1
|
Du M, Liu M, Wang Y, Qin C, Liu J. Global burden of sleep disturbances among older adults and the disparities by geographical regions and pandemic periods. SSM Popul Health 2024; 25:101588. [PMID: 38225953 PMCID: PMC10788304 DOI: 10.1016/j.ssmph.2023.101588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/17/2024] Open
Abstract
Sleep disturbances are highly prevalent during the COVID-19 pandemic, especially among older adults. We aimed to evaluate sleep heath during COVID-19 pandemic and assess the differences among geographical regions and pandemic periods. We searched three databases (PubMed, Embase, Web of Science) to find articles up to March 12, 2023. We included observational studies that reported the prevalence of sleep disturbances among adults aged 60 years or older in any setting. Two researchers independently reviewed the literature and retrieved the data. We used Der Simonian-Laird random effects meta-analyses to pool the data, followed by subgroup analysis, sensitivity analysis, and meta-regression. A total of 64 studies with 181,224 older adults during the pandemic were included. The prevalence of poor sleep quality, short sleep duration, long sleep duration, and insomnia symptoms were 47.12% (95% CI: 25.97%, 68.27%), 40.81% (95% CI: 18.49%, 63.12%), 31.61% (95% CI: 24.83%, 38.38%), and 21.15% (95% CI: 15.30%, 27.00%), respectively. The prevalence of sleep problems reported by self-constructed items was 26.97% (95% CI: 20.73%, 33.22%). When compared to America (64.13%), Europe (20.23%) and the Western Pacific (21.31%) showed a lower prevalence of sleep problems (all P < 0.0001). The prevalence of worsened sleep problems was 27.88% (95% CI: 11.94%, 43.82%). Compared to 2020 (15.14%), it increased to 47.42% in 2021 (P < 0.05). Eight studies on sleep disturbances among 672 older COVID-19 patients were included. The prevalence of sleep problems and insomnia symptoms among older COVID-19 patients were 41.58% (95% CI: 21.97%, 61.20%) and 41.56% (95% CI: 28.11%, 58.02%), respectively. A significant burden related to poor sleep has been observed among older adults worldwide over the past three years, with variations across different regions and time periods. It is important to make more efforts in prevention and intervention to identify the risk factors, treatment, and rehabilitation of sleep disturbances for healthy aging.
Collapse
Affiliation(s)
- Min Du
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Min Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Chenyuan Qin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, China
- Institute for Global Health and Development, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing, 100871, China
- Global Center for Infectious Disease and Policy Research & Global Health and Infectious Diseases Group, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Key Laboratory of Reproductive Health, National Health and Family Planning Commission of the People's Republic of China, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, USA
| |
Collapse
|
2
|
Pachi A, Tselebis A, Sikaras C, Sideri EP, Ivanidou M, Baras S, Milionis C, Ilias I. Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era. AIMS Public Health 2023; 11:36-57. [PMID: 38617404 PMCID: PMC11007420 DOI: 10.3934/publichealth.2024003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/10/2023] [Accepted: 12/11/2023] [Indexed: 04/16/2024] Open
Abstract
Introduction The pandemic has led to notable psychological challenges among healthcare professionals, including nurses. Objective Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience. Methods Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected. Results The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship. Conclusions Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.
Collapse
Affiliation(s)
- Argyro Pachi
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Athanasios Tselebis
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Christos Sikaras
- Nursing Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Eleni Paraskevi Sideri
- Emergency Department of General Hospital of Athens Korgialeneio-Benakeio Hellenic Red Cross, 11526, Athens, Greece
| | - Maria Ivanidou
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | - Spyros Baras
- Psychiatric Department, Sotiria Thoracic Diseases Hospital of Athens, 11527 Athens, Greece
| | | | - Ioannis Ilias
- Department of Endocrinology, “Elena Venizelou” Hospital, 11521 Athens, Greece
| |
Collapse
|
3
|
Dvořáková T, Měrková R, Bušková J. Sleep disorders after COVID-19 in Czech population: Post-lockdown national online survey. Sleep Med X 2023; 6:100087. [PMID: 37811367 PMCID: PMC10551886 DOI: 10.1016/j.sleepx.2023.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Objective This study aimed to determine the frequency, type, and correlates of a broad spectrum of sleep disorders in adults with COVID-19 up to 32 months after infection. Methods We conducted a national online survey (Jun 2021-Dec 2022), gathering information on COVID-19 diagnosis, acute disease course, and the subsequent development of sleep disorders from 1507 respondents (mean age 44.5 ± 13.1 years, 64.1% women). Results 81.3% (1223) reported at least one sleep difficulty that either worsened or first appeared with COVID-19. Females reported a higher number of symptoms (2.03 ± 1.44 versus 1.72 ± 1.43 in men, p < 0.0001). Most common were insomnia symptoms (59.4%), followed by night sweats (38.4%), hypersomnolence (33.3%), vivid dreams or nightmares (26.4%), restless leg syndrome (RLS) (22.8%), and sleep-related breathing disorders (11.1%). All symptoms were associated with a more severe acute disease. A mild decreasing trend in the persistence of sleep symptoms with a longer latency since infection was observed, with 66.7% reporting at least half of their symptoms present at 3-5 months after acute infection, compared to 64.9% at 6-8 months, and 62.4% at 9-11 months (p = 0.0427). However, among those after 12 or more months, over half of the symptoms persisted in 69.5%. The frequency of vivid dreams and nightmares increased in association with COVID-19 in 32.9% (p < 0.001). 9.4% (141) reported new-onset or increased parasomnic manifestations after the infection. Conclusions Our research shows that sleep disturbances are a common and persistent manifestation of COVID-19 that affects a large proportion of the population and deserves careful monitoring.
