Quality of sleep among social media users during the lockdown period due to COVID-19 in Spain

Unveiling Coronasomnia: Pandemic Stress and Sleep Problems During the COVID-19 Outbreak

The COVID-19 pandemic posed an unprecedented challenge to public well-being, necessitating an examination of its health impact. This review discusses the relationship between pandemic-induced stressors and individual sleep patterns and quality. The pandemic stressors include lockdown or physical distancing measures, direct virus exposure, and the dissemination of misinformation and disinformation. The pandemic led to delayed sleep-wake cycles, except for healthcare professionals, and worsened sleep quality. The prevalence of insomnia was higher for women due to pre-existing conditions and susceptibility stressors such as lockdown stress and family responsibilities. Healthcare professionals, who experienced worsened work conditions during the pandemic, reported higher rates of insomnia and sleep difficulties due to infection anxiety and post-traumatic stress from direct virus exposure. For the general population, stress stemmed from social isolation under lockdown and overwhelming false information available online, resulting in sleep problems. Taken together, the findings highlight the importance of promoting social interactions, providing psychological support services, and caution in navigating health information. In summary, this review underscores the need for individual- and group-centered approaches in ongoing research and interventions to address pandemic-related stress and sleep issues during COVID-19.

Sleep quality and job satisfaction in Spanish nurses: the consequences of COVID-19

Introduction

Sleep is fundamental to the quality of life and can affect individuals' well-being and mental health.

Objective

This study analyzed sleep quality and job satisfaction among Spanish nurses following the COVID-19 pandemic.

Materials and Methods

A cross-sectional study was conducted using the Pittsburgh Sleep Quality Index (PSQI), Font Roja Job Satisfaction Questionnaire, and sociodemographic and work- related variables. A "snowball" sampling method was employed through social media dissemination.

Results

The mean PSQI score was 9.75 ± 4.36 points. The poorest sleep quality was identified in participants without dependents (p=0.031; p=3.329; 95% CI=0.035-6.354) and those with dependents other than children (p=0.022; p=4.121; 95% CI=0.575- 7.667). However, having a Ph.D degree (p=0.001; p=-3.406; 95% CI=-5.503- 1.309) or specialist degree (p=0.021; p=-1.639; 95% CI=-3.031- -0.247) was associated with better sleep quality. Higher job satisfaction was found among women (p=0.034; p=0.104; 95% CI=0.007-0.201) who did not work with COVID-19 patients (p=0.049; p=-0.085; 95% CI=-0.174- -0.003).

Discussion

Improving working conditions, such as the nurse-to-patient ratio and distribution of work shifts, is crucial to enhancing nurses' sleep quality.

Conclusions

Spanish nurses reported poor sleep quality. Not having dependents or having dependents other than children were risk factors for poor sleep quality. Job satisfaction was higher among women who did not work with COVID-19 patients. No relationship was found between job satisfaction and sleep quality.

Scoping review of the methodology of large health surveys conducted in Spain early on in the COVID-19 pandemic

Background

The use of health surveys has been key in the scientific community to promptly communicate results about the health impact of COVID-19. But what information was collected, where, when and how, and who was the study population?

Objective

To describe the methodological characteristics used in large health surveys conducted in Spain early on in the COVID-19 pandemic.

Methods

Scoping review. Inclusion criteria: observational studies published between January 2020 and December 2021, with sample sizes of over 2,000 persons resident in Spain. Databases consulted: PubMed, CINAHL, Literatura Latinoamericana y del Caribe en CC de la Salud, Scopus, PsycINFO, Embase, Sociological Abstracts, Dialnet and Web of Science Core Collection. We analyzed the characteristics of the literature references, methodologies and information gathered in the surveys selected. Fifty five studies were included.

Results

Sixty percentage of the studies included had mental health as their main topic and 75% were conducted on the general adult population. Thirteen percentage had a longitudinal design, 93% used the internet to gather information and the same percentage used non-probability sampling. Thirty percentage made some type of sampling correction to reduce coverage or non-response biases, but not selection biases. Sixty seven percentage did not state the availability of their data.

Conclusions

Consistent with the extensive use of non-probability sampling without any bias correction in the extraordinary setting created by COVID-19, quality population frameworks are required so that probability and representative samples can be extracted quickly to promptly address other health crises, as well as to reduce potential coverage, non-response and particularly selection biases by utilizing reweighting techniques. The low data accessibility despite the huge opportunity that COVID-19 provided for Open Science-based research is striking.

