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Wen LY, Zhang L, Zhu LJ, Song JG, Wang AS, Tao YJ, Li HQ, Feng Y, Jin YL, Su H, Chang WW. Depression and suicidal ideation among Chinese college students during the COVID-19 pandemic: the mediating roles of chronotype and sleep quality. BMC Psychiatry 2024; 24:583. [PMID: 39192231 DOI: 10.1186/s12888-024-06027-0] [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: 02/26/2024] [Accepted: 08/20/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND This study was intended to investigate the correlation between depression and suicidal ideation among Chinese college students during the COVID-19 pandemic and the potential mediating roles of chronotype and sleep quality in this relationship . METHODS A sample of 4,768 college students was selected from four institutions in Anhui Province, China, and the study was conducted during the COVID-19 pandemic (November to December 2020) using a stratified, cluster, multi-stage sampling method. This study used the two-item Patient Health Questionnaire (PHQ-2) to assess depressive symptoms, the Morningness-Eveningness Questionnaire 19 (MEQ-19) to determine individual sleep chronotypes (i.e., morning or evening preference), and the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality. Participants were asked about suicidal ideation. MPLUS 8.3 software was used to analyze the mediating effect of chronotype and sleep quality on the relationship between depression and suicidal ideation. RESULTS During the COVID-19 pandemic, the prevalence of suicidal ideation among Chinese college students was 5.4%. Depression was inversely correlated with chronotype (beta = - 0.346, P < 0.01) and positively correlated with sleep quality (beta = 0.846, P < 0.001), indicating that students experiencing depressive symptoms were more likely to have a later chronotype and poor sleep quality. A later chronotype (beta = - 0.019, P < 0.05) and poor sleep quality (beta = 0.066, P < 0.01) predicted suicidal ideation. Depression emerged as a direct and significant risk factor for suicidal ideation (effect value = 0.535, 95% confidence interval: 0.449 ~ 0.622). Chronotype and sleep quality were found to have potential mediating effects on the relationship between depression and suicidal ideation; however, the chain-mediating effect of chronotype and sleep quality was not statistically significant. CONCLUSIONS Our findings suggest that during the COVID-19 pandemic, depression can precipitate suicidal ideation through its influence on sleep chronotype and quality. These compelling findings highlight the urgency of early intervention strategies intended to mitigate suicidal thoughts, particularly among students exhibiting depressive symptoms, who experience disrupted sleep patterns and poor sleep quality.
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Affiliation(s)
- Li-Ying Wen
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Liu Zhang
- Department of Hospital Infection Management Office, Wuhu Hospital of Traditional Chinese Medicine, Wuhu, Anhui, 241000, China
| | - Li-Jun Zhu
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Jian-Gen Song
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - An-Shi Wang
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Yu-Jing Tao
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Hao-Qi Li
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Ying Feng
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China
| | - Yue-Long Jin
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China.
| | - Hong Su
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei, Anhui, 230032, China.
| | - Wei-Wei Chang
- Department of Epidemiology and Health statistics, School of Public Health, Wannan Medical College, Wuhu, Anhui, 241002, China.
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Hasler BP, Wallace ML, Graves JL, Witt R, Guo K, Buysse DJ, Siegle GJ, Clark DB. Pre-pandemic circadian phase predicts pandemic alcohol use among adolescents. J Sleep Res 2024; 33:e13905. [PMID: 37039532 PMCID: PMC10564965 DOI: 10.1111/jsr.13905] [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: 11/04/2022] [Revised: 03/15/2023] [Accepted: 03/29/2023] [Indexed: 04/12/2023]
Abstract
Later circadian timing during adolescence is linked to worse sleep, more severe depression and greater alcohol involvement, perhaps due to circadian misalignment imposed by early school schedules. School schedules shifted later during the COVID-19 pandemic, ostensibly reducing circadian misalignment and potentially mitigating problems with depression and alcohol. We used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing showed improvements in sleep, depression and alcohol involvement. Participants were 42 adolescents reporting alcohol use. We assessed circadian phase via dim light melatonin onset prior to the pandemic, then conducted remote assessments of sleep, depressive symptoms and alcohol use during the pandemic. Mixed-effects models were used to test for pandemic effects, covarying for age, sex, time since baseline evaluation, and current school/work status. Adolescents with later circadian timing reported less sleep than other teens on school nights, both before and during the pandemic. Although school night sleep increased during the pandemic (F = 28.36, p < 0.001), those increases were not greater for individuals with later circadian timing. Individuals with later circadian timing reported larger increases in alcohol use than other teens during the pandemic (X2 = 36.03, p < 0.001). Depressive symptoms increased during the pandemic (X2 = 46.51, p < 0.001) but did not differ based on circadian timing. Consistent with prior reports, adolescents with later circadian timing obtained less sleep, and later school schedules facilitated increased sleep duration. Nonetheless, individuals with later circadian timing reported the sharpest increases in alcohol use, suggesting that circadian timing contributes to risk for alcohol use beyond the effects of insufficient sleep.
