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Xie MR, Li G, Shi YT, Kang L, Dou NN, Liu B, Cao JL, Fu SQ, Hao SG. Study on the correlation between insomnia degree and quality of life in psychiatric outpatients in Chifeng city. World J Psychiatry 2025; 15:103669. [DOI: 10.5498/wjp.v15.i5.103669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2024] [Revised: 01/27/2025] [Accepted: 03/06/2025] [Indexed: 04/30/2025] Open
Abstract
BACKGROUND Insomnia is a common sleep disorder that negatively impacts quality of life and is frequently comorbid with depression and anxiety. Chronic insomnia affects approximately 15% of the global population, with higher prevalence among females and the elderly. While existing research suggests a bidirectional relationship between insomnia and emotional disorders, the specific impact of insomnia severity on depression, anxiety, and quality of life remains unclear. This study investigates the correlation between insomnia severity and these factors in psychiatric outpatients, hypothesizing that greater insomnia severity is associated with higher levels of depression and anxiety, as well as poorer quality of life.
AIM To explore the correlation between insomnia severity and depression, anxiety, and quality of life in primary chronic insomnia patients.
METHODS From June to December 2023, 345 patients with primary insomnia in Chifeng city were recruited and divided into three groups based on Pittsburgh sleep quality index (PSQI) scores: Mild (n = 137), moderate (n = 162), and severe (n = 46). Demographic data were collected via questionnaires. Self-rating depression scale (SDS), self-rating anxiety scale (SAS), PSQI, and short form 36 (SF-36) scores were compared, and Pearson and partial correlation analyses were performed.
RESULTS The greater the degree of insomnia, the greater the symptoms of depression and anxiety (P < 0.001). The more severe the insomnia, the lower the SF-36 score (excluding body pain), and the difference between the three groups was statistically significant (P < 0.001). Pearson correlation analysis and partial correlation analysis depicted the SDS score and SAS score were apparently positively correlated with the severity of insomnia (P < 0.001). Pearson correlation analysis and partial correlation analysis depicted the SF-36 scores were apparently positively correlated with the severity of insomnia (P < 0.05).
CONCLUSION Depression and anxiety are independent factors influencing insomnia severity in primary chronic insomnia patients. Higher depression/anxiety levels correlate with worse insomnia, impacting quality of life.
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Affiliation(s)
- Meng-Ran Xie
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Gang Li
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Yu-Ting Shi
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Li Kang
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Na-Na Dou
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Bing Liu
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Jia-Li Cao
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Shi-Qi Fu
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
| | - Shi-Guang Hao
- Sleep Center, Anding Hospital of Chifeng, Chifeng 024000, Inner Mongolia Autonomous Region, China
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Ausserhofer D, Piccoliori G, Engl A, Marino P, Barbieri V, Lombardo S, Gärtner T, Wiedermann CJ. Sleep Problems and Sleep Quality in the General Adult Population Living in South Tyrol (Italy): A Cross-Sectional Survey Study. Clocks Sleep 2025; 7:23. [PMID: 40407629 PMCID: PMC12101147 DOI: 10.3390/clockssleep7020023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2025] [Revised: 04/30/2025] [Accepted: 05/06/2025] [Indexed: 05/26/2025] Open
Abstract
It remains unclear how sleep health has developed in the general population after the COVID-19 pandemic. This study aimed to (1) investigate the prevalence of sleep problems and poor sleep quality and (2) explore the associated sociodemographic and health-related factors in South Tyrol, Italy. A cross-sectional, population-based survey was conducted with a stratified probabilistic sample of 4000 adults aged ≥ 18 years. Sleep quality was assessed using the brief version of the Pittsburgh Sleep Quality Index. Descriptive and logistic regression analyses were performed to analyze the data. A total of 2090 adults (53%) completed the survey. Poor sleep quality was reported by 17.8%, with 28.2% of participants reporting insufficient sleep duration (i.e., six hours or less), 12.7% having problems staying asleep (i.e., waking up to 3-4 times a week and unable to fall asleep again), and 8.7% having problems falling asleep (i.e., >30 min). Sleep problems and poor sleep quality were associated with sociodemographic and health-related factors, including gender, age, mother tongue, chronic disease, and sleep hygiene. Notably, Italian-speaking participants reported poorer sleep quality and greater difficulty staying asleep compared to German-speaking participants, highlighting potential sociocultural influences on sleep health. This study contributes to understanding the unique sleep health challenges in a multilingual region, highlighting the role of sociocultural factors in sleep quality differences between language groups.
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Affiliation(s)
- Dietmar Ausserhofer
- Institute of General Practice and Public Health, Claudiana, 39100 Bolzano-Bozen, Italy; (G.P.); (A.E.); (P.M.); (V.B.); (C.J.W.)
- Claudiana Research, College of Healthcare Professions, 39100 Bolzano-Bozen, Italy
| | - Giuliano Piccoliori
- Institute of General Practice and Public Health, Claudiana, 39100 Bolzano-Bozen, Italy; (G.P.); (A.E.); (P.M.); (V.B.); (C.J.W.)
| | - Adolf Engl
- Institute of General Practice and Public Health, Claudiana, 39100 Bolzano-Bozen, Italy; (G.P.); (A.E.); (P.M.); (V.B.); (C.J.W.)
| | - Pasqualina Marino
- Institute of General Practice and Public Health, Claudiana, 39100 Bolzano-Bozen, Italy; (G.P.); (A.E.); (P.M.); (V.B.); (C.J.W.)
| | - Verena Barbieri
- Institute of General Practice and Public Health, Claudiana, 39100 Bolzano-Bozen, Italy; (G.P.); (A.E.); (P.M.); (V.B.); (C.J.W.)
| | - Stefano Lombardo
- Provincial Institute of Statistics (ASTAT), 39100 Bolzano-Bozen, Italy; (S.L.); (T.G.)
| | - Timon Gärtner
- Provincial Institute of Statistics (ASTAT), 39100 Bolzano-Bozen, Italy; (S.L.); (T.G.)
| | - Christian J. Wiedermann
- Institute of General Practice and Public Health, Claudiana, 39100 Bolzano-Bozen, Italy; (G.P.); (A.E.); (P.M.); (V.B.); (C.J.W.)
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Mongeau M, Huo Yung Kai S, Bongard V, Coley N, Bérard E, Ferrières J. One-year post lockdown trajectories of mental health and impact of COVID-19 lockdown-related factors. Front Public Health 2025; 13:1457895. [PMID: 40144985 PMCID: PMC11936785 DOI: 10.3389/fpubh.2025.1457895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 02/26/2025] [Indexed: 03/28/2025] Open
Abstract
Introduction Concerns about the impact of restrictive measures on people's wellbeing, especially mental health, were raised by the COVID-19 pandemic and related lockdown measures. Methods In this study, we examined longitudinal trajectories of mental health during the initial French lockdown period and up to one-year post-lockdown, among a representative sample of French adults aged over 50. We also assessed the impact of COVID-19 lockdown-related factors on mental health. A cohort of 534 individuals was enrolled during the first French lockdown in March 2020, and four telephone interviews were conducted during the lockdown, and at 1-, 6- and 12-months post-lockdown. Mental health was assessed using validated scores of anxiety and depression (GAD-7 and PHQ-9, respectively). Participants undergoing treatment for anxiety or depression at inclusion were excluded. Results Our analysis revealed a significant decrease in the proportion of individuals experiencing poor mental health (elevated GAD-7 or PHQ-9 > 4) from lockdown period to 1 month and 6 months post-lockdown. However, this improvement stopped at 12 months post-lockdown, likely reflecting the reinstatement of strict measures in 2021. We used logistic regression to identify factors independently associated with early and long-lasting deterioration in mental health (elevated GAD-7 or PHQ-9 > 4 at first or second interview that persisted over at least two interviews). History of anxiety, poor perceived global health, female gender, working during lockdown, not being in a relationship, and having a relative suspected of being COVID-positive were significantly associated with deterioration in mental health. Discussion Our study highlights factors associated with a mental health impact during and following a lockdown in a representative sample of people, aged over 50 years old, thus at increased risk of severe COVID-19 and more likely to be subject to lockdown measures. These factors could be targeted in public health actions in future pandemics.
