Sleep in Older Adults and Its Possible Relations With COVID-19

The Association Between Lifestyle Factors and COVID-19 Among Older Adults in Southern California: The Loma Linda Longevity Study

Amid a global aging trend, particularly notable in the U.S., there is a growing focus on achieving enhanced longevity and well-being. We evaluated the association between lifestyle factors (sleep, diet, and healthy lifestyle index) and COVID-19 infection in an older adult population in San Bernardino and Riverside counties in Southern California, the United States. A sample of 380 older adults ≥75 years old were surveyed cross-sectionally and self-reported lifestyle behaviors and COVID-19 infection. The results revealed that half the participants reported COVID-19 infection. Participants who slept less than 7 hours or more than 8 hours/night had higher odds of COVID-19 infection than those who slept 7-8 hours/night (OR = 1.62, 95% CI: 1.03, 2.55). Healthy lifestyle behaviors were significantly associated with reduced COVID-19 infection (OR = 0.61, 95% CI: 0.40, 0.92). In conclusion, adequate sleep and healthy lifestyle behaviors may be protective against COVID-19 infection among older adults and should be investigated further.

Mental health among centenarians living in Switzerland

BACKGROUND

Given the increasing number of people achieving exceptionally long lifespans, there is an urgent need for a better understanding of mental health in centenarians. This study aimed to understand the prevalence of mental health conditions-depressive symptoms, anxiety, sleep disturbances, disinhibition, and aberrant motor behaviour-among centenarians in Switzerland.

METHODS

Data were collected from N = 169 participants via telephone interviews or paper questionnaires, either directly from centenarians or through proxy informants. Half the data were collected during a period when protective measures were imposed due to the COVID-19 pandemic, and half were collected after the measures were lifted.

RESULTS

Mental health conditions were prevalent in our sample, particularly depressive symptoms (44.51%) and anxiety (42.17%). Significant positive associations were found between depressive symptoms and anxiety, and between disinhibition and aberrant motor behaviour. Furthermore, we identified statistical predictors for the occurrence of mental health conditions. Notably, institutionalised living increased the odds of depressive symptomatology, while those with higher education levels or an absence of cognitive impairment experienced more sleep disturbances. Finally, cognitive impairment was linked to increased disinhibition and aberrant motor behaviour.

CONCLUSIONS

The high prevalence of mental health conditions underscores the need for proactive mental health care strategies in advanced old age. Moreover, it is vital to consider the interconnected nature of mental health conditions and to prioritise vulnerable groups, such as centenarians in institutional settings.

Sleep quality during and after severe acute respiratory syndrome coronavirus 2 (COVID-19) lockdowns in the UK: Results from the SleepQuest study

Sleep is fundamental to health. The aim of this study was to analyse and determine factors predicting sleep quality during and after national lockdowns due to severe acute respiratory syndrome coronavirus 2 (COVID-19) in the UK. A longitudinal online survey-based study (SleepQuest) involving UK adults was administered in Spring 2020, Winter 2020, and Winter 2022 including questionnaires probing sleep quality, depression, anxiety, beliefs about sleep, demographics, COVID-19 status, and exercise. The primary outcome was sleep quality (Pittsburgh Sleep Quality Index). A linear mixed-effects model evaluated factors associated with baseline and longitudinal sleep quality. Complete data were provided by 3306 participants in Spring 2020, 2196 participants in Winter 2020, and 1193 in Winter 2022. Participants were mostly female (73.8%), white (97.4%), and aged over 50 years (81.0%). On average, participants reported poor sleep quality in Spring 2020 (mean [SD] Pittsburgh Sleep Quality Index score = 6.59 [3.6]) and Winter 2020 (mean [SD] Pittsburgh Sleep Quality Index score = 6.44 [3.6]), with improved but still poor sleep quality in Winter 2022 (mean [SD] Pittsburgh Sleep Quality Index score = 6.17 [3.5]). Improved sleep quality was driven by better subjective sleep and reduced daytime dysfunction and sleep latency. Being female, older, having caring responsibilities, working nightshifts, and reporting higher levels of depression, anxiety, and unhelpful beliefs about sleep were associated with worse baseline PSQI scores. Better sleep quality was associated with more days exercising per week at baseline. Interventions focusing on improving mental health, exercise, and attitudes towards sleep, particularly in at-risk groups, may improve sleep-related outcomes in future pandemics.

