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Wang J, Liu X, Xu X, Wang H, Yang G. The Effect of Physical Activity on Sleep Quality Among Chinese College Students: The Chain Mediating Role of Stress and Smartphone Addiction During the COVID-19 Pandemic. Psychol Res Behav Manag 2024; 17:2135-2147. [PMID: 38826679 PMCID: PMC11143986 DOI: 10.2147/prbm.s462794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 05/21/2024] [Indexed: 06/04/2024] Open
Abstract
Purpose During the period of COVID-19 pandemic, the social restrictions and isolation exerted a significant impact on the sleep quality of Chinese college students. This study aims to delve into the influence of physical activity on the sleep quality of college students as well as the mediating roles of stress and smartphone addiction. Materials and Methods A cohort of 274 eligible college students (146 males and 128 females) were selected for the investigation. The International Physical Activity Questionnaire Short Form, Stress Perception Scale, Smartphone Addiction Scale, and Pittsburgh Sleep Quality Index were employed to assess the levels of physical activity, stress, smartphone addiction, and sleep quality among college students. For data analysis, descriptive statistics, correlation analysis, and chained mediation effect tests were performed sequentially. Results The findings revealed: (1) a significant negative correlation between physical activity and stress, smartphone addiction, and sleep quality among college students (r = -0.216, p < 0.001; r = -0.224, p < 0.001; r = -0.259, p < 0.001); (2) independent mediating roles of stress and smartphone addiction in the relationship between physical activity and sleep quality; and (3) chained mediating effects of stress and smartphone addiction in the association between physical activity and sleep quality. Conclusion This study deepens our comprehension of how physical activity augments the quality of slumber, concurrently emphasizing that mitigating stress levels and alleviating smartphone addiction constitute effective strategies for preventing sleep issues among college students.
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Affiliation(s)
- Jinfu Wang
- School of Physical Education, South China University of Technology, Guangdong, Guangzhou, People’s Republic of China
| | - Xiuxia Liu
- School of Physical Education, Xiamen University, Fujian, Xiamen, People’s Republic of China
| | - Xue Xu
- School of Finance and Economy, Guangdong Engineering Polytechnic, Guangdong, Guangzhou, People’s Republic of China
| | - Haiyun Wang
- School of Physical Education, Guangzhou College of Commerce, Guangdong, Guangzhou, People’s Republic of China
| | - Guan Yang
- School of Physical Education, South China University of Technology, Guangdong, Guangzhou, People’s Republic of China
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Camaioni M, Scarpelli S, Alfonsi V, Gorgoni M, Calzolari R, De Bartolo M, Mangiaruga A, Couyoumdjian A, De Gennaro L. How COVID-19 Affected Sleep Talking Episodes, Sleep and Dreams? Brain Sci 2024; 14:486. [PMID: 38790464 PMCID: PMC11119596 DOI: 10.3390/brainsci14050486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic increased symptoms of stress and anxiety and induced changes in sleep quality, dream activity, and parasomnia episodes. It has been shown that stressful factors and/or bad sleep habits can affect parasomnia behaviors. However, investigations on how COVID-19 has affected sleep, dreams, and episode frequency in parasomnias are rare. The current study focuses on the impact of the pandemic on a specific parasomnia characterized by speech production (sleep talking, ST). METHODS We selected 27 participants with frequent ST episodes (STs) during the pandemic and compared them with 27 participants with frequent STs from a previous study conducted during a pre-pandemic period. All participants performed home monitoring through sleep logs and recorded their nocturnal STs for one week. RESULTS We observed a higher frequency of STs in the pandemic group. Moreover, STs were related to the emotional intensity of dreams, independent of the pandemic condition. The pandemic was associated with lower bizarreness of dreams in the pandemic group. There were no differences in sleep variables between the two groups. CONCLUSION Overall, these results suggest a stressful effect of COVID-19 on the frequency of STs. Both the pandemic and the frequency of STs affect qualitative characteristics of dreams in this population.
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Affiliation(s)
- Milena Camaioni
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
| | - Rossana Calzolari
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
- Department of General Psychology, University of Padova, Via Venezia 8, 35131 Padova, Italy
| | - Mina De Bartolo
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Anastasia Mangiaruga
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Alessandro Couyoumdjian
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy; (M.C.); (S.S.); (V.A.); (M.G.); (M.D.B.); (A.C.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Via Ardeatina 306, 00179 Rome, Italy
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Das S, Khan R, Banerjee S, Ray S, Ray S. Alterations in Circadian Rhythms, Sleep, and Physical Activity in COVID-19: Mechanisms, Interventions, and Lessons for the Future. Mol Neurobiol 2024:10.1007/s12035-024-04178-5. [PMID: 38702566 DOI: 10.1007/s12035-024-04178-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 04/04/2024] [Indexed: 05/06/2024]
Abstract
Although the world is acquitting from the throes of COVID-19 and returning to the regularity of life, its effects on physical and mental health are prominently evident in the post-pandemic era. The pandemic subjected us to inadequate sleep and physical activities, stress, irregular eating patterns, and work hours beyond the regular rest-activity cycle. Thus, perturbing the synchrony of the regular circadian clock functions led to chronic psychiatric and neurological disorders and poor immunological response in several COVID-19 survivors. Understanding the links between the host immune system and viral replication machinery from a clock-infection biology perspective promises novel avenues of intervention. Behavioral improvements in our daily lifestyle can reduce the severity and expedite the convalescent stage of COVID-19 by maintaining consistent eating, sleep, and physical activity schedules. Including dietary supplements and nutraceuticals with prophylactic value aids in combating COVID-19, as their deficiency can lead to a higher risk of infection, vulnerability, and severity of COVID-19. Thus, besides developing therapeutic measures, perpetual healthy practices could also contribute to combating the upcoming pandemics. This review highlights the impact of the COVID-19 pandemic on biological rhythms, sleep-wake cycles, physical activities, and eating patterns and how those disruptions possibly contribute to the response, severity, and outcome of SARS-CoV-2 infection.
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Affiliation(s)
- Sandip Das
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, 502284, Telangana, India
| | - Rajni Khan
- National Institute of Pharmaceutical Education and Research (NIPER) - Hajipur, Vaishali, Hajipur, 844102, Bihar, India
| | - Srishti Banerjee
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, 502284, Telangana, India
| | - Shashikant Ray
- Department of Biotechnology, Mahatma Gandhi Central University, Motihari, 845401, India.
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Sandipan Ray
- Department of Biotechnology, Indian Institute of Technology Hyderabad, Kandi, Sangareddy, 502284, Telangana, India.
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Baek SU, Yoon JH, Won JU. Association between constant connectivity to work during leisure time and insomnia: does work engagement matter? Soc Psychiatry Psychiatr Epidemiol 2024; 59:657-667. [PMID: 37566235 DOI: 10.1007/s00127-023-02542-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 07/30/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE The influx of communication media to contemporary workplaces has exposed workers to be always connected to their work. Constant connectivity to work (CCW) refers to the condition in which workers are always connected to work, even during their non-work hours, and are not detached from the work situation. We investigated the association between CCW and insomnia and the moderating effect of work engagement. METHODS A total of 29,512 nationally representative samples of workers in Korea were used. Insomnia was assessed by the Minimal Insomnia Symptom Scale. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). The additive interaction between CCW and low work engagement was estimated by calculating Relative Excess Risk due to Interaction (RERI). RESULTS Exposure to CCW was related to insomnia (OR [95% CI] 1.33 [1.22-1.46]). Additionally, a significant negative interaction between CCW and work engagement was observed. The effects of CCW were mitigated in those with high work engagement. The OR of the combined effect of CCW exposure and low work engagement was 2.52 (95% CI 2.22-2.87). RERI between exposure to CCW and low work engagement was 0.69 (95% CI 0.38-0.99), indicating that there is a supra-additive interaction. CONCLUSION Our study found that CCW is related to an increased risk of insomnia and that high work engagement can mitigate the effect of CCW. Our study suggests that improving work engagement and disconnecting from work outside of work hours can help protect employees' sleep quality.
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Affiliation(s)
- Seong-Uk Baek
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- The Institute for Occupational Health, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
- Graduate School, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-Ha Yoon
- The Institute for Occupational Health, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
- Department of Public Health, Yonsei University College of Medicine, Seoul, Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jong-Uk Won
- Department of Occupational and Environmental Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
- The Institute for Occupational Health, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
- Department of Public Health, Yonsei University College of Medicine, Seoul, Korea.
