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Chan WS, Cheng WY, Lok SHC, Cheah AKM, Lee AKW, Ng ASY, Kowatsch T. Assessing the Short-Term Efficacy of Digital Cognitive Behavioral Therapy for Insomnia With Different Types of Coaching: Randomized Controlled Comparative Trial. JMIR Ment Health 2024; 11:e51716. [PMID: 39110971 PMCID: PMC11339566 DOI: 10.2196/51716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 03/07/2024] [Accepted: 05/25/2024] [Indexed: 08/25/2024] Open
Abstract
BACKGROUND Digital cognitive behavioral therapy for insomnia (dCBTi) is an effective intervention for treating insomnia. The findings regarding its efficacy compared to face-to-face cognitive behavioral therapy for insomnia are inconclusive but suggest that dCBTi might be inferior. The lack of human support and low treatment adherence are believed to be barriers to dCBTi achieving its optimal efficacy. However, there has yet to be a direct comparative trial of dCBTi with different types of coaching support. OBJECTIVE This study examines whether adding chatbot-based and human coaching would improve the treatment efficacy of, and adherence to, dCBTi. METHODS Overall, 129 participants (n=98, 76% women; age: mean 34.09, SD 12.05 y) whose scores on the Insomnia Severity Index [ISI] were greater than 9 were recruited. A randomized controlled comparative trial with 5 arms was conducted: dCBTi with chatbot-based coaching and therapist support (dCBTi-therapist), dCBTi with chatbot-based coaching and research assistant support, dCBTi with chatbot-based coaching only, dCBTi without any coaching, and digital sleep hygiene and self-monitoring control. Participants were blinded to the condition assignment and study hypotheses, and the outcomes were self-assessed using questionnaires administered on the web. The outcomes included measures of insomnia (the ISI and the Sleep Condition Indicator), mood disturbances, fatigue, daytime sleepiness, quality of life, dysfunctional beliefs about sleep, and sleep-related safety behaviors administered at baseline, after treatment, and at 4-week follow-up. Treatment adherence was measured by the completion of video sessions and sleep diaries. An intention-to-treat analysis was conducted. RESULTS Significant condition-by-time interaction effects showed that dCBTi recipients, regardless of having any coaching, had greater improvements in insomnia measured by the Sleep Condition Indicator (P=.003; d=0.45) but not the ISI (P=.86; d=-0.28), depressive symptoms (P<.001; d=-0.62), anxiety (P=.01; d=-0.40), fatigue (P=.02; d=-0.35), dysfunctional beliefs about sleep (P<.001; d=-0.53), and safety behaviors related to sleep (P=.001; d=-0.50) than those who received digital sleep hygiene and self-monitoring control. The addition of chatbot-based coaching and human support did not improve treatment efficacy. However, adding human support promoted greater reductions in fatigue (P=.03; d=-0.33) and sleep-related safety behaviors (P=.05; d=-0.30) than dCBTi with chatbot-based coaching only at 4-week follow-up. dCBTi-therapist had the highest video and diary completion rates compared to other conditions (video: 16/25, 60% in dCBTi-therapist vs <3/21, <25% in dCBTi without any coaching), indicating greater treatment adherence. CONCLUSIONS Our findings support the efficacy of dCBTi in treating insomnia, reducing thoughts and behaviors that perpetuate insomnia, reducing mood disturbances and fatigue, and improving quality of life. Adding chatbot-based coaching and human support did not significantly improve the efficacy of dCBTi after treatment. However, adding human support had incremental benefits on reducing fatigue and behaviors that could perpetuate insomnia, and hence may improve long-term efficacy. TRIAL REGISTRATION ClinicalTrials.gov NCT05136638; https://www.clinicaltrials.gov/study/NCT05136638.
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Affiliation(s)
- Wai Sze Chan
- Department of Psychology, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Wing Yee Cheng
- Department of Psychology, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Samson Hoi Chun Lok
- Department of Psychology, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Amanda Kah Mun Cheah
- Department of Psychology, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Anna Kai Win Lee
- Department of Psychology, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Albe Sin Ying Ng
- Department of Psychology, The University of Hong Kong, Hong Kong, China (Hong Kong)
| | - Tobias Kowatsch
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St.Gallen, St. Gallen, Switzerland
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, Eidgenössische Technische Hochschule Zürich, Zurich, Switzerland
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Guo W, Nazari N, Sadeghi M. Cognitive-behavioral treatment for insomnia and mindfulness-based stress reduction in nurses with insomnia: a non-inferiority internet delivered randomized controlled trial. PeerJ 2024; 12:e17491. [PMID: 39071123 PMCID: PMC11283175 DOI: 10.7717/peerj.17491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 05/09/2024] [Indexed: 07/30/2024] Open
Abstract
Background Insomnia is a highly prevalent sleep disorder frequently comorbid with mental health conditions in nurses. Despite the effectiveness of evidence-based cognitive behavioral therapy for insomnia (CBT-I), there is a critical need for alternative approaches. This study investigated whether internet-delivered mindfulness-based stress reduction (IMBSR) for insomnia could be an alternative to internet-delivered CBT-I (ICBT-I). Objective The hypothesis was that the IMBSR would be noninferior to the ICBT-I in reducing the severity of insomnia among nurses with insomnia. Additionally, it was expected that ICBT-I would produce a greater reduction in the severity of insomnia and depression than IMBSR. Method Among 240 screened nurses, 134 with insomnia were randomly allocated (IMBSR, n = 67; ICBT-I, n = 67). The assessment protocol comprised clinical interviews and self-reported outcome measures, including the Insomnia Severity Index (ISI), Patient Health Questionnaire-9 (PHQ-9), the 15-item Five Facet Mindfulness Questionnaire (FFMQ), and the Client Satisfaction Questionnaire (CSQ-I). Results The retention rate was 55% with 77.6% (n = 104) of participants completing the study. At post-intervention, the noninferiority analysis of the ISI score showed that the upper limit of the 95% confidence interval was 4.88 (P = 0.46), surpassing the pre-specified noninferiority margin of 4 points. Analysis of covariance revealed that the ICBT-I group had significantly lower ISI (Cohen's d = 1.37) and PHQ-9 (Cohen's d = 0.71) scores than did the IMBSR group. In contrast, the IMBSR group showed a statistically significant increase in the FFMQ-15 score (Cohen's d = 0.67). Within-group differences showed that both the IMBSR and ICBT-I were effective at reducing insomnia severity and depression severity and improving mindfulness. Conclusion Overall, nurses demonstrated high levels of satisfaction and adherence to both interventions. The IMBSR significantly reduced insomnia severity and depression, but the findings of this study do not provide strong evidence that the IMBSR is at least as effective as the ICBT-I in reducing insomnia symptoms among nurses with insomnia. The ICBT-I was found to be significantly superior to the IMBSR in reducing insomnia severity, making it a recommended treatment option for nurses with insomnia.
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Affiliation(s)
- Wanran Guo
- School of Public Policy and Administration, Nanchang University, Nanchang, Nanchang, China
| | - Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, University of Lorestan, Khorramabad, Lorestan, Iran
| | - Masoud Sadeghi
- Department of Psychology, Faculty of Human Sciences, University of Lorestan, Khorramabad, Lorestan, Iran
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Meng R, Ying Y, Luo Y, Huang M, Miller CB, Xie Y, Jia Y, Fan L, Chen W, Yi J, Yang N, Xu J, Jiang C, Lu L, Ma H, Spruyt K, Lau EYY. A longitudinal examination of the measurement properties and invariance of the Sleep Condition Indicator in Chinese healthcare students. BMC Psychiatry 2024; 24:518. [PMID: 39039484 PMCID: PMC11264982 DOI: 10.1186/s12888-024-05844-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 05/13/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The Sleep Condition Indicator (SCI), an insomnia measurement tool based on the updated Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria with sound psychometric properties when applied in various populations, was evaluated here among healthcare students longitudinally, to demonstrate its measurement properties and invariance in this particularly high-risk population. METHODS Healthcare students of a Chinese university were recruited into this two-wave longitudinal study, completing the simplified Chinese version of the SCI (SCI-SC), Chinese Regularity, Satisfaction, Alertness, Timing, Efficiency, Duration (RU_SATED-C) scale, Chinese Patient Health Questionnaire-4 (PHQ-4-C), and sociodemographic variables questionnaire (Q-SV) between September and November 2022. Structural validity, measurement invariance (MI), convergent and discriminant validity, internal consistency, and test-retest reliability of the SCI-SC were examined. Subgroups of gender, age, home location, part-time job, physical exercise, and stress-coping strategy were surveyed twice to test cross-sectional and longitudinal MI. RESULTS We identified 343 valid responses (62.9% female, mean age = 19.650 ± 1.414 years) with a time interval of seven days. The two-factor structure was considered satisfactory (comparative fit index = 0.953-0.989, Tucker-Lewis index = 0.931-0.984, root means square error of approximation = 0.040-0.092, standardized root mean square residual = 0.039-0.054), which mostly endorsed strict invariance except for part-time job subgroups, hence establishing longitudinal invariance. The SCI-SC presented acceptable convergent validity with the RU_SATED-C scale (r ≥ 0.500), discriminant validity with the PHQ-4-C (0.300 ≤ r < 0.500), internal consistency (Cronbach's alpha = 0.811-0.835, McDonald's omega = 0.805-0.832), and test-retest reliability (intraclass correlation coefficient = 0.829). CONCLUSION The SCI-SC is an appropriate screening instrument available for assessing insomnia symptoms among healthcare students, and the promising measurement properties provide additional evidence about validity and reliability for detecting insomnia in healthcare students.
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Affiliation(s)
- Runtang Meng
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China.