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Affiliation(s)
- Brant P. Hasler
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | | | - Jessica L. Graves
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Rachel Witt
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Kathryn Guo
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Daniel J. Buysse
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Greg J. Siegle
- University of Pittsburgh School of Medicine, Department of
Psychiatry
| | - Duncan B. Clark
- University of Pittsburgh School of Medicine, Department of
Psychiatry
- School of Pharmacy, Department of Pharmaceutical Sciences,
Pittsburgh, PA, USA
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Raman S, Hyland P, Coogan AN. Stability of social jetlag and sleep timing into the second year of the Covid-19 pandemic: Results from a longitudinal study of a nationally representative adult sample in Ireland. Chronobiol Int 2024; 41:29-37. [PMID: 38093635 DOI: 10.1080/07420528.2023.2292098] [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: 09/06/2023] [Accepted: 12/02/2023] [Indexed: 01/16/2024]
Abstract
The early phase of the COVID-19 pandemic has previously been associated with marked changes in sleep/wake timing arising from the imposition of society-wide infection mitigation measures. Such observations are considered of broader significance as they reveal the social pressures that sleep timing normally operates under. In order to assess how persistent such changes were as the COVID-19 pandemic developed, we assessed sleep timing and quality in a longitudinal study of a nationally-representative sample of Irish adults with data collected at two time-points (December 2021 and March 2021). Data on social jetlag and chronotype was derived from the micro Munich Chronotype Questionnaire from 830 and 843 participants who provided data in December 2020 and March 2021 respectively, of which 338 contributed data to both timepoints. Demographics and measures of insomnia symptoms, anxiety, depression and loneliness were also collected, and data was analysed both within-subjects and cross-sectionally within data waves. Social jetlag (the mismatch between sleep timing on "work" and "free" days) and other measures of sleep timing were stable across the two time-points, although insomnia symptoms improved slightly from December 2020 to March 2021. The mean social jetlag at both timepoints was ~ 30 minutes, considerably lesser than reported pre-pandemic levels in similar populations. Multiple regression analysis of cross-sectional data reveals that the timing of midsleep on "free" days was only a weak-to-moderate predictor of social jetlag, whilst hours worked per week was the strongest predictor of social jetlag. Requirement for "face-to-face" contact with the public at work and urban location of residence also emerged as predictors of social jetlag, although insomnia, anxiety and depression symptoms and loneliness rating did not. We conclude that sleep timing changes that occurred during the initial phase of the COVID-19 pandemic persisted into the second year of the pandemic, and these results further illustrate the key roles working practices and other social factors have in shaping social jetlag.