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Yazdani N, Hoyt LT, Pathak A, Breitstone L, Cohen AK. Inequalities in emerging adult college students' sleep quality during the COVID-19 pandemic. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-11. [PMID: 38376566 DOI: 10.1080/07448481.2024.2317178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 01/30/2024] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To examine inequalities in sleep quality during the COVID-19 pandemic by gender, sexual orientation, race/ethnicity, and socioeconomic position (SEP), and test associations between discrimination and sleep quality in a national longitudinal cohort of emerging adult college students. PARTICIPANTS Participants were enrolled in college full-time and were aged 18-22 at baseline. METHODS Participants completed online surveys in spring 2020 (N = 707) and summer 2021 (n = 313). Measures included the Pittsburgh Sleep Quality Index (PSQI) and the Everyday Discrimination Scale. RESULTS Most students reported poor sleep quality (78% in 2020; 82% in 2021) and those from marginalized groups generally experienced worse sleep quality. Discrimination was associated with poorer concurrent sleep quality at both time points. CONCLUSIONS Sleep inequalities among college students continued to manifest during the pandemic, even when students were not necessarily on campus. Colleges should take a multi-pronged approach to promote sleep quality through individual, community, and institutional interventions.
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Affiliation(s)
- Neshat Yazdani
- Department of Psychology, Fordham University, Bronx, New York, USA
| | | | - Ayurda Pathak
- Department of Psychology, Fordham University, Bronx, New York, USA
| | - Lauren Breitstone
- Silver School of Social Work, New York University, New York, New York, USA
| | - Alison K Cohen
- Department of Epidemiology & Biostatistics, University of California San Francisco, School of Medicine, San Francisco, California, USA
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Yang Z, Huang J, Kwan MP, Liu D. The interplay among individuals' distress, daily activities, and perceptions of COVID-19 and neighborhood cohesion: A study using network analysis. PLoS One 2024; 19:e0293157. [PMID: 38236893 PMCID: PMC10796027 DOI: 10.1371/journal.pone.0293157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/05/2023] [Indexed: 01/22/2024] Open
Abstract
The reduction of social interactions through non-pharmaceutical interventions (NPIs) has been shown to effectively curb COVID-19 transmission. However, these control measures were often accompanied by changes in people's daily routines and constraints on their activity space, which could lead to mental distress (i.e., anxiety and depression). This study examined the interplay among individuals' anxiety, depression, daily activities, and perceptions of COVID-19 and neighborhood cohesion. Taking Hong Kong as an example, an online survey (N = 376) was conducted to collect data from participants between March 14 to May 11, 2022. The data include respondents' self-reported anxiety and depressive symptoms, daily activities (e.g., smartphone use), perceptions of COVID-19 (e.g., the possibility of infecting COVID-19), and perceptions of neighborhood cohesion. Using network analysis, we found that excessive smartphone use, life disturbance by COVID-19, and a community with people getting along well with each other were significant factors associated with participants' anxiety and depression. Using critical path analysis, we observed that NPIs reduced human mobility, led to delayed bedtime, and increased smartphone use, which were associated with participants' mental distress. We also found that NPIs and COVID-19 were associated with people's perceptions of infection and the severity of COVID-19 and human mobility flexibility, which may further lead to mental distress. Our results also demonstrated that people with high education levels were vulnerable. These results provided important insights for designing appropriate interventions without generating deleterious impacts on people's mental health in the future.
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Affiliation(s)
- Zhenchuan Yang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jianwei Huang
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Mei-Po Kwan
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Institute of Future Cities, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Dong Liu
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Shatin, Hong Kong, China
- Institute of Future Cities, The Chinese University of Hong Kong, Shatin, Hong Kong, China
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7
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Fichten CS, Wing S, Costin G, Jorgensen M, Havel A, Wileman S, Bailes S, Creti L, Libman E. Sleep and Well-Being during the COVID-19 Remote and In-Person Periods: Experiences of College Faculty and Staff with and without Disabilities. Behav Sci (Basel) 2023; 13:844. [PMID: 37887493 PMCID: PMC10604366 DOI: 10.3390/bs13100844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
We explored the impacts of the remote and return-to-in-person work periods on sleep and well-being as reported by faculty (n = 22) and non-teaching staff (n = 21) with and without disabilities. Participants were recruited through college platforms and personal contacts. Our results show that contrary to expectations, the COVID-19 remote teaching/working period resulted in better sleep, as well as greater well-being, than the return-to-in-person work period. With respect to sleep, faculty members had slightly more negative outcomes than staff, most evident in heightened anxiety and work aspects. Faculty with disabilities had somewhat worse sleep and well-being during the remote period than faculty without disabilities. During the return to in-person work, both faculty and non-teaching staff reported more negative than positive sleep and well-being outcomes. In particular, during the in-person period, faculty members experienced slightly more negative sleep outcomes related to anxiety and work, while staff members experienced slightly more negative sleep outcomes related to the need to commute and lifestyle. Our findings show that there were benefits and disadvantages to both remote and in-person work periods, suggesting a hybrid work schedule should be considered in more detail, particularly as an optional reasonable accommodation for faculty and staff with disabilities. Our study highlights that training to keep faculty abreast of the latest technological innovations, ways to promote work-life balance, and steps to remedy classroom size and building ventilation to prevent the spread of disease all need urgent attention.
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Affiliation(s)
- Catherine S. Fichten
- Department of Psychology, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Samantha Wing
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- McGill Cognitive Science Program, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Georgiana Costin
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Department of Psychology, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Mary Jorgensen
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Alice Havel
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Susie Wileman
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Sally Bailes
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Laura Creti
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Eva Libman
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
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Qi M, Gao Y, Zhao X, Jones C, Moyle W, Shen S, Li P. Development and validity of a mentally-passive and mentally-active sedentary time questionnaire in nursing college students. Front Public Health 2023; 11:1180853. [PMID: 37794895 PMCID: PMC10546406 DOI: 10.3389/fpubh.2023.1180853] [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: 03/21/2023] [Accepted: 08/28/2023] [Indexed: 10/06/2023] Open
Abstract
Objective This study aimed to develop and validate a questionnaire to evaluate nursing college students' mentally-passive and mentally-active sedentary time (M-PAST) in China. Methods An initial M-PAST questionnaire with mentally-passive and mentally-active sedentary behaviors was developed with content validity undertaken through a consensus panel and pilot test where a convenience sample of six nursing students was recruited to assess the relevance, comprehensiveness, and comprehensibility of the refined questionnaire after expert panelists' responses. A cross-sectional online survey using a self-reported questionnaire was distributed to nursing students by email and then conducted using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the construct validity of the M-PAST questionnaire and factor structures. Finally, the criterion validity was examined by exploring the associations between the M-PAST and the IPAQ sitting time, psychological distress, and insomnia. Results Eight items regarding learning and leisure were included in the final version of the M-PAST questionnaire. A group of 650 nursing college students in China completed the study. Principal component analysis revealed two factors (i.e., mentally-passive and mentally-active sedentary behaviors), which explained 41.98% of the variance contributing to the questionnaire. The CFA reached the adaptive standard. Cronbach's α ranged from 0.730 to 0.742. The correlations between M-PAST and IPAQ total sitting time were significant (p < 0.01, r = 0.125-0.396). Mentally-passive sedentary time was associated with psychological distress and insomnia (p < 0.01, r = 0.078-0.163), while no significant associations were found in mentally-active sedentary behaviors. Conclusion and implications for practice The M-PAST questionnaire appears to be a reliable and valid tool that reported both mentally-passive and mentally-active sedentary behaviors in nursing college students in China. However, future studies may need to further examine its validity among international nursing college students. This study further confirmed that mentally-passive sedentary behavior was positively associated with psychological distress and insomnia. Effective strategies are needed to reduce nursing college students' mentally-passive sedentary time to improve their health and wellbeing in China.