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China.
| | - Yiwei Ying
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yi Luo
- School of Nursing, Ningbo College of Health Sciences, Ningbo, Zhejiang, China
| | - Mengyi Huang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | | | - Yuhuan Xie
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Yuxin Jia
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Lianxia Fan
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Wukang Chen
- School of Clinical Medicine, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Jiayu Yi
- School of Nursing, Hangzhou Normal University, Hangzhou, Zhejiang, China
| | - Nongnong Yang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Jiale Xu
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Chen Jiang
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Liping Lu
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
| | - Haiyan Ma
- School of Public Health, Hangzhou Normal University, Hangzhou 311121, Zhejiang, China
- Engineering Research Center of Mobile Health Management System, Ministry of Education, Hangzhou, Zhejiang, China
| | - Karen Spruyt
- Université Paris Cité, NeuroDiderot, INSERM, Paris, France
| | - Esther Yuet Ying Lau
- Sleep Laboratory, Department of Psychology, The Education University of Hong Kong, Hong Kong, China
- Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, China
- Centre for Religious and Spirituality Education, The Education University of Hong Kong, Hong Kong, China
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Bifarin O, Collier-Sewell F, Smith G, Moriarty J, Shephard H, Andrews L, Pearson S, Kasperska M. Standards of proficiency for registered nurses-To what end? A critical analysis of contemporary mental health nursing within the United Kingdom context. Nurs Inq 2024; 31:e12630. [PMID: 38436620 DOI: 10.1111/nin.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/17/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Against the backdrop of cultural and political ideals, this article highlights both the significance of mental health nursing in meeting population needs and the regulatory barriers that may be impeding its ability to adequately do so. Specifically, we consider how ambiguous notions of 'proficiency' in nurse education-prescribed by the regulator-impact the development of future mental health nurses and their mental health nursing identity. A key tension in mental health practice is the ethical-legal challenges posed by sanctioned powers to restrict patients' freedom at the same time as the desire (and obligation) to promote patients' self-determined recovery. The genericism of the UK's Future Nurse Standards do little to prepare mental health nurses to navigate the tensions that ensue. This has consequences for nurses and patients alike, as both risk experiencing the distress and dissonance that attends giving or receiving poor care. We argue that more needs to be done to enable mental health nurses to define and articulate the nuances of the profession as part of becoming critical, thoughtful and confident practitioners. Educators can contribute to this mission by aligning curriculum, pedagogy and assessment to create meaningful opportunities for mental health nursing students to engage with the complexities of mental health nursing practice. Without this, the credibility of the profession will continue to be questioned; its future uncertain.
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Affiliation(s)
- Oladayo Bifarin
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
- Research & Innovation, Mersey Care NHS FT, Liverpool, UK
| | - Freya Collier-Sewell
- Centre for Culture, Media and Society, Sheffield Hallam University, Sheffield, UK
| | - Grahame Smith
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Jo Moriarty
- NIHR Policy Research Unit in Health and Social Care Workforce, The Policy Institute, King's College London, London, UK
| | | | - Lauren Andrews
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Sam Pearson
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
| | - Mari Kasperska
- School of Nursing and Advanced Practice, Liverpool John Moores University, Liverpool, UK
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Sun HL, Wang YY, Feng Y, Cui X, Cheung T, Su Z, Tang YL, Ungvari GS, Ng CH, Xiang YT. COVID-19 and Sleep Problems: A Perspective from Bibliometric Analysis. Behav Sleep Med 2024; 22:457-471. [PMID: 38240561 DOI: 10.1080/15402002.2023.2301412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVES The Coronavirus Disease 2019 (COVID-19) pandemic and the containment measures for COVID-19 have affected sleep quality in the population. This study explored sleep-related research from a bibliometric perspective to provide an overview of the research outputs in this field. METHODS Original and review articles were retrieved from the Web of Science Core Collection (WOSCC) database from December 2019 to 7 Aug 2023. R package "bibliometrix" was used to summarize the number of articles of authors, institutions, and countries; count the citations of the articles, and generate a Three-Fields Plot. VOSviewer software was applied to visualize the collaboration network among authors and institutions, and to conduct a co-occurrence analysis of keywords. RESULTS A total of 4,499 articles on COVID-19 and sleep, and 25,883 articles on non-COVID-19 and sleep were included. Sleep related articles were mainly published by authors from China, the USA, and Italy. For COVID-19 and sleep research, Huazhong University of Science was the most productive institution. The Psychiatry Research was the most influential journal across the different subject categories of this field. "Mental health", "anxiety", and "depression" were the most common keywords, while "sleep quality" and "quality of life" were the likely topic areas in terms of future research directions. CONCLUSIONS Our findings provide a comprehensive perspective for researchers to understand the wider landscape of both COVID-19 and non-COVID-19 sleep-related research area.
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Affiliation(s)
- He-Li Sun
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yue Ying Wang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiling Cui
- Department of Business Administration, Hong Kong Shue Yan University, Hong Kong SAR, China
| | - Teris Cheung
- School of Nursing, Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Zhaohui Su
- School of Public Health, Southeast University, Nanjing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
- Atlanta Veterans Affairs Medical Center, Decatur, GA, USA
| | - Gabor S Ungvari
- Section of Psychiatry, University of Notre Dame Australia, Fremantle, Australia
- Division of Psychiatry, School of Medicine, University of Western Australia, Perth, Australia
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao SAR, China
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Meaklim H, Le F, Drummond SPA, Bains SK, Varma P, Junge MF, Jackson ML. Insomnia is more likely to persist than remit after a time of stress and uncertainty: a longitudinal cohort study examining trajectories and predictors of insomnia symptoms. Sleep 2024; 47:zsae028. [PMID: 38308584 PMCID: PMC11009016 DOI: 10.1093/sleep/zsae028] [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: 08/28/2023] [Revised: 12/07/2023] [Indexed: 02/05/2024] Open
Abstract
STUDY OBJECTIVES The study aimed to characterize insomnia symptom trajectories over 12 months during a time of stress and uncertainty, the coronavirus disease 2019 (COVID-19) pandemic. It also aimed to investigate sleep and psychological predictors of persistent insomnia symptoms. METHODS This longitudinal cohort study comprised 2069 participants with and without insomnia symptoms during the first year of the pandemic. Participants completed online surveys investigating sleep, insomnia, and mental health at four timepoints over 12 months (April 2020-May 2021). Additional trait-level cognitive/psychological questionnaires were administered at 3 months only. RESULTS Six distinct classes of insomnia symptoms emerged: (1) severe persistent insomnia symptoms (21.65%), (2) moderate persistent insomnia symptoms (32.62%), (3) persistent good sleep (32.82%), (4) severe insomnia symptoms at baseline but remitting over time (2.27%), (5) moderate insomnia symptoms at baseline but remitting over time (7.78%), and (6) good sleep at baseline but deteriorating into insomnia symptoms over time (2.85%). Persistent insomnia trajectories were predicted by high levels of sleep reactivity, sleep effort, pre-sleep cognitive arousal, and depressive symptoms at baseline. A combination of high sleep reactivity and sleep effort reduced the odds of insomnia remitting. Higher sleep reactivity also predicted the deterioration of good sleep into insomnia symptoms over 12 months. Lastly, intolerance of uncertainty emerged as the only trait-level cognitive/psychological predictor of insomnia trajectory classes. CONCLUSIONS Insomnia was more likely to persist than remit over the first year of the COVID-19 pandemic. Addressing sleep reactivity and sleep effort appears critical for reducing insomnia persistence rates after times of stress and uncertainty.
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Affiliation(s)
- Hailey Meaklim
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Flora Le
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Sukhjit K Bains
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Prerna Varma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Moira F Junge
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Sleep Health Foundation, East Melbourne, VIC, Australia
| | - Melinda L Jackson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
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Chacón V, Chung M, Folta SC, Hennessy E, Macfarlane H, Roberto CA, Tovar A, Wilson NLW, Economos CD. The longitudinal association between caregivers' perceived competence and autonomy and children's dietary consumption before and 10 months into the COVID-19 pandemic. Appetite 2024; 195:107205. [PMID: 38242361 DOI: 10.1016/j.appet.2024.107205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 01/05/2024] [Accepted: 01/08/2024] [Indexed: 01/21/2024]
Abstract
The COVID-19 pandemic has been stressful, potentially affecting caregivers' feeding choices. Caregivers play a role in shaping children's diets, yet few studies have explored how their competence and autonomy, defined by the Self-Determination Theory, impact children's diets. We examined the relationship between caregivers' autonomy and competence and their feeding practices before and during the first year of the pandemic. A national convenience sample of caregivers with 3-12-year-old children completed an online survey during two time-periods. Questions adapted from the Intrinsic Motivation Inventory measured perceived competence and autonomy for feeding fruits and vegetables (F/V) and limiting sugar-sweetened beverages (SSBs) and desserts. National Health and Nutrition Examination Survey Dietary Screener questions measured children's consumption of F/V, SSBs, and desserts. Paired t-tests examined how child consumption and caregiver's perceived competence and autonomy changed, and logistic regressions examined whether caregivers' competence and autonomy predicted the change in child consumption and if changes in competence and autonomy were associated with changes in child consumption. Caregivers (n = 597) were mostly Black/African American (33.0%) or Latina/o/x (42.7%) and older than 30 years (84.1%). Children's consumption did not change overall, but caregivers' competence for feeding F/V increased, and their competence for limiting SSBs and desserts decreased. Caregiver competence and autonomy before COVID-19 did not predict child dietary consumption during the pandemic. However, change in competence was a significant predictor of the change in child consumption of F/V [OR (95%CI): 0.70 (0.57, 0.86)]. The association between caregiver's perceived competence for feeding F/V and child consumption remained positive and significant in both periods [OR (95%CI) pre and during COVID: 2.09 (1.69, 2.57) - 2.40 (1.88, 3.06)]. This study can inform behavioral interventions supporting caregivers' competence and autonomy around feeding choices.
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Affiliation(s)
- Violeta Chacón
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA.
| | - Mei Chung
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Sara C Folta
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Erin Hennessy
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Hannah Macfarlane
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
| | - Christina A Roberto
- Department of Medical Ethics & Health Policy, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Drive Blockley Hall, Philadelphia, PA, 19104-4884, USA
| | - Alison Tovar
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity, Brown School of Public Health, Brown University, Providence, RI 02912 USA
| | - Norbert L W Wilson
- Duke Divinity School, Sanford School of Public Policy, and Director of the World Food Policy Center, Duke University, Durham, NC, 27708, USA
| | - Christina D Economos
- ChildObesity180, Friedman School of Nutrition Science and Policy, Tufts University, 150 Harrison Ave, Boston, MA, 02111, USA
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Krüger-Malpartida H, Arevalo-Flores M, Anculle-Arauco V, Dancuart-Mendoza M, Pedraz-Petrozzi B. Medical conditions, symptoms of anxiety, and depression during the COVID-19 pandemic in a population sample of Lima, Peru. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2024; 53:175-183. [PMID: 39129092 DOI: 10.1016/j.rcpeng.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 02/24/2022] [Accepted: 04/26/2022] [Indexed: 08/13/2024]
Abstract
INTRODUCTION This study aims to determine differences between the number of underlying medical conditions, depression, and anxiety, when controlling for the covariates of age, sex, and completed education. METHODS Participants (n = 484) indicated the number of medical conditions present during the survey, also including the PHQ-9 and GAD-7, to assess depression and anxiety, respectively. RESULTS Differences were found between groups of medical conditions and the combined values of PHQ-9 and GAD-7 after controlling for the covariates mentioned above (F4,954 = 5.78; Wilks' Λ = 0.95; P < 0.0005). The univariate tests showed differences for PHQ-9 (F2,478 = 8.70; P < 0.0005) and GAD-7 (F2,478 = 11.16; P < 0.0005) between the 3 groups. Finally, post-hoc analysis showed differences between participants with one medical condition and with no medical condition (PHQ-9: MD = 1.82; 95%CI, 0.25-3.40; GAD-7: MD = 1.73; 95%CI, 0.55-2.91), and between participants with more than one medical condition and participants with no medical condition (PHQ-9: MD = 3.10; 95%CI, 1.11-5.10; GAD-7: MD = 2.46; 95%CI, 0.97-3.95). CONCLUSIONS Our results suggest that people who had a medical condition during the COVID-19 pandemic were more prone to developing severe symptoms of anxiety and depression.
