P.)
| | - Sofia Bastoni
- Department of Psychology, Health & Technology, University of Twente, 7522 Enschede, The Netherlands; (A.B.-J.); (C.W.); (S.B.); (L.V.G.-P.)
- Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
| | - Carlos Soares Pernambuco
- Laboratório de Fisiologia do Exercício, Estácio de Sá University, Rio de Janeiro 20261-063, Brasil;
| | | | - Morteza Taheri
- Faculty of Social Science, Imam Khomeini International University, Qazvin 34148-96818, Iran; (M.T.); (K.I.)
| | - Khadijeh Irandoust
- Faculty of Social Science, Imam Khomeini International University, Qazvin 34148-96818, Iran; (M.T.); (K.I.)
| | - Nicola L. Bragazzi
- Department of Health Sciences, Postgraduate School of Public Health, University of Genoa, 16132 Genoa, Italy;
- Laboratory for Industrial and Applied Mathematics, Department of Mathematics and Statistics, York University, 4700 Keele Street, Toronto, ON M3J 1P3, Canada
| | - Jana Strahler
- Department of Psychology and Sport Science, University of Gießen, 35394 Gießen, Germany;
| | - Jad Adrian Washif
- Sports Performance Division, National Sports Institute of Malaysia, Kuala Lumpur 57000, Malaysia;
| | - Albina Andreeva
- Department of Sports Biomechanics, Moscow Center of Advanced Sport Technologies, 129272 Moscow, Russia;
| | - Stephen J. Bailey
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough E11 3TU, UK; (S.J.B.); (J.A.); (E.M.)
| | - Jarred Acton
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough E11 3TU, UK; (S.J.B.); (J.A.); (E.M.)
| | - Emma Mitchell
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough E11 3TU, UK; (S.J.B.); (J.A.); (E.M.)
| | - Nicholas T. Bott
- Clinical Excellence Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA;
| | - Faiez Gargouri
- Multimedia InfoRmation Systems and Advanced Computing Laboratory (MIRACL), Higher Institute of Computer Science and Multimedia of Sfax, University of Sfax, Sfax 3000, Tunisia; (B.B.); (F.G.)
| | - Lotfi Chaari
- Computer Science Department, University of Toulouse, IRIT-INP-ENSEEIHT (UMR 5505), BP 7122 Toulouse, France; (L.C.); (H.B.)
| | - Hadj Batatia
- Computer Science Department, University of Toulouse, IRIT-INP-ENSEEIHT (UMR 5505), BP 7122 Toulouse, France; (L.C.); (H.B.)
| | | | | | - Vasiliki Zisi
- Department of Physical Education and Sports Sciences, University of Thessaly, 421 00 Trikala, Greece;
| | - Parasanth Sankar
- Consultant in Internal Medicine and Diabetes, MGM Muthoot Hospitals Pathanamthitta, Kerala 689645, India;
| | - Waseem N. Ahmed
- Consultant Family Physician, CRAFT Hospital and Research Centre, Kodungallur, Kerala 680664, India;
| | - Gamal Mohamed Ali
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt; (G.M.A.); (O.A.)
| | - Osama Abdelkarim
- Faculty of Physical Education, Assiut University, Assiut 71515, Egypt; (G.M.A.); (O.A.)
- Institute for Sports and Sports Science, Karlsruher Institut für Technologie, 76131 Karlsruher, Germany
| | - Mohamed Jarraya
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
| | - Kais El Abed
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
| | - Wassim Moalla
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
| | - Nafaa Souissi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia; (K.T.); (L.M.); (O.B.); (H.C.); (H.H.); (Y.E.); (O.H.); (M.J.); (K.E.A.); (W.M.); (N.S.)
| | - Asma Aloui
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (A.A.); (N.S.)
| | - Nizar Souissi
- Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis 1003, Tunisia; (M.R.); (A.A.); (N.S.)
| | - Lisette Van Gemert-Pijnen
- Department of Psychology, Health & Technology, University of Twente, 7522 Enschede, The Netherlands; (A.B.-J.); (C.W.); (S.B.); (L.V.G.-P.)