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Affiliation(s)
- Mathilde Mongeau
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Samantha Huo Yung Kai
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
- Artherosclerosis Risk and Treatment Evaluation Towards Risk Reduction Epidemiology (ARTERRE) Axe, Centre for Epidemiology and Research in Population Health (CERPOP), INSERM-University of Toulouse UPS, Toulouse, France
| | - Vanina Bongard
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
- Artherosclerosis Risk and Treatment Evaluation Towards Risk Reduction Epidemiology (ARTERRE) Axe, Centre for Epidemiology and Research in Population Health (CERPOP), INSERM-University of Toulouse UPS, Toulouse, France
- Department of Cardiology, Toulouse University Hospital (CHU), Toulouse, France
| | - Nicola Coley
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
- Aging Research Team, Centre for Epidemiology and Research in Population Health (CERPOP), INSERM-University of Toulouse UPS, Toulouse, France
- Institut Hospitalo-Universitaire (IHU) HealthAge, Toulouse, France
| | - Emilie Bérard
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
- Artherosclerosis Risk and Treatment Evaluation Towards Risk Reduction Epidemiology (ARTERRE) Axe, Centre for Epidemiology and Research in Population Health (CERPOP), INSERM-University of Toulouse UPS, Toulouse, France
| | - Jean Ferrières
- Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
- Artherosclerosis Risk and Treatment Evaluation Towards Risk Reduction Epidemiology (ARTERRE) Axe, Centre for Epidemiology and Research in Population Health (CERPOP), INSERM-University of Toulouse UPS, Toulouse, France
- Department of Cardiology, Toulouse University Hospital (CHU), Toulouse, France
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Garbarino S, Bodini A, Sabina S, Leo CG, Mincarone P, Rissotto A, Fusco S, Guarino R, Tumolo MR, Tripepi GL, Scoditti E, Magnavita N. Not All Workers Experience Equal Sleep Changes: Insights from the "WorkInCovid" Project. Clocks Sleep 2025; 7:13. [PMID: 40136850 PMCID: PMC11941416 DOI: 10.3390/clockssleep7010013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 03/06/2025] [Accepted: 03/07/2025] [Indexed: 03/27/2025] Open
Abstract
The COVID-19 outbreak has changed work organization in favor of a working from home (WH) modality. We examined the association of WH during the pandemic with sleep health in workers of a public research organization. An online cross-sectional survey in 2022 at the National Research Council of Italy collected information on sociodemographics, work characteristics, and sleep pattern during WH compared with before WH. In the whole sample (n = 748), total sleep quality did not significantly change. Excessive daytime sleepiness (EDS) decreased during WH. Total sleep quality increased during WH in poor sleepers, while it decreased in good sleepers. The morning chronotype was protective against sleep worsening in poor sleepers. Risk factors were depression in poor and good sleepers, and increased daytime sleepiness and body weight gain in good sleepers. These findings emphasize the importance of baseline sleep pattern in shaping the impact of WH on sleep.
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Affiliation(s)
- Sergio Garbarino
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, 16132 Genoa, Italy
- Post-Graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
| | - Antonella Bodini
- Institute for Applied Mathematics and Information Technologies “E. Magenes” (IMATI), National Research Council (CNR), 20133 Milano, Italy;
| | - Saverio Sabina
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (S.S.); (C.G.L.); (R.G.); (E.S.)
| | - Carlo Giacomo Leo
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (S.S.); (C.G.L.); (R.G.); (E.S.)
| | - Pierpaolo Mincarone
- Institute for Research on Population and Social Policies (IRPPS), National Research Council (CNR), Research Unit of Brindisi, 72100 Brindisi, Italy;
| | - Antonella Rissotto
- Training and Welfare Unit, National Research Council (CNR), 00185 Rome, Italy; (A.R.); (S.F.)
| | - Stanislao Fusco
- Training and Welfare Unit, National Research Council (CNR), 00185 Rome, Italy; (A.R.); (S.F.)
| | - Roberto Guarino
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (S.S.); (C.G.L.); (R.G.); (E.S.)
| | - Maria Rosaria Tumolo
- Department of Biological and Environmental Sciences and Technology (DISTEBA), University of Salento, 73100 Lecce, Italy;
| | - Giovanni Luigi Tripepi
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 89124 Reggio Calabria, Italy;
| | - Egeria Scoditti
- Institute of Clinical Physiology (IFC), National Research Council (CNR), 73100 Lecce, Italy; (S.S.); (C.G.L.); (R.G.); (E.S.)
| | - Nicola Magnavita
- Post-Graduate School of Occupational Health, Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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5
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Paleari FG, Cavagnis L, Ertan I, Fincham FD. Moral transgressions, psychological well-being, and family conflict in the context of the COVID-19 pandemic: The role of self-forgiveness. BMC Psychol 2025; 13:200. [PMID: 40038826 PMCID: PMC11881389 DOI: 10.1186/s40359-025-02513-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 02/19/2025] [Indexed: 03/06/2025] Open
Abstract
PURPOSE The COVID-19 pandemic led many individuals to experience moral transgressions, exacerbating feelings of guilt and remorse. This study explored the role of the self-forgiveness of such transgressions in explaining their associations with psychological well-being and family conflict. We hypothesized that (a) higher levels of self-forgiveness would be associated with greater psychological well-being and reduced family conflict, (b) the perceived relevance of moral transgressions would be positively associated with self-forgiveness and indirectly associated with psychological well-being and family conflict through the mediation of self-forgiveness, and (c) the relationships between the variables of interest could vary across age. METHOD Adults (N = 277; M age = 30.04) completed anonymous online questionnaires assessing the relevance of transgressions committed, forgiveness and unforgiveness of self, psychological well-being, and family conflict during the first COVID-19 lockdown in Italy. RESULTS Structural equation modeling revealed that transgression relevance was positively associated with both forgiveness and unforgiveness of self, and indirectly related to psychological well-being and family conflict via self-forgiveness. Greater forgiveness of self was related to greater eudaimonic well-being, whereas greater unforgiveness of self was linked to increased family conflict and reduced eudaimonic well-being. The findings also indicated that age moderated the relationship between forgiveness of self and hedonic well-being, with the association weakening as age increased. CONCLUSIONS The results highlight the importance of promoting self-forgiveness to enhance psychological resilience and familial stability, particularly during challenging times.