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Affiliation(s)
- Sudha Raman
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andrew N Coogan
- Department of Psychology, Maynooth University, Kildare, Ireland
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Do R, Kim S, Lim YB, Kim SJ, Kwon H, Kim JM, Lee S, Kim BN. Korean adolescents' coping strategies on self-harm, ADHD, insomnia during COVID-19: text mining of social media big data. Front Psychiatry 2023; 14:1192123. [PMID: 38034911 PMCID: PMC10686066 DOI: 10.3389/fpsyt.2023.1192123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/31/2023] [Indexed: 12/02/2023] Open
Abstract
Introduction Since the Coronavirus disease 2019 (COVID-19), public safety measures, including social distancing and school closures, have been implemented, precipitating psychological difficulties and heightened online activities for adolescents. However, studies examining the impact of the pandemic on adolescent mental health and their coping strategies in Asian countries are limited. Further, most studies have used survey measures to capture mental health challenges so far. Accordingly, this study aimed to examine the psychological challenges South Korean adolescents experienced and their coping strategies during the pandemic using the Natural Language Processing (NLP) and Text mining (TM) technique on adolescents' social media texts/posts. Methods The data were gathered from social media texts/posts such as online communities, Twitter, and personal blogs from January 1, 2019, to October 31, 2021. The 12,520,250 texts containing keywords related to adolescents' common psychological difficulties reported during the pandemic, including self-harm, Attention-Deficit/Hyperactivity Disorders (ADHD), and insomnia, were analyzed by TM, NLP using information extraction, co-occurrence and sentiment analysis. The monthly frequency of the keywords and their associated words was also analyzed to understand the time trend. Results Adolescents used the word "self-harm" in their social media texts more frequently during the second wave of COVID-19 (August to September 2020). "Friends" was the most associated word with "self-harm." While the frequency of texts with "Insomnia" stayed constant throughout the pandemic, the word "ADHD" was increasingly mentioned in social media. ADHD and insomnia were most frequently associated with ADHD medications and sleeping pills, respectively. Friends were generally associated with positive words, while parents were associated with negative words. Conclusion During COVID-19, Korean adolescents often expressed their psychological challenges on social media platforms. However, their coping strategies seemed less efficient to help with their difficulties, warranting strategies to support them in the prolonged pandemic era. For example, Korean adolescents shared psychological challenges such as self-harm with friends rather than their parents. They considered using medicine (e.g., sleeping pills and ADHD medication) as coping strategies for sleep and attention problems.
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Affiliation(s)
- Ryemi Do
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soyeon Kim
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Waypoint Research Institute, Waypoint Centre for Mental Health Care, Penetanguishene, ON, Canada
| | - You Bin Lim
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Su-Jin Kim
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hyerim Kwon
- Biomedical Research Institute, Seoul National University Hospital, Seoul, Republic of Korea
| | | | - Sooyeon Lee
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Bung-Nyun Kim
- Division of Child and Adolescent Psychiatry, Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
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Tufik SB, Pires GN, Porcacchia AS, Bezerra AG, Andersen ML, Tufik S. Impact of the early months of the COVID-19 pandemic on the sleep patterns of a Brazilian population sample. Chronobiol Int 2023; 40:1133-1145. [PMID: 37700530 DOI: 10.1080/07420528.2023.2255667] [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: 01/04/2023] [Revised: 08/24/2023] [Accepted: 08/31/2023] [Indexed: 09/14/2023]
Abstract
Humanitarian and health crisis have drastic effects on the physical and mental well-being of people. The COVID-19 pandemic forced many countries to impose containment measures on its population to halt the spread of the new coronavirus (SARS-CoV-2). This aim of this study was to explore self-reported sleep quality and insomnia symptoms in a sample of the Brazilian population before and during the COVID-19 quarantine period. Our data was collected through online questionnaires, including the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Sleep Hygiene Index. The final sample comprised 1,109 volunteers. Generalized estimating equations (GEE) revealed that during the initial months of the COVID-19 pandemic, alterations in self-reported sleep parameters were observed in the participants. Sleep efficiency and sleep duration increased, but there was a worsening in sleep quality and an increase in symptoms related to insomnia.
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Affiliation(s)
| | - Gabriel Natan Pires
- Instituto do Sono, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Allan Saj Porcacchia
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Monica Levy Andersen
- Instituto do Sono, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Instituto do Sono, São Paulo, Brazil
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
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Rocha S, Fuligni A. The impact of the COVID-19 pandemic on adolescent sleep behavior. Curr Opin Psychol 2023; 52:101648. [PMID: 37454639 PMCID: PMC10290178 DOI: 10.1016/j.copsyc.2023.101648] [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: 06/01/2023] [Revised: 06/18/2023] [Accepted: 06/19/2023] [Indexed: 07/18/2023]
Abstract
Restorative sleep is a fundamental component of adolescent wellbeing, and the COVID-19 pandemic presented both challenges and opportunities for adolescents' sleep. In this review, we synthesize emergent themes from the growing scientific evidence for the impact of the pandemic on adolescent sleep behavior across different stages of the pandemic and in different locations around the world. We also highlight the ways in which COVID-19 shaped sleep patterns among college students-a subgroup of adolescents transitioning to emerging adulthood that were particularly impacted by the shift to remote learning. Finally, we discuss variations in the impact according to several potential moderating factors in adolescents' lives and point to areas that require additional longitudinal research.
