Psychological correlates of poor sleep quality among U.S. young adults during the COVID-19 pandemic

ObjectiveUncertainty due to the COVID-19 pandemic may result in problematic sleep that can lead to negative effects on overall health. This unprecedented and stressful time can be even more detrimental for young adults with pre-existing mental health conditions. The purpose of this study is to investigate potential risk factors (i.e., current mental health symptoms, and COVID-19-related grief and worry) on sleep quality of U.S. young adults during the initial months of the global pandemic.MethodThis cross-sectional study examined 908 young adults in the weeks following the declaration of the coronavirus pandemic as a national emergency by the United States. A series of hierarchical multiple regression analyses examined depression, anxiety, and PTSD, as well as COVID-19-related grief and worry as predictors of young adults’ sleep quality.ResultsYoung adults experienced high rates of sleep problems during the first two months (April to May 2020) of the pandemic. Depressive and anxiety symptoms appear to be predictors of sleep quality regardless of any pre-existing diagnosis. Furthermore, high levels of PTSD symptoms and COVID-19-related worry were associated with young adults’ poor sleep.ConclusionsOur findings point to possible psychological factors that uniquely explain young adults’ poor sleep quality during the COVID-19 pandemic in the U.S. This study shed new light on how the COVID-19 pandemic might affect the sleep behaviors of young adults without a pre-existing mental health diagnosis. Implications for supporting young adults sleep and well-being during the pandemic are addressed.     

How does the COVID-19 affect mental health and sleep among Chinese adolescents: a longitudinal follow-up study

ObjectiveThe Corona Virus Disease-19 (COVID-19) pandemic has evolved into the largest public health event in the world. Earlier COVID-19 studies have reported that the pandemic caused widespread impacts on mental health and sleep in the general population. However, it remains largely unknown how the prevalence of mental health problems and sleep disturbance developed and interacted in adolescents at different times in the epidemic.Methods831 teenagers (aged 14–19) underwent a longitudinal follow-up study to evaluate the prevalence of mental health problems and sleep disturbance among adolescents before, during, and after the COVID-19 breakout in China and to explore the interaction between mental health and sleep across the three measurements. The chronotype, anxiety and depression level, sleep quality, and insomnia were investigated during each measurement.ResultsThe adolescents had delayed sleep onset and sleep offset time, longer sleep duration during the quarantine than before and after the epidemic, whereas their chronotype tended to morning type during the epidemic. Yet, the highest prevalence of anxiety, depression, poor sleeper, and insomnia symptoms were observed before but not during the COVID-19 breakout. The females and adolescents who were eveningness type showed significantly higher anxiety and depression levels, poorer sleep quality, and severe insomnia status than the males and the intermediate and morning types. Sleep disturbance was positively associated with mental problems among three measurements. Pre-measured depression level significantly predicted sleep disturbance level at follow-ups.ConclusionThese findings suggested that adolescents' high prevalence of mental health and sleep problems occurred before the COVID breakout and decreased during and after the epidemic. Gender and chronotype were significant risk factors associated with affective and sleep disturbances. Depression positively predicted later sleep problems, but not vice versa.     