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Affiliation(s)
- Meiling Qi
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
- College of Xinjiang Uyghur Medicine, Hetian, Xinjiang, China
| | - Yiming Gao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiangyu Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Cindy Jones
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, QLD, Australia
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, Brisbane, QLD, Australia
- School of Nursing and Midwifery, Griffith University, Nathan Campus, Brisbane, QLD, Australia
| | - Shiyu Shen
- Jinan Vocational College of Nursing, Jinan, Shandong, China
| | - Ping Li
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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Viana Mendes J, Benedito-Silva AA, Medeiros Andrade MA, Vartanian D, da Silva Brandão Gonçalves B, Cipolla-Neto J, Pedrazzoli M. Actigraphic characterization of sleep and circadian phenotypes of PER3 gene VNTR genotypes. Chronobiol Int 2023; 40:1244-1250. [PMID: 37691400 DOI: 10.1080/07420528.2023.2256858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 07/12/2023] [Accepted: 09/02/2023] [Indexed: 09/12/2023]
Abstract
The molecular circadian timing system involves genes known as "clock genes," such as the PER3 gene. Studies have demonstrated associations among a repeat polymorphism (VNTR) of the PER3 gene with chronotypes, with the occurrence of circadian rhythm disorders and with sleep homeostasis phenotypes. The aim of this study was to investigate, by actigraphy, sleep and circadian rhythm profiles of people with different genotypes for the VNTR polymorphism of the PER3 gene. We genotyped 467 individuals (46,39% male) for the PER3 VNTR polymorphism. The mean age of the participants was 21.84 ± 2.64, ranging from 18 to 30 y old. Actigraphy data were collected from a subsample of 81 subjects with PER3 4-repeats homozygous (PER34/4) or 5-repeats homozygous (PER35/5) genotypes from April to June of 2021. From this sample, 48 PER34/4 and 33 PER35/5 subjects wore a wrist actigraph between 12 and 19 d. The sleep onset (weekdays, p = 0.015; weekend, p = 0.022) and offset (weekdays, p = 0.004; weekend, p = 0.041) of the PER35/5 group occurred later than the PER34/4 group. Similar results were observed for the mid-sleep phase of weekdays (MSW) (p = 0.008) and free days (MSF) (p = 0.019), and for the mid-sleep phase corrected for sleep debt accumulated over the week (MSFsc) (p = 0.024). Despite the phase differences found between the PER34/4 and PER35/5 groups, no differences were found in sleep duration and social jet lag. However, the PER34/4 group presented, on average, a longer sleep rebound on the days off when compared to the PER35/5 (p = 0.002). The PER35/5 group showed lower interdaily stability (IS) (p = 0.032) and higher daily activity rhythm variability (IV) (p = 0.035). The findings of the present study revealed associations between the PER3 gene, sleep, and circadian rhythms. In general, we found that the gene is associated with the expression of sleep timing and duration and to the phase of the activity rhythm. The experiments carried out here occurred in the COVID-19 pandemic scenario, which should be considered as an environmental element with potential effects on the results obtained.
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Affiliation(s)
- Juliana Viana Mendes
- School of Arts, Sciences and Humanities of University of São Paulo, São Paulo, Brazil
| | | | | | - Daniel Vartanian
- School of Arts, Sciences and Humanities of University of São Paulo, São Paulo, Brazil
| | | | - José Cipolla-Neto
- Laboratory of Neurobiology, Institute of Biomedical Sciences of University of São Paulo, São Paulo, Brazil
| | - Mario Pedrazzoli
- School of Arts, Sciences and Humanities of University of São Paulo, São Paulo, Brazil
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Meaklim H, Junge MF, Varma P, Finck WA, Jackson ML. Beyond Stress: Altered Sleep-Wake Patterns are a Key Behavioral Risk Factor for Acute Insomnia During Times of Crisis. Behav Sleep Med 2023; 21:208-225. [PMID: 35604338 DOI: 10.1080/15402002.2022.2074996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Stress is a common precipitant of acute insomnia; however, reducing stress during times of crisis is challenging. This study aimed to determine which modifiable factors, beyond stress, were associated with acute insomnia during a major crisis, the COVID-19 pandemic. PARTICIPANTS/METHODS A global online survey assessed sleep/circadian, stress, mental health, and lifestyle factors between April-May 2020. Logistic regression models analyzed data from 1319 participants (578 acute insomnia, 731 good sleepers), adjusted for demographic differences. RESULTS Perceived stress was a significant predictor of acute insomnia during the pandemic (OR 1.23, 95% CI1.19-1.27). After adjusting for stress, individuals who altered their sleep-wake patterns (OR 3.36, CI 2.00-5.67) or increased technology use before bed (OR 3.13, CI 1.13-8.65) were at increased risk of acute insomnia. Other sleep factors associated with acute insomnia included changes in dreams/nightmares (OR 2.08, CI 1.32-3.27), increased sleep effort (OR 1.99, CI1.71-2.31) and cognitive pre-sleep arousal (OR 1.18, CI 1.11-1.24). For pandemic factors, worry about contracting COVID-19 (OR 3.08, CI 1.18-8.07) and stringent government COVID-19 restrictions (OR 1.12, CI =1.07-1.18) were associated with acute insomnia. Anxiety (OR 1.02, CI 1.01-1.05) and depressive (OR 1.29, CI 1.22-1.37) symptoms were also risk factors. A final hierarchical regression model revealed that after accounting for stress, altered sleep-wake patterns were a key behavioral predictor of acute insomnia (OR 2.60, CI 1.68-5.81). CONCLUSION Beyond stress, altered sleep-wake patterns are a key risk factor for acute insomnia. Modifiable behaviors such as maintaining regular sleep-wake patterns appear vital for sleeping well in times of crisis.
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Affiliation(s)
- Hailey Meaklim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Moira F Junge
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,The Sleep Health Foundation, Blacktown, New South Wales, Australia
| | - Prerna Varma
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Wendy A Finck
- Faculty of Education, Monash University, Clayton, Victoria, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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11
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Christodoulou N, Bertrand L, Palagini L, Frija-Masson J, d'Ortho MP, Lejoyeux M, Riemann D, Maruani J, Geoffroy PA. Factors associated with insomnia symptoms: A cross-sectional study during a Covid-19 fully restrictive lockdown. J Sleep Res 2023; 32:e13752. [PMID: 36217818 DOI: 10.1111/jsr.13752] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 07/05/2022] [Accepted: 09/21/2022] [Indexed: 02/03/2023]
Abstract
Insomnia is the most frequent sleep disorder and a public health concern that increased during the Covid 19 pandemic. Fully restrictive lockdowns during Covid are interesting periods to examine the impact of environmental and behavioural changes on the emergence of insomnia symptoms. In this cross-sectional study we aimed to (1) determine the main factors associated with insomnia symptoms during a Covid-19 fully restrictive lockdown examining the associated daily life alterations and (2) create a predictive model of insomnia symptoms. We used the data drawn from the "Covid-RythmE" study that reached volunteers from the general French population through an online survey during the last 2 weeks of the 2 month full lockdown. Associations with insomnia symptoms were tested and significant associations were entered in a Backward Stepwise Logistic Regression (BSLR) to assess the best combination to classify individuals with or without insomnia symptoms. From the 1624 participants, 50.64% suffered from mild to severe insomnia symptoms as assessed by the ISI. The best combination for explaining insomnia symptoms with 74.26% of accuracy included: age (OR = 1.15), females (OR = 1.26), smaller home sizes (OR = 0.77), environmental noises (OR = 1.59), anxiety symptoms (OR = 1.24), depressive symptoms (OR = 1.15), regularity of sleep-wake schedules (OR = 1.25), exposure to screen during the morning (OR = 1.13), and LED light during the evening (OR = 1.17). Thus, lifestyle schedule and exposure to natural synchronizers such as light, are primordial in considering in insomnia physiopathology, prevention and treatment, as well as the associated mental health status.
