Elevated Prevalence of Probable Insomnia among Young Men during Social Unrest in Hong Kong: A Population-Based Study

Social Outbreak in Chile, and Its Association with the Effects Biological, Psychological, Social, and Quality of Life

The World Health Organization has defined collective violence as the instrumental use of violence by people who identify themselves as members of a group against other individuals and have political, economic, or social objectives. In Chile, the "Social Outbreak" was used to describe an episode of collective violence, which began on October 18, 2019, triggered by a multitude of socioeconomic and political factors, with protests and mobilizations in the country's large and small cities; in central, commercial, and residential areas, that lasted for several months, affecting a large part of the population. The objective of the present study was to associate the social outbreak in Chile with its biological, psychological, and social effects on people's health and quality of life, as well as its characteristics in terms of exposure, proximity, type, and frequency. This was a cross-sectional study with non-probabilistic national-level sampling, conducted from 28 November 2019, to 3 March 2020. The instrument had four sections. A total of 2651 participants answered the survey; 70.8% were female, and the mean age was 35.2. The main disturbances perceived were protests (70.9%), alarm sounds (68.1%), shooting sounds (59.0%), and tear gas bombs (56.9%). When quantifying the magnitude of these associations, people who had a medium exposure have a higher probability (OR: 1.99, CI: 1.58; 2.50) of suffering three or more biological effects than people that have a low exposure, while people with higher exposition have a 4.09 times higher probability (CI: 3.11; 5.38). A similar pattern was observed regarding psychological effects, although social effects were primarily experienced by those with high exposure. Social networks, TV, and radio were the most used media among people who perceived a greater effect. People who lived, worked, or shopped near the disturbance's areas show a higher proportion negative effect.

The Indirect Effect of Sleep on the Association Between Protracted Social Stressors and Psychological Distress Among Hong Kong Young People

PURPOSE

Hong Kong youth and young adults experienced unprecedented stress amid social unrest and the COVID-19 pandemic. Few studies have examined how these stressors were related to psychological distress among youth and young adults. This study assessed how psychological distress is associated with stress from social unrest, financial circumstances, and the COVID-19 pandemic, and whether poor sleep quality may explain these associations.

METHODS

Participants of a representative phone survey included 1,501 Hong Kong youth and young adults (Mage = 26.1 (4.0); 48.2% female). We examined the associations between psychological distress and three types of stress (social unrest, financial, and COVID-19 stress), and the indirect effect of poor sleep.

RESULTS

Eleven point nine percent, 4.1%, and 9.7% of respondents reported feeling very seriously distressed by social unrest, financial circumstances, and the COVID-19 pandemic, respectively. All three forms of stress were associated with poor sleep. The indirect effects of poor sleep on the association between all three forms of stress and psychological distress were identified. Moderated indirect effect analysis indicated that being female intensified the effect of COVID-19-related stress on psychological distress and that younger female youth and older male youth were more vulnerable to financial stress and social unrest stress (vs. older female youth and younger male youth).

DISCUSSION

Sleep may be one mechanism that accounts for the association between psychological distress and protracted stressors among Hong Kong youth and young adults. These results suggest the importance of prioritizing sleep improvement in mental health interventions during times of societal change.

Association between quarantine and sleep disturbance in Hong Kong adults: The mediating role of COVID-19 mental impact and distress

BACKGROUND

COVID-19 quarantine has been associated with increased sleep problems and prolonged psychological responses to the pandemic could mediate this relationship. The present study attempted to examine the mediating role of COVID-19 mental impact and distress between quarantine and sleep disturbance.

METHODS

The present study recruited 438 adults (109 with quarantine experience) in Hong Kong via an online survey between August and October 2021. The respondents completed a self-report questionnaire on quarantine, Mental Impact and Distress Scale: COVID-19 (MIDc), and Pittsburgh Sleep Quality Index (PSQI). The MIDc was treated as a latent mediator and continuous PSQI factor and poor sleep quality (PSQI score > 5) were the study outcomes. We evaluated the direct and indirect effects of quarantine on sleep disturbance via MIDc using structural equation modeling. Analyses were adjusted for gender, age, education level, knowing confirmed COVID-19 cases, COVID-19 frontline work, and primary income source of the family.

RESULTS

More than half (62.8%) of the sample reported poor sleep quality. Quarantine was associated with significantly higher levels of MIDc and sleep disturbance (Cohen d = 0.23 - 0.43, p < 0.05). In the structural equation model, the MIDc mediated the relationship between quarantine and sleep disturbance (αβ = 0.152, 95% CI = 0.071 to 0.235). Quarantine significantly increased the proportion of poor sleep quality by 10.7% (95% CI = 0.050 to 0.171) indirectly via MIDc.