Mid-to-Late-Life Anxiety and Sleep during Initial Phase of COVID-19: Age- and Sex-Specific Insights to Inform Future Pandemic Healthcare

This study examined associations between COVID-19-related anxiety and sleep in middle-aged and older adults and tested whether these varied by age or sex. In June/July 2020, middle-aged/older adults aged 50+ (n = 277, 45% women, Mage = 64.68 ± 7.83) in the United States completed measures of sleep and COVID-19-related anxiety. Multiple regressions examined whether anxiety was independently associated with or interacted with age or sex in its associations with sleep health, controlling for age, education, medical conditions, sleep/pain medication use, and COVID-19 status. Greater COVID-19 anxiety was associated with worse sleep quality and daytime dysfunction. COVID-19-related anxiety interacted with age (not sex) in associations with total sleep time and sleep efficiency. Greater anxiety was associated with shorter total sleep time and lower sleep efficiency in oldest-older adults (~73 years old) and youngest-older adults (~65 years old) but not middle-aged adults (~57 years old). In mid to late life, older adults may be most vulnerable to the impact of COVID-19-related anxiety on sleep health. Social and behavioral (e.g., knowledge on age-related vulnerability to COVID-19 risk/morbidity/mortality, uncertainty, and changes to daily routines) and physiological factors (sleep disruption and age-related autonomic dysfunction) may underlie these associations. Interventions that mitigate negative pandemic-related psychological and sleep outcomes may be particularly relevant for older adults.

The context of COVID-19 affected the long-term sleep quality of older adults more than SARS-CoV-2 infection

Introduction

Sleep problems are one of the most persistent symptoms of post-COVID syndrome in adults. However, most recent research on sleep quality has relied on the impact of the pandemic, with scarcely any data for older adults on the long-term consequences of COVID infection. This study aims to understand whether older individuals present persistently impaired sleep quality after COVID-19 infection and possible moderators for this outcome.

Methods

This is a cross-sectional analysis of a longitudinal cohort study with 70 elders with 6-month-previous SARS-CoV-2 infection and 153 controls. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality; Geriatric Depression Scale and Geriatric Anxiety Inventory for screening depression and anxiety. Demographics and comorbid conditions were collected.

Results

The mean age of participants was 66,97 ± 4,64 years. There were no statistical differences in depression and anxiety between groups. Poor sleep quality was found in 52,9% and 43,8% of the COVID and control groups (p=.208). After controlling for multiple variables, all the following factors resulted in greater chances of poor sleep quality: female gender (OR, 2.12; p=.027), memory complaints (OR, 2.49; p=.074), insomnia (OR, 3.66; p=.032), anxiety (OR, 5.46; p<.001), depression (OR, 7.26; p=.001), joint disease (OR, 1.80; p=.050), glucose intolerance (OR, 2.20; p=.045), psychoactive drugs (OR, 8.36; p<.001), diuretics (OR, 2.46; p=.034), and polypharmacy (OR, 2.84; p=.016).

Conclusion

Psychosocial burden in the context of the COVID-19 pandemic and pre-existing conditions seems to influence the sleep quality of older adults more than SARS-CoV-2 infection.