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Affiliation(s)
| | - Martin Arevalo-Flores
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú; Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
| | - Victor Anculle-Arauco
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú; Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
| | - Mauricio Dancuart-Mendoza
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú; Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
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Selak Š, Šorgo A, Crnkovič N, Gabrovec B, Cesar K, Žmavc M. Three measures of internet use, social media use and video game playing as predictors of insomnia during the pandemic among students. Sci Rep 2024; 14:3290. [PMID: 38332170 PMCID: PMC10853167 DOI: 10.1038/s41598-024-53351-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 01/31/2024] [Indexed: 02/10/2024] Open
Abstract
Existing research indicates that the relationship between digital technology use and insomnia can largely depend on which digital technology measure and which insomnia measure is considered. Data on 4261 Slovenian tertiary students was gathered through an online survey in February 2021, which included measures of depression and insomnia symptoms, as well as measures of internet, social media and video game use divided into three measurement levels (use, duration of use, addictive use). Regression analysis revealed an apparent effect of measurement level, where addictive use measures consistently outperformed other technology use measures in predicting insomnia. Regardless of measurement level, social media use seems to produce more risk for insomnia, compared to playing video games or general internet use for leisure purposes. Importantly, a single measure of depression symptoms explained more variance in insomnia than the nine measures of digital technology use combined, meaning that the effect of digital technology on sleep should not be overstated. Most of the effect of social media use on insomnia may in fact be explained by understanding users' depression symptoms. In case of gaming, a larger part of its effect on insomnia is independent of depression symptoms.
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Affiliation(s)
- Špela Selak
- National Institute of Public Health, Ljubljana, Slovenia.
| | - Andrej Šorgo
- Faculty of Natural Sciences and Mathematics, University of Maribor, Maribor, Slovenia
| | - Nuša Crnkovič
- National Institute of Public Health, Ljubljana, Slovenia
| | | | - Katarina Cesar
- National Institute of Public Health, Ljubljana, Slovenia
| | - Mark Žmavc
- National Institute of Public Health, Ljubljana, Slovenia
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10
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Bolgeo T, Di Matteo R, Gatti D, Cassinari A, Damico V, Ruta F, Gambalunga F, Maconi A. Impact of COVID-19 on Quality of Life After Hospital Discharge in Patients Treated With Noninvasive Ventilation/Continuous Positive Airway Pressure: An Observational, Prospective Multicenter Study. Dimens Crit Care Nurs 2024; 43:3-12. [PMID: 38059706 DOI: 10.1097/dcc.0000000000000614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND COVID-19 has caused a worldwide pandemic that has significantly affected people's health and daily lives. Patients hospitalized with COVID-19 have impaired physical and psychological conditions. Despite this, few studies have examined the physical and psychological health of COVID-19 patients after discharge from the hospital. AIMS To assess the impact of COVID-19 pneumonia on quality of life and residual disability, anxiety, and insomnia at 4 and 8 months after hospital discharge in patients treated with continuous positive airway pressure and noninvasive ventilation. METHODS This is a prospective, multicenter, longitudinal observational study. The STROBE checklist was observed. We administered the Post-COVID-19 Functional Status scale to identify and objectively quantify the degree of residual disability and the impact on the patient's functional status. Simultaneously, we used the EuroQOL-5D scale to measure the quality of life, the 7-item Generalized Anxiety Disorder Scale to monitor anxiety, and the Insomnia Severity Index to monitor insomnia. RESULTS The study enrolled 199 patients 4 months after discharge; 145 completed the 8-month follow-up. The quality of life, insomnia, pain, and movement ability seem to worsen over time in our cohort of patients. The quality of life deteriorated significantly between 4 and 8 months after discharge especially in terms of mobility (27.6% of the patients interviewed) and pain (31% of the patients interviewed). There was a significant correlation between COVID-19 symptoms and comorbidities present at admission and inadequate quality-of-life perception. DISCUSSION The recognition of early signs and symptoms in patients who have already experienced COVID-19 disease is essential for early detection and prevention of chronicity. Health care professionals need to pay more attention to the physical and psychological rehabilitation of COVID-19 patients after hospital discharge. To determine the long-term impacts of COVID-19, a long-term follow-up of COVID-19 patients after discharge is required.
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11
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Zhai XY, Lei DC, Zhao Y, Jing P, Zhang K, Han JT, Ni AH, Wang XY. Surviving the shift: College student satisfaction with emergency online learning during COVID-19 pandemic. World J Psychiatry 2023; 13:1106-1120. [PMID: 38186724 PMCID: PMC10768495 DOI: 10.5498/wjp.v13.i12.1106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 11/02/2023] [Accepted: 12/04/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) epidemic disrupted education systems by forcing systems to shift to emergency online leaning. Online learning satisfaction affects academic achievement. Many factors affect online learning satisfaction. However there is little study focused on personal characteristics, mental status, and coping style when college students participated in emergency online courses. AIM To assess factors related to satisfaction with emergency online learning among college students in Hebei province during the COVID-19 pandemic. METHODS We conducted a cross-sectional survey of 1600 college students. The collected information included demographics, psychological aspects of emergent public health events, and coping style. Single factor, correlation, and multiple linear regression analyses were performed to identify factors that affected online learning satisfaction. RESULTS Descriptive findings indicated that 62.9% (994/1580) of students were satisfied with online learning. Factors that had significant positive effects on online learning satisfaction were online learning at scheduled times, strong exercise intensity, good health, regular schedule, focusing on the epidemic less than one hour a day, and maintaining emotional stability. Positive coping styles were protective factors of online learning satisfaction. Risk factors for poor satisfaction were depression, neurasthenia, and negative coping style. CONCLUSION College students with different personal characteristics, mental status, and coping style exhibited different degrees of online learning satisfaction. Our findings provide reference for educators, psychologists, and school administrators to conduct health education intervention of college students during emergency online learning.
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Affiliation(s)
- Xiao-Yan Zhai
- Institute of Mental Health of Hebei Medical University, Department of Clinical Psychology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Dong-Chuan Lei
- Sculpture Institute, Hebei Academy of Fine Arts, Shijiazhuang 050700, Hebei Province, China
| | - Yan Zhao
- Department of Pathogenic Biology, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Peng Jing
- Department of Clinical Psychology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Kun Zhang
- Basic Medical College, Hebei Medical University, Shijiazhuang 050017, Hebei Province, China
| | - Ji-Ting Han
- Department of Media Art, Shijiazhuang Information Engineering Vocational College, Shijiazhuang 052160, Hebei Province, China
| | - Ai-Hua Ni
- Department of Clinical Psychology, Hebei General Hospital, Shijiazhuang 050051, Hebei Province, China
| | - Xue-Yi Wang
- Institute of Mental Health of Hebei Medical University, Psychiatric Department of the First Hospital of Hebei Medical University, Shijiazhuang 050031, Hebei Province, China
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12
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Kang KW, Kim J, Kim KT, Kim MK, Cho YW. Association Between Electronic Device Use at Bedtime and COVID-19 Vaccine-Related Adverse Events During the COVID-19 Pandemic in Korean Adults: A Nationwide Cross-Sectional Population-Based Study. J Korean Med Sci 2023; 38:e413. [PMID: 38111283 PMCID: PMC10727916 DOI: 10.3346/jkms.2023.38.e413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 09/14/2023] [Indexed: 12/20/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has led to heightened mood disturbances linked to increased electronic device use at bedtime (EUB). General anxiety may contribute to an increased likelihood of experiencing nocebo responses, which have been reported to be associated with COVID-19 vaccine-related adverse events (CAEs). However, no related studies have been conducted to examine this association to date. METHODS We executed a nationwide cross-sectional study to explore these correlations during the pandemic. Using data from the 2022 National Sleep Survey of South Korea, we analyzed the sleep health of 4,000 adults aged 20-69 years between January and February 2022. Shift workers and those with severe sleep disorders were excluded. Participants with EUB more than four days a week were labeled as high frequency EUB, and those reporting CAEs after both vaccine doses were marked as having a presence of CAEs. The survey also included details about anthropometric data, socioeconomic status, and sleep status. RESULTS Of the 3,702 participants, 92.6% had received two or more vaccine doses, with 41.2% experiencing CAEs. Furthermore, 73.7% had a high EUB frequency. Factors associated with CAE reporting included younger age, female sex, and high EUB frequency, while heavy alcohol use was found to be less likely to be associated with CAE reporting. Notably, a high EUB frequency was significantly associated with reported CAEs (odds ratio, 1.223; 95% confidence interval, 1.028-1.455; P = 0.023). CONCLUSION A nationwide online survey conducted in South Korea during the pandemic found that individuals who engaged in the relatively frequent use of electronic devices during bedtime had worse sleep quality and increased COVID-19-related adverse events compared with those using these devices less frequently. These findings have the potential to enhance our understanding of the impact of the use of electronic devices at bedtime on health.
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Affiliation(s)
- Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea
| | - Jiyoung Kim
- Department of Neurology, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Korea
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea
| | - Myeong-Kyu Kim
- Department of Neurology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, Korea.