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Affiliation(s)
- Nausicaa Christodoulou
- Université Paris Cité, Paris, France.,Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France
| | - Léa Bertrand
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France
| | - Laura Palagini
- Psychiatry Division, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy - Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Justine Frija-Masson
- Université Paris Cité, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France.,Département de Physiologie - Explorations Fonctionnelles, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France
| | - Marie-Pia d'Ortho
- Université Paris Cité, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France.,Département de Physiologie - Explorations Fonctionnelles, AP-HP, Hôpital Bichat - Claude Bernard, Paris, France
| | - Michel Lejoyeux
- Université Paris Cité, Paris, France.,Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,GHU Paris - Psychiatry & Neurosciences, Paris, France
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Julia Maruani
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France
| | - Pierre A Geoffroy
- Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat - Claude Bernard, Paris, France.,Université de Paris, NeuroDiderot, Inserm, Paris, France.,GHU Paris - Psychiatry & Neurosciences, Paris, France.,CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
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12
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Alfonsi V, Scarpelli S, Gorgoni M, Couyoumdjian A, Rosiello F, Sandroni C, Corsi R, Pietrantonio F, De Gennaro L. Healthcare Workers after Two Years of COVID-19: The Consequences of the Pandemic on Psychological Health and Sleep among Nurses and Physicians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1410. [PMID: 36674167 PMCID: PMC9859438 DOI: 10.3390/ijerph20021410] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 05/06/2023]
Abstract
COVID-19 has challenged the health workforce worldwide. In this cross-sectional study with a retrospective assessment, we explored the impact of the pandemic on mental health and sleep among a sample of Italian nurses and medical doctors. A total of 287 healthcare workers (212 nurses and 75 physicians) completed a web survey on socio-demographic, psychological, and sleep-related aspects referring to the period before the pandemic and to the present period of February to June 2022. Comparisons between nurses and physicians revealed that the former had greater distress in response to the pandemic. Consistently, the multivariate analysis of covariance showed that even if both groups were negatively impacted by the pandemic, nurses presented a greater worsening over time regarding several psychological and sleep symptoms. Furthermore, we observed that working on the frontline represented an additional risk factor for nurses. In line with previous evidence, we also found that personal experiences with COVID-19 are significant predictors of the current health status. Our results underscore the urgent need for preventive programs among healthcare operators to increase their coping skills and prevent the long-term consequences of chronic stress, especially for high-risk professionals. Specific attention should also be devoted to programs to improve sleep quality and reduce sleep-related traumatic symptoms.
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Affiliation(s)
- Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | | | - Francesco Rosiello
- Internal Medicine Department, Ospedale dei Castelli, Azienda Sanitaria Locale Roma 6, Ariccia, 00040 Rome, Italy
| | - Cinzia Sandroni
- UOC Professione Infermieristica, Azienda Sanitaria Locale Roma 6, Albano, 00041 Rome, Italy
| | - Roberto Corsi
- Direzione Sanitaria Aziendale, Azienda Sanitaria Locale Roma 6, Albano, 00041 Rome, Italy
| | - Filomena Pietrantonio
- Internal Medicine Department, Ospedale dei Castelli, Azienda Sanitaria Locale Roma 6, Ariccia, 00040 Rome, Italy
- Department of Health Economics, St. Camillus International University of Health Sciences, 00131 Rome, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
- IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
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13
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Building a case for incorporating sport as an indicator in human development index. SPORT SCIENCES FOR HEALTH 2023; 19:177-184. [PMID: 36408531 PMCID: PMC9643920 DOI: 10.1007/s11332-022-01017-9] [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: 08/30/2021] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
Abstract
Purpose United Nations General Assembly adopted a resolution 73/24 on 3rd December 2018, to recognize sport as an enabler of sustainable development. To examine whether sport really plays an enabling role, the medals ranking of countries on the basis of medals obtained (per million population) in Summer Olympics during the five Olympics games over the first two decades of 21st century has been chosen as an indicator of sports achievement of a country and has been compared with their Human Development Index (HDI) ranking during that particular year of Olympics. The aim of this research was to examine the correlation between sports achievement and HDI. Methods This research uses the Summer Olympic Rank as per medals obtained per million population (for the years 2000, 2004, 2008, 2012, 2016) of various countries as the Indicator of their sports achievement and compares them with their HDI Rank during these specific years. Results The researchers tested the hypothesis that the higher the sports achievement, the higher the HDI of a country and vice-versa. The analysis shows a very high positive correlation between the Olympic medal ranking and the HDI ranking, revealing that the countries with higher sports achievement have higher HDI. Conclusions Hence, the conclusion is, if a sport is include in HDI as an indicator of the Human Development Index, sport could become an important vehicle for the improvement of HDI, especially in low and middle-income countries where the sports achievement is low and the HDI is also low.
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14
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Limongi F, Siviero P, Trevisan C, Noale M, Catalani F, Ceolin C, Conti S, di Rosa E, Perdixi E, Remelli F, Prinelli F, Maggi S. Changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown: A systematic review and meta-analysis. Front Psychiatry 2023; 14:1166815. [PMID: 37124253 PMCID: PMC10134452 DOI: 10.3389/fpsyt.2023.1166815] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction This systematic review and meta-analysis aims to explore changes in sleep quality and sleep disturbances in the general population from before to during the COVID-19 lockdown. Methods The protocol was registered in PROSPERO (CRD42021256378) and the PRISMA guidelines were followed. The major databases and gray literature were systematically searched from inception to 28/05/2021 to identify observational studies evaluating sleep changes in the general population during the lockdown with respect to the pre-lockdown period. A random effects meta-analysis was undertaken for studies reporting (a) the means of the Pittsburgh Sleep Quality Index (PSQI) global scores or the means of the sleep onset latency (SOL) times (minutes - min) before and during the lockdown, (b) the percentages of poor sleep quality before and during the lockdown, or (c) the percentages of changes in sleep quality. Subgroup analysis by risk of bias and measurement tool utilized was carried out. A narrative synthesis on sleep efficiency, sleep disturbances, insomnia and sleep medication consumption was also performed. Results Sixty-three studies were included. A decline in sleep quality, reflected in a pooled increase in the PSQI global scores (standardized mean difference (SMD) = 0.26; 95% CI 0.17-0.34) and in SOL (SMD = 0.38 min; 95% CI 0.30-0.45) were found. The percentage of individuals with poor sleep quality increased during the lockdown (pooled relative risk 1.4; 95% CI 1.24-1.61). Moreover, 57.3% (95% CI 50.01-61.55) of the individuals reported a change in sleep quality; in 37.3% (95% CI 34.27-40.39) of these, it was a worsening. The studies included in the systematic review reported a decrease in sleep efficiency and an increase in sleep disturbances, insomnia, and in sleep medication consumption. Discussion Timely interventions are warranted in view of the decline in sleep quality and the increase in sleep disturbances uncovered and their potentially negative impact on health. Further research and in particular longitudinal studies using validated instruments examining the long-term impact of the lockdown on sleep variables is needed. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021256378, identifier CRD42021256378.
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Affiliation(s)
- Federica Limongi
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
| | - Paola Siviero
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
- *Correspondence: Paola Siviero, ; orcid.org/0000-0001-6567-5808
| | - Caterina Trevisan
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Marianna Noale
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
| | - Filippo Catalani
- Geriatric Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Chiara Ceolin
- Geriatric Unit, Department of Medicine, University of Padova, Padova, Italy
| | - Silvia Conti
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Elisa di Rosa
- Department of General Psychology, University of Padova, Padova, Italy
| | - Elena Perdixi
- Unit of Behavioral Neurology and Dementia Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Francesca Remelli
- Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Federica Prinelli
- Epidemiology Unit, Institute of Biomedical Technologies, National Research Council, Milano, Italy
| | - Stefania Maggi
- Aging Branch, Neuroscience Institute, National Research Council, Padova, Italy
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15
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Drumheller K, Fan CW. Unprecedented times and uncertain connections: A systematic review examining sleep problems and screentime during the COVID-19 pandemic. SLEEP EPIDEMIOLOGY 2022; 2:100029. [PMID: 35692715 PMCID: PMC9076584 DOI: 10.1016/j.sleepe.2022.100029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/27/2022] [Indexed: 12/14/2022]
Abstract
Objective Sleep has been impacted by the COVID-19 pandemic around the world. Furthermore, screen time has been reported to influence sleep and has increased during pandemic quarantines. This systematic review searched databases to determine if screen time affected sleep during the COVID-19 pandemic. Methods PubMed, Nursing and Allied Health Proquest, and Science Direct Health and Lifescience college edition were searched for articles that fit the inclusion criteria. There were 2750 articles initially screened. Then, 119 articles were further assessed to determine eligibility, creating a final sample of 18 articles that explored whether screen time affected sleep. Results After reviewing the included articles (n = 18), the main theme revealed that screen time negatively affected sleep during the COVID-19 pandemic, specifically aspects such as sleep duration, sleep quality, sleep onset latency, and wake time. However, several articles countered this implication. Therefore, it is important to consider other factors that may influence the relationship between screen time and sleep. Conclusions Although the number of articles included is limited, the overall synthesis suggests that COVID-19-related lifestyle changes, such as increased screen time, may negatively affect sleep health. However, other unidentified factors may have contributed to these findings and warrant further research. Nonetheless, community leaders must consider the long-term consequences of the pandemic and implement initiatives to address sleep challenges due to the intricate connection between sleep and well-being.