Pre-sleep arousal and sleep quality during the COVID-19 lockdown in Italy

ObjectiveThe COVID-19 pandemic has strongly affected daily habits and psychological wellbeing, and many studies point to large modifications in several sleep and sleep-related domains. Nevertheless, pre-sleep arousal during the pandemic has been substantially overlooked. Since hyperarousal represents one of the main factors for the development and the perpetuation of chronic insomnia disorder, the assessment of variables associated with high levels of pre-sleep arousal during the pandemic is clinically relevant. The study aimed to assess the prevalence and predictors of perceived sleep quality and pre-sleep arousal in an Italian sample during the COVID-19 lockdown.MethodsWe used an online survey to collect self-reported sociodemographic, environmental, clinical, sleep, and sleep-related data. Our final sample included 761 participants.ResultsBeyond a high frequency of poor sleep quality, depressive and stress symptoms, our results show that almost half of the sample suffered from clinically relevant levels of at least one component (ie, cognitive, somatic) of pre-sleep arousal. Subjects with greater pre-sleep arousal exhibited poorer sleep quality. Also, sleep quality was strongly associated with somatic and cognitive pre-sleep arousal. Regarding the predictors of sleep and sleep-related measures, depressive and event-related stress symptoms were the main factors associated with both poor sleep quality and pre-sleep arousal components. Moreover, specific sociodemographic and environmental variables were uniquely related to sleep quality, cognitive or somatic pre-sleep arousal.ConclusionsThese findings suggest that the assessment of specific sleep-related factors (ie, pre-sleep arousal), together with more global measures of sleep quality, may be crucial to depict the complex impact of the pandemic on sleep, and to help prevent and counteract the spread of insomnia symptoms.     

Prevalence of sleep disturbances during COVID-19 outbreak in an urban Chinese population: a cross-sectional study

ObjectiveThe COVID-19 pandemic is a large-scale public health emergency that likely precipitated sleep disturbances in the community. This study aimed to investigate the prevalence and correlates of sleep disturbances during the early phase of COVID-19 pandemic.MethodsThis web-based cross-sectional study recruited 1138 Hong Kong adults using convenience sampling over a two-week period from 6th April 2020. The survey collected data on sleep disturbances, mood, stress, stock of infection control supplies, perceived risk of being infected by COVID-19, and sources for acquiring COVID-19 information. The participants were asked to compare their recent sleep and sleep before the outbreak. The Insomnia Severity Index (ISI) was used to assess their current insomnia severity. Prevalence was weighted according to 2016 population census.ResultsThe weighted prevalence of worsened sleep quality, difficulty in sleep initiation, and shortened sleep duration since the outbreak were 38.3%, 29.8%, and 29.1%, respectively. The prevalence of current insomnia (ISI score of ≥10) was 29.9%. Insufficient stock of masks was significantly associated with worsened sleep quality, impaired sleep initiation, shortened sleep duration, and current insomnia in multivariate logistic regression (adjusted OR = 1.57, 1.72, 1.99, and 1.96 respectively, all p < 0.05).ConclusionA high proportion of people in Hong Kong felt that their sleep had worsened since the COVID-19 outbreak. Insufficient stock of masks was one of the risk factors that were associated with sleep disturbances. Adequate and stable supply of masks may play an important role to maintain the sleep health in the Hong Kong general population during a pandemic outbreak.     

Self-reported sleep quality and dysfunctional sleep-related beliefs in young and older adults: changes in times of COVID-19 lockdown

ObjectiveThis study examined changes due to COVID-19 lockdown in young and older adults’ self-reported sleep quality and dysfunctional sleep-related beliefs.MethodsAdults involved in studies prior to the pandemic were contacted during the COVID-19 lockdown. Seventeen young adults (age range: 18–35 years) and 21 older adults (age range: 65–90 years) agreed to participate. Participants were interviewed by phone (between 27th April and 4^th May, 2020) to complete the Pittsburgh Sleep Quality Index (PSQI) and the Dysfunctional Beliefs About Sleep (DBAS) questionnaire they had been administered before the pandemic.ResultsIn terms of mean changes, the results showed null effect sizes for changes in self-reported sleep quality for both age groups. In young adults, a medium effect size emerged for changes in sleep latency, which increased during lockdown. No changes in any of the self-reported sleep quality dimensions emerged in older adults. In both age groups, the effect sizes for changes in dysfunctional sleep-related beliefs were negligible. In older adults, however, changes in self-reported sleep quality were largely associated with changes in dysfunctional sleep-related beliefs.ConclusionsOur results suggest that self-reported sleep quality and dysfunctional sleep-related beliefs were not affected by the COVID-19 lockdown in young or older adults. They also suggest that it might be useful to consider changes in dysfunctional sleep-related beliefs to better capture the impact of stressful events (such as a period of quarantine) on sleep quality, especially where older adults are concerned.     

