Insomnia,anxiety, and depression during the COVID-19 pandemic: an international collaborative study |
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| Affiliation: | 1. École de Psychologie, Centre d’étude des Troubles du Sommeil, Centre de Recherche CERVO/Brain Research Center, Université Laval, Québec, Canada;2. Department of Global Public Health and Primary Care, University of Bergen, Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway;3. Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Canada;4. Institute for Dream and Consciousness Research, Medical University of Vienna, Austria;5. Helsinki Sleep Clinic, Vitalmed Research Center, Terveystalo, Department of Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland;6. Sleep Medicine Center, Charité Universitätsmedizin Berlin, Berlin, Germany;7. Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China;8. SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland;9. Department of Public Health Solutions, Finnish Institute for Health and Welfare, Helsinki, Finland;10. Brain Institute, Physiology and Behavior Department, Onofre Lopes University Hospital - Federal University of Rio Grande do Norte, Natal, Brazil;11. Department of Psychology, Federal University of Rio Grande do Norte, Natal, Brazil;12. Department of Psychology, Sapienza University of Rome, Rome, Italy;13. IRCCS Fondazione Santa Lucia, Rome, Italy;14. Université de Paris, APHP, VIFASOM, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France;15. Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, INM, Univ Montpellier, INSERM, Montpellier, France;p. IRCCS, Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy;q. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy;r. Mississippi State University, Starkville, MS, USA and Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA;s. Department of Emergency Medicine, Medical University of Gdansk, Gdansk, Poland;t. Department of Neuroscience (Sleep Science Lab), BMC, Uppsala University, Uppsala, Sweden;u. Department of Medical Sciences, Uppsala University, Uppsala, Sweden;v. Tokyo Medical University, Tokyo, Japan;w. Department of Respiratory Medicine, Peking University People''s Hospital, China;x. Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK |
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| Abstract: | 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. |
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| Keywords: | Insomnia Sleep problems Anxiety Depression COVID-19 Pandemic |
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