Collapse
Affiliation(s)
- Tereza Dvořáková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Radana Měrková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Jitka Bušková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| |
Collapse
|
4
|
Koppehele-Gossel J, Weinmann LM, Klimke A, Windmann S, Voss U. Dreaming during a pandemic: Low incorporation of COVID-19-specific themes and lucidity in dreams of psychiatric patients and healthy controls. Int J Clin Health Psychol 2023; 23:100364. [PMID: 36589551 PMCID: PMC9790876 DOI: 10.1016/j.ijchp.2022.100364] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/15/2022] [Indexed: 12/27/2022] Open
Abstract
The present study examined the impact of the COVID-19 pandemic on the emotional quality of dreams, the incorporation of pandemic-related themes, and the occurrence of lucid dreaming. Dream reports and lucidity ratings of psychiatric outpatients (n = 30) and healthy controls (n = 81) during two lockdowns in Germany were compared to those of healthy controls (n = 33) before the pandemic. Results confirmed previous reports that pandemic-specific themes were incorporated into dreams. Overall, however, incorporation into dreams was rare. Contrary to expectations, psychiatric outpatients did not differ from controls in the frequency of dream incorporation of pandemic-related content. Moreover, incorporation was independent of psychiatric symptoms and loneliness. Loneliness was, however, associated with threat-related content, suggesting that it represents a risk for bad dreams but not for crisis-specific dream incorporation. Regarding lucid dreaming, both groups had similar scores for its underlying core dimensions, i.e., insight, control, and dissociation, during the two lockdowns. Scores for control and dissociation but not insight were lower compared to the pre-pandemic sample. Our working hypothesis is that REM sleep during lockdowns intensified as a means of increased emotional consolidation, rendering the associated mental state less hybrid and thereby less lucid.
Collapse
Affiliation(s)
| | - Lena-Marie Weinmann
- Department of Psychology, Goethe-University Frankfurt, Building PEG, Theodor-W.-Adorno-Platz 6, Frankfurt/Main 60629, Germany
| | - Ansgar Klimke
- Department of Clinical Sleep Research, VITOS Hochtaunus Klinik, Friedrichsdorf, Germany
- Department of Psychiatry, Duesseldorf University, Duesseldorf, Germany
| | - Sabine Windmann
- Department of Psychology, Goethe-University Frankfurt, Building PEG, Theodor-W.-Adorno-Platz 6, Frankfurt/Main 60629, Germany
| | - Ursula Voss
- Department of Clinical Sleep Research, VITOS Hochtaunus Klinik, Friedrichsdorf, Germany
- Department of Psychology, Goethe-University Frankfurt, Building PEG, Theodor-W.-Adorno-Platz 6, Frankfurt/Main 60629, Germany
| |
Collapse
|
5
|
Xu T, Zheng K, Wu X. Risk Perception, Perceived Government Coping Validity, and Individual Sleep Problems in the Early Stage of the COVID-19 Pandemic in China: Mediation Analysis Based on Negative Emotions. Healthcare (Basel) 2023; 11:healthcare11070986. [PMID: 37046913 PMCID: PMC10094412 DOI: 10.3390/healthcare11070986] [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: 02/10/2023] [Revised: 03/23/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023] Open
Abstract
This study aimed to investigate the relationship among risk perception, negative emotions, perceived government coping validity, and the sleep problem of the public, through regression analysis and mediation analysis of data from the early stages of the COVID-19 outbreak in China (three months after the outbreak). It found that people's perception of the risk of the pandemic, negative emotions, and perceived government coping validity significantly affected people's sleep quality and nightmares. Further analysis found that individuals' perception of risk not only affected their sleep but also intensified their negative emotions, ultimately impairing the quality of their sleep and leading to nightmares. However, having a high level of coping validity can mitigate negative emotions and consequently decrease the occurrence of nightmares, thereby enhancing the quality of sleep. Specifically, perceived government coping validity could not only directly reduce nightmares, but also indirectly reduce nightmares by lowering negative emotions. However, it could only indirectly improve sleep by reducing negative emotions. It implicated that improving and resolving sleep problems required not only medical intervention but also psychological intervention. Simultaneously, improving the government's response effectiveness could strengthen people's trust in the government, stabilize their mental states, and significantly improve their quality of life by reducing negative emotions and improving sleep.
Collapse
Affiliation(s)
- Tao Xu
- Department of Social Work, College of International Culture and Social Development, Zhejiang Normal University, Jinhua 321000, China
- Institute for Silk Road Culture and International Sinology, Zhejiang Normal University, Jinhua 321000, China
| | - Kai Zheng
- Department of Economics and International Trade, School of Economics, Management & Law, Hubei Normal University, Huangshi 435002, China
| | - Xiaoqin Wu
- Department of Social Work, College of International Culture and Social Development, Zhejiang Normal University, Jinhua 321000, China
| |
Collapse
|
6
|
Slonkova J, Chudy M, Togtokhjargal A, Tomaskova H, Vacovska H, Rytirova G, Dolezalova I. The effects of COVID-19 on sleep and general health of Czech patients with epilepsy. Heliyon 2023; 9:e13413. [PMID: 36816256 PMCID: PMC9918435 DOI: 10.1016/j.heliyon.2023.e13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/14/2022] [Accepted: 01/30/2023] [Indexed: 02/13/2023] Open
Abstract
Objectives To assess the impact of COVID-19 illness and pandemic era on sleep, general health, health care, and social status in patients with epilepsy in the Czech Republic. Methods Our designed and approved questionnaire consisted of 23 questions. We focused on (1) patients' demographic and epidemiological data regarding COVID-19, (2) subjective assessment of sleep; (3) epilepsy, and (4) perception of general health during the first year of the COVID-19 pandemic in the Czech Republic from March 2020 to May 2021. We administered the questionnaires during outpatient visits or by phone calls in three major university Czech epilepsy centers (Ostrava, Brno, Pilsen). Results We enrolled 227 (100%) patients. The mean age (±SD) was 41.2 ± 14.82 years (min 18, max 86 years), and 138 (61%) were women. COVID-19 was confirmed using the PCR test method in 57 (25.1%) patients. In the pre-pandemic era, 62 (27.3%) patients reported sleep disturbances. Insomnia in 46 (74.2%) and excessive daytime sleepiness in 6 (9.7%) were the most mentioned sleep abnormalities. Nocturnal seizures predispose to sleep impairment (p = 0.014) and vivid dreams and nightmares (p = 0.033). COVID-19 infection significantly increased the risk of vivid dreams and nightmares in patients with diurnal seizures (p = 0.006). Sleep quality impairment and seizure frequency worsening [(p < 0.001) and (p = 0.001), respectively] were the most significant risk factors to perform general health deterioration regardless of having COVID-19 (p = 0.559). The most affected age group was 51+ years (p = 0.033). The three centers provided adequate outpatient care during the first year of the pandemic. The employment and social status of the patients remained unchanged (p = 0.074). Conclusions COVID- 19 infection significantly increased the occurrence of vivid dreams and nightmares in patients with diurnal seizures. Sleep quality deterioration and seizure frequency worsening significantly negatively impacted general health performance.