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Affiliation(s)
| | - Lucrezia Cavagnis
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Irem Ertan
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Frank D Fincham
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
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Arcand M, Zerroug Y, Peyrot C, Cernik R, Herba CM, Marin M. Effect of Coping Strategies on Perceived Stress and Hair Cortisol Levels During the COVID-19 Pandemic According to Sex. Stress Health 2025; 41:e70012. [PMID: 39905738 PMCID: PMC11795019 DOI: 10.1002/smi.70012] [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: 02/20/2024] [Revised: 01/20/2025] [Accepted: 01/23/2025] [Indexed: 02/06/2025]
Abstract
The COVID-19 crisis generated subjective and physiological stress, with important interindividual differences. Studies have shown that coping strategies and sex modulate subjective stress, although their effects on stress hormones have been overlooked. In addition, it remains unknown whether sex and coping interact to predict these stress metrics during long-term stressful events. To examine the impact of coping strategies, sex, and their interaction on subjective and physiological indicators of stress during the year following the arrival of the COVID-19 virus. Coping strategies were assessed using the Brief COPE questionnaire in May 2020. Stress symptoms were assessed as a subjective indicator of stress every 3 months (June 2020 to March 2021) with the Perceived Stress Scale questionnaire in 155 participants (49 men). Of these individuals, 111 provided a 6-cm hair sample in June 2020 to estimate cortisol levels as a physiological indicator of stress before and during the first lockdown. A factor analysis identified three clusters of coping strategies: positive-oriented, avoidance-oriented, and social support. For subjective stress, a linear-mixed model showed that women reported more stress than men. Positive-oriented and avoidance-oriented strategies were associated with less and more stress, respectively. An interaction between sex and coping strategies indicated a positive relationship between social support and perceived stress levels in men. However, among men and women who used this strategy infrequently, women reported higher stress levels than men. For physiological stress, a regression revealed that women had greater cortisol secretion in response to the pandemic. These findings suggest that coping and sex modulate subjective stress, whereas sex influences physiological stress.
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Affiliation(s)
- Maryse Arcand
- Centre de recherche de l’Institut universitaire en santé mentale de MontréalMontrealCanada
- Department of Psychiatry and AddictionUniversité de MontréalMontréalCanada
| | - Yasmine Zerroug
- Centre de recherche de l’Institut universitaire en santé mentale de MontréalMontrealCanada
- Department of PsychologyUniversité du Québec à MontréalMontréalCanada
- Sainte‐Justine University Hospital Research CenterMontréalCanada
| | - Clémence Peyrot
- Centre de recherche de l’Institut universitaire en santé mentale de MontréalMontrealCanada
- Department of Psychiatry and AddictionUniversité de MontréalMontréalCanada
| | - Rebecca Cernik
- Centre de recherche de l’Institut universitaire en santé mentale de MontréalMontrealCanada
- Department of PsychologyUniversité du Québec à MontréalMontréalCanada
| | - Catherine M. Herba
- Department of Psychiatry and AddictionUniversité de MontréalMontréalCanada
- Department of PsychologyUniversité du Québec à MontréalMontréalCanada
- Sainte‐Justine University Hospital Research CenterMontréalCanada
| | - Marie‐France Marin
- Centre de recherche de l’Institut universitaire en santé mentale de MontréalMontrealCanada
- Department of Psychiatry and AddictionUniversité de MontréalMontréalCanada
- Department of PsychologyUniversité du Québec à MontréalMontréalCanada
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Blackman J, Gabb VG, Carrigan N, Wearn A, Meky S, Selwood J, Desai B, Piggins HD, Turner N, Greenwood R, Coulthard E. Sleep quality during and after severe acute respiratory syndrome coronavirus 2 (COVID-19) lockdowns in the UK: Results from the SleepQuest study. J Sleep Res 2024; 33:e14205. [PMID: 38650540 PMCID: PMC11597021 DOI: 10.1111/jsr.14205] [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: 12/14/2023] [Revised: 02/23/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024]
Abstract
Sleep is fundamental to health. The aim of this study was to analyse and determine factors predicting sleep quality during and after national lockdowns due to severe acute respiratory syndrome coronavirus 2 (COVID-19) in the UK. A longitudinal online survey-based study (SleepQuest) involving UK adults was administered in Spring 2020, Winter 2020, and Winter 2022 including questionnaires probing sleep quality, depression, anxiety, beliefs about sleep, demographics, COVID-19 status, and exercise. The primary outcome was sleep quality (Pittsburgh Sleep Quality Index). A linear mixed-effects model evaluated factors associated with baseline and longitudinal sleep quality. Complete data were provided by 3306 participants in Spring 2020, 2196 participants in Winter 2020, and 1193 in Winter 2022. Participants were mostly female (73.8%), white (97.4%), and aged over 50 years (81.0%). On average, participants reported poor sleep quality in Spring 2020 (mean [SD] Pittsburgh Sleep Quality Index score = 6.59 [3.6]) and Winter 2020 (mean [SD] Pittsburgh Sleep Quality Index score = 6.44 [3.6]), with improved but still poor sleep quality in Winter 2022 (mean [SD] Pittsburgh Sleep Quality Index score = 6.17 [3.5]). Improved sleep quality was driven by better subjective sleep and reduced daytime dysfunction and sleep latency. Being female, older, having caring responsibilities, working nightshifts, and reporting higher levels of depression, anxiety, and unhelpful beliefs about sleep were associated with worse baseline PSQI scores. Better sleep quality was associated with more days exercising per week at baseline. Interventions focusing on improving mental health, exercise, and attitudes towards sleep, particularly in at-risk groups, may improve sleep-related outcomes in future pandemics.
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Affiliation(s)
- Jonathan Blackman
- Institute of Clinical NeurosciencesUniversity of BristolBristolUK
- Bristol Brain CentreSouthmead Hospital, North Bristol NHS TrustBristolUK
| | - Victoria Grace Gabb
- Institute of Clinical NeurosciencesUniversity of BristolBristolUK
- Bristol Brain CentreSouthmead Hospital, North Bristol NHS TrustBristolUK
- NIHR Bristol Biomedical Research CentreUniversity of BristolBristolUK
| | - Neil Carrigan
- Institute of Clinical NeurosciencesUniversity of BristolBristolUK
| | - Alfie Wearn
- Institute of Clinical NeurosciencesUniversity of BristolBristolUK
| | - Saba Meky
- Bristol Brain CentreSouthmead Hospital, North Bristol NHS TrustBristolUK
- Department of PsychologyUniversity of BathBathUK
| | - James Selwood
- Institute of Clinical NeurosciencesUniversity of BristolBristolUK
- Bristol Brain CentreSouthmead Hospital, North Bristol NHS TrustBristolUK
| | - Bhavisha Desai
- Institute of Clinical NeurosciencesUniversity of BristolBristolUK
| | - Hugh D. Piggins
- School of Physiology, Pharmacology and NeuroscienceUniversity of BristolBristolUK
| | - Nicholas Turner
- Population Health Sciences InstituteBristol Medical School, University of BristolBristolUK
| | - Rosemary Greenwood
- NIHR Research & Design Service South WestUniversity Hospitals Bristol and Weston NHS Foundation Trust, Education & Research CentreBristolUK
| | - Elizabeth Coulthard
- Institute of Clinical NeurosciencesUniversity of BristolBristolUK
- Bristol Brain CentreSouthmead Hospital, North Bristol NHS TrustBristolUK
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8
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Liu S, Wang LX, Chen MS, Cao H, Cunningham TJ, Joormann J. Sleep bad, feel bad: Unpacking the role of exercise and socializing. Behav Res Ther 2024; 183:104652. [PMID: 39549309 DOI: 10.1016/j.brat.2024.104652] [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: 06/28/2024] [Revised: 10/26/2024] [Accepted: 11/08/2024] [Indexed: 11/18/2024]
Abstract
This study investigates the daily associations between sleep disturbances and emotional well-being, focusing on exercise and social interaction as potential moderating factors. Using a longitudinal daily diary approach, we analyzed data from 455 participants (mean age = 41.98 years, 382 females) who reported daily diaries over 20 days. Multilevel modeling was employed to analyze both within- and between-person relations between sleep variables (duration, efficiency, difficulty falling asleep) and next day positive/negative affect. The analysis also explored the moderating roles of exercise and socializing, adjusting for age, sex, and COVID-related variables. Our findings indicate that at both within- and between-person levels, higher sleep efficiency predicted increased positive affect and reduced negative affect; conversely, difficulty falling asleep predicted diminished positive affect and heightened negative affect. Sleep duration had a nonlinear relationship with positive and negative affect, with both longer and shorter than usual sleep duration predicting less positive and more negative affect. Exercise and socializing showed different moderating roles in the relationship between sleep and negative affect. Exercise was found to mitigate the negative impact of poor sleep on negative affect, whereas extended socializing amplified the salutary impact of good sleep on reducing negative affect. Our findings underscore the importance of sleep health in daily emotional well-being, suggesting associations between sleep efficiency, difficulty falling asleep, and next-day affect at both within- and between-person levels. Furthermore, the distinct moderation patterns of exercise and socializing provide unique insights into the interplay of sleep, exercise, and social interaction, allowing more targeted interventions.