| | - Bryan L. Riemann
- Department of Health Sciences and Kinesiology, Georgia Southern University, Statesboro, GA 30458, USA;
| | | | - Jan Delhey
- Institute of Social Science, Otto-Von-Guericke University, 39106 Magdeburg, Germany;
| | - Jonathan Gómez-Raja
- FundeSalud, Department of Health and Social Services, Government of Extremadura, 06800 Merida, Spain;
| | | | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands;
| | - Sebastian Schulz
- Sports- and Rehabilitation Medicine, Ulm University Hospital, Leimgrubenweg 14, 89075 Ulm, Germany; (S.S.); (A.J.); (J.S.)
| | - Achim Jerg
- Sports- and Rehabilitation Medicine, Ulm University Hospital, Leimgrubenweg 14, 89075 Ulm, Germany; (S.S.); (A.J.); (J.S.)
| | - Ramzi Al-Horani
- Department of Exercise Science, Yarmouk University, Irbid 21163, Jordan;
| | - Taysir Mansi
- Faculty of Physical Education, The University of Jordan, Amman 11942, Jordan;
| | - Ismail Dergaa
- PHCC, Primary Health Care Corporation, Doha 3050, Qatar;
| | - Mohamed Jmail
- Digital Research Centre of Sfax, Sfax 3000, Tunisia;
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal; (F.B.); (F.F.-S.)
| | - Fernando Ferreira-Santos
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, 4200-135 Porto, Portugal; (F.B.); (F.F.-S.)
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Garibaldijeva 1, 6000 Koper, Slovenia; (B.Š.); (R.P.); (S.P.)
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Garibaldijeva 1, 6000 Koper, Slovenia; (B.Š.); (R.P.); (S.P.)
| | - Saša Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Garibaldijeva 1, 6000 Koper, Slovenia; (B.Š.); (R.P.); (S.P.)
| | - Andrea Gaggioli
- Department of Psychology, Catholic University of the Sacred Heart I UNICATT, 20123 Milano, Italy;
| | - Jürgen Steinacker
- Sports- and Rehabilitation Medicine, Ulm University Hospital, Leimgrubenweg 14, 89075 Ulm, Germany; (S.S.); (A.J.); (J.S.)
| | - Piotr Zmijewski
- Faculty of Physical Education, Jozef Pilsudski University of Physical Education in Warsaw, 00-809 Warsaw, Poland;
| | - Christian Apfelbacher
- Institute for Social Medicine and Health Economy, Otto-Von-Guericke University, 39106 Magdeburg, Germany;
| | - Jordan M. Glenn
- Exercise Science Research Center, Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR 72701, USA;
| | - Aïmen Khacharem
- UVHC, DeVisu, Valenciennes, LIRTES-EA 7313, Université Paris Est Créteil Val de Marne, 94000 Creteil, France;
| | - Cain C.T. Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry CV1 5FB, UK;
| | - Helmi Ben Saad
- Hôpital Farhat HACHED de Sousse, Laboratoire de Recherche “Insuffisance Cardiaque”, Université de Sousse, Sousse LR12SP09, Tunisie;
| | - Karim Chamari
- ASPETAR, Qatar Orthopaedic and Sports Medicine Hospital, Doha 29222, Qatar;
- Laboratory “Sport Performance Optimization”, (CNMSS), ISSEP Ksar-Said, Manouba University, Manouba 2010, Tunisia
| | - Tarak Driss
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, 92000 Nanterre, France;
| | - Anita Hoekelmann
- Institute of Sport Science, Otto-Von-Guericke University, 39106 Magdeburg, Germany;
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Del Brutto OH, Mera RM, Costa AF, Recalde BY, Castillo PR. Sleep quality deterioration in middle-aged and older adults living in a rural Ecuadorian village severely struck by the SARS-CoV-2 pandemic. A population-based longitudinal prospective study. Sleep 2021; 44:6145160. [PMID: 33608714 PMCID: PMC7928566 DOI: 10.1093/sleep/zsab041] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/09/2021] [Indexed: 12/30/2022] Open
Abstract
Study objectives This study assessed changes in sleep quality before and after the peak of the SARS-CoV-2 pandemic in community-dwellers enrolled in the Atahualpa Project. Methods Atahualpa residents aged ≥40 were eligible if they had a Pittsburgh Sleep Quality Index (PSQI) nine months before the pandemic and a lateral flow-based test for identification of SARS-CoV-2 antibodies during the peak of the pandemic. Six months later, individuals completed a follow-up PSQI. The independent relationship between SARS-CoV-2 infection and deterioration in sleep quality was assessed by fitting logistic mixed models for longitudinal data. Results Of 639 participants (mean age at baseline: 59±12.8 years), 325 (51%) had SARS-CoV-2 antibodies. A total of 185 (29%) individuals at baseline and 311 (49%) at follow-up were poor sleepers (p<0.001). Mixed logistic regression models demonstrated a significant increase in poor sleepers at follow-up (OR: 2.85; 95% C.I.: 2.16 – 3.75), which was more marked among SARS-CoV-2 seropositive subjects (OR: 3.8; 95% C.I.: 2.48 – 5.81). The adjusted proportion of poor sleepers increased from 29% to 56.2% (95% C.I.: 50.9 – 61.6%) among SARS-CoV-2 seropositive individuals, but only to 40.7% (95% C.I.: 35.3 – 46.1%) in their seronegative counterparts (p<0.001). Likewise, progression from a good to a poor sleeper status was higher among seropositive individuals than in their seronegative counterparts (38.1% versus 22.3%; p<0.001), after adjusting for relevant covariates. Conclusions This study shows a deleterious effect of SARS-CoV-2 in sleep quality. An effect of SARS-CoV-2 in disrupting sleep-related pathways cannot be ruled out.