Collapse
Affiliation(s)
- Jana Slonkova
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic,Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic,Corresponding author. Department of Neurology, University Hospital Ostrava, 17 listopadu 1790, 70852, Ostrava- Poruba, Czech Republic, ,
| | - Milos Chudy
- Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic,Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Ariunjargal Togtokhjargal
- Department of Neurology, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava- Poruba, Czech Republic,Center of Clinical Neurosciences, Faculty of Medicine University of Ostrava, Syllabova 19, 703 00 Ostrava, Czech Republic
| | - Hana Tomaskova
- Department of Epidemiology and Public Health, Faculty of Medicine University of Ostrava, Syllabova 19, Ostrava, Czech Republic
| | - Hana Vacovska
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic,Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Gisela Rytirova
- Department of Neurology, University Hospital Pilsen, E. Benese 1128, Pilsen 3, Czech Republic,Faculty of Medicine in Pilsen Charles University in Prague, Husova 3, Pilsen 3, 306 05, Czech Republic
| | - Irena Dolezalova
- First Department of Neurology, St. Anne′s University Hospital Brno, Pekarska 53, 656 91 Brno, Czech Republic,Faculty of Medicine Masaryk University Brno, Kamenice 5, 625 00 Bohunice, Czech Republic
| |
Collapse
|
7
|
Remedios A, Marin-Dragu S, Routledge F, Hamm S, Iyer RS, Orr M, Meier S, Schredl M. Nightmare frequency and nightmare distress during the COVID-19 pandemic. J Clin Sleep Med 2023; 19:163-169. [PMID: 36073841 PMCID: PMC9806780 DOI: 10.5664/jcsm.10290] [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: 01/26/2022] [Revised: 09/02/2022] [Accepted: 09/02/2022] [Indexed: 01/07/2023]
Abstract
STUDY OBJECTIVES The current study investigated nightmare frequency and distress during the pandemic and associated factors. METHODS Participants (n = 1,718) completed a survey, 747 of which were youth. The MADRE dream questionnaire was used to collect self-reported data on nightmare frequency and distress. In addition, personality traits, current stressors, and COVID-related anxiety were also measured. An ordinal regression model was used for statistical analysis, and P < .05 was considered significant. RESULTS The findings from this study suggest (1) COVID-related anxiety is associated with the frequency of nightmares and the severity of nightmare distress experienced by a person, and (2) findings support the continuity hypothesis, which suggests waking life experiences are related to nightmares and (3) increased COVID-related anxiety contributes independently to nightmare frequency. COVID-related anxiety appeared to be more prevalent within adults (P < .001, effect size = 0.18) compared to youth. Similar results were found for nightmare distress. CONCLUSIONS The risk of nightmares may have increased due to disruptions in mental health and sleep caused by the COVID-19 crisis. These findings may be important in clinician efforts to understand nightmares and the risk of problematic sleep during the pandemic. CITATION Remedios A, Marin-Dragu S, Routledge F, et al. Nightmare frequency and nightmare distress during the COVID-19 pandemic. J Clin Sleep Med. 2023;19(1):163-169.
Collapse
Affiliation(s)
- Anellka Remedios
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Silvia Marin-Dragu
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Francis Routledge
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sara Hamm
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Matt Orr
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michael Schredl
- Central Institute of Mental Health Medical Mannheim, Mannheim, Germany
| |
Collapse
|
8
|
Margherita G, Caffieri A. An observatory on changes in dreaming during a pandemic: a living systematic review (part 1). J Sleep Res 2022; 32:e13742. [PMID: 36320190 PMCID: PMC9877779 DOI: 10.1111/jsr.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/09/2022] [Accepted: 09/12/2022] [Indexed: 01/28/2023]
Abstract
A 'new' way of dreaming has emerged during the pandemic, enhancing the interest of psychological literature. Indeed, during the years of the spread of coronavirus disease 2019 (COVID-19), many studies have investigated dream-related phenomena and dreaming functions. Considering the constant and rapid emergence of new results on this topic, the main aim of this study was to create an 'observatory' on the short- and long-term consequences of the COVID-19 pandemic on dreaming, by means of a living systematic review. The baseline results are presented, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines, to identify and discuss existing studies about dreams and dreaming during the COVID-19 pandemic published until February 2022. Web of Science, Embase, EBSCO, and PubMed were used for the search strategy, yielding 71 eligible papers included in the review. Our results show: (a) a more intense oneiric activity during lockdown; (b) changes in dreaming components (especially dream-recall and nightmare frequency); (c) a particular dreaming scenario ('pandemic dreams'); (d) an alteration of the dreaming-waking-life continuum and a specific function of dreaming as emotional regulator. Findings suggest that monitoring changes in dreaming provides important information about psychological health and could also contribute to the debate on the difficulties of dreaming, as well as sleeping, in particular during and after a period of 'collective trauma'.