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Affiliation(s)
- Sihan Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China; Department of Psychology, Yale University, United States.
| | - Lin-Xin Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | | | - Huiting Cao
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Tony J Cunningham
- Center for Sleep and Cognition, Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, United States
| | - Jutta Joormann
- Department of Psychology, Yale University, United States
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9
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Kim D, Yun JY, Lee HA, Song P, Ahn H, Yang CM, Kim JH. Validation of the Korean version of the Sleep Hygiene Practice Scale in a Non-Clinical Population. Behav Sleep Med 2024; 22:791-802. [PMID: 38889314 DOI: 10.1080/15402002.2024.2367461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
OBJECTIVES This study aimed to validate the Korean version of the sleep hygiene practice scale (SHPS-K) and determine its effectiveness in screening poor sleepers with insomnia. METHODS Online survey was conducted using translated SHPS in Korean, the Korean versions of the Pittsburgh Sleep Quality Index (PSQI-K), Insomnia Severity Index (ISI-K), and Epworth Sleepiness Scale (KESS) in a non-clinical population. The internal consistency and test-retest reliability of the SHPS-K were assessed using Cronbach's alpha and intraclass correlation coefficients (ICC), respectively. Construct validity was evaluated using correlation analyses with other questionnaires and confirmatory factor analysis. We determined the cutoff values that could identify poor sleepers with insomnia symptoms (PSQI-K > 5 and ISI-K ≥ 15) using receiver operating characteristic analysis. RESULTS A total of 484 participants (242 women, mean age of 43.8 years) were enrolled. The average SHPS-K score was 71.2, with no significant sex differences. Women had poorer sleep scheduling and timing behaviors, and men had poorer eating and drinking behaviors. Good internal consistency (Cronbach's alpha = 0.88) and test-retest reliability (ICC = 0.80) were observed. The SHPS-K was positively correlated with the PSQI-K (r = 0.55), ISI-K (r = 0.54), and KESS (r = 0.42). A cutoff value of 73 identified poor sleepers with insomnia (area under the curve = 0.828). CONCLUSIONS The SHPS-K is a reliable instrument for evaluating sleep hygiene in non-clinical Korean populations.
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Affiliation(s)
- Dongyeop Kim
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Ji Young Yun
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
| | - Hye Ah Lee
- Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea
| | - Pamela Song
- Department of Neurology, Ilsan Baek Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Heeyoung Ahn
- Korean Linguistics & Korean Language Education Institute of International Cooperation and Education, University of Seoul, Seoul, Republic of Korea
| | - Chien-Ming Yang
- Department of Psychology/Research Center for Mind, Brain, & Learning, National Chengchi University, Taipei, Taiwan
| | - Jee Hyun Kim
- Department of Neurology, Ewha Womans University Seoul Hospital, Ewha Womans University College of Medicine, Seoul, Republic of Korea
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10
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Acosta Enríquez ME, Azzolina D, De la Cruz Alvarez A, Bezáres Sarmiento VDR, Gregori D, Lorenzoni G. Sleep Patterns, Social Media Usage, and Dietary Habits during COVID-19 Lockdown in Mexico: A Cross-Sectional Study. Behav Sci (Basel) 2024; 14:906. [PMID: 39457778 PMCID: PMC11504667 DOI: 10.3390/bs14100906] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2024] [Revised: 09/21/2024] [Accepted: 09/25/2024] [Indexed: 10/28/2024] Open
Abstract
During the COVID-19 lockdown, a high prevalence of disruption in lifestyle habits was reported, especially concerning sleep habits. The present study aimed to explore the relationship between lifestyles and the COVID-19 lockdown on subjects living in Mexico. A cross-sectional survey was conducted. An online questionnaire was administered to survey participants. A clustering procedure was performed to identify groups of survey respondents with similar characteristics. There were 155 survey respondents. Most of them were women (83%) of young age. The clustering identified two distinct groups of subjects, i.e., Cluster 1 and 2. The subjects in Cluster 2 were younger, more likely to use social media, and spent much more time watching TV/surfing the internet than subjects in Cluster 1. Furthermore, the prevalence of problems with falling and staying asleep during the lockdown was higher in Cluster 2 than in Cluster 1 (14% in Cluster 2 vs. 4% in Cluster 1) even though nobody from Cluster 2 had sleep problems before the lockdown. The study showed that younger respondents were those more affected by lockdown measures.
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Affiliation(s)
- María Elena Acosta Enríquez
- Facultad de Ciencias de la Salud, Universidad de Montemorelos, Montemorelos 67515, Nuevo León, Mexico; (M.E.A.E.); (A.D.l.C.A.)
| | - Danila Azzolina
- Department of Environmental and Preventive Science, University of Ferrara, 44121 Ferrara, Italy;
| | - Anairotciv De la Cruz Alvarez
- Facultad de Ciencias de la Salud, Universidad de Montemorelos, Montemorelos 67515, Nuevo León, Mexico; (M.E.A.E.); (A.D.l.C.A.)
| | | | - Dario Gregori
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy;
| | - Giulia Lorenzoni
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy;
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11
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Mukherjee U, Sehar U, Brownell M, Reddy PH. Mechanisms, consequences and role of interventions for sleep deprivation: Focus on mild cognitive impairment and Alzheimer's disease in elderly. Ageing Res Rev 2024; 100:102457. [PMID: 39154978 DOI: 10.1016/j.arr.2024.102457] [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: 08/02/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
Sleep is established as an essential physiological need that impacts physical, emotional, and cognitive functions profoundly. Physiologically, inadequate sleep weakens immune function, heightening susceptibility to infections and chronic illnesses such as obesity, diabetes, and cardiovascular diseases. Hormonal disruptions due to sleep loss further exacerbate metabolic dysregulation, contributing to weight gain and other health complications. Emotionally, sleep deprivation leads to mood disturbances, including increased irritability, heightened stress responses, and a greater likelihood of mood disorders like depression and anxiety. These effects are compounded by cognitive impairments such as reduced alertness, impaired memory consolidation, and compromised decision-making abilities, akin to the impairments caused by alcohol consumption. Motor skills and coordination also suffer, elevating the risk of accidents, particularly in high-stress environments. For older adults, sleep quality is closely linked to cognitive function and overall longevity. Optimal sleep patterns are associated with slower brain aging and improved health outcomes. However, sleep disorders exacerbate existing conditions such as epilepsy and asthma, necessitating interventions like cognitive behavioral therapy (CBT) and medications such as melatonin to mitigate their impact. Education emerges as a crucial tool in promoting healthier sleep habits across all age groups. Addressing misconceptions about sleep and integrating sleep health into public health policies are essential steps toward improving overall well-being. Additionally, lifestyle factors such as diet and physical activity play significant roles in regulating sleep patterns, further emphasizing the interconnectedness of sleep with broader health outcomes. In summary, the articles underscore the intricate mechanisms through which sleep influences physiological functions and advocate for comprehensive approaches to enhance sleep hygiene and mitigate the adverse effects of sleep deprivation on human health.