Sleep Quality in Older People: The Impact of Age, Professional Activity, Financial Situation, and Chronic Diseases During the SARS-CoV-2 Pandemic

BACKGROUND The SARS-CoV-2 pandemic negatively affected health and social life, notably deteriorating sleep quality in older adults. Studies report inconsistent findings on sleep disturbances during this period, influenced by various physiological, emotional, and sociodemographic factors. This study aimed to identify these determining factors. MATERIAL AND METHODS The study was conducted among 342 people 60 years of age or older participating in online classes of randomly selected Senior Clubs and the University of the Third Age in the southern regions of Poland. RESULTS Sleep problems (PSQI >5 points) were diagnosed in 250 subjects (83.6%). Logistic regression analysis showed that the quality of sleep significantly depends on: age, as people aged 66-70 were more likely to have better sleep quality than people aged 60-65 (OR=3.07), and those over 70 scored better than people aged 60-65 (OR=2.87); current job - employed people have a better chance of better sleep quality (OR=3.08) than unemployed people; financial situation, people assessing their financial situation as very good/good had a better chance of better sleep quality (OR=2.00) compared to people assessing their financial situation as very bad, bad/average; chronic diseases, people without chronic diseases had a chance of better sleep quality (OR=2.45) than people with chronic diseases. CONCLUSIONS Age, financial situation, current job, and chronic disease were the most important factors determining sleep quality in older people. The identification of factors affecting sleep quality can be used as important data to develop interventions and programs to improve sleep quality.

Impact of the early months of the COVID-19 pandemic on the sleep patterns of a Brazilian population sample

Humanitarian and health crisis have drastic effects on the physical and mental well-being of people. The COVID-19 pandemic forced many countries to impose containment measures on its population to halt the spread of the new coronavirus (SARS-CoV-2). This aim of this study was to explore self-reported sleep quality and insomnia symptoms in a sample of the Brazilian population before and during the COVID-19 quarantine period. Our data was collected through online questionnaires, including the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Sleep Hygiene Index. The final sample comprised 1,109 volunteers. Generalized estimating equations (GEE) revealed that during the initial months of the COVID-19 pandemic, alterations in self-reported sleep parameters were observed in the participants. Sleep efficiency and sleep duration increased, but there was a worsening in sleep quality and an increase in symptoms related to insomnia.

Socioeconomic Background and Self-Reported Sleep Quality in Older Adults during the COVID-19 Pandemic: An Analysis of the English Longitudinal Study of Ageing (ELSA)

The COVID-19 pandemic negatively impacted sleep quality. However, research regarding older adults' sleep quality during the pandemic has been limited. This study examined the association between socioeconomic background (SEB) and older adults' sleep quality during the COVID-19 pandemic. Data on 7040 adults aged ≥50 were acquired from a COVID-19 sub-study of the English Longitudinal Study of Ageing (ELSA). SEB was operationalized using educational attainment, previous financial situation, and concern about the future financial situation. Sociodemographic, mental health, physical health, and health behavior variables were included as covariates. Chi-squared tests and binary logistic regression were used to examine associations between SEB and sleep quality. Lower educational attainment and greater financial hardship and concerns were associated with poor sleep quality. The relationship between educational attainment and sleep quality was explained by the financial variables, while the relationship between previous financial difficulties and sleep quality was explained by physical health and health behavior variables. Greater financial concerns about the future, poor mental health, and poor physical health were independent risk factors for poor sleep quality in older adults during the pandemic. Healthcare professionals and service providers should consider these issues when supporting older patients with sleep problems and in promoting health and wellness.

Comparing the centrality symptoms of major depressive disorder samples across junior high school students, senior high school students, college students and elderly adults during city lockdown of COVID-19 pandemic-A network analysis

INTRODUCTION

Recently, in the view of network analysis, depression has been conceptualized as a complex and dynamic network model combining individual symptoms. To date, no studies have systematically examined and compared depressive symptom networks across different populations.

METHODS

A total of 36,105 participants were recruited and asked to complete the Patient Health Questionnaire-9 among junior high school students, senior high school students, college students, and elderly adults who were more susceptible to depression during the COVID-19 lockdown in China. In the analysis, we applied the optimal cutoff score ≥ 8 for students and a score ≥ 6 for elderly adults to identify 5830 participants who were likely to be depressed. The index of "strength" was used to identify central symptoms in the network structure.