Collapse
Affiliation(s)
- Giorgia Margherita
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| | - Alessia Caffieri
- Department of Humanistic StudiesUniversity of Naples Federico IINaplesItaly
| |
Collapse
|
9
|
Pellitteri G, Surcinelli A, De Martino M, Fabris M, Janes F, Bax F, Marini A, Milanic R, Piani A, Isola M, Gigli GL, Valente M. Sleep alterations following COVID-19 are associated with both neuroinflammation and psychological disorders, although at different times. Front Neurol 2022; 13:929480. [PMID: 36062000 PMCID: PMC9428349 DOI: 10.3389/fneur.2022.929480] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionBy the end of 2019, severe acute respiratory syndrome coronavirus 2 rapidly spread all over the world impacting mental health and sleep habits. Insomnia, impaired sleep quality, and circadian rhythm alterations were all observed during the pandemic, especially among healthcare workers and in patients with acute and post-acute COVID-19. Sleep disruption may induce a pro-inflammatory state associated with an impairment of immune system function.ObjectiveWe investigated the relationship between sleep alterations, psychological disorders, and inflammatory blood biomarkers in patients with post-acute COVID-19.MethodsWe enrolled 47 subjects diagnosed with COVID-19 pneumonia at Santa Maria della Misericordia University Hospital (Udine, Italy) between March and May 2020. Selected patients were evaluated at 2 months (T1) and 10 months (T2) after discharge. Each time, we collected clinical interviews, neurological examinations, and self-administered questionnaires to assess sleep and life quality, anxiety, depression, and post-traumatic stress disorder. Blood biomarkers of endothelial activation, neuroinflammation, and inflammatory cytokines were also measured at each follow-up. Collected variables were analyzed using comparisons between groups and linear regression models.ResultsPrevalence of insomnia increased from 10.6% up to 27.3% after COVID-19. Poor sleep quality was found in 41.5% of patients at both study visits. At T1 follow-up, poor sleepers showed higher levels of neurofilament light chain, vascular cell adhesion molecule 1, and interleukin 10; no significant associations were found between sleep quality and psychological disorders. At T2 follow-up, lower sleep quality was associated with higher levels of vascular cell adhesion molecule 1 and interleukin 8, but also with higher scores for anxiety, depression, and post-traumatic stress disorder.ConclusionOur results suggest an association of poor sleep quality with both psychological disorders and neuroinflammation, although at different times, in previously hospitalized patients with moderate-to-critical COVID-19.
Collapse
Affiliation(s)
- Gaia Pellitteri
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- *Correspondence: Gaia Pellitteri
| | - Andrea Surcinelli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Maria De Martino
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Martina Fabris
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Janes
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Francesco Bax
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | | | - Romina Milanic
- Institute of Clinical Pathology, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Antonella Piani
- Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
| | - Miriam Isola
- Division of Medical Statistics, Department of Medical Area, University of Udine, Udine, Italy
| | - Gian Luigi Gigli
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| | - Mariarosaria Valente
- Clinical Neurology Unit, Santa Maria della Misericordia University Hospital, Udine, Italy
- Department of Medical Area (DAME), University of Udine, Udine, Italy
| |
Collapse
|
10
|
Dreaming during the COVID-19 pandemic: A narrative review. Neurosci Biobehav Rev 2022; 138:104710. [PMID: 35643121 PMCID: PMC9132492 DOI: 10.1016/j.neubiorev.2022.104710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 05/20/2022] [Accepted: 05/21/2022] [Indexed: 12/05/2022]
Abstract
According to several influential models, dreams can be affected by state- and trait-like factors, sleep features, and diurnal experiences. The COVID-19 pandemic globally affected daily habits, emotional experiences, and sleep. Previous studies suggested an influence of collective traumatic events on dreaming. Starting from these premises, several studies assessed the effect of the pandemic on dreams. This paper aims to review findings concerning the oneiric activity during the COVID-19 pandemic. We report pandemic-related changes in dreams and nightmares, and we consider the possible factors associated with dreaming. Moreover, we provide results about changes in the oneiric activity in different phases of the pandemic. The reviewed findings suggest a pandemic-related enhancement of dream and nightmare frequency, emotional intensity, and distressing contents, modulated by modifications in restrictive measures and associated with diurnal experiences, emotional status, and sleep pattern. We highlight several methodological issues and a large heterogeneity in the present literature, limiting results’ generalizability. However, we provide possible interpretations of the most consistent findings in light of the main theoretical frameworks about dreaming.
Collapse
|
11
|
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.
Collapse
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
| |
Collapse
|
12
|
Que JY, Shi L, Yan W, Chen SJ, Wu P, Sun SW, Yuan K, Liu ZC, Zhu Z, Fan JY, Lu Y, Hu B, Xiao H, Liu ZS, Li Y, Wang GH, Wang W, Ran MS, Shi J, Wing YK, Bao YP, Lu L. Nightmares mediate the association between traumatic event exposure and suicidal ideation in frontline medical workers exposed to COVID-19. J Affect Disord 2022; 304:12-19. [PMID: 35176338 PMCID: PMC8843324 DOI: 10.1016/j.jad.2022.02.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 12/04/2021] [Accepted: 02/13/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trauma experience increases the risk of suicidal ideation, but little is known about potentially psychological mechanisms underlying this relationship. This study aims to examine the relationship between coronavirus disease 2019 (COVID-19)-related traumatic event (CTE) exposure and suicidal ideation among hospital workers, and identify mediating roles of sleep disturbances in this relationship. METHODS Workers in seven designated hospitals in Wuhan, China, were invited to participate in an online survey from May 27, 2020, to July 31, 2020. Participants completed a self-report questionnaire to evaluate demographic characteristics, level of CTE exposures, nightmare frequency, insomnia severity, symptoms of depression and anxiety, and suicidal ideation. A series of correlation analyses were performed, and a mediation model was generated to examine correlations between CTE exposure, sleep disturbances, and suicidal ideation. RESULTS A total of 16,220 hospital workers were included in the final analysis, 13.3% of them reported suicidal ideation in the past month. CTE exposure was significantly associated with insomnia severity, nightmare frequency, and suicidal ideation. After controlling potential confounders, nightmares but not insomnia, depression, or anxiety were shown to be independent risk factors for suicidal ideation. Pathway analyses showed that the relationship between CTE exposure and suicidal ideation was fully mediated by nightmares (proportion mediated 66.4%) after adjusting for demographic characteristics and psychological confounders. LIMITATIONS Cross-sectional design precluded the investigation of causal relationships. CONCLUSIONS CTE exposure increases risk of hospital workers' suicidal ideation that is mediated by nightmares, suggesting nightmares intervention might be considered as a component when developing suicide prevention strategies.