Have COVID-19 Stimulus Packages Mitigated the Negative Health Impacts of Pandemic-Related Job Losses? A Systematic Review of Global Evidence from the First Year of the Pandemic

Social protection can buffer the negative impacts of unemployment on health. Have stimulus packages introduced during the COVID-19 pandemic mitigated potential harms to health from unemployment? We performed a systematic review of the health effects of job loss during the first year of the pandemic. We searched three electronic databases and identified 49 studies for inclusion. Three United States-based studies found that stimulus programs mitigated the impact of job loss on food security and mental health. Furloughs additionally appeared to reduce negative impacts when they were paid. However, despite the implementation of large-scale stimulus packages to reduce economic harms, we observed a clear pattern that job losses were nevertheless significantly associated with negative impacts, particularly on mental health, quality of life, and food security. We also observe suggestive evidence that COVID-related job loss was associated with child maltreatment, worsening dental health, and poor chronic disease outcomes. Overall, although we did find evidence that income-support policies appeared to help protect people from the negative health consequences of pandemic-related job loss, they were not sufficient to fully offset the threats to health. Future research should ascertain how to ensure adequate access to and generosity of social protection programs during epidemics and economic downturns.

Sleep Patterns during the COVID-19 Lockdown in Spain

BACKGROUND

To mitigate the spread of the coronavirus disease (COVID-19) pandemic, governments around the world adopted exceptional lockdown measures. This led to the disruption of normal life routines, including sleep. The aim of this study was to analyze differences in sleep patterns and subjective variables of sleep quality before and during lockdown.

METHODS

A sample of 1673 Spanish adults (30% men; 82% of the total were between 21 and 50 years of age) was evaluated. The following sleep variables were evaluated: Sleep latency, sleep time, number and duration of awakenings, sleep satisfaction, daytime sleepiness, and the manifestation of symptoms related to sleep problems.

RESULTS

Although 45% of people changed their sleep schedules (resulting in 42% sleeping longer during lockdown), sleep quality (37.6% worse), daytime sleepiness (28% worse), number of awakenings (36.9% more), and duration of awakenings (45% longer) were markedly worse. Statistical analyses indicated significant differences in all the evaluated sleep variables before and during lockdown in both men and women. Women reported less sleep satisfaction, and more symptoms related to sleep problems than men.

CONCLUSIONS

A deterioration in the sleep patterns of the Spanish population, especially women, because of the lockdown declared due to the COVID-19 pandemic.

Sleep quality among inpatients of Spanish public hospitals

Sleep is a complex process and is needed both in health and illness. Deprivation of sleep is known to have multiple negative physiological effects on people's bodies and minds. Despite the awareness of these harmful effects, previous studies have shown that sleep is poor among hospitalised patients. We utilized an observational design with 343 patients recruited from medical and surgical units in 12 hospitals located in nine Spanish regions. Sociodemographic and clinical characteristics of patients were collected. Sleep quality at admission and during hospitalisation was measured by the Pittsburgh Sleep Quality Index. Sleep quantity was self-reported by patients in hours and minutes. Mean PSQI score before and during hospitalisation were respectively 8.62 ± 4.49 and 11.31 ± 4.04. Also, inpatients slept about an hour less during their hospital stay. Lower educational level, sedative medication intake, and multi-morbidity was shown to be associated with poorer sleep quality during hospitalisation. A higher level of habitual physical activity has shown to correlate positively with sleep quality in hospital. Our study showed poor sleep quality and quantity of inpatients and a drastic deterioration of sleep in hospital versus at home. These results may be helpful in drawing attention to patients' sleep in hospitals and encouraging interventions to improve sleep.

Subjective sleep alterations in healthy subjects worldwide during COVID-19 pandemic: A systematic review, meta-analysis and meta-regression

OBJECTIVE

We conducted a systematic review and meta-analysis to provide an update on sleep quality in different world areas and better characterize subjective sleep alterations during the COVID-19 pandemic. Considering gender distribution and specific pandemic-related parameters, we also intend to identify significant predictors of sleep problems.

METHODS

Six electronic databases were searched from December 2019 to November 2021 for studies investigating sleep during COVID-19 employing the Pittsburgh Sleep Quality Index, the Medical Outcomes Study Sleep, the Insomnia Severity Index or the Epworth Sleepiness Scale. Random-effects models were implemented to estimate the pooled raw means of subjective sleep alterations. Also, we considered the role of several pandemic-related parameters (i.e., days from the first COVID-19 case, government stringency index, new cases for a million people, new deaths for a million people) by means of meta-regression analyses.

RESULTS

A total of 139 studies were selected. The pooled mean of the global Pittsburgh Sleep Quality Index score (PSQIgen) was 6.73 (95% CI, 6.61-6.85). The insomnia severity index score was reported from 50 studies with a pooled mean of 8.44 (95% CI, 7.53-9.26). Subgroup analyses confirmed that most subcategories had poor sleep quality and subclinical insomnia. Meta-regressions showed that PSQIgen was predicted by days from the first COVID-19 case and government restrictions with a negative slope and by female gender with a positive slope. The government stringency index was positively correlated with the direct subjective evaluation of sleep quality.

CONCLUSIONS

We found an overall impaired sleep and widespread subthreshold insomnia during the COVID-19 pandemic. The female percentage seems to be the best predictor of impaired sleep quality, consistently to the available literature. Noteworthy, sleep alterations were inversely associated with governmental restrictions and decreased during the pandemic. Our results give a contribution to critically orienting further studies on sleep since COVID-19 pandemic.