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Affiliation(s)
- Upasana Mukherjee
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Malcolm Brownell
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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12
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Jiang Y, Ge S, Wang C, Jin C, Zhao Y, Liu Q. Causal Relationship Between Micronutrient and Sleep Disorder: A Mendelian Randomization Study. Nat Sci Sleep 2024; 16:1267-1277. [PMID: 39219617 PMCID: PMC11363938 DOI: 10.2147/nss.s475171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024] Open
Abstract
Background Sleep played an important part in human health, and COVID-19 led to a continuous deterioration of sleep. However, the causal relationship between micronutrient and sleep disorder was not yet fully understood. Methods In this research, the genetic causal relationship between micronutrient and sleep disorder was analyzed utilizing a two-sample Mendelian randomization (MR). Single nucleotide polymorphisms (SNPs) were used as instrumental variables. The analyses were conducted using the MR-Egger, inverse variance weighted, weighted mode, weighted median, simple mode, Cochran's Q test and leave-one-out. Results Our results suggested that 8 genetically predicted micronutrients participated in sleep disorders, including liver iron (L-iron) and iron in sleeping too much, spleen iron (S-iron) in sleeplessness/insomnia, trouble falling or staying asleep, sleep duration (undersleepers) and nonorganic sleeping disorders, iron metabolism disorder (IMD) and vitamin B12 deficiency anaemia (VB12DA) in narcolepsy, urine sodium (uNa) in narcolepsy, sleep apnea syndrome and sleep disorder, vitamin D (VD) in sleep duration (oversleepers), 25-Hydroxyvitamin D (25(OH)D) in trouble falling or staying asleep. Conclusion Our study used Mendelian randomization methods at the SNP level to explore the potential causal relationship among L-iron, iron, S-iron, IMD, uNa, 25(OH)D, VD, VB12DA with certain sleep disorder subtypes. Our results uncovered a micronutrient-based strategy for alleviating sleep disorder symptoms.
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Affiliation(s)
- Yingying Jiang
- Department of Neuropharmacology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China
| | - Siqi Ge
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China
| | - Chunyang Wang
- Department of Neuropharmacology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China
| | - Chen Jin
- Department of Neuropharmacology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China
| | - Yumei Zhao
- Department of Neuropharmacology, Beijing Neurosurgical Institute, Capital Medical University, Beijing, People’s Republic of China
| | - Qingying Liu
- Department of Pain Medicine, the First Affiliated Hospital of Zhengzhou University, Henan, 450052, People’s Republic of China
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13
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Windal M, Roland A, Laeremans M, Briganti G, Kornreich C, Mairesse O. Chronotype Differences and Symptom Network Dynamics of Post-Pandemic Sleep in Adolescents and Young Adults. J Clin Med 2024; 13:5020. [PMID: 39274233 PMCID: PMC11395810 DOI: 10.3390/jcm13175020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Revised: 08/20/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
Background: Social restrictions during the COVID-19 pandemic resulted in altered sleep patterns and mental health challenges, particularly among adolescents and young adults. Our objective was to examine the potential difference in insomnia prevalence and sleep patterns in this population between the first COVID-19 lockdown and the post-lockdown period, with a focus on chronotype. Additionally, we explored the network of sleep-related differences between these two periods. Methods: A total of 946 respondents participated in our online questionnaire. We performed mixed ANOVA, Ising network and Directed Acyclic Graph (DAG) analyses. Results: Respondents reported going to bed earlier, waking up earlier, sleeping less, and feeling less mentally tired than during the lockdown. The severity of insomnia symptoms did not change. The lethargic chronotype reported more insomnia symptoms, depressive feelings, and agitation than others. Mental fatigue was the central symptom in the Ising network and served as the parent node in the DAG. Conclusions: Post-lockdown, adolescents and young adults have shifted to earlier sleep and wake times with reduced overall sleep, and they experience fewer depressive feelings and less agitation, though insomnia symptoms remain unchanged. Participants who reported increased irritability or poorer sleep quality during confinement also reported similar or diminished attentional capacities compared to their usual levels.
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Affiliation(s)
- Maxime Windal
- Faculty of Psychology, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Aurore Roland
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | | | - Giovanni Briganti
- Chair of Artificial Intelligence and Digital Medicine, Faculté de Médecine, Université de Mons, 7000 Mons, Belgium
- Laboratoire de Psychologie Médicale et Addictologie, Faculté de Médecine, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Department of Clinical Sciences, Faculté de Médecine, Université de Liège, 4000 Liège, Belgium
| | - Charles Kornreich
- Laboratoire de Psychologie Médicale et Addictologie, Faculté de Médecine, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Laboratoire de Psychologie Médicale et Addictologie, Centre Hospitalier Universitaire Brugmann, 1020 Brussels, Belgium
| | - Olivier Mairesse
- Brain, Body and Cognition, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Brussels, Belgium
- Laboratoire de Psychologie Médicale et Addictologie, Centre Hospitalier Universitaire Brugmann, 1020 Brussels, Belgium
- Vital Signs and PERformance Monitoring (VIPER), LIFE Department, Royal Military Academy, 1000 Brussels, Belgium
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14
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Alshammari TK, Rogowska AM, Alobaid AM, Alharthi NW, Albaker AB, Alshammari MA. Examining Anxiety and Insomnia in Internship Students and Their Association with Internet Gaming Disorder. J Clin Med 2024; 13:4054. [PMID: 39064091 PMCID: PMC11278388 DOI: 10.3390/jcm13144054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Revised: 07/07/2024] [Accepted: 07/08/2024] [Indexed: 07/28/2024] Open
Abstract
Background: Internships are a mandatory graduation requirement to help medical students transition to the work environment. Some individuals are prone to anxiety in an unfamiliar environment, which is a public concern among young adults. Here, we investigated the mechanism between internet gaming disorder and anxiety and insomnia among internship students. Methods: A convenient sample of 267 internship students was collected in a cross-sectional study module between 17 July and 27 December 2022. The survey contained a 7-item Generalized Anxiety Disorder (GAD-7), Athens Insomnia Scale (AIS), and Internet Gaming Disorder Scale-Short-Form (IGDS9-SF). The association was estimated using Pearson's correlations, and network analysis was performed to characterize these associations. Results: Our results indicate that about 60% of participants exhibited mild to severe anxiety and insomnia, while 2.28% showed symptoms of internet gaming disorder. Also, we found a moderate association between anxiety and insomnia. An item-level analysis indicated that GAD_1 "feeling anxious" and GAD_5 "unable to sit still" are essential for gaming, and that GAD_2 "uncontrollable worrying" is crucial for insomnia. This indicated an interplay between these items, supported by our centrality analysis, where we found that GAD_1 and GAD_2 depicted high centrality. Conclusions: We found high rates of anxiety and insomnia in internship students and the association between selected symptoms of anxiety and insomnia. At the same time, low rates of internet gaming disorder could be attributed to a lack of time for entertainment and an increased awareness of its risks. Given these findings, an awareness of anxiety and insomnia risk should be emphasized.
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Affiliation(s)
- Tahani K. Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.B.A.); (M.A.A.)
| | | | - Anan M. Alobaid
- College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.A.); (N.W.A.)
| | - Noor W. Alharthi
- College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.M.A.); (N.W.A.)
| | - Awatif B. Albaker
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.B.A.); (M.A.A.)
| | - Musaad A. Alshammari
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia; (A.B.A.); (M.A.A.)