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16
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Hailu Tesfaye A, Alemayehu M, Abere G, Kabito GG. Risk factors for the prevalence of poor sleep quality in lecturers during COVID-19 pandemic in Ethiopia: an institution-based cross-sectional study. BMJ Open 2022; 12:e066024. [PMID: 36198464 PMCID: PMC9534775 DOI: 10.1136/bmjopen-2022-066024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study was conducted to assess the prevalence and risk factors of poor sleep quality (SQ) among the academic staff at the University of Gondar, Northwestern Ethiopia. DESIGN An institution-based cross-sectional study was conducted from March to April 2021. A validated, self-administered, standardised Pittsburgh Sleep Quality Index (PSQI) was used to quantify the amount of self-reported poor SQ. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. Binary logistic regressions were computed to determine the association between variables. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. SETTING The study was conducted at the University of Gondar, Northwestern Ethiopia. PARTICIPANTS A total of 607 lecturers participated in this study. OUTCOME MEASURES The primary outcome is the prevalence of poor SQ, which was measured using the PSQI. RESULTS Overall response rate was 95.60% (N=607). The age of the participants ranges from 21 to 70 with a mean of 32.39 (SD±6.80) years. The magnitude of poor SQ during the COVID-19 pandemic in the last month was 60.30% (95% CI (56.28% to 64.21%)). Working greater than 10 hours per day (AOR=2.19, 95% CI (1.16 to 4.27)), electronic device use before bedtime (AOR=1.53, 95% CI (1.04 to 2.27)), high-risk perception of COVID-19 infections (AOR=1.60, 95% CI (1.04 to 2.46)) and perceived job stress (AOR=2.15 (95% CI (1.50 to 3.08)) were risk factors for poor SQ. CONCLUSION The study revealed that the prevalence of poor SQ was high during the COVID-19 pandemic. The finding highlights the importance of optimising the working hours per day, minimising electronic device use before bedtime, promoting risk perception toward COVID-19 infection and developing workplace coping strategies for stress, which play a substantial role in minimising poor SQ.
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Affiliation(s)
- Amensisa Hailu Tesfaye
- Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - M Alemayehu
- Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Giziew Abere
- Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Gebisa Guyasa Kabito
- Environmental and Occupational Health and Safety, Institute of Public Health, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
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17
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Currò CT, Ciacciarelli A, Vitale C, La Spina P, Toscano A, Vita G, Trimarchi G, Silvestri R, Autunno M. Sleep and sleep-modifying factors in chronic migraine patients during the COVID-19 lockdown. Neurol Sci 2022; 43:6639-6655. [PMID: 36138296 PMCID: PMC9510535 DOI: 10.1007/s10072-022-06378-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 08/28/2022] [Indexed: 11/30/2022]
Abstract
Aims The objective of the present study was to evaluate sleep features and sleep-modifying factors in patients with chronic migraine (CM) during the first Italian COVID-19 lockdown. Material and methods The study was based on an e-mail survey addressed to CM patients of our headache center. The survey investigated demographic, life-style, sleep, psychological, and migraine features during the first COVID-19 lockdown period and the month before. The outcomes were sleep quality (measured using PSQI) and variation in sleep quality, duration, and latency. Results Ninety-two patients were included. The mean PSQI was 11.96. Sleep quality was improved in 14.1%, stable in 47.8%, and worsened in 38.0%. Sleep latency was reduced in 5.4%, stable in 46.7%, and increased in 47.8%. Sleep duration was reduced in 29.3%, stable in 34.8%, and increased in 35.9%. Significant associations were found with age, work/study, remote working, job loss, meal quality change, smoking variation, COVID-19 province prevalence, home-inhabitant relationship, ratio of house size/number of people, stress, state anxiety, anxiety/depression variation, future concern variation, computer hours, internet hours, and television hours. Conclusion The study described sleep features of chronic migraineurs during COVID-19 lockdown, pinpointing the main factors involved in sleep quality and sleep changes. Our findings revealed that migraineurs’ sleep was closely linked with life-style and psychological features. Several modifiable factors came to light and they should be considered in order to develop an optimal management of CM. An appropriate and more aware treatment of sleep problems could be a way to improve migraineurs’ life. Supplementary Information The online version contains supplementary material available at 10.1007/s10072-022-06378-0.
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Affiliation(s)
- Carmelo Tiberio Currò
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy.
- Neurological Department, Mirano Hospital, ULSS3 Serenissima, Mirano, Venice, Italy.
| | - Antonio Ciacciarelli
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
- Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
| | - Chiara Vitale
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
- Department of Neurology, Sant'Elia Hospital, ASP Caltanissetta, Caltanissetta, Italy
| | - Paolino La Spina
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
| | - Antonio Toscano
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
| | - Giuseppe Vita
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
| | | | - Rosalia Silvestri
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
| | - Massimo Autunno
- Department of Clinical and Experimental Medicine, University of Messina, Via Consolare Valeria 1, 98124, Messina, Italy
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18
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De Fazio R, Mattei V, Al-Naami B, De Vittorio M, Visconti P. Methodologies and Wearable Devices to Monitor Biophysical Parameters Related to Sleep Dysfunctions: An Overview. MICROMACHINES 2022; 13:mi13081335. [PMID: 36014257 PMCID: PMC9412310 DOI: 10.3390/mi13081335] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/15/2022] [Accepted: 08/16/2022] [Indexed: 06/13/2023]
Abstract
Sleep is crucial for human health from metabolic, mental, emotional, and social points of view; obtaining good sleep in terms of quality and duration is fundamental for maintaining a good life quality. Over the years, several systems have been proposed in the scientific literature and on the market to derive metrics used to quantify sleep quality as well as detect sleep disturbances and disorders. In this field, wearable systems have an important role in the discreet, accurate, and long-term detection of biophysical markers useful to determine sleep quality. This paper presents the current state-of-the-art wearable systems and software tools for sleep staging and detecting sleep disorders and dysfunctions. At first, the paper discusses sleep's functions and the importance of monitoring sleep to detect eventual sleep disturbance and disorders. Afterward, an overview of prototype and commercial headband-like wearable devices to monitor sleep is presented, both reported in the scientific literature and on the market, allowing unobtrusive and accurate detection of sleep quality markers. Furthermore, a survey of scientific works related the effect of the COVID-19 pandemic on sleep functions, attributable to both infection and lifestyle changes. In addition, a survey of algorithms for sleep staging and detecting sleep disorders is introduced based on an analysis of single or multiple biosignals (EEG-electroencephalography, ECG-electrocardiography, EMG-electromyography, EOG-electrooculography, etc.). Lastly, comparative analyses and insights are provided to determine the future trends related to sleep monitoring systems.
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Affiliation(s)
- Roberto De Fazio
- Department of Innovation Engineering, University of Salento, 73100 Lecce, Italy
| | - Veronica Mattei
- Department of Innovation Engineering, University of Salento, 73100 Lecce, Italy
| | - Bassam Al-Naami
- Department of Biomedical Engineering, Faculty of Engineering, The Hashemite University, Zarqa 13133, Jordan
| | - Massimo De Vittorio
- Department of Innovation Engineering, University of Salento, 73100 Lecce, Italy
- Center for Biomolecular Nanotechnologies, Italian Technology Institute IIT, 73010 Arnesano, Italy
| | - Paolo Visconti
- Department of Innovation Engineering, University of Salento, 73100 Lecce, Italy
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19
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Abstract
The pandemic caused by the coronavirus disease 2019 (COVID-19) had a huge impact on public mental health. This was also reflected in dreams. Not only did people start to remember more dreams, but dream content changed as themes like sickness, confinement, and—in the English-speaking world—even bugs began to dominate. This also led to an increase in nightmare frequency. There are various factors that contributed to this change in the dream landscape. Some people have started to sleep more and hereby spend more time in REM sleep, which is known to increase dream recall and further lead to bizarre and vivid dreams. On the other hand, stress and poor mental health had an impact on sleep, and sleep quality thus dropped in many individuals. Poor sleep quality can also lead to an increase in dream recall. Dreams are known to regulate mood, so the rise in dreams and the change in dream content could also reflect a reaction to the overall rise in stress and decline in mental health. Recent studies have shown that as the pandemic progresses, further changes in mental health, dream recall, and dream content arise, but data are still scarce. Further research could help understand the impact the pandemic still has on mental health and dreams, and how this impact is changing over the course of the pandemic.