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13
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Xie M, Zou X, Xie Y, Hu L, Tang Y, Cai J, Kuang Y, Zhu L, Zou M, Wang Q. Childhood trauma and suicide risk in hospitalized patients with schizophrenia: the sequential mediating roles of pandemic related post-traumatic stress symptoms, sleep quality, and psychological distress. Front Psychiatry 2023; 14:1221529. [PMID: 37810605 PMCID: PMC10551446 DOI: 10.3389/fpsyt.2023.1221529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/01/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Stressful global situation due to the COVID-19 pandemic caused a tremendous impact on mental health in hospitalized patients with schizophrenia. The mediating roles of psychological impact related to COVID-19, sleep quality, and psychological distress were investigated in the association between childhood trauma and suicidal risk in hospitalized patients with schizophrenia. Methods We analyzed cross-sectional data of 147 patients with schizophrenia and 189 healthy controls (HCs). Results Histories of childhood trauma and schizophrenia were good predictors of COVID-19-related psychological impact, global sleep quality, and psychological distress. Moreover, the series mediation model showed that the effect of childhood trauma on suicidal risk in hospitalized patients with schizophrenia was totally sequential mediated by the psychological impact of COVID-19, sleep quality, and psychological distress. Conclusion Clinicians need to recognize the increased suicidal risk associated with COVID-19-related psychological distress in schizophrenia patients with a history of childhood trauma.
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Affiliation(s)
- Min Xie
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Xuemin Zou
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Yingjing Xie
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Li Hu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Yiguo Tang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Jai Cai
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
| | - Yunxue Kuang
- The First People’s Hospital of Longquanyi District Chengdu, West China Longquan Hospital Sichuan University, Chengdu, China
| | - Ling Zhu
- Department of Clinical Psychology, Southwest Hospital, The First Hospital Affiliated to Army Medical University (Third Military Medical University), Chongqing, China
| | - Min Zou
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Sichuan Clinical Medical Research Center for Mental Disorders, Chengdu, China
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14
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Munteanu I, Marc M, Gheorghevici C, Diaconu GA, Feraru N, Sion D, Nemes RM, Mahler B. Sleep Quality Aspects in Post-COVID-19 Patients. J Pers Med 2023; 13:1125. [PMID: 37511738 PMCID: PMC10381792 DOI: 10.3390/jpm13071125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/07/2023] [Accepted: 07/09/2023] [Indexed: 07/30/2023] Open
Abstract
In this observational cohort study, sleep quality in post-COVID-19 patients was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. This study aimed to examine aspects of sleep quality in patients who have undergone SARS-CoV-2 infection and if there is a pattern of progression or regression over time (6 months). We also observed and analyzed the results in order to identify any possible links between the severity of COVID-19 and sleep quality as measured by the PSQI questionnaire. The study group consisted of 65 adult patients with confirmed SARS-CoV-2 infection who were referred to a pulmonologist for evaluation. Sleep quality was impacted at a high rate in post-COVID-19 patients, quantified by a PSQI score ≥5. Out of 65 patients, 51% of them had scores greater than or equal to 5. Sleep was subjectively reported as unsatisfactory predominantly in mild and moderate COVID-19 patients. According to the PSQI score and a 6-month follow-up, many patients presented persistency in poor sleep quality. Investigation and individualized treatment of sleep disorders in post-COVID-19 patients should be part of the routine pneumological control, as improvement in sleep quality has an impact not only on the health but also on the psychological state of patients. Educating patients about the importance of sleep and sleep quality impairment should be a primary concern.
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Affiliation(s)
- Ioana Munteanu
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Monica Marc
- Department of Pneumology, "Victor Babes" University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | | | | | - Nicolae Feraru
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Dragos Sion
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Roxana Maria Nemes
- Faculty of Medicine, Titu Maiorescu University, 040441 Bucharest, Romania
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
| | - Beatrice Mahler
- "Marius Nasta" Institute of Pneumophtisyiology, 050159 Bucharest, Romania
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15
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Mash HBH, Morganstein JC, Fullerton CS, Ursano RJ. COVID-19 Pandemic Responses among National Guard Service Members: Stressors, Coping Strategies, Sleep Difficultiesand Substance Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20095731. [PMID: 37174249 PMCID: PMC10178564 DOI: 10.3390/ijerph20095731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 04/26/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023]
Abstract
The National Guard (NG) served as a critical component of the US COVID-19 response while concurrently managing personal COVID-19 responses. Understanding pandemic-related concerns, sleep difficulties, increased substance use, and stress management strategies can promote readiness for subsequent disasters. We surveyed 3221 NG service members (75% Army; 79% enlisted; 52% 30-49 years; 81% male) during COVID-19 (August-November 2020). Almost half were activated in response to COVID-19 (mean = 18.6 weeks) and completed the survey 2-3 months post-activation. Service members indicated great concern about family health (39%), the indefinite nature of the pandemic (35%), and their financial situation (23%). Over one-third reported changes in usual sleep amount, 33% described poor sleep quality, and 21% had trouble falling/staying asleep. Increased substance use was reported by 30%, including increased alcohol (13.5%), tobacco (9%), and caffeine/energy drinks (20.1%) consumption. Chi-square analyses and analyses of variance found those who activated reported more increased tobacco and caffeine/energy drink use versus non-activated, with no sleep difficulties nor alcohol use differences. Helpful stress management strategies included spending time outdoors (53%), exercising (48%), talking to family/friends (38%), and having a daily routine (38%). Specific health-, financial-, and job-related stressors were associated with COVID-19. Incorporating stress management in planning/preventive efforts promotes resilience during disasters.
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Affiliation(s)
- Holly B Herberman Mash
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Joshua C Morganstein
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Carol S Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
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16
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Diotaiuti P, Valente G, Mancone S, Corrado S, Bellizzi F, Falese L, Langiano E, Vilarino GT, Andrade A. Effects of Cognitive Appraisals on Perceived Self-Efficacy and Distress during the COVID-19 Lockdown: An Empirical Analysis Based on Structural Equation Modeling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5294. [PMID: 37047910 PMCID: PMC10094671 DOI: 10.3390/ijerph20075294] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 03/13/2023] [Accepted: 03/15/2023] [Indexed: 06/19/2023]
Abstract
During the COVID-19 lockdown, individuals and households had to responsibly manage the difficulties and problems caused by the restrictions on their mobility, such as the interruptions to work schedules, insecure food supplies, and the procurement of services and health care. The perceptions of risk as well as the fear of disease were strongly linked to worry, defined as a sequence of thoughts that evoke negative emotions and elevated levels of anxiety and distress. This study evaluated how different cognitive appraisals of an individual's sources of worry could influence their perceived self-efficacy and directly or indirectly moderate their perceived general distress. A sample of 544 participants completed a survey that included questions based on the generalized self-efficacy scale, the sources of concern during the epidemic, the cognitive appraisal scale in emergency, and perceived discomfort. Subsequently, a structural-equation-modeling (SEM) analysis was performed to test the moderating role of cognitive appraisals and perceived self-efficacy on participants' overall distress during a lockdown. Overall, the model reported acceptable fit values and confirmed the hypotheses of the study. An individual's worries activated either a dysfunctional threat appraisal, which prompted a fear-and-closure response that then increased their overall state of distress; or two other functional appraisals (i.e., adaptive or supportive) that contributed to significantly improving the individual's self-efficacy. Higher self-efficacy was shown to be associated with lower levels of perceived distress. For the purposes of prevention and distress containment, it would be appropriate to promote psycho-educational interventions that promote the adoption of appraisal strategies that are functional and beneficial for perceived self-efficacy.
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Affiliation(s)
- Pierluigi Diotaiuti
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Giuseppe Valente
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Stefania Mancone
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Stefano Corrado
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Fernando Bellizzi
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Lavinia Falese
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Elisa Langiano
- Department of Human Sciences, Society and Health, University of Cassino and Southern Lazio, 03043 Cassino, Italy
| | - Guilherme Torres Vilarino
- Department of Human Movement Science, Santa Catarina State University, Florianòpolis 88035-901, Brazil
| | - Alexandro Andrade
- Department of Human Movement Science, Santa Catarina State University, Florianòpolis 88035-901, Brazil
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17
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Meaklim H, Junge MF, Varma P, Finck WA, Jackson ML. Beyond Stress: Altered Sleep-Wake Patterns are a Key Behavioral Risk Factor for Acute Insomnia During Times of Crisis. Behav Sleep Med 2023; 21:208-225. [PMID: 35604338 DOI: 10.1080/15402002.2022.2074996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Stress is a common precipitant of acute insomnia; however, reducing stress during times of crisis is challenging. This study aimed to determine which modifiable factors, beyond stress, were associated with acute insomnia during a major crisis, the COVID-19 pandemic. PARTICIPANTS/METHODS A global online survey assessed sleep/circadian, stress, mental health, and lifestyle factors between April-May 2020. Logistic regression models analyzed data from 1319 participants (578 acute insomnia, 731 good sleepers), adjusted for demographic differences. RESULTS Perceived stress was a significant predictor of acute insomnia during the pandemic (OR 1.23, 95% CI1.19-1.27). After adjusting for stress, individuals who altered their sleep-wake patterns (OR 3.36, CI 2.00-5.67) or increased technology use before bed (OR 3.13, CI 1.13-8.65) were at increased risk of acute insomnia. Other sleep factors associated with acute insomnia included changes in dreams/nightmares (OR 2.08, CI 1.32-3.27), increased sleep effort (OR 1.99, CI1.71-2.31) and cognitive pre-sleep arousal (OR 1.18, CI 1.11-1.24). For pandemic factors, worry about contracting COVID-19 (OR 3.08, CI 1.18-8.07) and stringent government COVID-19 restrictions (OR 1.12, CI =1.07-1.18) were associated with acute insomnia. Anxiety (OR 1.02, CI 1.01-1.05) and depressive (OR 1.29, CI 1.22-1.37) symptoms were also risk factors. A final hierarchical regression model revealed that after accounting for stress, altered sleep-wake patterns were a key behavioral predictor of acute insomnia (OR 2.60, CI 1.68-5.81). CONCLUSION Beyond stress, altered sleep-wake patterns are a key risk factor for acute insomnia. Modifiable behaviors such as maintaining regular sleep-wake patterns appear vital for sleeping well in times of crisis.