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Affiliation(s)
- Oscar H Del Brutto
- School of Medicine, Universidad Espíritu Santo - Ecuador, Samborondón, Ecuador
| | - Robertino M Mera
- Department of Epidemiology, Gilead Sciences, Inc., Foster City, CA, USA
| | - Aldo F Costa
- Department of Neurology, Hospital Universitario Reina Sofía, Córdoba, Spain
| | | | - Pablo R Castillo
- Sleep Disorders Center, Mayo Clinic College of Medicine, Jacksonville, Florida, USA
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Lin YN, Liu ZR, Li SQ, Li CX, Zhang L, Li N, Sun XW, Li HP, Zhou JP, Li QY. Burden of Sleep Disturbance During COVID-19 Pandemic: A Systematic Review. Nat Sci Sleep 2021; 13:933-966. [PMID: 34234598 PMCID: PMC8253893 DOI: 10.2147/nss.s312037] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 05/30/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) pandemic may exert adverse impacts on sleep among populations, which may raise awareness of the burden of sleep disturbance, and the demand of intervention strategies for different populations. We aimed to summarize the current evidence for the impacts of COVID-19 on sleep in patients with COVID-19, healthcare workers (HWs), and the general population. We searched PubMed and Embase for studies on the prevalence of sleep disturbance. Totally, 86 studies were included in the review, including 16 studies for COVID-19 patients, 34 studies for HWs, and 36 studies for the general population. The prevalence of sleep disturbance was 33.3%-84.7%, and 29.5-40% in hospitalized COVID-19 patients and discharged COVID-19 survivors, respectively. Physiologic and psychological traumatic effects of the infection may interact with environmental factors to increase the risk of sleep disturbance in COVID-19 patients. The prevalence of sleep disturbance was 18.4-84.7% in HWs, and the contributors mainly included high workloads and shift work, occupation-related factors, and psychological factors. The prevalence of sleep disturbance was 17.65-81% in the general population. Physiologic and social-psychological factors contributed to sleep disturbance of the general population during COVID-19 pandemic. In summary, the sleep disturbance was highly prevalent during COVID-19 pandemic. Specific health strategies should be implemented to tackle sleep disturbance.
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Affiliation(s)
- Ying Ni Lin
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Zhuo Ran Liu
- Department of Thyroid and Vascular Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Shi Qi Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Chuan Xiang Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Department of Respiratory Medicine, Wuhan No.3 Hospital, Wuhan, 430000, People's Republic of China
| | - Liu Zhang
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Ning Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Xian Wen Sun
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Hong Peng Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Jian Ping Zhou
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
| | - Qing Yun Li
- Department of Respiratory and Critical Care Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China.,Institute of Respiratory Disease, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, People's Republic of China
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Rajkumar RP. Sleep, physical activity and mental health during the COVID-19 pandemic: complexities and opportunities for intervention. Sleep Med 2020; 77:307-308. [PMID: 33594979 PMCID: PMC7547309 DOI: 10.1016/j.sleep.2020.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Ravi Philip Rajkumar
- Additional Professor, Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.
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