Impact of COVID-19 pandemic on sleep in children and adolescents: a systematic review and meta-analysis

ObjectiveThis systematic review and meta-analysis were conducted to study the prevalence and pattern of sleep disturbances in children and adolescents during the COVID-19 pandemic.MethodsMEDLINE, EMBASE, and Web of Science were searched for original studies describing sleep abnormalities in children and adolescents with or without pre-existing neurobehavioral disorders during the COVID-19 pandemic. The pooled estimates for various sleep abnormalities were calculated using a random-effect model.ResultsOf 371 articles screened, 16 studies were included. Among these, five studies were in preschool children, two were in children with pre-existing neurobehavioral disorders and the remaining were in school going children and adolescents. The outcome measures used for sleep were markedly heterogeneous across the studies.The pooled prevalence of any sleep disturbance in children during the pandemic was 54%(95%CI:50–57%). Interestingly, the prevalence in pre-school children was lower than pre-pandemic times (RR = 0.87; 95% CI:0.58–1.30) but this was not statistically significant. The pooled prevalence of children not meeting sleep recommendation was 49% (95%CI: 39–58%).ConclusionThe prevalence of sleep problems in children and adolescents during the COVID-19 pandemic is alarming. Pre-school children had a trend towards relatively fewer sleep disturbances due to home confinement measures in comparison with pre-pandemic times. Sleep duration recommendations were not met in nearly half of healthy children. However, these conclusions need to be seen in light of limited literature on the topic, few included studies done in heterogenous populations, and dubious quality of inferences drawn from these studies which were predominantly online surveys.Prospero registration idCRD42020213788.     

Pandemic dreams: quantitative and qualitative features of the oneiric activity during the lockdown due to COVID-19 in Italy

ObjectiveThe lockdown due to COVID-19 pandemic had a strong impact on daily habits, emotional experience, mental health and sleep. A large body of evidence suggests that dreams are affected by both waking experiences and sleep pattern. In this view, the lockdown should have induced intense modifications in dreaming activity. The aim of the study was to assess dream features during the lockdown in Italy.MethodsWe used an online survey to collect self-reported demographic, clinical, sleep and dream data. Our sample included 1091 participants.ResultsResults point to an increased dream frequency, emotional load, vividness, bizarreness and length during the lockdown, compared to a pre-lockdown period. Higher dream frequency and specific qualitative features were found in females and subjects with poor sleep quality, nocturnal disruptive behaviours and depressive symptoms. Most of the dream features assessed during the lockdown were predicted by age, gender, depressive symptoms, presence/absence of other people at home, and territorial area. A specific focus on sleep features revealed that sleep duration and several sleep quality indexes were the best predictors of dream variables. During the lockdown, dreams were also characterized by increased negative emotions, which were particularly frequent in females, younger adults, and participants with poor sleep quality, nocturnal disruptive behaviours, anxiety and depressive symptoms.ConclusionsOur results confirm the hypothesis of a strong influence of the pandemic on dreaming, supporting both the hypothesis of continuity between wake and sleep mental processes and the view of a crucial influence of sleep quality and duration on dreaming activity.     

Worry,avoidance, and coping during the COVID-19 pandemic: A comprehensive network analysis