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15
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Kulbin K, Jõgi AL, Pulver A, Kask K. Heterogeneous trajectories of perceived stress and their associations with active leisure: a longitudinal study during the first year of COVID-19. Front Public Health 2024; 12:1327966. [PMID: 38784577 PMCID: PMC11112114 DOI: 10.3389/fpubh.2024.1327966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Introduction There is a plethora of literature on the dynamics of mental health indicators throughout the COVID-19 pandemic, yet research is scarce on the potential heterogeneity in the development of perceived stress. Furthermore, there is a paucity of longitudinal research on whether active leisure engagement, which typically is beneficial in reducing stress, might have similar benefits during times of major disruption. Here we aimed to extend previous work by exploring the dynamics of change in stress and coping, and the associations with active leisure engagement over the first year of COVID-19. Methods Data from 439 adults (Mage = 45, SD = 13) in Estonia who participated in a longitudinal online study were analyzed. The participants were assessed at three timepoints: April-May 2020; November-December 2020; and April-May 2021. Results Mean stress and coping levels were stable over time. However, latent profile analysis identified four distinct trajectories of change in stress and coping, involving resilient, stressed, recovering, and deteriorating trends. Participants belonging to the positively developing stress trajectories reported higher active leisure engagement than those belonging to the negatively developing stress trajectories. Discussion These findings highlight the importance of adopting person-centered approaches to understand the diverse experiences of stress, as well as suggest the promotion of active leisure as a potentially beneficial coping resource, in future crises.
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Affiliation(s)
- Karel Kulbin
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Anna-Liisa Jõgi
- School of Educational Sciences, Tallinn University, Tallinn, Estonia
- Department of Teacher Education, University of Jyväskylä, Jyväskylä, Finland
| | - Aleksander Pulver
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
| | - Kristjan Kask
- School of Natural Sciences and Health, Tallinn University, Tallinn, Estonia
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16
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Zagaria A, Serena S, Musetti A, Rapelli G, De Gennaro L, Plazzi G, Franceschini C. Poor sleep hygiene practices are associated with a higher increase in sleep problems during the COVID-19 pandemic: A latent change score model. J Sleep Res 2024; 33:e14057. [PMID: 37776031 DOI: 10.1111/jsr.14057] [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: 08/31/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
The Coronavirus 2019 (COVID-19) pandemic significantly influenced physical and mental health worldwide. The present study aimed to investigate changes in sleep problems across three waves of the COVID-19 pandemic, and to identify potential predictors of the inter-individual variability around these changes, with a particular focus on the role of detrimental sleep hygiene practices. A total of 352 participants completed an online survey of self-report questionnaires at three different waves of the COVID-19 pandemic: T1 (Spring 2020); T2 (Autumn-Winter 2020); and T3 (Spring 2021). The questionnaires collected information on socio-demographic and COVID-19-related variables, psychological distress (i.e. the Depression Anxiety Stress Scale-21), sleep hygiene (i.e. the Sleep Hygiene Index) and sleep problems (i.e. the Medical Outcomes Study-Sleep Scale). Latent change score modelling revealed an average increase in sleep problems between T1 and T2 with significant inter-individual variability. No substantial changes were observed on average between T2 and T3. Notably, poorer sleep hygiene practices were associated with a more pronounced increase in sleep problems between T1 and T2 (β = 0.191, p = 0.013), even after controlling for relevant confounders such as demographic factors, COVID-19-related information and psychological distress. These findings expand on previous research regarding the detrimental effects of the pandemic on mental health, suggesting that interventions targeting sleep hygiene practices may be beneficial for mitigating its negative impact on sleep disruptions.
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Affiliation(s)
- Andrea Zagaria
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Scarpelli Serena
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Alessandro Musetti
- Department of Humanities, Social Sciences and Cultural Industries, University of Parma, Parma, Italy
| | - Giada Rapelli
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
- Body and Action Lab, IRCSS Fondazione Santa Lucia, Rome, Italy
| | - Giuseppe Plazzi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio-Emilia, Modena, Italy
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17
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Meaklim H, Le F, Drummond SPA, Bains SK, Varma P, Junge MF, Jackson ML. Insomnia is more likely to persist than remit after a time of stress and uncertainty: a longitudinal cohort study examining trajectories and predictors of insomnia symptoms. Sleep 2024; 47:zsae028. [PMID: 38308584 PMCID: PMC11009016 DOI: 10.1093/sleep/zsae028] [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: 08/28/2023] [Revised: 12/07/2023] [Indexed: 02/05/2024] Open
Abstract
STUDY OBJECTIVES The study aimed to characterize insomnia symptom trajectories over 12 months during a time of stress and uncertainty, the coronavirus disease 2019 (COVID-19) pandemic. It also aimed to investigate sleep and psychological predictors of persistent insomnia symptoms. METHODS This longitudinal cohort study comprised 2069 participants with and without insomnia symptoms during the first year of the pandemic. Participants completed online surveys investigating sleep, insomnia, and mental health at four timepoints over 12 months (April 2020-May 2021). Additional trait-level cognitive/psychological questionnaires were administered at 3 months only. RESULTS Six distinct classes of insomnia symptoms emerged: (1) severe persistent insomnia symptoms (21.65%), (2) moderate persistent insomnia symptoms (32.62%), (3) persistent good sleep (32.82%), (4) severe insomnia symptoms at baseline but remitting over time (2.27%), (5) moderate insomnia symptoms at baseline but remitting over time (7.78%), and (6) good sleep at baseline but deteriorating into insomnia symptoms over time (2.85%). Persistent insomnia trajectories were predicted by high levels of sleep reactivity, sleep effort, pre-sleep cognitive arousal, and depressive symptoms at baseline. A combination of high sleep reactivity and sleep effort reduced the odds of insomnia remitting. Higher sleep reactivity also predicted the deterioration of good sleep into insomnia symptoms over 12 months. Lastly, intolerance of uncertainty emerged as the only trait-level cognitive/psychological predictor of insomnia trajectory classes. CONCLUSIONS Insomnia was more likely to persist than remit over the first year of the COVID-19 pandemic. Addressing sleep reactivity and sleep effort appears critical for reducing insomnia persistence rates after times of stress and uncertainty.
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Affiliation(s)
- Hailey Meaklim
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
- Melbourne School of Psychological Sciences, University of Melbourne, Parkville, VIC, Australia
| | - Flora Le
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Sean P A Drummond
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Sukhjit K Bains
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Prerna Varma
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
| | - Moira F Junge
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Sleep Health Foundation, East Melbourne, VIC, Australia
| | - Melinda L Jackson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Clayton, VIC, Australia
- Institute for Breathing and Sleep, Austin Health, Heidelberg, VIC, Australia
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18
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Probst-Hensch N, Imboden M, Jeong A, Keidel D, Vermes T, Witzig M, Cullati S, Tancredi S, Noor N, Rodondi PY, Harju E, Michel G, Frank I, Kahlert C, Cusini A, Rodondi N, Chocano-Bedoya PO, Bardoczi JB, Stuber MJ, Vollrath F, Fehr J, Frei A, Kaufmann M, Geigges M, von Wyl V, Puhan MA, Albanese E, Crivelli L, Lovison GF. Long-term trajectories of densely reported depressive symptoms during an extended period of the COVID-19 pandemic in Switzerland: Social worries matter. Compr Psychiatry 2024; 130:152457. [PMID: 38325041 DOI: 10.1016/j.comppsych.2024.152457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/04/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
Previous mental health trajectory studies were mostly limited to the months before access to vaccination. They are not informing on whether public mental health has adapted to the pandemic. The aim of this analysis was to 1) investigate trajectories of monthly reported depressive symptoms from July 2020 to December 2021 in Switzerland, 2) compare average growth trajectories across regions with different stringency phases, and 3) explore the relative impact of self-reported worries related to health, economic and social domains as well as socio-economic indicators on growth trajectories. As part of the population-based Corona Immunitas program of regional, but harmonized, adult cohorts studying the pandemic course and impact, participants repeatedly reported online to the DASS-21 instrument on depressive symptomatology. Trajectories of depressive symptoms were estimated using a latent growth model, specified as a generalised linear mixed model. The time effect was modelled parametrically through a polynomial allowing to estimate trajectories for participants' missing time points. In all regions level and shape of the trajectories mirrored those of the KOF Stringency-Plus Index, which quantifies regional Covid-19 policy stringency. The higher level of average depression in trajectories of those expressing specific worries was most noticeable for the social domain. Younger age, female gender, and low household income went along with higher mean depression score trajectories throughout follow-up. Interventions to promote long-term resilience are an important part of pandemic preparedness, given the observed lack of an adaptation in mental health response to the pandemic even after the availability of vaccines in this high-income context.