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Affiliation(s)
- Hailey Meaklim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Moira F Junge
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,The Sleep Health Foundation, Blacktown, New South Wales, Australia
| | - Prerna Varma
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Wendy A Finck
- Faculty of Education, Monash University, Clayton, Victoria, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
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18
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Meaklim H, Saunders WJ, Byrne ML, Junge MF, Varma P, Finck WA, Jackson ML. Insomnia is a key risk factor for persistent anxiety and depressive symptoms: A 12-month longitudinal cohort study during the COVID-19 pandemic. J Affect Disord 2023; 322:52-62. [PMID: 36372131 DOI: 10.1016/j.jad.2022.11.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/26/2022] [Accepted: 11/07/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Insomnia is a risk factor for affective disorders. This study examined whether individuals with insomnia symptoms early in the pandemic, either pre-existing or new-onset, were more vulnerable to anxiety and depressive symptoms over time than those who maintained normal sleep. Additionally, sleep-related factors such as pre-sleep arousal were assessed for their influence on clinically significant anxiety and depression risk. METHODS Using a global online survey with 3-, 6-, and 12-month follow-ups between April 2020 and May 2021, data from 2069 participants (M = 46.16 ± 13.42 years; 75.3 % female) with pre-existing, new-onset, or no insomnia symptoms was examined using mixed-effects and logistic regression models. RESULTS New-onset and pre-existing insomnia predicted persistent anxiety and depressive symptoms longitudinally (p's < 0.001), over other known risk factors, including age, sex, and previous psychiatric diagnoses. Anxiety and depressive symptoms in both insomnia groups remained above clinically significant thresholds at most time points, whereas normal sleepers remained subclinical. Pre-sleep arousal was found to increase the risk of clinically significant anxiety (OR = 1.05) and depressive symptoms (OR = 1.09) at 12-months. Sleep effort contributed to anxiety (OR = 1.06), whereas dysfunctional sleep-related beliefs and attitudes predicted clinically significant depression (OR = 1.22). LIMITATIONS Insomnia group categorization was based on self-report at baseline supported by a validated measure. High participant attrition was observed at 3-months (53 %; n = 971), but retention remained steady till 12-months (63 %, n = 779). CONCLUSIONS Insomnia is a modifiable risk factor for persistent anxiety and depressive symptoms that needs to be addressed in mental healthcare. Additionally, pre-sleep arousal may be an important transdiagnostic process linking insomnia with affective disorders.
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Affiliation(s)
- Hailey Meaklim
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| | - William J Saunders
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Michelle L Byrne
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia; Department of Psychology, University of Oregon, Eugene, OR, USA; The Sleep Health Foundation, Blacktown, New South Wales, Australia
| | - Moira F Junge
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia; School of Educational Psychology and Counselling, Faculty of Education, Monash University, Victoria, Australia
| | - Prerna Varma
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Wendy A Finck
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Victoria, Australia
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.
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19
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Kuo W, Ersig AL, Kunkul F, Brown RL, Oakley LD. Linking chronic stress to insomnia symptoms in older adults: The role of stress co-occurrence during the pandemic. Res Nurs Health 2023; 46:68-79. [PMID: 36445114 PMCID: PMC9839487 DOI: 10.1002/nur.22278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/30/2022] [Accepted: 11/06/2022] [Indexed: 12/02/2022]
Abstract
Studies examining the associations of chronic stressors with sleep health in older adults have shown conflicting results. While the COVID-19 pandemic increased perceived stress at the population level, less is known about chronic stressors experienced by older adults in the context of the COVID-19 pandemic and its impact on sleep health in an aging population. This study aims to examine the association of older adults' chronic stress with insomnia symptoms during the first year of the COVID-19 pandemic. A cross-sectional analysis was performed using early-release COVID-19 data from the Health and Retirement Study. Data on chronic stressors and insomnia symptoms in older adults (N = 2021; mean age = 68.8) were examined. Co-occurrence network analysis, latent class analysis, Rao-Scott χ2 tests, and multivariable logistic regression were used to characterize the co-occurrence of chronic stressors and associations with insomnia symptoms. The most common co-occurring chronic stressors during the first year of the COVID-19 pandemic were self-health issues, family-health issues, and financial stress. Older adults experiencing frequent stress co-occurrence had 91% higher odds of difficulty initiating sleep (p < 0.001), 40% higher odds of frequent nocturnal awakening (p = 0.028), and 83% higher odds of nonrestorative sleep (p < 0.001). However, adjustment for health risk factors and COVID-19 concerns attenuated the effects, leaving strongest association for difficulty initiating sleep (odds ratio = 1.51, p = 0.010). Frequent stress co-occurrence plays an important role linking chronic stress to insomnia symptoms in an aging population. Ongoing research is needed to examine the lingering effects of frequent stress co-occurrence on older adults' sleep health in the post COVID-19 era.
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Affiliation(s)
- Wan‐Chin Kuo
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Anne L. Ersig
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Fatih Kunkul
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Roger L. Brown
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
| | - Linda D. Oakley
- School of Nursing University of Wisconsin–Madison Madison Wisconsin USA
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Cybulska AM, Weymann A, Rachubińska K, Grochans S, Wójcik G, Grochans E. Factors Associated with Insomnia and Aggression among Healthcare Workers during COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1433. [PMID: 36674188 PMCID: PMC9859312 DOI: 10.3390/ijerph20021433] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
(1) Healthcare workers are exposed to increased risks of insomnia and aggression during the COVID-19 pandemic. The aim of the study was to assess insomnia, sleep disturbances, and aggression and identify the associated risk factors among healthcare workers during the COVID-19 pandemic. (2) A total of 264 healthcare workers participated in the study. The study was conducted with the diagnostic survey method, using the Buss−Perry Aggression Questionnaire, the Athens Insomnia Scale, the Pittsburgh Sleep Quality Index, and a self-administered questionnaire. (3) The vast majority of the respondents (81.06%) suffered from insomnia and had poor sleep quality (78.03%). Education (p = 0.038), marital status (p = 0.043), and working with patients suffering from COVID-19 (p = 0.024) were statistically significant contributors to insomnia. Age was found to significantly correlate with total aggression (r = −0.133 p = 0.031), verbal aggression (r = −0.138 p = 0.025), and anger (r = −0.151 p = 0.014). The analysis demonstrated statistically significant relationships between gender and physical aggression (p = 0.017), anger (p = 0.032), and hostility (p = 0.002). A statistically significant positive correlation between the quality of sleep as per the PSQI and all subscales of the BPAQ was found (p < 0.001). (4) A considerable proportion of HCWs experienced sleep disturbances during the outbreak, stressing the need to establish ways to reduce long-term adverse outcomes associated with chronic insomnia and mental health problems and adjust interventions under pandemic conditions.
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Affiliation(s)
- Anna Maria Cybulska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Agnieszka Weymann
- Independent Clinical Public Hospital No. 2 in Szczecin, Pomeranian Medical University in Szczecin, Powstancow Wielkopolskich 72, 72-111 Szczecin, Poland
| | - Kamila Rachubińska
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Szymon Grochans
- Department of Clinical Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Grzegorz Wójcik
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
| | - Elżbieta Grochans
- Department of Nursing, Faculty of Health Sciences, Pomeranian Medical University in Szczecin, 48 Żołnierska St., 71-210 Szczecin, Poland
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21
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Kim J, Kang KW, Kim KT, Cho YW. Prevalence of restless legs syndrome during the 2019 coronavirus disease pandemic in South Korea: A nationwide cross-sectional population-based study. Front Neurol 2022; 13:1101711. [PMID: 36619937 PMCID: PMC9814963 DOI: 10.3389/fneur.2022.1101711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
Background The 2019 coronavirus disease (COVID-19) pandemic has been associated with a significant increase in sleep disorders. This study aimed to determine the prevalence of restless leg syndrome (RLS) and the effect of COVID-19 on RLS during the pandemic in Korea. Methods The National Sleep Survey of South Korea 2022 was employed in this study. This study was a large population-based web survey using a structural questionnaire of a four thousand representative sample of individuals aged 20-69 years in Korea. The survey was conducted between January 2022 and February 2022 during the COVID-19 pandemic. RLS was diagnosed using the Korean version of the paradigm of questions for epidemiological studies of RLS. Chronic persistent RLS was defined for individuals with RLS symptoms at least twice a week. Results Six hundred forty-nine (16.2%) and 172 (4.3%) patients were classified as having RLS and chronic persistent RLS, respectively. Female sex, being employed, the presence of COVID-19 vaccine-related adverse events, decreased sleep duration, the presence of EDS, and current treatment for insomnia were significantly associated with chronic persistent RLS. Conclusion During the COVID-19 pandemic, the prevalence of RLS and chronic persistent RLS in the adult Korean population was higher than that reported in previous studies.
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Affiliation(s)
- Jiyoung Kim
- Department of Neurology and Sleep Disorder Center, Bio Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea
| | - Kyung Wook Kang
- Department of Neurology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, South Korea
| | - Keun Tae Kim
- Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea
| | - Yong Won Cho
- Department of Neurology, Keimyung University School of Medicine, Daegu, South Korea,*Correspondence: Yong Won Cho ✉
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22
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Crisan RM, Băcilă CI, Toboltoc PC, Morar S. Completed Suicide Linked to the COVID-19 Pandemic by Using the Psychological Autopsy Method in Sibiu County, Romania: Case Series and Literature Review. Healthcare (Basel) 2022; 10:healthcare10122377. [PMID: 36553902 PMCID: PMC9777587 DOI: 10.3390/healthcare10122377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 11/29/2022] Open
Abstract
The COVID-19 pandemic is associated with suicide, as some data suggests. Our study aims to investigate the emergence of eleven completed suicide cases suspected to be linked to the COVID-19 pandemic during the restrictive measures imposed by the Romanian government, and to identify the consequences of mental health, suicidal motivation, and behavioral changes. To this end, we analyzed the deceased's medical records and applied the psychological autopsy method to the relatives/caregivers of the deceased for a suicidal investigation history, within conducted free-flow discussions. To highlight behavioral changes that occurred in the distant antecedents as well as immediately before the suicidal act, we used two sets of closed questions comprised of fifteen alarm signs, including depressive and/or anxiety symptoms. Our results showed that a deterioration of the mental status, especially concerning depressive and anxiety symptoms, was evident in people without or with pre-existing psychiatric pathology. The suicidal motivation proved to be complex including, in addition to the SARS-CoV-2 infection, social and economic consequences of the COVID-19 pandemic. We noted an intensification of the investigated alarm signs and even the emergence of new warning signs in the recent antecedents. Based on our findings, we reaffirmed the important role of the psychological autopsy method in suicide investigation, proving that it can detect the specific impact of the COVID-19 pandemic on people prone to suicide. This impact can be psycho-emotional, social, and/or economical, and thus we can state that the COVID-19 pandemic and its consequences can be, at least, a triggering factor that enhances completed suicide risk. Further studies are needed in this particular area because correlations between the COVID-19 pandemic and completed suicide do not appear to be accidental.