BackgroundMany psychological factors play a role in the COVID-19 pandemic, including various forms of worry, avoidance, and coping. Adding to the complexity, some people believe the threat of COVID-19 is exaggerated. We used network analysis to investigate how these diverse elements are interrelated.MethodsA population-representative sample of 3075 American and Canadian adults completed an online survey, including measures of COVID-19-related worry, avoidance, self-protective behaviors, and other variables.ResultsThe network contained three major hubs, replicated across gender and age groups. The most important hub centered around worries about the dangerousness of COVID-19, and formed the core of the previously identified COVID Stress Syndrome. The second most important hub, which was negatively correlated with the first hub, centered around the belief that the COVID-19 threat is exaggerated, and was associated with disregard for social distancing, poor hand hygiene, and anti-vaccination attitudes. The third most important hub, which was linked to the first hub, centered around COVID-19-related compulsive checking and reassurance-seeking, including self-protective behaviors such as panic buying and use of personal protective equipment.ConclusionNetwork analysis showed how various forms of worry, avoidance, coping, and other variables are interrelated. Implications for managing disease and distress are discussed.     

COVID-19 and sleep patterns in adolescents and young adults

ObjectiveIn March 2020, the world experienced a global pandemic, which involved the shutdown of schools or a transposition to remote teaching in most countries. The objective of the present study was to investigate the impact of the COVID-19 pandemic related lockdown on sleep patterns and sleep quality in adolescents and young adults.MethodsAn online survey was conducted in June 2020 with adolescents and young adults (n = 498) aged 12–25 years. Participants had to answer questions on sleep, first retrospectively, referring to the time prior to the pandemic, and then referring to the time during the pandemic.ResultsA pronounced shift towards later sleep combined with an increase in sleep duration was found during the pandemic. However, these changes in sleep habits were more pronounced in adolescents than in young adults and seem to occur mostly during weekdays compared to weekends. During the pandemic, teens also reported an improvement in daytime sleepiness and subjective sleep quality, while young adults reported an increase in sleep difficulties associated with sleep onset difficulties, nocturnal and early morning awakenings, and nightmares.ConclusionsThe COVID-19 related lockdown seems to have had a beneficial effect on sleep in adolescents. In young adults, benefits are not as obvious. These results support that later school start times would be beneficial for adolescents. However, in young adults it could be important to investigate the effects of other situational or interindividual factors (stress, lifestyle habits, employment, etc.).     

Correlates of insomnia among the adults during COVID19 pandemic: evidence from an online survey in India

BackgroundPsychosocial distresses are often associated with sleep disorders. This is found as a common population level observation during natural calamities or emergency situations like a pandemic. The current study was conducted to determine the magnitude of self-reported insomnia, and to identify its associated factors among the apparently healthy Indian adult population having access to social media during the lockdown period of COVID 19 pandemic.MethodsA cross-sectional, region-stratified survey was conducted from April 20 – May 19, 2020 in India using online questionnaire comprising Perceived Stress Scale, Generalized Anxiety Disorder Scale, Insomnia Severity Index, variables related to concern, fear and apprehension about COVID19 pandemic, and different socio-clinical variables. The questionnaire was disseminated via different social media platforms and responses from 1081 respondents were included in the analysis.ResultsModerate clinical insomnia was present in 13.32% (95% confidence interval [CI]: 12.23%–14.50%), and severe clinical insomnia was present in 1.85% (95% CI: 1.08%–3.14%). For higher levels of insomnia mild anxiety was associated with a proportional odds ratio (OR) of 1.83 (95% CI: 1.24–2.71), and moderate and severe anxiety had an OR of 4.01 (95% CI: 2.57–6.25). Factors associated with higher severity of insomnia were middle age group (36–50 years), being a professional, living alone, perceiving COVID as serious disease, urban residence and those having comorbidity. The OR for being concerned for staying indoors was 5.09 (95% CI: 4.09–5.33), whereas the OR for fear of scarcity in availability of masks and sanitizers was 1.48 (95% CI: 1.26–1.75); and the OR for fear of unavailability of essential goods was 3.20 (95% CI: 2.06–4.98).ConclusionsPsychosocial factors like generalized anxiety, higher age, higher perceived severity, and various concerns related to COVID19 pandemic were identified to be associated with higher degrees of insomnia. Necessary psychosocial interventions, may be required to address the burden of insomnia in a timely and long-term mode.     