Effects of COVID-19-related psychological distress and anxiety on quality of sleep and life in healthcare workers in Iran and three European countries

Introduction

The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line.

Methods

This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded.

Results

Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p-values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF.

Discussion

This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations.

Psychological Research on Sleep Problems and Adjustment of Working Hours during Teleworking in the COVID-19 Pandemic: An Exploratory Study

Mandatory home isolation caused by COVID-19 in professional contexts led to a situation that required work activities to be converted into a remote modality. The literature on this topic is very recent, given the pandemic and the uncertainty of virtual and face-to-face work modalities. This study aimed to examine the effects of adults' prolonged exposure to screens on sleep quality, the type of devices used according to age and gender, periods of access to such devices and the impact on performance in the context of telework due to COVID-19. Specifically, the study analyzed the differences in the use of devices and in the time spent using them during and after teleworking between genders and age groups. A total of 127 Portuguese participants answered the Pittsburgh Sleep Quality Index and a questionnaire that we specifically developed to characterize teleworking habits. The results showed differences between men and women regarding the use of devices and its impact on sleep quality, as well as differences in terms of age. These results are discussed in terms of how the current work context may affect performance, sleep, gender differences and the adverse effects of exposure to screens during and after work hours.

Evening-types show highest increase of sleep and mental health problems during the COVID-19 pandemic-multinational study on 19 267 adults

STUDY OBJECTIVES

Individual circadian type is a ubiquitous trait defining sleep, with eveningness often associated with poorer sleep and mental health than morningness. However, it is unknown whether COVID-19 pandemic has differentially affected sleep and mental health depending on the circadian type. Here, the differences in sleep and mental health between circadian types are examined globally before and during the COVID-19 pandemic.

METHODS

The sample collected between May and August 2020 across 12 countries/regions consisted of 19 267 adults with information on their circadian type. Statistical analyses were performed by using Complex Sample procedures, stratified by country and weighted by the number of inhabitants in the country/area of interest and by the relative number of responders in that country/area.

RESULTS

Evening-types had poorer mental health, well-being, and quality of life or health than other circadian types during the pandemic. Sleep-wake schedules were delayed especially on working days, and evening-types reported an increase in sleep duration. Sleep problems increased in all circadian types, but especially among evening-types, moderated by financial suffering and confinement. Intermediate-types were less vulnerable to sleep changes, although morningness protected from most sleep problems. These findings were confirmed after adjusting for age, sex, duration of the confinement, or socio-economic status during the pandemic.

CONCLUSIONS

These findings indicate an alarming increase in sleep and mental health problems, especially among evening-types as compared to other circadian types during the pandemic.

Sleep Pattern Changes and the Level of Fatigue Reported in a Community Sample of Adults During COVID-19 Pandemic

PURPOSE

The study aimed to (a) assess the sleep pattern changes and the level of fatigue among COVID positive adults (b) determine the association of sociodemographic and lifestyle factors (age, gender, marital status, occupation, income, exercise, nap, diet, and comorbidities) on sleep pattern and level of fatigue c) examine the relationship between sleep and fatigue, and between sleep problems, sleep quality and fatigue, among a community sample of COVID-19 affected adults.

METHODS

A non-experimental, descriptive, cross-sectional survey design was used. Participants were adults, between 18 and 63 years (n = 782), who tested positive for COVID-19 infection using RT-PCR or Antigen test, confined to home quarantine/under observation, and without any complications. Data was collected using the socio-demographic-sleep and related activity questionnaire, Fatigue Assessment Scale, and Sleep Quality Scale.

RESULTS

A majority of the participants reported either mild to moderate sleep quality problems (97.31%) and 377 of them (48.21%) reported fatigue levels. A significant association between sleep quality and fatigue with gender, and lifestyle factors such as sleep duration, food intake, napping, exercise pattern, and influence of COVID-19 on livelihood after being affected with COVID-19, and time of experiencing sleep problems after COVID-19 infection (all, p ˂ 0.01) were observed, as well as age with sleep quality. Poor sleep quality and fatigue were significantly correlated with each other, and also with sleep problems before being affected with COVID-19 (p = 0.000).

CONCLUSIONS

The study has shown that COVID-19 has an effect on an individual's demographic factors and a multitude of lifestyle factors, and highlights the need for post-COVID-19 monitoring even after recovery from the disease.

Identification of Measures to Strengthen Resilience in Homes on the Basis of Lockdown Experience during COVID-19

The COVID-19 pandemic and the need to put population into lockdown require a reflection on the capacity of homes to adjust to a specific function for which they are not designed: ensuring the health and wellbeing of people during lockdown periods. Thus, the government in the Comunitat Valenciana promoted a study to evaluate house suitability in this Spanish region through the Valencia Institute of Building. The information was obtained by directly asking people affected through an online survey. On the basis of a series of indicators proposed in the study, the level of resilience and measures that favour house adaptation to such an extreme situation are analysed. The ultimate purpose is to offer solutions to enhance house behaviour against similar risks. The information obtained will be further useful for regional regulations of house design to be amended, currently under revision.