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Affiliation(s)
- Roxana-Mihaela Crisan
- Doctoral Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
- Forensic Department, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
| | - Ciprian Ionuț Băcilă
- 'Dr. Gheorghe Preda' Clinical Psychiatry Hospital, 550082 Sibiu, Romania
- Dental Medicine and Nursing Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
| | - Paul-Cătălin Toboltoc
- Doctoral Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
- Department of Anatomical Pathology, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
| | - Silviu Morar
- Forensic Department, County Clinical Emergency Hospital of Sibiu, Corneliu Coposu Boulevard 2-4, 550245 Sibiu, Romania
- Preclinical Department, Faculty of Medicine, Lucian Blaga University of Sibiu, 550024 Sibiu, Romania
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Zhang R, Song W, Zhu L. Effects of traditional Chinese exercises on insomnia after coronavirus disease 2019: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31709. [PMID: 36451411 PMCID: PMC9704889 DOI: 10.1097/md.0000000000031709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND There is growing evidence that coronavirus disease 2019 (COVID-19) can trigger acute episodes of insomnia. Reports on the treatment of COVID-19-related insomnia are limited. Therefore, our study aims to perform a systematic evaluation and meta-analysis of the effects of traditional Chinese exercises (TCEs) in patients with insomnia due to COVID-19. METHODS We will search the Embase, PubMed, Cochrane Library, Web of Science, MEDLINE, Scopus, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure Database, and Wan Fang Database from December 1, 2019 to October 2, 2022 to identify all articles on treatment of COVID-19-related insomnia using TCEs. Two researchers will screen the articles and extract the relevant information. RESULTS The results will provide a systematic overview of the current evidence on the use of TCE to treat patients with insomnia after COVID-19. CONCLUSIONS The conclusions of this study will help clarify the effects of TCEs on patients with insomnia after COVID-19.
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Affiliation(s)
- Runtong Zhang
- Genertec Medical Corporation Limited, Beijing, China
| | - Wenjing Song
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
- * Correspondence: Luwen Zhu, The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150000, China (e-mail: )
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24
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Fernández-Agüera J, Domínguez-Amarillo S, Campano MÁ, Al-Khatri H. Effects of covid-induced lockdown on inhabitants' perception of indoor air quality in naturally ventilated homes. AIR QUALITY, ATMOSPHERE, & HEALTH 2022; 16:193-212. [PMID: 36212165 PMCID: PMC9527135 DOI: 10.1007/s11869-022-01239-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 08/19/2022] [Indexed: 05/05/2023]
Abstract
The intensified indoor living during the spring 2020 lockdown, with enhanced user awareness of the prevailing conditions in their homes, constituted a natural stress test for the housing design in place today. Surveys conducted during this period have yielded lessons for designing better intervention strategies for the residential sector, taking into account the systematic morphological and economic limitations of the buildings concerned. These considerations should inform the development of policies and strategies for improving environmental quality compatible with lower residential energy consumption and higher quality of life. This study explores the effect of occupant behaviour on home ventilation and the perception of the impact of indoor air quality on user health before and during lockdown. The method deployed consisted in monitoring environmental variables and conducting user surveys before and after restrictions came into force. The findings showed that prior to lockdown, occupants were unaware of or paid little heed to changes in indoor air quality, failed to perceive stuffiness, and, as a rule, reported symptoms or discomfort only at night during the summer months. During lockdown, however, users came to attach greater importance to air quality, and a greater sensitivity to odours and a heightened awareness of CO2 concentration prompted them to ventilate their homes more frequently. In the spring of 2020, occupants also indicated a wider spectrum of indisposition, in particular in connection with sleep patterns.
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Affiliation(s)
- Jesica Fernández-Agüera
- Escuela Técnica Superior de Arquitectura, Instituto Universitario de Arquitectura y Ciencias de La Construcción, Universidad de Sevilla, Avenida de Reina Mercedes, no. 2, 41014 Seville, Spain
| | - Samuel Domínguez-Amarillo
- Escuela Técnica Superior de Arquitectura, Instituto Universitario de Arquitectura y Ciencias de La Construcción, Universidad de Sevilla, Avenida de Reina Mercedes, no. 2, 41014 Seville, Spain
| | - Miguel Ángel Campano
- Escuela Técnica Superior de Arquitectura, Instituto Universitario de Arquitectura y Ciencias de La Construcción, Universidad de Sevilla, Avenida de Reina Mercedes, no. 2, 41014 Seville, Spain
| | - Hanan Al-Khatri
- Department of Civil & Architectural Engineering, College of Engineering, Sultan Qaboos University, Seeb, Oman
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25
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Cho E, Lee D, Cho IK, Lee J, Ahn J, Bang YR. Insomnia Mediate the Influence of Reassurance-Seeking Behavior and Viral Anxiety on Preoccupation With COVID-19 Among the General Population. SLEEP MEDICINE RESEARCH 2022. [DOI: 10.17241/smr.2022.01291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background and Objective We explored in this study whether insomnia, viral anxiety, reassurance- seeking behavior, and preoccupation with coronavirus disease (COVID-19) are related among the general population. As well, we explored the possibility that insomnia may mediate the association between COVID-19 viral anxiety and preoccupation.Methods During November 9–15, 2021, 400 participants voluntarily completed this survey, and participants’ age, sex, living location, and marital status were collected. Responses to questions about COVID-19 were also gathered, and their symptoms were rated using the Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Fear of COVID-19 scale (FCV-19S), and Insomnia Severity Index (ISI).Results Preoccupation with COVID-19 was predicted by young age (β = -0.08, p = 0.012), CRBS (β = 0.52, p < 0.001), FCV-19S (β = 0.30, p < 0.001), and ISI (β = 0.07, p = 0.029) (adjusted R2 = 0.62, F = 163.6, p < 0.001). Mediation analysis showed that insomnia partially mediates the influence of reassurance seeking behavior and viral anxiety on preoccupation with COVID-19.Conclusions Sleep disturbances can contribute to a vicious cycle of hypochondriacal preoccupation with COVID-19. In order to reduce an individual’s viral anxiety, insomnia symptoms must be addressed.
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26
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Meaklim H, Burge M, Le F, Bains SK, Saunders W, Ghosh S, Junge MF, Varma P, Rehm IC, Jackson ML. Strange themes in pandemic dreams: Insomnia was associated with more negative, anxious and death-related dreams during the COVID-19 pandemic. J Sleep Res 2022; 32:e13655. [PMID: 35699296 PMCID: PMC9350044 DOI: 10.1111/jsr.13655] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 05/03/2022] [Accepted: 05/08/2022] [Indexed: 02/03/2023]
Abstract
Dreaming and insomnia are important markers of distress in times of crisis. Here, we present a longitudinal, mixed-methods study examining changes in dreaming between individuals with and without insomnia symptoms and their relationship to mental health during the COVID-19 pandemic. A global survey examining insomnia symptoms, dreams and mental health was launched in April 2020 and followed participants over 12 months. Of 2240 participants, 1009 (45%) reported dream changes at baseline. A higher proportion of participants with new-onset insomnia reported dream changes (55%) than those with pre-existing insomnia (45%) or good sleepers (36%). Overall, thematic analysis identified key dream change themes of increased dream activity, with participants dreaming vividly, in high-definition, and with a strong negative charge. Themes around survival, adjusting to pandemic life, meaning-making and poor sleep quality were also noted. Linguistic Inquiry Word Count showed that individuals with insomnia used more negative words to describe their dream changes than good sleepers. Specifically, the new-onset insomnia group used more anxious and death-related words than those who slept well. Notably, all groups experienced a significant reduction in dream activity by 3-month follow-up. Lastly, dream changes were associated with worse mental health symptoms over time, and this effect was more pronounced in individuals with insomnia. Our results highlight that insomnia symptoms, especially new-onset insomnia, are associated with more negative dream changes during collective stressful events, potentially compounding daytime distress and mental health symptoms over time. During times of crisis, dreaming and insomnia may reveal an important target for mental health interventions.
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Affiliation(s)
- Hailey Meaklim
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Malisa Burge
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Flora Le
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Sukjhit K. Bains
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - William Saunders
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Stephen Ghosh
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Moira F. Junge
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia,The Sleep Health FoundationBlacktownNew South WalesAustralia
| | - Prerna Varma
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
| | - Imogen C. Rehm
- College of Health and BiomedicineVictoria UniversityMelbourneVictoriaAustralia
| | - Melinda L. Jackson
- Turner Institute for Brain and Mental Health, School of Psychological SciencesMonash UniversityMonashVictoriaAustralia
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27
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Raman S, Hyland P, Coogan AN. Temporal associations between insomnia and depression symptoms in adults during the COVID-19 pandemic: A cross-lagged path modelling analysis. Psychiatry Res 2022; 312:114533. [PMID: 35381505 PMCID: PMC8964445 DOI: 10.1016/j.psychres.2022.114533] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/07/2022] [Accepted: 03/26/2022] [Indexed: 11/24/2022]
Abstract
It is well recognised that there is an intimate relationship between sleep and depression, with poor quality or short duration sleep associated with greater symptoms of depression. However, it is not clear from the current evidence base what the temporal relationship is between symptoms of insomnia and depression. Further, it is also unclear how the COVID-19 pandemic may impact on such relationships. In this study we have examined the longitudinal relationships between symptoms of depression and insomnia during the COVID-19 pandemic at two points separated by one year (April/May 2020 and March/April 2021) in a sample of 1032 Irish adults using a cross-lagged paths model. We report that there is a bidirectional relationship across time between depression and insomnia symptoms (β = -0.115 between Insomnia symptoms and subsequent depression symptoms and β = -0.163 between depression symptoms and subsequent insomnia symptoms; scales scored in opposite directions), and that these relationships persist when COVID-19 anxiety, age and sex are introduced into the model. Our analyses suggest that during the first year of the COVID-19 pandemic that insomnia symptoms predicted depression symptoms one year later, and conversely that depression symptoms predicted subsequent insomnia symptoms.
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Krüger-Malpartida H, Arevalo-Flores M, Anculle-Arauco V, Dancuart-Mendoza M, Pedraz-Petrozzi B. [Medical conditions, symptoms of anxiety, and depression during the COVID-19 pandemic in a population sample of Lima, Peru]. REVISTA COLOMBIANA DE PSIQUIATRIA 2022:S0034-7450(22)00052-X. [PMID: 35663409 PMCID: PMC9135661 DOI: 10.1016/j.rcp.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 04/26/2022] [Indexed: 11/30/2022]
Abstract
Introduction: This study aims to determine differences between the number of underlying medical conditions, depression, and anxiety, when controlling for the covariates of age, sex, and completed education.Methods: Participants (n=484) indicated the number of medical conditions present during the survey, also including the PHQ-9 and GAD-7, to assess depression and anxiety, respectively.Results: Differences were found between groups of medical conditions and the combined values of PHQ-9 and GAD-7 after controlling for the covariates mentioned above (F4,954=5.78; Wilks' Λ=0.95; P<0.0005). The univariate tests showed differences for PHQ-9 (F2,478=8.70; P<0.0005) and GAD-7 (F2,478=11.16; P<0.0005) between the 3 groups. Finally, post-hoc analysis showed differences between participants with one medical condition and with no medical condition (PHQ-9: MD=1.82; 95%CI, 0.25-3.40; GAD-7: MD=1.73; 95%CI, 0.55-2.91), and between participants with more than one medical condition and participants with no medical condition (PHQ-9: MD=3.10; 95%CI, 1.11-5.10; GAD-7: MD=2.46; 95%CI, 0.97-3.95).Conclusions: Our results suggest that people who had a medical condition during the COVID-19 pandemic were more prone to developing severe symptoms of anxiety and depression.