Perceived stress and sleep quality among the non-diseased general public in China during the 2019 coronavirus disease: a moderated mediation model

BackgroundThe 2019 coronavirus disease (COVID-19) has spread worldwide, and its associated stressors have resulted in decreased sleep quality among front-line workers. However, in China, the general public displayed more psychological problems than the front-line workers during the pandemic. Therefore, we investigated the influence of perceived stress on the sleep quality of the non-diseased general public and developed a moderated mediation model to explain said relationship.MethodsQuestionnaire-based surveys were conducted online from February 18–25, 2020 with 1630 Chinese participants (aged 18–68 years).ResultsAround one-third (36.38%) of participants were poor sleepers during the COVID-19 pandemic. Moreover, higher perceived stress was significantly associated with higher anxiety levels, which, in turn, was associated with lower sleep quality. Self-esteem moderated the indirect effect of perceived stress on sleep quality through its moderation of the effect of perceived stress on anxiety. This indicated that the mediation effect of anxiety was stronger in those with low levels of self-esteem than in those with high levels of self-esteem.ConclusionsThese findings suggest that both the sleep quality and perceived stress levels of the non-diseased general public required attention during the COVID-19 pandemic. Our findings also identify personality characteristics related to better sleep quality, demonstrating the important role of self-esteem in environmental adaptation.     

Sleep quality in times of Covid-19 pandemic

BackgroundDue to the 2019 novel coronavirus (COVID-19) disease outbreak, social distancing measures were imposed to control the spread of the pandemic. However, isolation may affect negatively the psychological well-being and impair sleep quality. Our aim was to evaluate the sleep quality of respiratory patients during the COVID-19 pandemic lockdown.MethodsAll patients who underwent a telemedicine appointment from March 30 to April 30 of 2020 were asked to participate in the survey. Sleep difficulties were measured using Jenkins Sleep Scale.ResultsThe study population consisted of 365 patients (mean age 63.9 years, 55.6% male, 50.1% with sleep-disordered breathing [SDB]). During the lockdown, 78.9% of participants were confined at home without working. Most patients (69.6%) reported at least one sleep difficulty and frequent awakenings was the most prevalent problem. Reporting at least one sleep difficulty was associated with home confinement without working, female gender and diagnosed or suspected SDB, after adjustment for cohabitation status and use of anxiolytics. Home confinement without working was associated with difficulties falling asleep and waking up too early in the morning. Older age was a protective factor for difficulties falling asleep, waking up too early and non-restorative sleep. Notably, SDB patients with good compliance to positive airway pressure therapy were less likely to report sleep difficulties.ConclusionsHome confinement without working, female gender and SDB may predict a higher risk of reporting sleep difficulties. Medical support during major disasters should be strengthened and potentially delivered through telemedicine, as this comprehensive approach could reduce psychological distress and improve sleep quality.     

Mental health and sleep disturbances in physically active adults during the COVID-19 lockdown in Norway: does change in physical activity level matter?

Study objectiveTo assess mental health and sleep disturbances among physically active adults during the Norwegian lockdown caused by the coronavirus disease 2019 (COVID-19), and to investigate if change in physical activity (PA) level during the lockdown moderates the association between mental health and sleep disturbances.MethodsMembers of a Norwegian fitness association were invited to fill out an online questionnaire including the Hospital Anxiety and Depression Scale (HADS), sleep disturbances and change in PA habits (decreased, unchanged, increased) during the COVID-19 lockdown from 12 March to 15 June 2020.ResultsA sample of 1281 members aged 19–81 years were included (31% females; mean ± SD age 49 ± 11.5). Prevalence of anxiety and depressive symptoms was 9.0% and 4.4%, respectively. During the lockdown period, 13.8% reduced, 21.9% increased and 64.3% did not change PA level. In total 21.9% reported sleeping disturbances. Anxiety symptoms and depressive symptoms were statistically significantly associated with sleep disturbances. Change in PA did not influence the association between mental health and sleep.ConclusionCompared to studies from the general population during the COVID-19 pandemic levels of anxiety and depressive symptoms were substantial lower in this Norwegian sample of relatively physically active adults. Anxiety and depressive symptoms were associated with sleep disturbances, but change in PA level during the COVID-19 lockdown did not influence the association between mental health and sleep disturbances.     