Collapse
Affiliation(s)
- Jian-Yu Que
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Le Shi
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Wei Yan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Si-Jing Chen
- Faculty of Medicine, Department of Psychiatry, Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Ping Wu
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China
| | - Si-Wei Sun
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Kai Yuan
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China
| | - Zhong-Chun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhou Zhu
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Jing-Yi Fan
- Department of Pediatrics, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yu Lu
- Affiliated Wuchang Hospital, Wuhan University of Science and Technology, Wuhan, China
| | - Bo Hu
- Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Han Xiao
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhi-Sheng Liu
- Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Li
- Department of Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Gao-Hua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Wei Wang
- Department of Neurology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Mao-Sheng Ran
- Department of Social Work and Social Administration, University of Hong Kong, Hong Kong, China
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China
| | - Yun Kwok Wing
- Faculty of Medicine, Department of Psychiatry, Chinese University of Hong Kong, Sha Tin, Hong Kong SAR, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China.
| | - Lin Lu
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Peking University Sixth Hospital, Peking University Institute of Mental Health, 51 Huayuanbei Road, Beijing 100191, China; National Institute on Drug Dependence and Beijing Key Laboratory on Drug Dependence Research, Peking University, 38 Xueyuan Road, Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Beijing 100191, China.
| |
Collapse
|
13
|
Strzelecki AM, Moloney ME, Brooks AT, Weafer J. Alcohol use, sleep, and depression among family caregivers in the time of COVID-19. Alcohol 2022; 102:35-42. [PMID: 35500757 PMCID: PMC9052708 DOI: 10.1016/j.alcohol.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 02/28/2022] [Accepted: 04/26/2022] [Indexed: 11/15/2022]
Abstract
The COVID-19 pandemic has substantially altered daily life around the world, resulting in significant impacts on health behaviors. The additional burdens imposed by family caregiving (i.e., providing unpaid care for children and/or adults) may further exacerbate negative effects of the pandemic on health and health behaviors, including increased alcohol consumption, poor sleep, and increased depressive symptoms. The current study examined this possibility. Participants (N = 320, mean age = 35.11 years) completed an online questionnaire assessing alcohol use, sleep, and depression during the COVID-19 pandemic (June–August 2020) and retrospectively assessed the same health behaviors in the months prior to the pandemic. Insomnia severity increased, sleep quality decreased, and depressive symptoms increased for both caregivers and non-caregivers during the pandemic (p < 0.001). By contrast, alcohol consumption increased among caregivers only (p < 0.05). Further, increased alcohol use was associated with decreased sleep quality and increased insomnia symptoms among caregivers, but not non-caregivers. While additional longitudinal research is warranted in this population, our findings offer important insight on self-reported changes in alcohol consumption, sleep patterns, and mood among family caregivers during the COVID-19 pandemic.
Collapse
|
14
|
Abstract
This chapter summarizes the known associations between COVID-19 and sleep dysfunction, including insomnia, excessive daytime sleepiness, restless legs syndrome and nightmares, and touches upon pandemic-related considerations for obstructive sleep apnea and continuous positive airway pressure treatment. Treatment strategies and management approaches are also briefly discussed.
Collapse
Affiliation(s)
- Sushanth Bhat
- Hackensack Meridian-Health JFK University Medical Center, 65 James Street, Edison, NJ, 08818, USA.
| | - Sudhansu Chokroverty
- Sleep Medicine Research, and Co-Chair Emeritus of Neurology, Hackensack Meridian-Health JFK University Medical Center, 65 James Street, Edison, NJ, 08818, USA.
| |
Collapse
|
15
|
Alghamdi AA, Alafif NO, BaHammam AS, Almuammar M, Alharbi NS, Alhefdhi NA, Al-Musharaf S, Al Ghamdi KS, AlYousif GF, Al Muhanna NF. Nightmares' Pattern and Predictors among a Saudi University Students during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031776. [PMID: 35162799 PMCID: PMC8835620 DOI: 10.3390/ijerph19031776] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/21/2022] [Accepted: 01/30/2022] [Indexed: 12/16/2022]
Abstract
Purpose: During the coronavirus disease 2019 (COVID-19) pandemic quarantine, university students were under various types of stressors, including the exams period, which might have affected their quality and quantity of sleep, and consequently, their quality of life. This study aimed to investigate the pattern and predictors of nightmares among university students and coinvestigate the presence of other types of sleep disturbances, mental disorders, and quarantine-related stressors. Methods: This cross-sectional study included 368 university students who answered a self-completed questionnaire covering their sociodemographic features, nightmare indicators, and associated quarantine stressors. Additionally, sleep disturbances were measured using the Generalized Sleep Disturbance Scale (GSDS), anxiety using the Generalized Anxiety Disorder 2 scale, and depression using the Patient Health Questionnaire-2. Results: The participants’ mean age was 20.4 ± 1.6 years, and male participants represented 35.9% of the sample. Nightmares were experienced by 117 (31.8%) of the participants, of whom 44.4% had new-onset nightmares. The mean GSDS was 45.0 ± 14.9 (min. = 12, max. = 130). This value is associated with elevated odds of the following outcomes: the presence of nightmares (odds ratio [OR] = 1.8; confidence interval [CI] 95% = 1.1–3.0); new-onset nightmares at the time of pandemic (OR = 2.6; CI 95% = 1.3–5.5); and anxiety (OR = 1.74; CI 95% = 1.0–2.9). The presence of nightmares elevated the score of GSDS by 11.3 points (S.E. = 1.6, p < 0.001), elevated the odds of anxiety by 4.1 (CI 95% = 2.5–6.8), and depression by 2.1 (CI 95% = 1.3–3.4). Conclusions: Stressors resulting from both the exams period and the fact that it was conducted during COVID-19 quarantine increased the rate and affected the pattern of nightmares. These stressors also led to other sleep disturbances and mental disorders that were significantly more prevalent among females.