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Affiliation(s)
- Severin Ableidinger
- Institut für Bewusstseins- und Traumforschung, Canongasse 13/1, 1180 Vienna, Austria
| | - Franziska Nierwetberg
- Institut für Bewusstseins- und Traumforschung, Canongasse 13/1, 1180 Vienna, Austria
| | - Brigitte Holzinger
- Institut für Bewusstseins- und Traumforschung, Canongasse 13/1, 1180 Vienna, Austria
- Medizinisches Schlafcoaching, Postgraduate Medizinische Universität Wien, Spitalgasse 23, 1090 Vienna, Austria
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Moraleda-Cibrián M, Albares-Tendero J, Pin-Arboledas G. Screen media use and sleep patterns in Spanish adolescents during the lockdown of the coronavirus pandemic. Sleep Breath 2022; 26:1993-2000. [PMID: 35031931 PMCID: PMC8760131 DOI: 10.1007/s11325-021-02558-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/20/2021] [Accepted: 12/23/2021] [Indexed: 01/01/2023]
Abstract
Purpose The aim of this study was to investigate screen media use and sleep patterns among Spanish adolescents during the lockdown (LD) of the first peak of the coronavirus pandemic. Methods Cross-sectional community-based study of adolescents aged 11–18 years. An online questionnaire with queries about screen time, sleep, and other healthy habits was completed by parents or guardians. Results Overall 265 adolescents were enrolled. The mean age was 13.6 ± 2.3 years, 58% were boys, 68% were in secondary school and 72% lived in urban areas. Before the LD (BLD) 87% of adolescents used electronic devices < 4 h/d, while during the LD (DLD) screen time was > 4 h/d in 75% of cases (p < 0.0001). A delayed wake time and bedtime weekdays (BLD wake time weekdays: later than 09:45 0.0% vs. DLD 30%, p < 0.0001, and BLD bedtime weekdays: later than 00:30 3% vs. DLD 35%, p < 0.0001) and weekends DLD was observed. Adolescents who used electronic devices > 4 h/d DLD compared with those who used < 4 h/d reported more frequently long sleep latency (93% vs. 7%, p = 0.007), low sunlight exposure (77% vs. 23%, p = 0.031), less physical activity (86%. vs. 15%, p = 0.011) and weight gain (78%. vs. 22%, p = 0.049). Conclusions During the lockdown Spanish adolescents reported elevated screen time and delayed sleep patterns. An increase in screen media use was associated with unhealthy habits.
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Affiliation(s)
- Marta Moraleda-Cibrián
- Sleep Disorders Center, Centro Médico Teknon, 12 De la Vilana Street, Marquesa building, Box 5, 08022, Barcelona, Spain.
| | - Javier Albares-Tendero
- Sleep Disorders Center, Centro Médico Teknon, 12 De la Vilana Street, Marquesa building, Box 5, 08022, Barcelona, Spain
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21
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Zhang J, Mi L, Zhao J, Chen H, Wang D, Ma Z, Fan F. The Moderating Role of Lifestyle on Insomnia in Home Quarantine College Students During the COVID-19 Epidemic. Front Psychiatry 2022; 13:830383. [PMID: 35308877 PMCID: PMC8924361 DOI: 10.3389/fpsyt.2022.830383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/09/2022] [Indexed: 12/04/2022] Open
Abstract
There has been sufficient evidence for the relationship between lifestyle and insomnia in the general population, but for individuals who already suffer from insomnia, it is not clear whether a healthy lifestyle can also pose similar benefits. The present study investigated the roles of different aspects of lifestyle in the development of individual insomnia by tracking insomnia symptoms of college students during the COVID-19 lock-down. Two surveys were conducted on 65,200 college students in the process of home isolation in Guangdong Province of China, at the pandemic outbreak period (T1) and the initial remission period (T2), respectively. Given the objectives of the present study, a total of 1,702 college students with clinical insomnia from T1 were selected as subjects. Insomnia symptoms were assessed using the Youth Self Rating Insomnia Scale (YSIS), while demographic information, epidemic exposure, and lifestyle were all measured by self-developed questionnaire, through network survey. The 1,702 college students (mean age ± standard deviation, 20.06 ± 1.46, range 16-25; 71.9% females) with insomnia symptoms were divided into three trajectory groups: recovery group, remission group, and chronic insomnia group according to their insomnia scores in T2 phase. The results showed that there was no significant difference in demographic backgrounds or epidemic exposure among the three groups, however, there were significant differences in food intake, exercise, and Internet use. The regression results further showed that both the recovery group and the remission group adopted more regular food intake than the chronic group. The recovery group exhibited better daily exercise habits than both the remission group and the chronic group. The duration of Internet use was significantly shorter for the recovery group than for the chronic group. These findings indicate a strong relationship between the lifestyle and the recovery of insomnia for college students isolated at home during the epidemic period. Significance of the different aspects of lifestyle on the recovery of insomnia are discussed.
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Affiliation(s)
- Jinfang Zhang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Lin Mi
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jingbo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Huilin Chen
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Dongfang Wang
- School of Psychology, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, South China Normal University, Guangzhou, China
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22
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Li G, Liu H, Qiu C, Tang W. Fear of COVID-19, prolonged smartphone use, sleep disturbances, and depression in the time of COVID-19: A nation-wide survey. Front Psychiatry 2022; 13:971800. [PMID: 36311498 PMCID: PMC9614217 DOI: 10.3389/fpsyt.2022.971800] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/21/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has had a wide range of behavioral and psychological effects on the general population. This study examined the relationship between fear of COVID-19, daily smartphone use, sleep disturbance, and depression in the general population during the early stage of COVID-19. METHODS An online nation-wide survey was conducted from March 20 to April 10, 2020. Sociodemographic information, including age, gender, educational attainment, vocation, and duration of self-isolation, was collected; fear of COVID-19 and other objective exposures, daily hours of smartphone use, night sleep duration, sleep disturbance, and depressive symptoms were measured with structured questions and PHQ-9. There were 1,280 questionnaires in total, and 1,250 valid questionnaires remained. RESULTS The prevalence of sleep disturbance and depression were found to be 13.1 and 10.7%, respectively. Feelings of extreme fear, longer smartphone use, difficulty initiating sleep, and early morning awakening were significant risk factors for depression. Daily hours of smartphone use, difficulty initiating sleep, and early morning awakening partially mediated the association between feeling extremely scared of the pandemic and depression. CONCLUSION Psychological interventions in a major public health crisis should focus more on the subjective perception of pandemic fear. At the same time, daily smartphone use and sleep disturbances could serve as targets for monitoring and intervention for depression during a pandemic.
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Affiliation(s)
- Gangqin Li
- Department of Forensic Psychiatry, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Hao Liu
- West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjie Tang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
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23
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Sleep Quality, Insomnia Symptoms, and Depressive Symptomatology among Italian University Students before and during the Covid-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413346. [PMID: 34948954 PMCID: PMC8705602 DOI: 10.3390/ijerph182413346] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/15/2021] [Accepted: 12/16/2021] [Indexed: 12/14/2022]
Abstract
The COVID-19 pandemic led world authorities to adopt extraordinary measures to counteract the spread of the virus. The Italian government established a national lockdown from 9 March to 3 May 2020, forcing people in their homes and imposing social distancing. During the pandemic emergency, university students emerged as a vulnerable category. Indeed, higher rates of sleep problems and mental disorders were reported in this population. However, these outcomes were derived from cross-sectional investigations adopting retrospective assessments. Retrospective evaluations suffer from different biases, putatively leading to erroneous outcomes. To overcome this limitation, we adopted a between-subject approach comparing a sample of 240 Italian undergraduate university students assessed in 2016 (mean age ± standard deviation, 20.39 ± 1.42, range 18–25; 80.42% females), with an age/gender-matched sample of university students assessed during the third week of lockdown in Spring 2020. We evaluated sleep quality, insomnia symptoms, and depressive symptomatology using validated questionnaires. We found worse sleep quality, a delayed bedtime, and more severe insomnia and depression symptoms in the students sampled under COVID-19 restrictive measures. We suggest paying special attention to this at-risk population during the current pandemic emergency and applying preventive and supportive interventions to limit the exacerbation of sleep and psychological problems.