Factors Associated With Sleep Disturbances Related to the COVID-19 Pandemic Among Older Adults With Chronic Conditions

ObjectivesThe COVID-19 pandemic may contribute to sleep problems among older adults with chronic conditions. We examined factors linked to pandemic-related sleep disturbances in a US sample of adults aged 50 and older with chronic conditions.DesignCross-sectional anonymous online survey between May 14 and July 9, 2020.SettingMichigan (82.3% of participants) and 33 other US states.ParticipantsTotal of 705 adults (M = 64.57 years, SD = 8.82, range = 50–94) who reported at least one chronic condition.MeasurementsSociodemographic and health characteristics, physical activity, media use, pandemic-related stress, social resources, and pandemic-related sleep disturbances.ResultsIn the fully adjusted regression models, people who reported more worry about COVID-19 infection, more financial strain, and greater loneliness reported significantly greater pandemic-related sleep disturbances.ConclusionsThese findings identify factors that may heighten risk of sleep problems since the COVID-19 pandemic in an especially vulnerable subgroup of older adults.     

Sufficient sleep attenuates COVID-19 pandemic-related executive dysfunction in late adolescents and young adults

PurposeTo investigate the interaction between (1) sleep and the COVID-19 pandemic; and (2) social cumulative risk and COVID-19 pandemic on executive function (EF).MethodsForty late adolescents/young adults (19.25 ± 1.12 y.o.) completed sleep questionnaires and the Behavior Rating Inventory of Executive Function- Adults (BRIEF-A) before and during the COVID-19 pandemic, yielding 80 observations for data analysis. Multilevel random-effects models with interaction terms were used to estimate the associations.ResultsCompared to pre-pandemic sleep, participants slept 24 min longer (t = −2.07, p = 0.03) and also had increased sleep latency (t = −1.83, p = 0.07) during COVID-19. Mid-sleep times shifted 40 min later (t = −3.22, p = 0.003), and BRIEF-A scores increased (indicating greater dysfunction), during the pandemic (p < 0.05). The worsening in EF during the pandemic was attenuated by increasing sleep duration (B = -4.38, p = 0.04) and magnified by social cumulative risk (B = 3.19, p = 0.04). Poor sleep quality was independently associated with increase in EF problems (p < 0.05).ConclusionSufficient sleep may represent a resilience factor against EF decline during this unprecedented crisis.     

Predictors of sleep quality in medical students during COVID-19 confinement

ObjectivesWe aimed to assess sleep quality of Tunisian medical students during home confinement due to the COVID-19 pandemic, and to analyze the relationship between sleep quality and sociodemographic, clinical, confinement-related and psychological variables.MethodsA correlational cross-sectional study was conducted from April 11th to May 3rd 2020. Medical students who have been in home confinement and who accepted to participate in an online survey were targeted. Sociodemographic data, clinical variables, and data related to home confinement were collected. Participants also completed Pittsburgh Sleep Quality Index, Depression, Anxiety and Stress Scale and Beck Hopelessness Scale.ResultsResults showed a high prevalence of poor sleepers among medical students (72.5%) with poor subjective sleep quality, increased sleep latency, sleep disturbances and daytime dysfunction. Multiple regression analysis revealed that family history of suicide attempts, tobacco use, perception of home confinement and reduced physical activity during home confinement significantly contributed to poor sleep quality. Among the psychological variables, anxiety and hopelessness significantly contributed to poor sleep quality in medical students during home confinement.ConclusionsResults revealed a high prevalence of poor sleep quality in medical students who have been in home confinement due to the COVID-19 pandemic. Except family history of suicide attempts, factors that significantly contributed to poor sleep quality were modifiable factors. Sleep quality and sleep parameters need to be assessed in this particular population and adequate measures aiming to promote quality of sleep need to be enhanced, given the crucial regenerative, homeostatic and psychological roles of sleep.     