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Affiliation(s)
- N Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland.
| | - M Imboden
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - A Jeong
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - D Keidel
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - T Vermes
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - M Witzig
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - S Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland; Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - S Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - N Noor
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - P-Y Rodondi
- Institute of Family Medicine (IMF), University of Fribourg, Fribourg, Switzerland
| | - E Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland.; ZHAW Zurich University of Applied Sciences, School of Health Sciences, Winterthur, Switzerland
| | - G Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland
| | - I Frank
- Clinical Trial Unit, Cantonal Hospital Luzern, Luzern, Switzerland
| | - C Kahlert
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - A Cusini
- Division of Infectious Diseases, Cantonal Hospital of Grisons, Chur, Switzerland
| | - N Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - P O Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - J B Bardoczi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - M J Stuber
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - F Vollrath
- Corona Immunitas Program Management Group, Swiss School of Public Health, Zurich, Switzerland
| | - J Fehr
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - A Frei
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - M Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - M Geigges
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - V von Wyl
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| | - M A Puhan
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - E Albanese
- Institute of Public Health, Faculty of BioMedicine, Università Della Svizzera Italiana, Lugano, Switzerland
| | - L Crivelli
- Institute of Public Health, Faculty of BioMedicine, Università Della Svizzera Italiana, Lugano, Switzerland; Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
| | - G F Lovison
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
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19
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Zou J, Bian B, Li M, Liu G. The interrelationship between sleep disturbance symptoms and aggression before and after the campus closure of the COVID-19 pandemic: insight from a cross-lagged panel network model. Front Public Health 2024; 12:1357018. [PMID: 38577287 PMCID: PMC10991807 DOI: 10.3389/fpubh.2024.1357018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 02/20/2024] [Indexed: 04/06/2024] Open
Abstract
Background The COVID-19 pandemic is detrimental to sleep quality and increases aggression among college students. Nevertheless, relevant studies were rare. Hence, we collected longitudinal data during and post-campus closure in the current study to investigate the relationship between sleep disturbance and aggression. Methods Data from 665 college students (59.2% females, Meanage = 19.01, SD age = 1.25) were collected before (wave 1) and after (wave 2) the campus closure of COVID-19. All participants were asked to fill out the Buss-Perry Aggression Questionnaire and the Youth Self-Rating Insomnia Scale. Two symptom networks and a cross-lagged panel network were formed and tested. Results Hostility has the highest centrality in the symptom network both in waves 1 and 2, and it bridges sleep disturbance and aggression. "Easily be woken" - "wake up too early" and "wake up with tired" - "function hindrance" are two important symptom associations in networks of waves 1 and 2. All symptoms except "difficulty in falling asleep" and "easily be woken" ameliorated after closure. Moreover, "physical aggression" and "hostility" can trigger other symptoms in wave 2. Conclusion As the first study about aggression and sleep disturbance in the background of COVID-19, we provide valuable information about the relationship between sleep disturbance and aggression on the symptom dimension.
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Affiliation(s)
- Jinhua Zou
- Lianyungang Fourth People's Hospital, Lianyungang, China
| | - Baohua Bian
- Lianyungang Fourth People's Hospital, Lianyungang, China
| | - Min Li
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
| | - Gang Liu
- Department of Psychiatry, Affiliated Nanjing Brain Hospital, Nanjing Medical University, Nanjing, China
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20
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Huang WY, Feng J, Zheng C, Jiao J, Wong SHS. Associations of social jetlag with physical activity and sedentary behaviour in children and adolescents: A systematic review and meta-analysis. J Sleep Res 2024; 33:e13997. [PMID: 37443521 DOI: 10.1111/jsr.13997] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 06/07/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
Sleep and daytime movement behaviours occur co-dependently with each other within a finite 24 h day. Sleep parameters other than sleep duration, such as social jetlag and chronotype, have been linked to health problems and unhealthy behaviours among children and adolescents. Given the increasing number of studies examining sleep timing/chronotype and weight-related behaviours, including physical activity and sedentary behaviour, in the past decade, this systematic review and meta-analysis collated and evaluated the evidence on the relationships of social jetlag and chronotype with physical activity and sedentary behaviour among children and adolescents aged 3-17 years. Seven databases were searched on 16 March 2022, and 52 studies were identified as eligible for inclusion, 47 of which were suitable for the meta-analysis. A positive association was found between social jetlag and screen media use (r = 0.14, 95% CI: 0.04-0.24; I2 = 96%; p = 0.008). The morning chronotype was associated with a higher level of physical activity and a lower level of sedentary behaviour than the evening chronotype. No relationship was found between social jetlag and physical activity. The magnitude of heterogeneity among the included studies was high. Further experimental studies are urgently required to understand how circadian preference or misalignment affects activity behaviours. Interventions to promote an active lifestyle in young populations should consider their circadian preference, especially among individuals with the evening chronotype.
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Affiliation(s)
- Wendy Y Huang
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
- Dr Stephen Hui Research Centre for Physical Recreation and Wellness, Hong Kong Baptist University, Hong Kong, China
| | - Jie Feng
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Chen Zheng
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
| | - Jiao Jiao
- Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Stephen H S Wong
- Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China
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21
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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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22
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Cheung DST, Yu BYM, Lam SC, Leung DYP, Chung KF, Ho FYY, Chen SC, Yeung WF. A longitudinal study on the change in sleep across three waves of the COVID-19 outbreaks in Hong Kong. Sleep Biol Rhythms 2024; 22:93-102. [PMID: 38476851 PMCID: PMC10899949 DOI: 10.1007/s41105-023-00486-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/19/2023] [Indexed: 03/14/2024]
Abstract
In the year 2020, Hong Kong experienced four COVID-19 epidemic waves. The present study aimed to examine the transition of sleep disturbances and explore its associated factors across the later three epidemic waves. Among the 1138 respondents who participated in an online survey at the second wave (T1, April 2020), 338 and 378 participants also completed a follow-up at the third (T2, August 2020) and fourth waves (T3, December 2020), respectively. Participants completed the Insomnia Severity Index and an investigator-designed questionnaire regarding potential factors associated with sleep change such as perceived risk of being infected, economic stress, and confidence in the government and health care professional. Sample of this study were mainly female (67.7%), married (50.3%), young adults (54.2%) with tertiary education (81.6%). Maintaining normal sleep was the most prevalent trajectory of sleep of all three waves (50.5%), followed by persistent insomnia (17.2%) and remitted insomnia (9.0%). Besides female, older-age and lower education level, the results showed that increment in worry about family being infected (adjusted risk ratio, RR = 1.28), perceived interference of daily lives (adjusted RR = 1.19), and economic distress (adjusted RR = 1.24) were significantly associated with the development of clinical insomnia during the three epidemic waves. These factors were also associated with worsening of other sleep parameters. Insomnia being persistent across the three waves of COVID-19 outbreaks was common. Increasing economic distress, daily interference, and worry about family members being infected were associated with an increasing risk of clinical insomnia across the three COVID-19 outbreaks. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00486-w.