RESULTS

The results showed that Sad Mood was the most central symptom among junior high school students, senior high school students, and college students, but the most central symptom in the elderly was Guilt. Among the top three central symptoms, Suicide Ideation was unique to senior high school students, while Anhedonia was most prevalent among college students. Guilt - Suicide Ideation, Anhedonia - Energy, Anhedonia - Sad Mood, and Sleep - Energy showed the strongest association among junior and senior high school students, college students, and elderly adults, respectively. NCT (i.e., Network Comparison Test) suggested that the network's global connectivity was ultimately inconsistent, but the network structure remained roughly intact.

CONCLUSION

In treatment, targeting central symptoms may be critical to alleviating depression.

Association between Sleep Onset Problem and Subjective Cognitive Complaints among Japanese Older Adults during the Coronavirus Disease 2019 Pandemic

Older adults are more likely to have age-related sleep problems, which may result in the reduction of cognitive functions. This study was designed to examine the relationship between sleep onset problem and subjective cognitive complaints (SCC) among community-dwelling older adults during the coronavirus disease 2019 pandemic. In this study, 186 older adults aged 65 and above were enrolled and were instructed to respond to an online survey. This survey comprised questions regarding sleep quality (four items such as sleep duration, use of sleep medication), SCC (six domains), and sociodemographic information (eight items such as age, gender, stress condition). We classified the participants into two groups according to the presence or absence of sleep onset problem and examined the relationship between each SCC domain. The sleep onset problem (+) (n = 70) group had significantly higher frequency of scheduled memory decline, misplacement, disorientation in time, word recall decline, and forgetfulness. Furthermore, the sleep onset problem affected the participants' scheduled memory after adjusted for potential covariates (OR, 2.28; 95%CI, 1.13-4.73; p = 0.02). Older adults with sleep onset problem may need to be evaluated for SCC and supported in term of both sleep status and SCC.

Lifestyle pattern changes, eating disorders, and sleep quality in diabetes: how are the effects of 18 months of COVID-19 pandemic being felt?

AIMS

The pandemic resulted in a lifestyle crisis which may negatively affect patients with diabetes. Despite current knowledge, there is a lack of longitudinal studies evaluating this effect. To assess patients' perceptions about changes in lifestyle, and eating and sleeping patterns after 18 months of the COVID-19 pandemic, and to identify if aspects related to the pandemic (social distancing, COVID-19 infection, behavioral changes, and financial difficulties) are predictors of worsening in eating and sleeping parameters.

METHODS

This was a longitudinal study that followed patients with diabetes from April 2020 to July 2021 in Southern Brazil. Individuals with type 1 or type 2 diabetes, aged ≥ 18 years, were included. The outcome of this study was the assessment of daily habits during a 18-month period of the COVID-19 pandemic. Specific questionnaires were applied once participants were included in this study (3 months after the onset of the pandemic) and at the 18-month follow-up, which included the Eating Attitudes Test-26 (EAT-26), the Mini-Sleep Questionnaire (MSQ), and a specific questionnaire on diet, physical activity, and sleep pattern. Data were compared within and between groups (type 1 and type 2 diabetes), and multivariable models were used to identify subgroups of worse outcomes.

RESULTS

A total of 118 (78.6%) participants remained in the study at follow-up (mean age 54.6 ± 13.9 years, 41.3% male). In total, 33.9% of participants perceived weight gain during the pandemic, especially those with type 1 diabetes (43.1% vs 25.0% in type 2 diabetes, P = 0.04). About one in four participants reported emotional eating and changes in their eating habits for financial reasons. Regarding sleep patterns, more than half the participants reported taking naps during the day, out of which 30.5% of them perceived worse sleep quality, with no difference between type 1 and type 2 diabetes groups. There were no within-group differences in MSQ and EAT-26 scores. Among participants with type 2 diabetes, age ≥ 60 years (OR 27.6, 95%CI 2.2-345.7), diabetes duration ≥ 15 years (OR 28.9, 95%CI 1.4-597.9), and perceived emotional eating (OR 10.9, 95%CI 1.1-107.5) were associated with worsened food quality. Worse sleep quality during the pandemic was associated with age ≥ 60 years for both type 2 diabetes (OR 5.6, 95%CI 1.1-31.5) and type 1 diabetes (OR 5.5, 95%CI 1.0-29.9).