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Affiliation(s)
| | - Martin Arevalo-Flores
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú
- Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
| | - Victor Anculle-Arauco
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú
- Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
| | - Mauricio Dancuart-Mendoza
- Departmento de Psiquiatría, Facultad de Medicina, Universidad Cayetano Heredia, Lima, Perú
- Servicio de Neuropsiquiatría, Hospital Cayetano Heredia, Lima, Perú
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Lee J, Cho IK, Kim K, Kim C, Park CHK, Yi K, Chung S. Discrepancy Between Desired Time in Bed and Desired Total Sleep Time, Insomnia, Depression, and Dysfunctional Beliefs About Sleep Among the General Population. Psychiatry Investig 2022; 19:281-288. [PMID: 35500901 PMCID: PMC9058269 DOI: 10.30773/pi.2021.0373] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/06/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The aim of this study was to explore the factors that can influence the severity of insomnia in the general population. We also aimed to examine whether sleep effort mediates the association between dysfunctional beliefs about sleep or the discrepancy between desired time in bed and desired total sleep time (DBST) and insomnia severity in individuals. METHODS A total of 387 participants enrolled in this e-survey study. The symptoms were rated using the insomnia severity index (ISI), Patients Health Questionnaire-9 items, Dysfunctional Beliefs about Sleep-2 items, Glasgow Sleep Effort Scale, and Stress and Anxiety to Viral Epidemics-6 items. In addition, we defined a new sleep index named the DBST index. A linear regression analysis was performed to explore the factors predicting ISI scores, and mediation analysis was implemented to explore whether persistent preoccupation with sleep mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity. RESULTS A linear regression analysis investigated depression (β=0.17, p<0.001), sleep effort (β=0.50, p<0.001), dysfunctional beliefs about sleep (β=0.13, p=0.001), and DBST (β=0.09, p=0.014) (adjusted R2=0.50, F=65.7, p<0.001). Additionally, we observed that persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and DBST on insomnia severity. CONCLUSION Depression, preoccupation with sleep, dysfunctional beliefs about sleep, and DBST influenced the insomnia severity of the general population. We also observed that a persistent preoccupation with sleep partially mediated the influence of dysfunctional beliefs about sleep and the DBST index on insomnia severity.
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Affiliation(s)
- Joohee Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Inn-Kyu Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kyumin Kim
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Changnam Kim
- Department of Psychiatry, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
| | - C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kikyoung Yi
- Department of Psychiatry, Yongin Mental Hospital, Yongin, Republic of Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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30
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Diaz F, Cornelius T, Bramley S, Venner H, Shaw K, Dong M, Pham P, McMurry CL, Cannone DE, Sullivan AM, Lee SA, Schwartz JE, Shechter A, Abdalla M. The association between sleep and psychological distress among New York City healthcare workers during the COVID-19 pandemic. J Affect Disord 2022; 298:618-624. [PMID: 34695497 PMCID: PMC8532501 DOI: 10.1016/j.jad.2021.10.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Healthcare workers (HCWs) treating patients with COVID-19 report psychological distress. We examined whether disturbed sleep was associated with psychological distress in New York City (NYC) HCWs during the initial peak of the COVID-19 pandemic (April-May 2020). METHODS HCWs completed a survey screening for acute stress (4-item Primary Care PTSD screen), depressive (Patient Health Questionaire-2), and anxiety (2-item Generalized Anxiety Disorder scale) symptoms. Insomnia symptoms (modified item from the Insomnia Severity Index) and short sleep (SS, sleep duration <6 h/day) were assessed. Poisson regression analyses predicting psychological distress from SS and insomnia symptoms, adjusting for demographics, clinical role/setting, redeployment status, shifts worked, and multiple comparisons were performed. RESULTS Among 813 HCWs (80.6% female, 59.0% white) mean sleep duration was 5.8 ± 1.2 h/night. Prevalence of SS, insomnia, acute stress, depressive, and anxiety symptoms were 38.8%, 72.8%, 57.9%, 33.8%, and 48.2%, respectively. Insomnia symptoms was associated with acute stress (adjusted prevalence ratio [PR]: 1.51, 95% CI: 1.35, 1.69), depressive (PR: 2.04, 95% CI: 1.78, 2.33), and anxiety (PR: 1.74, 95% CI: 1.55, 1.94) symptoms. SS was also associated with acute stress (PR: 1.17, 95% CI: 1.07, 1.29), depressive (PR: 1.36, 95% CI: 1.233, 1.51), and anxiety (PR: 1.38, 95% CI: 1.26, 1.50) symptoms. LIMITATIONS Our cross-sectional analysis may preclude the identification of temporal associations and limit causal claims. CONCLUSIONS In our study, SS and insomnia were associated with psychological distress symptoms in NYC HCWs during the COVID-19 pandemic. Sleep may be a target for interventions to decrease psychological distress among HCWs.
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Affiliation(s)
- Franchesca Diaz
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States,Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Talea Cornelius
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Sean Bramley
- Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Hadiah Venner
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Kaitlin Shaw
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Melissa Dong
- Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Patrick Pham
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Cara L. McMurry
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Diane E. Cannone
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Alexandra M. Sullivan
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Sung A.J. Lee
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Joseph E. Schwartz
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States,Department of Psychiatry and Behavioral Sciences, Stony Brook University, Stony Brook, NY, United States
| | - Ari Shechter
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - Marwah Abdalla
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States.
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Nazari N, Sadeghi M, Samusenkov V, Aligholipour A. Factors associated with insomnia among frontline nurses during COVID-19: a cross-sectional survey study. BMC Psychiatry 2022; 22:40. [PMID: 35038999 PMCID: PMC8763304 DOI: 10.1186/s12888-022-03690-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/06/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Research predominantly suggests that nurses are at high risk of developing psychopathology. The empirical data show that the occurrence rate of problem-related sleep quality among clinical nurses is high. Therefore, this study was conducted to address the lack of information on the relationship between the coronavirus disease 2019 (COVID-19) pandemic and insomnia. METHODS A convenience sample of nurses (n = 680) completed an online survey that included the Insomnia severity index, the COVID-19-related psychological distress scale, the general health questionnaire, neuroticism, dysfunctional beliefs, attitudes about sleep scale, and difficulties in emotion regulation scale. RESULTS The results showed that 35.8% (n = 253) of nurses were classified as individuals with moderate to severe clinical insomnia. The results showed that the psychological distress generated by COVID-19 predicted insomnia (β = .47, SE = 0.02, P < .001, t = 13.27, 95% CI 0.31-0.46). Additionally, the association is mediated by psychopathology vulnerabilities, emotion dysregulation, dysfunctional beliefs about sleep, and neuroticism. Moreover, female nurses exhibited higher levels of insomnia (Cohen's d = .37), neuroticism (Cohen's d = 30), psychopathology vulnerability (Cohen's d = .26), and COVID-19-related psychological distress (Cohen's d = .23). CONCLUSION The present study's findings help to explain how pandemic consequences can be associated with insomnia. Additionally, the findings make a significant contribution to better understanding the role of neuroticism, emotion dysregulation, beliefs, and psychopathology vulnerability in the development of insomnia among nurses. The findings suggest the potential influence of cognitive behavioral therapy for insomnia (CBT-I) and transdiagnostic integrated therapies that could be incorporated into therapeutic programs designed to develop as a way of inhibiting or preventing insomnia among clinical nurses.
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Affiliation(s)
- Nabi Nazari
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran.
| | - Masoud Sadeghi
- Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
| | - Vadim Samusenkov
- Department of Prosthetic Dentistry, Sechenov First Moscow State Medical University, Moscow, Russia
| | - Akram Aligholipour
- Departments of Psychology, Faculty of Human Sciences, Allameh Tabatabai University, Tehran, Iran
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Habbash F, Ben Salah A, Almarabheh A, Jahrami H. Insomnia and Related Factors During the Delta Wave of the COVID-19 Pandemic in the Kingdom of Bahrain: A Cross-Sectional Study. Nat Sci Sleep 2022; 14:1963-1975. [PMID: 36340636 PMCID: PMC9635386 DOI: 10.2147/nss.s380141] [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: 06/26/2022] [Accepted: 10/23/2022] [Indexed: 11/06/2022] Open
Abstract
PURPOSE This study aims to estimate the prevalence of insomnia and related risk factors during the Delta wave of the COVID-19 pandemic in the Kingdom of Bahrain. METHODS An analytical cross-sectional study included 646 individuals from the general population aged 18 years and over, living in the Kingdom of Bahrain during the Delta wave of the pandemic. Data were collected by an anonymous online questionnaire using the snowball-sampling technique between June and August 2021. We used the Insomnia Severity Index (ISI) and the generalized anxiety disorder scale (GAD-7) to measure the level of insomnia and anxiety, respectively. RESULTS A total of 646 individuals participated in the study. Most of the participants were females (86%). The mean age was 38.7 ± 12.7 years (age range 18-89) and around half of the participants were 35 years or older. Clinical insomnia was reported by 20% [95% CI, 16.9-20.0] of the participants, and 50.1% [95% CI, 46.2-50.1] had subclinical insomnia according to ISI. The proportion of insomnia was significantly higher among females, healthcare workers, participants with lower educational levels, a lower or decreased monthly income during the pandemic, or participants who reported anxiety symptoms (all P < 0.01). Scales of anxiety and insomnia revealed a high correlation (r2 = 0.347, P< 0.01). The logistic regression model confirmed that factors independently associated with insomnia are female gender (OR=1.94, 95% CI, 1.00-3.76, P < 0.050) as well as presence of anxiety (GAD-7 score ≥ 5) [OR=12.98, 95% CI, 5.61-30.00, P < 0.001]. CONCLUSION The burden of insomnia was significant among the general population in the Kingdom of Bahrain during the Delta wave of the COVID-19 pandemic despite the low severity of this variant. Mental health programs are a high priority during the pandemic and afterward. Detection of insomnia could be used to treat some mental health problems at an early stage.