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24
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Bean SR, Khawaja IS, Ventimiglia JB, Khan SS. COVID-somnia: Sleep Disruptions Associated with the COVID-19 Pandemic. Psychiatr Ann 2021. [DOI: 10.3928/00485713-20211109-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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25
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Gorgoni M, Scarpelli S, Mangiaruga A, Alfonsi V, Bonsignore MR, Fanfulla F, Ferini-Strambi L, Nobili L, Plazzi G, De Gennaro L. Persistence of the Effects of the COVID-19 Lockdown on Sleep: A Longitudinal Study. Brain Sci 2021; 11:brainsci11111520. [PMID: 34827519 PMCID: PMC8615786 DOI: 10.3390/brainsci11111520] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/02/2021] [Accepted: 11/15/2021] [Indexed: 02/05/2023] Open
Abstract
The effects of the COVID-19 pandemic on sleep have been widely documented, but longitudinal evaluations during different phases of the “COVID-19 era” are needed to disentangle the specific consequences of the r145estrictive measures on sleep variables. The aim of this study was to assess the immediate effect of the lockdown’s end on sleep and sleep-related dimensions in an Italian sample, also considering the stress and depressive symptoms. We used an online survey to longitudinally collect data on sociodemographic, environmental, clinical, sleep, and sleep-related variables in two time points: during and immediately after the lockdown. The final sample included 102 participants. The large prevalence of poor sleep quality, clinically relevant pre-sleep arousal, and depressive symptoms, as well as poor sleep quality and pre-sleep arousal score observed during the lockdown, remained stable after its end. On the other hand, the prevalence of moderate-to-severe event-related stress and intrusive symptom scores exhibited a drastic reduction after the end of home confinement. Both bedtime and rise time were anticipated after the lockdown, while sleep quality exhibited only a trend of post-lockdown sleep disturbance reduction. Our findings point to a reduced stress level (specific for the intrusive symptomatology) after the end of the lockdown and persistence of sleep problems, suggesting two non-mutually exclusive hypotheses: (a) the strict restrictive measures are not the main cause of sleep problems during the pandemic and (b) home confinement induces long-lasting effects on sleep observable after its end, and a longer period of time might be needed to observe an improvement.
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Anastasia Mangiaruga
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
| | - Maria R. Bonsignore
- PROMISE Department, University of Palermo, and IRIB-CNR, 90127 Palermo, Italy;
| | - Francesco Fanfulla
- Sleep Medicine Unit, Clinical and Scientific Maugeri Institutes, Scientific Institute of Pavia, IRCCS, 27100 Pavia, Italy;
| | - Luigi Ferini-Strambi
- Sleep Disorders Center, Vita-Salute San Raffaele University, 20127 Milan, Italy;
| | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy;
- Department of Medical and Surgical Neuroscience and Rehabilitation (DINOGMI), University of Genoa, 16147 Genoa, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
- IRCCS Istituto delle Scienze Neurologiche di Bologna, 40139 Bologna, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy; (M.G.); (S.S.); (V.A.)
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Correspondence: ; Tel.: +39-064-9917-508
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26
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O’Regan D, Jackson ML, Young AH, Rosenzweig I. Understanding the Impact of the COVID-19 Pandemic, Lockdowns and Social Isolation on Sleep Quality. Nat Sci Sleep 2021; 13:2053-2064. [PMID: 34795545 PMCID: PMC8593898 DOI: 10.2147/nss.s266240] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2021] [Indexed: 12/15/2022] Open
Abstract
The uncertain, ever-changing and an ongoing nature of the COVID-19 pandemic means that it may take some time before we can fully appreciate the negative effect of the pandemic and lockdown on our sleep and mental health. It is increasingly recognised that in the aftermath of pandemic, several persistent sleep, neuropsychiatric and physical sequelae may continue long after the pandemic is over. A body of evidence to date also highlights a significant disparity in sleep and mental health difficulties in specific vulnerable groups in the community, with different temporal profiles and sleep issues that are reported. In this perspective, we argue for a possible mechanistic impact of the COVID-19 pandemic, with its imposed restrictions and social isolation on sleep quality. We similarly discuss some of the potential international differences, as well as similarities, behind reported idiosyncratic biological vulnerabilities that may have contributed to the genesis of sleep issues. Lastly, we propose some possible implementations and innovations that may be needed in restructuring of sleep disorders services in order to benefit recovering COVID-19 patients.
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Affiliation(s)
- David O’Regan
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Faculty of Life and Sciences Medicine, King’s College London, London, UK
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Allan H Young
- School of Academic Psychiatry, IoPPN, King’s College London, London, UK
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King’s College London, London, UK
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27
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Gorgoni M, Scarpelli S, Mangiaruga A, Alfonsi V, Bonsignore MR, Fanfulla F, Ferini-Strambi L, Nobili L, Plazzi G, De Gennaro L. Pre-sleep arousal and sleep quality during the COVID-19 lockdown in Italy. Sleep Med 2021; 88:46-57. [PMID: 34731828 PMCID: PMC8577578 DOI: 10.1016/j.sleep.2021.10.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 09/18/2021] [Accepted: 10/09/2021] [Indexed: 02/08/2023]
Abstract
Objective The COVID-19 pandemic has strongly affected daily habits and psychological wellbeing, and many studies point to large modifications in several sleep and sleep-related domains. Nevertheless, pre-sleep arousal during the pandemic has been substantially overlooked. Since hyperarousal represents one of the main factors for the development and the perpetuation of chronic insomnia disorder, the assessment of variables associated with high levels of pre-sleep arousal during the pandemic is clinically relevant. The study aimed to assess the prevalence and predictors of perceived sleep quality and pre-sleep arousal in an Italian sample during the COVID-19 lockdown. Methods We used an online survey to collect self-reported sociodemographic, environmental, clinical, sleep, and sleep-related data. Our final sample included 761 participants. Results Beyond a high frequency of poor sleep quality, depressive and stress symptoms, our results show that almost half of the sample suffered from clinically relevant levels of at least one component (ie, cognitive, somatic) of pre-sleep arousal. Subjects with greater pre-sleep arousal exhibited poorer sleep quality. Also, sleep quality was strongly associated with somatic and cognitive pre-sleep arousal. Regarding the predictors of sleep and sleep-related measures, depressive and event-related stress symptoms were the main factors associated with both poor sleep quality and pre-sleep arousal components. Moreover, specific sociodemographic and environmental variables were uniquely related to sleep quality, cognitive or somatic pre-sleep arousal. Conclusions These findings suggest that the assessment of specific sleep-related factors (ie, pre-sleep arousal), together with more global measures of sleep quality, may be crucial to depict the complex impact of the pandemic on sleep, and to help prevent and counteract the spread of insomnia symptoms.
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Affiliation(s)
- Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Anastasia Mangiaruga
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | | | | | - Francesco Fanfulla
- Sleep Medicine Unit, Clinical and Scientific Maugeri Institutes, Scientific Institute of Pavia IRCCS Pavia, Italy
| | | | - Lino Nobili
- Child Neuropsychiatry Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy; Department of Medical and Surgical Neuroscience and Rehabilitation (DINOGMI), University of Genoa, Genoa, Italy
| | - Giuseppe Plazzi
- Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy; IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy.