Insomnia,anxiety, and depression during the COVID-19 pandemic: an international collaborative study

Importance and study objectiveThe 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 participantsInternational, 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.ResultsClinical 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 relevanceInsomnia, 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.     

Sleep quality and mental health in the context of COVID-19 pandemic and lockdown in Morocco

BackgroundThe lockdown of COVID-19 (Coronavirus Disease 2019) is associated with several stressful factors that can negatively affect peoples' sleep quality and mental health. Objectives: We conducted this study to evaluate sleep disorders and psychological impact associated with the spread of the COVID-19 and the lockdown on the Moroccan population. We also aimed to study the effects of respondents' beliefs and attitudes about sleep on sleep disorders, anxiety-related symptoms, and depressive symptoms.Material and MethodsWe used a questionnaire enclosing respondents' sociodemographic information, five psychological and behavioral tests including Dysfunctional Beliefs and Attitudes about Sleep (DBAS-16), Athens Insomnia Scale (AIS), Epworth Sleepiness Scale (ESS), Hamilton Anxiety Rating Scale (HARS) and Beck Depression Inventory (BDI) test.ResultsOur results highlighted widespread false beliefs about sleep and the prevalence of sleep disorders, anxiety, and depression-related symptoms within the Moroccan population. Nearly 82.3% of respondents revealed false beliefs about sleep. Furthermore, we confirmed a strong positive correlation between knowledge and attitudes about sleep and the prevalence of sleep disorders, anxiety, and depression-related symptoms. However, we found no significant difference in the prevalence of sleep and psychological disorders, between healthcare workers and other professions workers.ConclusionOur study revealed a high prevalence of sleep disorders, anxiety, and depressive symptoms in the Moroccan population during the COVID-19 lockdown period. Moreover, false beliefs on sleep understanding were prevalent and were presenting a risk factor leading to sleep disorders, anxiety, and depressive symptoms.     

The enemy who sealed the world: effects quarantine due to the COVID-19 on sleep quality,anxiety, and psychological distress in the Italian population

BackgroundThe 2019 Coronavirus Disease (COVID-19) pandemic has become a global health emergency. The extreme actions aimed to reduce virus diffusion have profoundly changed the lifestyles of the Italian population. Moreover, fear of contracting the infection has generated high levels of anxiety. This study aimed to understand the psychological impact of the COVID-19 outbreak on sleep quality, general anxiety symptomatology, and psychological distress.MethodsAn online survey collected information on socio-demographic data and additional information concerning the COVID-19 pandemic. Furthermore, sleep quality, sleep disorders, generalized anxiety symptoms, psychological distress, and post-traumatic stress disorder (PTSD) symptomatology related to COVID-19 were assessed.ResultsThis study included 2291 respondents. The results revealed that 57.1% of participants reported poor sleep quality, 32.1% high anxiety, 41.8% high distress, and 7.6% reported PTSD symptomatology linked to COVID-19. Youth and women, those uncertain regarding possible COVID-19 infection, and greater fear of direct contact with those infected by COVID-19 had an increased risk of developing sleep disturbances, as well as higher levels of anxiety and distress. Finally, a significant relationship between sleep quality, generalized anxiety, and psychological distress with PTSD symptoms related to COVID-19 was evidenced.ConclusionsOur findings indicate that the COVID-19 pandemic appears to be a risk factor for sleep disorders and psychological diseases in the Italian population, as previously reported in China. These results should be used as a starting point for further studies aimed to develop psychological interventions to minimize the brief and long-term consequences of the COVID-19 pandemic.