CONCLUSIONS

Follow-up data from a cohort of patients with diabetes indicate that at the end of 18 months of social distancing, some lifestyle aspects worsened and some improved, showing that these patients responded differently to the adversities of this period. The evidence of clinical features associated with worsening in food and sleep quality provides new insights to prioritizing actions in crisis situations.

Bidirectional associations between physical activity and sleep in older adults: a multilevel analysis using polysomnography

Although recent studies have examined the bidirectional associations between physical activity and sleep parameters, few have focused on older adults utilizing objective assessments, such as polysomnography. This micro-longitudinal observational study included 92 Japanese older adults (aged 65–86 years) who underwent objective evaluations of sleep quality using polysomnography and completed subjective sleep-related questionnaires. Activity levels were assessed using an accelerometer. Polysomnography, subjective sleep-related questionnaires, and accelerometer were administered for 7 consecutive days. Multilevel models (participant-, day-level) were used to examine the temporal associations of objective and subjective sleep parameters with sedentary behavior and physical activity. In the day-level analysis, higher levels of sedentary behavior during daytime were associated with longer rapid eye movement (REM) sleep, shorter REM latency, lower levels of non-REM sleep (stage N3), and reduced delta power during daytime. Higher levels of low-intensity physical activity during daytime were associated with lower levels of REM sleep, longer REM latency, and increased stage N3 sleep in the day-level analysis. Higher levels of moderate-to-vigorous physical activity were associated with increased REM latency. Longer subjective sleep time was associated with increased next-day moderate-to-vigorous physical activity. Thus, low-intensity physical activity may provide objective benefits related to deep sleep parameters in older adults.

Associations between longitudinal changes in sleep disturbance and depressive and anxiety symptoms during the COVID-19 virus pandemic among older women with and without breast cancer in the thinking and living with breast cancer study

PURPOSE

Several studies have reported sleep disturbances during the COVID-19 virus pandemic. Little data exist about the impact of the pandemic on sleep and mental health among older women with breast cancer. We sought to examine whether women with and without breast cancer who experienced new sleep problems during the pandemic had worsening depression and anxiety.

METHODS

Breast cancer survivors aged ≥60 years with a history of nonmetastatic breast cancer (n = 242) and frequency-matched noncancer controls (n = 158) active in a longitudinal cohort study completed a COVID-19 virus pandemic survey from May to September 2020 (response rate 83%). Incident sleep disturbance was measured using the restless sleep item from the Center for Epidemiological Studies-Depression Scale (CES-D). CES-D score (minus the sleep item) captured depressive symptoms; the State-Anxiety subscale of the State Trait Anxiety Inventory measured anxiety symptoms. Multivariable linear regression models examined how the development of sleep disturbance affected changes in depressive or anxiety symptoms from the most recent prepandemic survey to the pandemic survey, controlling for covariates.

RESULTS

The prevalence of sleep disturbance during the pandemic was 22.3%, with incident sleep disturbance in 10% and 13.5% of survivors and controls, respectively. Depressive and anxiety symptoms significantly increased during the pandemic among women with incident sleep disturbance (vs. no disturbance) (β = 8.16, p < 0.01 and β = 6.14, p < 0.01, respectively), but there were no survivor-control differences in the effect.

CONCLUSION

Development of sleep disturbances during the COVID-19 virus pandemic may negatively affect older women's mental health, but breast cancer survivors diagnosed with the nonmetastatic disease had similar experiences as women without cancer.

Morbidities Worsening Index to Sleep in the Older Adults During COVID-19: Potential Moderators

Older adults were considered a vulnerable group for the COVID-19 infection and its consequences, including problems with sleep.

