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Factors associated with insomnia symptoms: A cross-sectional study during a Covid-19 fully restrictive lockdown
Authors:Nausicaa Christodoulou  Léa Bertrand  Laura Palagini  Justine Frija-Masson  Marie-Pia d'Ortho  Michel Lejoyeux  Dieter Riemann  Julia Maruani  Pierre A Geoffroy
Institution:1. Université Paris Cité, Paris, France;2. Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat – Claude Bernard, Paris, France;3. Psychiatry Division, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy – Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy;4. Université Paris Cité, Paris, France

Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat – Claude Bernard, Paris, France

GHU Paris – Psychiatry & Neurosciences, Paris, France;5. Department of Psychiatry and Psychotherapy, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany;6. Département de psychiatrie et d'addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hospital Bichat – Claude Bernard, Paris, France

Université de Paris, NeuroDiderot, Inserm, Paris, France

Abstract:Insomnia is the most frequent sleep disorder and a public health concern that increased during the Covid 19 pandemic. Fully restrictive lockdowns during Covid are interesting periods to examine the impact of environmental and behavioural changes on the emergence of insomnia symptoms. In this cross-sectional study we aimed to (1) determine the main factors associated with insomnia symptoms during a Covid-19 fully restrictive lockdown examining the associated daily life alterations and (2) create a predictive model of insomnia symptoms. We used the data drawn from the “Covid-RythmE” study that reached volunteers from the general French population through an online survey during the last 2 weeks of the 2 month full lockdown. Associations with insomnia symptoms were tested and significant associations were entered in a Backward Stepwise Logistic Regression (BSLR) to assess the best combination to classify individuals with or without insomnia symptoms. From the 1624 participants, 50.64% suffered from mild to severe insomnia symptoms as assessed by the ISI. The best combination for explaining insomnia symptoms with 74.26% of accuracy included: age (OR = 1.15), females (OR = 1.26), smaller home sizes (OR = 0.77), environmental noises (OR = 1.59), anxiety symptoms (OR = 1.24), depressive symptoms (OR = 1.15), regularity of sleep–wake schedules (OR = 1.25), exposure to screen during the morning (OR = 1.13), and LED light during the evening (OR = 1.17). Thus, lifestyle schedule and exposure to natural synchronizers such as light, are primordial in considering in insomnia physiopathology, prevention and treatment, as well as the associated mental health status.
Keywords:chronotype  covid-19  insomnia  sleep disorders  sleep habits  sleep–wake cycles
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