Collapse
Affiliation(s)
- Amal A. Alghamdi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.A.); (G.F.A.)
| | - Nora O. Alafif
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
- Correspondence:
| | - Ahmed S. BaHammam
- The University Sleep Disorders Center, Department of Medicine, College of Medicine, King Saud University, Riyadh 11324, Saudi Arabia;
- The Strategic Technologies Program of the National Plan for Sciences and Technology and Innovation in the Kingdom of Saudi Arabia, Riyadh 11362, Saudi Arabia
| | - May Almuammar
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Najd S. Alharbi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Nouf A. Alhefdhi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Sara Al-Musharaf
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 10219, Saudi Arabia; (M.A.); (N.S.A.); (N.A.A.); (S.A.-M.)
| | - Kholoud S. Al Ghamdi
- Department of Physiology, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia;
| | - Ghada F. AlYousif
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam 34212, Saudi Arabia; (A.A.A.); (G.F.A.)
| | - Norah F. Al Muhanna
- Psychiatry Department, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia;
| |
Collapse
|
16
|
Korabelnikova E, Tkachenko V. Nightmares in patients with insomnia. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:42-47. [DOI: 10.17116/jnevro202212205242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
17
|
Goncalves M, Henriques A, Costa A, Correia D, Severo M, Lucas R, Barros H, Santos AC, Ribeiro AI, Rocha A, Lopes C, Correia D, Ramos E, Gonçalves G, Barros H, Araújo J, Talih M, Tavares M, Severo M, Lunet N, Meireles P, Duarte R, Lucas R, Camacho R, Fraga S, Correia S, Silva S, Leão T. Insomnia and nightmare profiles during the COVID-19 pandemic in Portugal: characterization and associated factors. Sleep Med 2022; 90:44-52. [PMID: 35093683 PMCID: PMC8744402 DOI: 10.1016/j.sleep.2021.12.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 12/22/2022]
Abstract
Objective/background To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19. Patients/methods An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March–May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI). Results Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women: OR = 6.98 95%CI: 4.18–11.64; ≥60 years: OR = 0.30 95%CI: 0.18–0.53; Insufficient income: adjusted OR (aOR) = 8.413 95%CI: 3.93–16.84; Often presenting fear of being infected with SARS-CoV-2 infection: aOR = 9.13 95%CI: 6.36–13.11), and nightmares (Women: OR = 2.60 95%CI: 1.74–3.86; ≥60 years: OR = 0.45 95%CI: 0.28–0.74; Insufficient income: aOR = 2.60 95%CI: 1.20–5.20; Often/almost always presenting fear of being infected with SARS-CoV-2 infection: aOR = 6.62 95%CI: 5.01–8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic. Conclusions Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during the COVID-19 pandemic.
Collapse
|
18
|
Holzinger B, Nierwetberg F, Chung F, Bolstad CJ, Bjorvatn B, Chan NY, Dauvilliers Y, Espie CA, Han F, Inoue Y, Leger D, Macêdo T, Matsui K, Merikanto I, Morin CM, Mota-Rolim SA, Partinen M, Plazzi G, Penzel T, Sieminski M, Wing YK, Scarpelli S, Nadorff MR, De Gennaro L. Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey. Nat Sci Sleep 2022; 14:1469-1483. [PMID: 36052103 PMCID: PMC9426865 DOI: 10.2147/nss.s368147] [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: 05/02/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its risk factors. Further, the mediating role of post-traumatic stress disorder symptoms between the pandemic and nightmares is explored. PATIENTS AND METHODS For this cross-sectional survey data were obtained via self-rating online survey (ICOSS: details in Partinen et al, 2021), which was open to anyone older than 18 years. The final volunteer sample consisted of 15,292 participants, divided according to their nightmare frequency (high: ≥1-2 nights/week; low: <1-2 nights/week). A total of 9100 participants were excluded if answers on variables of interest were missing or receiving rewards for participation. Chi-square tests identified changes of nightmare frequency. Predictors of high nightmare frequency were assessed using logistic regression and presented as Odds Ratios. Post-hoc mediation models were used to investigate the role of post-traumatic stress symptoms (PTSS). RESULTS The mean age was 41.63 (SD=16.55) with 64.05% females. High nightmare frequency increased significantly from 13.24% to 22.35% during the pandemic. Factors associated with it included self-reported PTSS (OR=2.11), other mental disorders and various sleep disorders or problems. Financial burden due to the pandemic, confinement, having had COVID-19, and work situation during the pandemic were associated with nightmare frequency, those relations were partly mediated through PTSS. CONCLUSION Our results display the pandemic influence on nightmare frequency, which in turn connects to multiple mental health and sleep factors. These relations were partly mediated through PTSS. The COVID-19 pandemic appears to have caused traumatization of a substantial proportion of society. Health care workers should consider nightmares in their screening routines, as it might indicate PTSS and/or other mental and sleep disorders.