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Affiliation(s)
- Fatema Habbash
- Family and Community Medicine Department, Arabian Gulf University, Manama, Kingdom of Bahrain.,Family Medicine Department, King Abdullah University Medical Center, Manama, Kingdom of Bahrain
| | - Afif Ben Salah
- Family and Community Medicine Department, Arabian Gulf University, Manama, Kingdom of Bahrain.,Institute Pasteur de Tunis, Department of Medical Epidemiology, 13 Place Pasteur, Belvedere, Tunis, Tunisia
| | - Amer Almarabheh
- Family and Community Medicine Department, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Haitham Jahrami
- Department of Psychiatry, Ministry of Health, Manama, Kingdom of Bahrain.,Department of Psychiatry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
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Medium-term and peri-lockdown course of psychosocial burden during the ongoing COVID-19 pandemic: a longitudinal study on patients with pre-existing mental disorders. Eur Arch Psychiatry Clin Neurosci 2022; 272:757-771. [PMID: 34825249 PMCID: PMC8614217 DOI: 10.1007/s00406-021-01351-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022]
Abstract
While the COVID-19 pandemic continues, patients with pre-existing mental disorders are increasingly recognized as a risk group for adverse outcomes. However, data are conflicting and cover only short time spans so far. Here, we investigate the medium-term and peri-lockdown-related changes of mental health outcomes in such patients in a longitudinal study. A cohort of 159 patients comprising all major mental disorders (ICD-10 F0-F9) were interviewed twice with the Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) to evaluate psychosocial burden, psychiatric symptoms and resilience at the end of the first (April/May 2020) and the second lockdown in Germany (November/December 2020). For the primary outcome "psychosocial burden" ratings also comprised retrospective pre-pandemic (early 2020) and very early states during the pandemic (March 2020). For all diagnostic groups, psychosocial burden varied significantly over time (p < 0.001) with an increase from the pre-pandemic to the initial phase (p < 0.001), followed by a steady decrease across both lockdowns, normalizing in November/December 2020. Female gender, high adjustment disorder symptom load at baseline and psychiatric comorbidities were risk factors for higher levels and an unfavorable course of psychosocial burden. Most psychiatric symptoms changed minimally, while resilience decreased over time (p = 0.044 and p = 0.037). The longitudinal course of psychosocial burden indicates an initial stress response, followed by a return to pre-pandemic levels even under recurrent lockdown conditions, mimicking symptoms of an adjustment disorder. Strategies for proactive, specific and continuous treatment have to address resilience capacities before their depletion in the pandemic aftermath, especially for patients with additional risk factors.
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34
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O’Regan D, Jackson ML, Young AH, Rosenzweig I. Understanding the Impact of the COVID-19 Pandemic, Lockdowns and Social Isolation on Sleep Quality. Nat Sci Sleep 2021; 13:2053-2064. [PMID: 34795545 PMCID: PMC8593898 DOI: 10.2147/nss.s266240] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 10/17/2021] [Indexed: 12/15/2022] Open
Abstract
The uncertain, ever-changing and an ongoing nature of the COVID-19 pandemic means that it may take some time before we can fully appreciate the negative effect of the pandemic and lockdown on our sleep and mental health. It is increasingly recognised that in the aftermath of pandemic, several persistent sleep, neuropsychiatric and physical sequelae may continue long after the pandemic is over. A body of evidence to date also highlights a significant disparity in sleep and mental health difficulties in specific vulnerable groups in the community, with different temporal profiles and sleep issues that are reported. In this perspective, we argue for a possible mechanistic impact of the COVID-19 pandemic, with its imposed restrictions and social isolation on sleep quality. We similarly discuss some of the potential international differences, as well as similarities, behind reported idiosyncratic biological vulnerabilities that may have contributed to the genesis of sleep issues. Lastly, we propose some possible implementations and innovations that may be needed in restructuring of sleep disorders services in order to benefit recovering COVID-19 patients.
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Affiliation(s)
- David O’Regan
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Faculty of Life and Sciences Medicine, King’s College London, London, UK
| | - Melinda L Jackson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Allan H Young
- School of Academic Psychiatry, IoPPN, King’s College London, London, UK
| | - Ivana Rosenzweig
- Sleep Disorders Centre, Guy’s and St Thomas’ Hospital, GSTT NHS, London, UK
- Sleep and Brain Plasticity Centre, CNS, IoPPN, King’s College London, London, UK
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35
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Insomnia, anxiety, and depression during the COVID-19 pandemic: an international collaborative study. Sleep Med 2021; 87:38-45. [PMID: 34508986 PMCID: PMC8425785 DOI: 10.1016/j.sleep.2021.07.035] [Citation(s) in RCA: 160] [Impact Index Per Article: 53.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/19/2021] [Accepted: 07/22/2021] [Indexed: 02/05/2023]
Abstract
Importance and study objective The COVID-19 pandemic has produced unprecedented changes in social, work, and leisure activities, which all have had major impact on sleep and psychological well-being. This study documented the prevalence of clinical cases of insomnia, anxiety, and depression and selected risk factors (COVID-19, confinement, financial burden, social isolation) during the first wave of the pandemic in 13 countries throughout the world. Design and participants International, multi-center, harmonized survey of 22 330 adults (mean age = 41.9 years old, range 18–95; 65.6% women) from the general population in 13 countries and four continents. Participants were invited to complete a standardized web-based survey about sleep and psychological symptoms during the first wave of the COVID-19 pandemic from May to August 2020. Results Clinical insomnia symptoms were reported by 36.7% (95% CI, 36.0–37.4) of respondents and 17.4% (95% CI, 16.9–17.9) met criteria for a probable insomnia disorder. There were 25.6% (95% CI, 25.0–26.2) with probable anxiety and 23.1% (95% CI, 22.5–23.6) with probable depression. Rates of insomnia symptoms (>40%) and insomnia disorder (>25%) were significantly higher in women, younger age groups, and in residents of Brazil, Canada, Norway, Poland, USA, and United Kingdom compared to residents from Asian countries (China and Japan, 8% for disorder and 22%–25% for symptoms) (all Ps < 0.01). Proportions of insomnia cases were significantly higher among participants who completed the survey earlier in the first wave of the pandemic relative to those who completed it later. Risks of insomnia were higher among participants who reported having had COVID-19, who reported greater financial burden, were in confinement for a period of four to five weeks, and living alone or with more than five people in same household. These associations remained significant after controlling for age, sex, and psychological symptoms. Conclusion and relevance Insomnia, anxiety, and depression were very prevalent during the first wave of the COVID-19 pandemic. Public health prevention programs are needed to prevent chronicity and reduce long-term adverse outcomes associated with chronic insomnia and mental health problems.
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36
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Czeisler MÉ, Wiley JF, Facer-Childs ER, Robbins R, Weaver MD, Barger LK, Czeisler CA, Howard ME, Rajaratnam SMW. Mental health, substance use, and suicidal ideation during a prolonged COVID-19-related lockdown in a region with low SARS-CoV-2 prevalence. J Psychiatr Res 2021; 140:533-544. [PMID: 34174556 PMCID: PMC8177437 DOI: 10.1016/j.jpsychires.2021.05.080] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 05/11/2021] [Accepted: 05/29/2021] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has been associated with mental health consequences due to direct (i.e., SARS-CoV-2 infection, potentially due to neuronal or astrocytic infection, microvascular, or inflammatory mechanisms) and indirect (i.e., social and economic impacts of COVID-19 prevention measures) effects. Investigation of mental health in a region with one of the longest lockdowns and lowest COVID-19 prevalence globally (Victoria, Australia) allowed for evaluation of mental health in the absence of substantial direct pandemic mental health consequences. Surveys were administered during 15-24 September 2020 to Victorian residents aged ≥18 years for The COVID-19 Outbreak Public Evaluation (COPE) Initiative. Responses were compared cross-sectionally with April-2020 data, and longitudinally among respondents who completed both surveys. Multivariable Poisson regressions were used to estimate prevalence ratios for adverse mental health symptoms, substance use, and suicidal ideation adjusted for demographics, sleep, and behaviours (e.g., screen-time, outdoor-time). In September-2020, among 1157 Victorians, one-third reported anxiety or depressive disorder symptoms, one-fifth reported suicidal ideation, and one-tenth reported having seriously considered suicide in the prior 30 days. Young adults, unpaid caregivers, people with disabilities, and people with diagnosed psychiatric or sleep conditions showed increased prevalence of adverse mental health symptoms. Prevalence estimates of symptoms of burnout, anxiety, and depressive disorder were unchanged between April-2020 and September-2020. Persistently common experiences of adverse mental health symptoms despite low SARS-CoV-2 prevalence during prolonged lockdown highlight the urgent need for mental health support services.
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Affiliation(s)
- Mark É Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia; Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, United States.
| | - Joshua F Wiley
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Elise R Facer-Childs
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Rebecca Robbins
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Matthew D Weaver
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Laura K Barger
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Charles A Czeisler
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
| | - Mark E Howard
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, United States; Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
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37
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Poor Sleep Quality and Its Relationship with Individual Characteristics, Personal Experiences and Mental Health during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18116030. [PMID: 34205195 PMCID: PMC8200012 DOI: 10.3390/ijerph18116030] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 05/24/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023]
Abstract
While the COVID-19 has dramatically altered our lifestyle and sleep practices, the links between sleep, individual characteristics, personal experiences and mental health during the pandemic require further examination. This cross-sectional, multi-methods study examined differences in language used to describe personal experiences, and mental health, based on sleep quality during the early stages of the pandemic. N = 1745 participants (mean age 42.97 ± 14.46 years) from 63 countries responded to the survey. Sleep quality was assessed using the Pittsburgh Sleep Quality Index and mental health was examined using the Patient Health Questionnaire-9, the State Trait Anxiety Inventory, the Perceived Stress Scale and the UCLA-Loneliness Scale. Quantitative analysis of qualitative, language content of personal experiences was conducted using free-text responses and comments to a question on the survey. Almost 50% of the participants reported poor sleep quality, which was linked to a more negative emotional tone and greater mentions of money or finance related words. Good sleepers reported more positive emotional tone in their experiences. Greater reports of clinical state anxiety, moderate depression and moderate stress were observed in poor sleepers, even after accounting for demographics and pandemic-related factors such as loneliness, financial concerns and risk of contracting COVID-19 disease. Results from this study highlight an urgent need for sleep-related public health interventions. Practitioner education, sleep screening for those with mental health conditions, and encouraging people to adopt digital tools may help to reduce the burden of poor sleep on mental health. While the pandemic itself is a stressful and uncertain time, improving sleep can support positive emotion regulation, improving mood and consequential action.
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