CONCLUSIONS

The results provide empirical support to the mediating role of the MIDc as psychological responses in the relationship between quarantine and sleep disturbance.

Between- and within-person associations of mobile gaming time and total screen time with sleep problems in young adults: Daily assessment study

OBJECTIVES

To explore associations of screen time (total, mobile gaming) with sleep problems in Chinese young adults.

METHODS

This was a 4-week daily morning (completion rate = 82.1%, 909/1107) and evening (completion rate = 92.4%, 1061/1148) assessment study in 41 university students (22 female, mean age = 22.3 [SD 4.2] years). Short sleep duration < 7 h, difficulty initiating sleep, difficulty maintaining sleep, early morning awakening, and any of these three insomnia symptoms were self-reported in the morning. Mobile gaming time was self-reported in the evening, whilst total screen time was objectively tracked. Bayesian multilevel mixed-effects modeling disaggregated between- and within-person associations.

RESULTS

Between person, longer mobile gaming time predicted short sleep duration (adjusted odds ratio [AOR] = 1.90, 95% CI 1.39, 2.69), any insomnia symptoms (AOR = 1.59, 95% CI 1.20, 2.11), difficulty initiating sleep (AOR = 3.05, 95% CI 1.51, 6.24), and difficulty maintaining sleep (AOR = 2.19, 95% CI 1.18, 3.74). Short sleep duration (adjusted b = 0.99, 95% CI 0.05, 1.95), any insomnia symptoms (adjusted b = 1.19, 95% CI 0.24, 1.94), and difficulty initiating sleep (adjusted b = 1.72, 95% CI 0.11, 3.19) reversely increased mobile gaming time. Within person, any insomnia symptoms (adjusted b = 0.17, 95% CI 0.04, 0.31) and early morning awakening (adjusted b = 0.28, 95% CI 0.08, 0.48) increased next-day mobile gaming time. Total screen time was not associated with sleep problems both between and within person.

CONCLUSIONS

Bidirectional between-person associations of mobile gaming time with short sleep duration and insomnia symptoms informed multiple-health-behavior-change interventions. Unidirectional within-person associations of insomnia symptoms with next-day mobile gaming time informed just-in-time adaptive interventions addressing daily variations in insomnia symptoms. [250/250 word limits].

Daily Associations of Sleep Quality and Sleep Duration with Anxiety in Young Adults: The Moderating Effect of Alexithymia

OBJECTIVES

The present study examined the daily, within-individual associations of anxiety with sleep quality and sleep duration and the moderating effects of alexithymia on these associations in community-dwelling young adults. It was hypothesized that daily anxiety and sleep parameters would be bidirectionally related and alexithymia would moderate these relationships.

METHOD

Participants completed morning and evening diaries assessing daily anxiety and sleep parameters for 30 consecutive days. They also completed questionnaires assessing baseline sleep parameters, anxiety, and alexithymia. Multilevel modeling was used to evaluate the within-individual associations between daily anxiety and sleep parameters and whether between-individual differences in alexithymia moderated these associations.

RESULTS

Higher anxiety relative to personal averages across the study period was associated with shorter sleep duration at night. Poorer sleep quality and shorter sleep duration relative to personal averages were associated with higher next-day anxiety. A significantly stronger association between poorer sleep quality and higher next-day anxiety was observed in individuals with higher levels of alexithymia.

CONCLUSION

Daily anxiety and sleep quantity are bidirectionally associated within individuals in community-dwelling young adults. Poorer sleep quality was associated with higher next-day anxiety but not vice versa. Individuals with higher levels of alexithymia might be more vulnerable to the effects of poor sleep on next-day anxiety.

Sleep Characteristics According to Gender and Age Measured by Wrist Actigraphy

The sleep/wake rhythm is one of the most important biological rhythms. Quality and duration of sleep change during lifetime. The aim of our study was to determine differences in sleep efficiency, movement, and fragmentation during sleep period between genders and according to age. Sleep period was monitored by wrist actigraphy under home-based conditions. Seventy-four healthy participants-47 women and 27 men participated in the study. The participants were divided by age into groups younger than 40 years and 40 years and older. Women showed lower sleep fragmentation and mobility during sleep compared to men. Younger women showed a higher actual sleep and sleep efficiency compared to older women and younger men. Younger men compared to older men had a significantly lower actual sleep, lower sleep efficiency and significantly more sleep and wake bouts. Our results confirmed differences in sleep parameters between genders and according to age. The best sleep quality was detected in young women, but gender differences were not apparent in elderly participants, suggesting the impact of sex hormones on sleep.