Examining Risk Factors for Mental Health During the COVID-19 Pandemic-Focusing on Older Adults in South Korea

Objectives: Mental health is the cornerstone of public health, particularly for older adults. There is a clear need to examine the impact of COVID-19 on mental health among older adults in South Korea, where the incidence of COVID-19 was relatively low and widespread transmission was controlled without a national lockdown. Methods: This analysis included a total of 1917 participants from the Experience Survey on Healthcare Use of Older Adults, which was conducted for adults aged 65 years or older by face-to-face interview. Results: The results showed that older adults with a good understanding of COVID-19 public health measures were less likely to experience mental health problems. In contrast, those with a greater risk perception of contracting COVID-19 had higher odds of experiencing tension and anxiety in addition to sadness and depression. Older adults who had a greater fear of COVID-19 and perceived higher-risk of contracting COVID-19 experienced more sleep problems. Conclusion: The findings provide new evidence on the factors that influence the mental health of older adults in South Korea during the pandemic and suggest the development of policy interventions.

Sleep During the COVID-19 Pandemic

PURPOSE OF REVIEW

We reviewed current evidence on the impact of coronavirus disease 2019 (COVID-19) pandemic on sleep of different populations.

RECENT FINDINGS

Several studies demonstrated that sleep deprivation may cause immune system dysregulation, which deteriorates the course of COVID-19. The increased prevalence of sleep disorders among COVID-19 patients has been associated with more severe disease and worse clinical outcomes. Healthcare workers who were subjected to atypical workload and more nightshifts developed sleep disorders which associated with work-related errors and COVID-19 infection susceptibility. In general population, circadian misalignment and excessive stressors impaired sleep quality. Sleep dysfunction has been recorded due to the pandemic. It is essential to implement interventions in order to alleviate pandemic-related sleep disorders. Telemedicine, cognitive behavioral therapy, and sleep hygiene practices appear to be helpful. Psychotropic medication should be cautiously administered, while other pharmacological agents, such as melatonin, have shown promising results.

Effects of Obstructive Sleep Apnea on SARS-CoV-2 Antibody Response After Vaccination Against COVID-19 in Older Adults

INTRODUCTION

Previous studies have linked sleep disturbances (including sleep deprivation and obstructive sleep apnea) to an impairment in immune response after vaccination for several diseases, although it has not yet been tested for COVID-19. This study sought to evaluate the effects of obstructive sleep apnea on anti-SARS-CoV-2 IgG levels after vaccination against COVID-19 among older adults.

METHODS

The study was based on a convenience sample of inpatients who underwent full night type-I polysomnography. Inclusion criteria included being ≥60 years with full COVID-19 vaccination schedule. Exclusion criteria included previous COVID-19 diagnosis (assessed via self-report), less than 15 days between last dose and IgG testing, self-report of continuous positive air pressure (CPAP) use in the last three months, having undergone CPAP or split-night polysomnography, or incomplete/invalid data.

RESULTS

Out of 122 included patients (no/mild OSA: 35; moderate: 31; severe: 56), 9.8% were considered seronegative for the IgG anti-SARS-CoV-2 test (IgG count<50.0 AU/mL), and the median IgG levels for the whole sample was 273 AU/mL (IQR: 744), with no statistically significant differences among OSA severity groups. There was neither association between OSA severity and IgG serostatus nor correlation between IgG levels and apnea-hypopnea index. A linear regression model to predict IgG levels was built, produced an R² value of 0.066 and the only significant predictor was time from vaccination to testing; while OSA severity was considered non-significant.

DISCUSSION

Our results demonstrate that the severity of OSA is not correlated with a decrease in anti-SARS-CoV-2 IgG levels among older adults, and that the efficiency of COVID-19 vaccinations are not reduced from mild to severe OSA.

Experiencing the Unprecedented COVID-19 Lockdown: Abu Dhabi Older Adults' Challenges and Concerns