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28
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Massar SAA, Ng ASC, Soon CS, Ong JL, Chua XY, Chee NIYN, Lee TS, Chee MWL. Reopening after lockdown: The influence of working-from-home and digital device use on sleep, physical activity, and wellbeing following COVID-19 lockdown and reopening. Sleep 2021; 45:6390581. [PMID: 34636396 PMCID: PMC8549292 DOI: 10.1093/sleep/zsab250] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/09/2021] [Indexed: 12/02/2022] Open
Abstract
Study Objectives COVID-19 lockdowns drastically affected sleep, physical activity, and wellbeing. We studied how these behaviors evolved during reopening the possible contributions of continued working from home and smartphone usage. Methods Participants (N = 198) were studied through the lockdown and subsequent reopening period, using a wearable sleep/activity tracker, smartphone-delivered ecological momentary assessment (EMA), and passive smartphone usage tracking. Work/study location was obtained through daily EMA ascertainment. Results Upon reopening, earlier, shorter sleep and increased physical activity were observed, alongside increased self-rated stress and poorer evening mood ratings. These reopening changes were affected by post-lockdown work arrangements and patterns of smartphone usage. Individuals who returned to work or school in-person tended toward larger shifts to earlier sleep and wake timings. Returning to in-person work/school also correlated with more physical activity. Contrary to expectation, there was no decrease in objectively measured smartphone usage after reopening. A cluster analysis showed that persons with relatively heavier smartphone use prior to bedtime had later sleep timings and lower physical activity. Conclusions These observations indicate that the reopening after lockdown was accompanied by earlier sleep timing, increased physical activity, and altered mental wellbeing. Moreover, these changes were affected by work/study arrangements and smartphone usage patterns.
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Affiliation(s)
- Stijn A A Massar
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Alyssa S C Ng
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Chun Siong Soon
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Ju Lynn Ong
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Xin Yu Chua
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Nicholas I Y N Chee
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
| | - Tih Shih Lee
- Laboratory of Neurobehavioral Genomics, Neuroscience and Behavioral Disorders Programme, Duke-NUS Medical School, Singapore
| | - Michael W L Chee
- Sleep and Cognition Laboratory, Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore
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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: 31] [Impact Index Per Article: 10.3] [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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30
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Alfonsi V, Gorgoni M, Scarpelli S, Zivi P, Sdoia S, Mari E, Quaglieri A, Ferlazzo F, Giannini AM, De Gennaro L. Changes in sleep pattern and dream activity across and after the COVID-19 lockdown in Italy: A longitudinal observational study. J Sleep Res 2021; 31:e13500. [PMID: 34595786 PMCID: PMC8646575 DOI: 10.1111/jsr.13500] [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: 08/12/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 02/05/2023]
Abstract
A large body of evidence has documented the impact of the global COVID‐19 outbreak – and especially the lockdown period – on sleep quality and quantity. Here, we present the first Italian longitudinal study on sleep and COVID‐19 considering four different time points collected during lockdown (from 29 March 2020 to 3 May 2020) and a subsequent follow‐up period (October 2020). We used an online survey to collect socio‐demographic and COVID‐19 related information. Subjects were also asked to complete a sleep diary at each time point of the study. Our longitudinal sample included 147 participants. Statistical comparison across time intervals showed remarkable changes in sleep patterns during and after the lockdown. In particular, during lockdown we observed longer sleep latency, less ease of falling asleep, a higher total bedtime, and a lower dream frequency. The week‐by‐week evaluation described relatively stable patterns in the observed measures during the lockdown period, except for dream frequency, affected by a rapid increase in the early phase of lockdown. Our findings are in line with the current literature. Furthermore, the prospective longitudinal investigation comprising several time points offered the possibility of (a) observing the temporal dynamics and the different entities of such changes over time, and (b) reducing the typical memory bias for these studies.
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Affiliation(s)
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Pierpaolo Zivi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Stefano Sdoia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Emanuela Mari
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Fabio Ferlazzo
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy
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Narayanan M, Sriram S. COVID-19 and Depression: Prevalence and Risk Factors in Youth from Maharashtra, India. HUMAN ARENAS 2021. [PMCID: PMC8479262 DOI: 10.1007/s42087-021-00252-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The COVID-19 pandemic and the ensuing lockdown have been a seismic shock for youth in India, elevating their risk of mental health problems like depression. This cross-sectional study sought to measure the point prevalence levels of depression in university students (ages 19–25 years) from Maharashtra, India, during the peak of the first wave of the pandemic and lockdown, through an online opt-in survey. The BDI-II was self-administered by 783 respondents (males = 243; females = 540). Results indicated overall mild levels of depression (mean BDI = 16.48) and high point prevalence, with 51.8% (n = 406) of the population being symptomatic, of which 16.3% had severe, 17.9% had moderate, and 17.8% had mild levels of depression. No association was found with age, gender, educational level of participants, period of hostel stay, education, and occupational level of parents. Overall percentages of symptomatic women were higher, suggesting the gendered effects of the pandemic. This study explored the symptomatology of depression wherein “sadness,” “changes in sleep patterns,” and “concentration difficulties” emerged as the most commonly experienced symptoms. Symptom expression was found to vary with intensity and gender. Symptomatic men experienced significantly more cognitive symptoms like self-criticalness, punishment feelings, thoughts about past failures, and changes in sleep patterns, while symptomatic women felt significantly high “loss of energy.” No significant gender differences were seen in the experience of cognitive-affective symptoms. Possible reasons are discussed. Further exploration of the experiences of youth is essential to understand the full gamut of the pandemic’s impact on them.
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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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Alfonsi V, Gorgoni M, Scarpelli S, Zivi P, Sdoia S, Mari E, Fraschetti A, Ferlazzo F, Giannini AM, De Gennaro L. COVID-19 lockdown and poor sleep quality: Not the whole story. J Sleep Res 2021; 30:e13368. [PMID: 33955081 PMCID: PMC8236908 DOI: 10.1111/jsr.13368] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 03/23/2021] [Accepted: 03/30/2021] [Indexed: 02/05/2023]
Abstract
A growing body of evidence consistently describes the side‐effects of coronavirus disease 2019 lockdown on mental health and sleep quality. We conducted a longitudinal web‐based survey of 217 Italian participants at two time points: lockdown and subsequent follow‐up. To thoroughly investigate lockdown‐related changes in sleep quality, we first evaluated variations in overall sleep quality assessed by the Pittsburgh Sleep Quality Index. We then examined sleep changes in specific components of sleep quality. Results revealed a clear dissociation of sleep effects, as a function of the specific domain considered, with longer sleep latency, worse sleep efficiency, and massive sleep medication use during forced confinement. On the other hand, we simultaneously observed an increased sleep duration and better daytime functioning. Our present findings highlight the importance of an accurate examination of sleep quality during lockdown, as the effects were not uniform across populations and different sleep domains.
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Affiliation(s)
- Valentina Alfonsi
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Pierpaolo Zivi
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Stefano Sdoia
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Emanuela Mari
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Fabio Ferlazzo
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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Salfi F, D'Atri A, Tempesta D, Ferrara M. Sleeping under the waves: A longitudinal study across the contagion peaks of the COVID-19 pandemic in Italy. J Sleep Res 2021; 30:e13313. [PMID: 33687798 PMCID: PMC8250209 DOI: 10.1111/jsr.13313] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 01/25/2021] [Accepted: 01/30/2021] [Indexed: 01/17/2023]
Abstract
After the March–April 2020 coronavirus disease 2019 (COVID‐19) outbreak, a second contagion wave afflicted Europe in the autumn. The present study aimed to evaluate sleep health/patterns of Italians during this further challenging situation. A total of 2,013 Italians longitudinally participated in a web‐based survey during the two contagion peaks of the COVID‐19 outbreak. We investigated the risk factors for sleep disturbances during the second wave, and we compared sleep quality and psychological well‐being between the two assessments (March–April and November–December 2020). Female gender, low education, evening chronotype, being a high‐risk person for COVID‐19 infection, reporting negative social or economic impact, and evening smartphone overuse predicted a higher risk of poor sleep and insomnia symptoms during the second wave. Advanced age, living with a high‐risk person for COVID‐19 infection, and having a relative/friend infected with COVID‐19 before the prior 2 weeks were risk categories for poor sleep quality. Living with children, having contracted COVID‐19 before the prior 2 weeks, being pessimistic about the vaccine and working in healthcare, were risk factors for insomnia symptoms. The follow‐up assessment highlighted reduced insomnia symptoms and anxiety. Nevertheless, we found reduced sleep duration, higher daytime dysfunction, advanced bedtime and wake‐up time, and a shift to morningness, confirming the alarming prevalence of poor sleepers (~60%) and severe depression (~20%) in a context of increased perceived stress. The present study showed a persistent impact of the COVID‐19 pandemic on sleep and mental health. Large‐scale interventions to counteract the chronicity and exacerbation of sleep and psychological disturbances are necessary, especially for the at‐risk categories.
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Affiliation(s)
- Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Aurora D'Atri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Daniela Tempesta
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Michele Ferrara
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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