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Affiliation(s)
- Sarah Rocha
- Department of Psychology, University of California, 2311 Psychology Building, Los Angeles, CA 90095, USA.
| | - Andrew Fuligni
- Department of Psychology, Department of Psychiatry and Biobehavioral Sciences, University of California, 760 Westwood Plaza, Box 62, Los Angeles, CA 90095, USA
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7
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Deng J, Zhou F, Hou W, Heybati K, Lohit S, Abbas U, Silver Z, Wong CY, Chang O, Huang E, Zuo QK, Moskalyk M, Ramaraju HB, Heybati S. Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta-analysis. Ann N Y Acad Sci 2023; 1520:53-73. [PMID: 36537131 PMCID: PMC9880764 DOI: 10.1111/nyas.14947] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.
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Affiliation(s)
- Jiawen Deng
- Temerty Faculty of MedicineUniversity of TorontoTorontoOntarioCanada
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Fangwen Zhou
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Wenteng Hou
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Schulich School of Medicine & DentistryUniversity of Western OntarioLondonOntarioCanada
| | - Kiyan Heybati
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Mayo Clinic Alix School of MedicineMayo Clinic (Rochester)RochesterMinnesotaUSA
| | - Simran Lohit
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Umaima Abbas
- Schulich School of Medicine & Dentistry (Windsor Campus)University of Western OntarioWindsorOntarioCanada
| | - Zachary Silver
- Department of Neuroscience, Faculty of ScienceCarleton UniversityOttawaOntarioCanada
| | - Chi Yi Wong
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Michael G. DeGroote School of Medicine (Waterloo Regional Campus)McMaster UniversityKitchenerOntarioCanada
| | - Oswin Chang
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Physician Assistant Education Program, Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Emma Huang
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
- Faculty of MedicineUniversity of OttawaOttawaOntarioCanada
| | - Qi Kang Zuo
- Department of AnesthesiologyRutgers New Jersey Medical SchoolNewarkNew JerseyUSA
- Faculty of ScienceMcGill UniversityMontréalQuebecCanada
| | - Myron Moskalyk
- Faculty of Health SciencesMcMaster UniversityHamiltonOntarioCanada
| | - Harikrishnaa Ba Ramaraju
- Virginia Commonwealth University School of MedicineVirginia Commonwealth UniversityRichmondVirginiaUSA
| | - Shayan Heybati
- Faculty of Health SciencesQueen's UniversityKingstonOntarioCanada
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Griggs S, Horvat Davey C, Howard Q, Pignatiello G, Duwadi D. Socioeconomic Deprivation, Sleep Duration, and Mental Health during the First Year of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192114367. [PMID: 36361248 PMCID: PMC9658920 DOI: 10.3390/ijerph192114367] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 05/27/2023]
Abstract
The coronavirus disease 2019 (COVID-19) has had a rapid and sustained negative impact on sleep and mental health in the United States with disproportionate morbidity and mortality among socioeconomically deprived populations. We used multivariable and logistic regression to evaluate the associations among sleep duration, mental health, and socioeconomic deprivation (social deprivation index) in 14,676 Ohio residents from 1101 zip code tabulation areas from the 2020 Behavioral Risk Factor Surveillance System (BRFSS) survey. Higher socioeconomic deprivation was associated with shorter sleep and poorer mental health after adjusting for covariates (age, sex, race, education, income, and body mass index) in the multivariable linear regression models. Those in the highest socioeconomically deprived areas had 1.6 and 1.5 times higher odds of short sleep (duration < 6 h) and poor mental health (>14 poor mental health days), respectively, in the logistic regression models. Previous researchers have focused on limited socio-environmental factors such as crowding and income. We examined the role of a composite area based measure of socioeconomic deprivation in sleep duration and mental health during the first year of COVID-19. Our results suggest the need for a broader framework to understand the associations among socioeconomic deprivation, sleep duration, and mental health during a catastrophic event.
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Affiliation(s)
- Stephanie Griggs
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Christine Horvat Davey
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Quiana Howard
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Grant Pignatiello
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Deepesh Duwadi
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH 44106, USA
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