Collapse
Affiliation(s)
- Brigitte Holzinger
- Institute for Consciousness and Dream Research, Vienna, Austria.,Medical University Vienna, Postgraduate Master ULG Sleep Coaching, Vienna, Austria
| | | | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, ON, Canada
| | | | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen and Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - Yves Dauvilliers
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, INM, Univ Montpellier, INSERM, Montpellier, France
| | - Colin A Espie
- Sir Jules Thorn Sleep & Circadian Neuroscience Institute (SCNi), University of Oxford, Oxford, UK
| | - Fang Han
- Department of Pulmonary and Critical Care Medicine, Peking University People's Hospital, Beijing, People's Republic of China
| | | | - Damien Leger
- Université de Paris, APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Tainá Macêdo
- Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Kentaro Matsui
- Department of Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan.,Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan
| | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Charles M Morin
- École de Psychologie, Centre d'étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval, Québec, QC, Canada
| | - Sérgio A Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital - Federal University of Rio Grande do Norte, Natal, Brazil
| | - Markku Partinen
- Helsinki Sleep Clinic, Terveystalo Healthcare, and Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland
| | - Giuseppe Plazzi
- IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.,Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Thomas Penzel
- Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong, Special Administrative Region, People's Republic of China
| | - Serena Scarpelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Michael R Nadorff
- Mississippi State University, Mississippi State, MS, USA.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| |
Collapse
|
19
|
Partinen M, Holzinger B, Morin CM, Espie C, Chung F, Penzel T, Benedict C, Bolstad CJ, Cedernaes J, Chan RNY, Dauvilliers Y, De Gennaro L, Han F, Inoue Y, Matsui K, Leger D, Cunha AS, Merikanto I, Mota-Rolim S, Nadorff M, Plazzi G, Schneider J, Sieminski M, Wing YK, Bjorvatn B. Sleep and daytime problems during the COVID-19 pandemic and effects of coronavirus infection, confinement and financial suffering: a multinational survey using a harmonised questionnaire. BMJ Open 2021; 11:e050672. [PMID: 34903540 PMCID: PMC8671846 DOI: 10.1136/bmjopen-2021-050672] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES Sleep is important for human health and well-being. No previous study has assessed whether the COVID-19 pandemic impacts sleep and daytime function across the globe. METHODS This large-scale international survey used a harmonised questionnaire. Fourteen countries participated during the period of May-August 2020. Sleep and daytime problems (poor sleep quality, sleep onset and maintenance problems, nightmares, hypnotic use, fatigue and excessive sleepiness) occurring 'before' and 'during' the pandemic were investigated. In total, 25 484 people participated and 22 151 (86.9%) responded to the key parameters and were included. Effects of COVID-19, confinement and financial suffering were considered. In the fully adjusted logistic regression models, results (weighted and stratified by country) were adjusted for gender, age, marital status, educational level, ethnicity, presence of sleep problems before COVID-19 and severity of the COVID-19 pandemic in each country at the time of the survey. RESULTS The responders were mostly women (64%) with a mean age 41.8 (SD 15.9) years (median 39, range 18-95). Altogether, 3.0% reported having had COVID-19; 42.2% reported having been in confinement; and 55.9% had suffered financially. All sleep and daytime problems worsened during the pandemic by about 10% or more. Also, some participants reported improvements in sleep and daytime function. For example, sleep quality worsened in about 20% of subjects and improved in about 5%. COVID-19 was particularly associated with poor sleep quality, early morning awakening and daytime sleepiness. Confinement was associated with poor sleep quality, problems falling asleep and decreased use of hypnotics. Financial suffering was associated with all sleep and daytime problems, including nightmares and fatigue, even in the fully adjusted logistic regression models. CONCLUSIONS Sleep problems, fatigue and excessive sleepiness increased significantly worldwide during the first phase of the COVID-19 pandemic. Problems were associated with confinement and especially with financial suffering.
Collapse
Affiliation(s)
- Markku Partinen
- Department of Clinical Neurosciences, University of Helsinki Clinicum Unit, Helsinki, Finland
- Helsinki Sleep Clinic, Terveystalo Healthcare Services, Helsinki, Finland
| | - Brigitte Holzinger
- Institute for Dream and Consciousness Research, Medical University of Vienna, Wien, Austria
| | - Charles M Morin
- Centre d'étude des troubles du sommeil, Centre de recherche CERVO/Brain Research Center, Université Laval École de psychologie, Quebec, Quebec, Canada
| | - Colin Espie
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, Toronto, Ontario, Canada
| | - Thomas Penzel
- Sleep Medicine Center, Charite University Hospital Berlin, Berlin, Germany
| | - Christian Benedict
- Department of Neuroscience, Sleep Science (BMC), Uppsala University, Uppsala, Sweden
| | - Courtney J Bolstad
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Jonathan Cedernaes
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Department of Medicine, Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Rachel Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yves Dauvilliers
- National Reference Center for Narcolepsy, Sleep and Wake Unit, Department of Neurology, Gui-de-Chauliac Hospital, University Hospital Centre Montpellier, Montpellier, France
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Roma, Lazio, Italy
- IRCCS Fondazione Santa Lucia, Roma, Italy
| | - Fang Han
- Department of Pulmonary Medicine, Peking University People's Hospital, Beijing, China
| | - Yuichi Inoue
- Department of Somnology, Tokyo Medical University, Shinjuku-ku, Japan
- Neuropsychiatric Research Institute, Japan Somnology Center, Tokyo, Japan
| | - Kentaro Matsui
- Department of Clinical Laboratory and Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry National Institute of Mental Health, Kodaira, Japan
- Department of Psychiatry, Tokyo Women's Medical University, Shinjuku-ku, Japan
| | - Damien Leger
- Sleep and Vigilance Center, Hopital Hotel-Dieu de Paris, Paris, France
- VIFASOM (EA 7331 Vigilance Fatigue Sommeil et Santé Publique), Universite de Paris, Paris, France
| | - Ana Suely Cunha
- Production Engineering Department, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Ilona Merikanto