This study focused on older adults (60+ years old) of both genders in Abu Dhabi during the COVID-19 pandemic before vaccines were made available (age ranged from 60 years to 75 years). They faced more strict rules of movement restriction and isolation that might have resulted in certain psychological feelings and social reactions. The main objective was to understand Abu Dhabi older adults’ psychological feelings during the pandemic and to identify their main concerns and challenges considering the various COVID-19-related policies and restrictions. The psychological feelings focused on fear, loneliness, sadness, irritability, emotional exhaustion, depressive symptoms, sleeping disorders, overeating, and excessive screen use. The objectives also included the changes in the psychological feelings concerning time. Other objectives covered better understanding the differences in (some activities) compared to the other age categories. Data were gathered through an online survey of community members from February to July 2020 as part of government initiatives (Department of Community Development). Responses were collected from 574 older adults in Abu Dhabi (60.1% male and 39.9% female). The analysis mainly used descriptive analysis, t-tests, analysis of variance (ANOVA), and simple trend analysis. For all tests, a p-value less than 0.05 was used for significance. The results pointed to the significant rise in feelings related to excessive screen use, fear, loneliness, and stress. The most significant concerns were related to more restrictions being imposed and not being able to see the grandchildren.The impact of new technologies on their quality of life was significantly reflected by respondents. The influence of the pandemic on older adults’ health and weight was also investigated. Analysis of variance, t-tests, and regression analysis with relevant tests were employed. The relevant results showed that some negative psychological feelings were common among older adults during the pandemic. However, the psychological feelings did not portray significant changes with time, except for sleeping disorders and overeating. Overall, older adults scored significantly different from other age groups on many challenges, concerns, and views regarding new technologies during the pandemic. No significant differences were observed regarding gender and marital status for the challenges and concerns. The research summarizes some policy guidance while noting some limitations of this study and future research directions.

The Association Between Sleep Disturbances and Erectile Dysfunction During the COVID-19 Pandemic

INTRODUCTION

There is increasing concern about the impact of the SARS-CoV-2 pandemic on mental and physical health. Among the many possible outcomes of COVID-19, reports of sleep disturbances, and erectile dysfunction are becoming prevalent worldwide.

OBJECTIVES

We sought to evaluate the recent literature on this subject to produce a narrative review of the topic.

METHODS

We performed an extensive literature search to identify recent scientific findings on this subject.

RESULTS

To date, the precise mechanisms that trigger pandemic related sexual dysfunction are not completely understood, although it has been suggested that psychogenic effects play an important role, in addition to the direct effects of the disease itself on those infected. There is evidence that the stress induced by the pandemic has had a significant impact on sleep, and sleep disturbances are known to induce erectile dysfunction. Other mechanisms which trigger this phenomenon, such as hormonal changes and previous health conditions, have been suggested to be associated with SARS-CoV-2 infection, and these factors may have a potential link to sleep disturbance.

CONCLUSION

The combined effect of COVID-19 and the psychogenic disorders triggered by isolation, grief, and anxiety might be associated with the increased prevalence of erectile dysfunction. This feature might be worsened by the onset of pre-existing or pandemic-induced sleep disorders. However, few studies explored this subject. Understanding this phenomenon is important for the strategic planning of treatments that could improve the quality of life of the population. Andersen ML, Tufik S. The Association Between Sleep Disturbances and Erectile Dysfunction During the COVID-19 Pandemic. Sex Med Rev 2021;XX:XXX-XXX.

Are Sleep Problems Related to Psychological Distress in Healthy Aging during the COVID-19 Pandemic? A Review

The SARS-CoV-2 pandemic, characterized by home confinement and other restrictive measures to reduce the spread of the infection, led to significant changes in people's habits and lifestyle. One of the most common problems is the worsening of sleep quality or quantity, which could have negative effects on psychological wellbeing, particularly in older adults. The purposes of the present literature review considering healthy aging subjects are (a) to examine the existing research on sleep alterations during the current pandemic and (b) to highlight possible relationships between sleep problems and psychological distress. A systematic search strategy was implemented according to PRISMA guidelines in the international literature online databases, up to 1 July 2021. After identification and screening phases, 11 articles were included in this review. The studies found possible associations between sleep problems and mood changes-particularly in terms of depression and anxiety. In addition, altered sleep patterns seemed to be related to changes in individual aspects, lifestyle, and attitudes adopted by older adults during the COVID-19 lockdown. Thus, the pandemic could affect the sleep and psychological wellbeing of the older population, even in healthy aging.

The Differential Impact of COVID-19 Lockdown on Sleep Quality, Insomnia, Depression, Stress, and Anxiety among Late Adolescents and Elderly in Italy

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.