- Research Programs Unit, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sergio Mota-Rolim
- Brain Institute, Onofre Lopes University Hospital, Petropolis, Brazil
- Physiology and Behavior Department, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Michael Nadorff
- Department of Psychology, Mississippi State University, Mississippi State, Mississippi, USA
| | - Giuseppe Plazzi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Jules Schneider
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Mariusz Sieminski
- Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Yun-Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
20
|
Marogna C, Montanari E, Contiero S, Lleshi K. Dreaming during COVID-19: the effects of a world trauma. RESEARCH IN PSYCHOTHERAPY (MILANO) 2021; 24:541. [PMID: 34568109 PMCID: PMC8451215 DOI: 10.4081/ripppo.2021.541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/29/2021] [Indexed: 11/23/2022]
Abstract
On March 11, 2020, the World Health Organization (WHO) declared a state of health emergency affecting the entire world population. Given the serious practical and psychological difficulties and complications that have been experienced during this period, many scholars have created hypothesis, as a consequence, an increased possibility of developing post-traumatic stress disorder (PTSD) within the general population with significant implications for one's dream activity. Participants in the study were recruited via the instant messaging application 'WhatsApp' for a period of 14 days. The study consisted of three phases: the first phase provided information on the purpose of the research and how to carry it out; in the second phase, each participant, using the Bionian model of dream experience as a focus, was asked to write down dreams, emotions and free connections/associations related to the dream. At the end of the collection, the texts obtained were analysed by means of a qualitative analysis performed with the aid of the MAXQDA software. The study confirms the computational and exploratory analysis of the text carried out in the research of Pesonen et al. (2020), finding also in our sample the presence of the hypothesized clusters going to explain the manifestation of imagery related to COVID-19 also within the dream activity. To confirm this, the nightmare of participant number 6 of the study is reported. The following qualitative research has offered an insight into the traumatic nature of the COVID-19 pandemic, showing how many unmetabolized 'daytime elements' have been reproposed in the dream scenario, recalling the symptomatology of PTSD through the presence of distressing content that affect the quality of sleep and the daily life of the individual.
Collapse
Affiliation(s)
- Cristina Marogna
- Department of Philosophy, Sociology, Education & Applied Psychology (FISPPA), University of Padua, Italy
| | | | | | | |
Collapse
|
21
|
Abstract
PURPOSE OF REVIEW To understand the effect of COVID-19 pandemic and lockdown on persons with alcohol use disorders. RECENT FINDINGS From a total of 455 titles on COVID-19 and alcohol, 227 abstracts were screened, and 95 articles were reviewed (on November 25th, 2020). The immediate effect was an increase in alcohol related emergencies including alcohol withdrawal, related suicides, and methanol toxicity. Although there are mixed findings with respect to changes in the quantity of drinking, there are reports of binge/heavy drinking during the lockdown as well as relapse postlockdown. Psychological, social, biological, economic and policy-related factors appear to influence the changes in drinking. Although preliminary data suggest no change in alcohol use among persons with comorbid mental illness, findings in this population are presently limited. Among patients with alcohol related liver disease, outcomes appear worse and caution is warranted with the use of medications. Alcohol also appears to increases the risk of COVID-19 infection and complicates its course.Although some nations banned alcohol sales completely during lockdown, others declared it as an essential commodity, resulting in different problems across countries. Alcohol use has added to the burden of the problem particularly among vulnerable groups like the adolescents, elderly, patients with cancer, as well as health professionals. Services for patients with alcohol use disorders have been affected. SUMMARY The COVID-19 pandemic has had considerable impact on alcohol use, with an increase in alcohol related emergencies, changes in alcohol use patterns, increased risk of contracting COVID-19, effect on alcohol policies and sales, and an effect on vulnerable groups. It is essential to understand and respond to the current situation, intervene early, and prevent further repercussions of the pandemic.Video abstract link: https://drive.google.com/file/d/1IJWtIs6e554PryKWhdma4VB--mjSZq1C/view?usp=sharing.
Collapse
Affiliation(s)
- Pratima Murthy
- Department of Psychiatry, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru
| | | |
Collapse
|
22
|
Guerrero-Gomez A, Nöthen-Garunja I, Schredl M, Homberg A, Vulcan M, Brusić A, Bonizzi C, Iannaco C. Dreaming in Adolescents During the COVID-19 Health Crisis: Survey Among a Sample of European School Students. Front Psychol 2021; 12:652627. [PMID: 33959080 PMCID: PMC8093446 DOI: 10.3389/fpsyg.2021.652627] [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: 01/27/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022] Open
Abstract
According to the continuity hypothesis of dreaming and contemporary psychodynamic approaches, dreams reflect waking life. The aim of the present study was to explore the relationship between the COVID-19 pandemic and dreaming in adolescents. A cross-sectional survey was conducted in Italy, Romania and Croatia involving 2,105 secondary school students (69% girls, mean age 15.6 ± 2.1 years; 31% boys, mean age 15.1 ± 2.2 years; mean age of whole sample 15.4 ± 2.1 years). No substantial differences between countries were found. Thirty-one percent of the participants reported heightened dream recall, 18% noticed an increase in nightmares during the lockdown, and 15% of the provided dreams (n = 498) included pandemic-related content. The results indicate that subjective emotional reactions to lockdown had a significantly higher correlation to dreaming than objective distress (i.e., illness or death of a close one because of COVID-19). These findings suggest that attention to dreams should be included in preventive programs for adolescents with pandemic-related stress.
Collapse
Affiliation(s)
| | | | - Michael Schredl
- Sleep Laboratory, Central Institute of Mental Health, Medical Faculty, Mannheim/Heidelberg University, Mannheim, Germany
| | | | - Maria Vulcan
- Timișoara 2021 – European Capital of Culture Association, Timișoara, Romania
| | - Asja Brusić
- Rijeka 2020 – European Capital of Culture, Croatian Cultural Centre, Rijeka, Croatia
| | | | | |
Collapse
|