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Affiliation(s)
- Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 11 Yuk Choi Road, Hung Hom, Kowloon, Hong Kong, China
| | - Branda Yee-Man Yu
- Department of Psychology, The University of Hong Kong, Hong Kong SAR, China
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Ka-Fai Chung
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shu-Cheng Chen
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research Institute for Smart Ageing, The Hong Kong Polytechic University, Hong Kong, Hong Kong SAR
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23
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Dvořáková T, Měrková R, Bušková J. Sleep disorders after COVID-19 in Czech population: Post-lockdown national online survey. Sleep Med X 2023; 6:100087. [PMID: 37811367 PMCID: PMC10551886 DOI: 10.1016/j.sleepx.2023.100087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 09/20/2023] [Indexed: 10/10/2023] Open
Abstract
Objective This study aimed to determine the frequency, type, and correlates of a broad spectrum of sleep disorders in adults with COVID-19 up to 32 months after infection. Methods We conducted a national online survey (Jun 2021-Dec 2022), gathering information on COVID-19 diagnosis, acute disease course, and the subsequent development of sleep disorders from 1507 respondents (mean age 44.5 ± 13.1 years, 64.1% women). Results 81.3% (1223) reported at least one sleep difficulty that either worsened or first appeared with COVID-19. Females reported a higher number of symptoms (2.03 ± 1.44 versus 1.72 ± 1.43 in men, p < 0.0001). Most common were insomnia symptoms (59.4%), followed by night sweats (38.4%), hypersomnolence (33.3%), vivid dreams or nightmares (26.4%), restless leg syndrome (RLS) (22.8%), and sleep-related breathing disorders (11.1%). All symptoms were associated with a more severe acute disease. A mild decreasing trend in the persistence of sleep symptoms with a longer latency since infection was observed, with 66.7% reporting at least half of their symptoms present at 3-5 months after acute infection, compared to 64.9% at 6-8 months, and 62.4% at 9-11 months (p = 0.0427). However, among those after 12 or more months, over half of the symptoms persisted in 69.5%. The frequency of vivid dreams and nightmares increased in association with COVID-19 in 32.9% (p < 0.001). 9.4% (141) reported new-onset or increased parasomnic manifestations after the infection. Conclusions Our research shows that sleep disturbances are a common and persistent manifestation of COVID-19 that affects a large proportion of the population and deserves careful monitoring.
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Affiliation(s)
- Tereza Dvořáková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Radana Měrková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
| | - Jitka Bušková
- Sleep and Chronobiology Research Center, National Institute of Mental Health, Topolová 748, 250 67, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Ruská 87, 100 00, Prague, Czech Republic
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24
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Matsui K, Chung F, Bjelajac AK, Merikanto I, Korman M, Mota-Rolim S, Cunha AS, Bjorvatn B, Xue P, Benedict C, Morin CM, Espie CA, Landtblom AM, Penzel T, De Gennaro L, Holzinger B, Hrubos-Strøm H, Leger D, Bolstad CJ, Nadorff MR, Plazzi G, Reis C, Chan NY, Wing YK, Yordanova J, Dauvilliers Y, Partinen M, Inoue Y. Associations between changes in habitual sleep duration and lower self-rated health among COVID-19 survivors: findings from a survey across 16 countries/regions. BMC Public Health 2023; 23:2352. [PMID: 38017498 PMCID: PMC10683140 DOI: 10.1186/s12889-023-17258-3] [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: 07/13/2023] [Accepted: 11/18/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Self-rated health (SRH) is widely recognized as a clinically significant predictor of subsequent mortality risk. Although COVID-19 may impair SRH, this relationship has not been extensively examined. The present study aimed to examine the correlation between habitual sleep duration, changes in sleep duration after infection, and SRH in subjects who have experienced SARS-CoV-2 infection. METHODS Participants from 16 countries participated in the International COVID Sleep Study-II (ICOSS-II) online survey in 2021. A total of 10,794 of these participants were included in the analysis, including 1,509 COVID-19 individuals (who reported that they had tested positive for COVID-19). SRH was evaluated using a 0-100 linear visual analog scale. Habitual sleep durations of < 6 h and > 9 h were defined as short and long habitual sleep duration, respectively. Changes in habitual sleep duration after infection of ≤ -2 h and ≥ 1 h were defined as decreased or increased, respectively. RESULTS Participants with COVID-19 had lower SRH scores than non-infected participants, and those with more severe COVID-19 had a tendency towards even lower SRH scores. In a multivariate regression analysis of participants who had experienced COVID-19, both decreased and increased habitual sleep duration after infection were significantly associated with lower SRH after controlling for sleep quality (β = -0.056 and -0.058, respectively, both p < 0.05); however, associations between current short or long habitual sleep duration and SRH were negligible. Multinomial logistic regression analysis showed that decreased habitual sleep duration was significantly related to increased fatigue (odds ratio [OR] = 1.824, p < 0.01), shortness of breath (OR = 1.725, p < 0.05), diarrhea/nausea/vomiting (OR = 2.636, p < 0.01), and hallucinations (OR = 5.091, p < 0.05), while increased habitual sleep duration was significantly related to increased fatigue (OR = 1.900, p < 0.01). CONCLUSIONS Changes in habitual sleep duration following SARS-CoV-2 infection were associated with lower SRH. Decreased or increased habitual sleep duration might have a bidirectional relation with post-COVID-19 symptoms. Further research is needed to better understand the mechanisms underlying these relationships for in order to improve SRH in individuals with COVID-19.
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Affiliation(s)
- Kentaro Matsui
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Frances Chung
- Department of Anesthesiology and Pain Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Ilona Merikanto
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Orton Orthopaedics Hospital, Helsinki, Finland
| | - Maria Korman
- Department of Occupational Therapy, Faculty of Health Sciences, Ariel University, Ariel, Israel
| | - Sérgio Mota-Rolim
- Brain Institute, Physiology and Behavior Department, and Onofre Lopes University Hospital, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Pei Xue
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology, Uppsala University, Uppsala, Sweden
| | - Christian Benedict
- Department of Pharmaceutical Biosciences, Molecular Neuropharmacology, Uppsala University, Uppsala, Sweden
| | - Charles M Morin
- Centre de recherche CERVO/Brain Research Center, École de psychologie, Université Laval, Quebec City Quebec, Canada
| | - Colin A Espie
- Sir Jules Thorn Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Anne-Marie Landtblom
- Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Thomas Penzel
- Sleep Medicine Center, Charite University Hospital Berlin, Berlin, Germany
| | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Roma, Lazio, Italy
- IRCCS Fondazione Santa Lucia, Roma, Italy
| | - Brigitte Holzinger
- Institute for Consciousness and Dream Research; Medical University of Vienna, Postgraduate Sleep Coaching, WienVienna, Austria
| | - Harald Hrubos-Strøm
- Department of Otorhinolaryngology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Damien Leger
- VIFASOM (EA 7331 Vigilance Fatigue Sommeil et Santé Publique), Université Paris Cité, Paris, France
- APHP, Hôtel-Dieu, Centre du Sommeil et de la Vigilance, Paris, France
| | - Courtney J Bolstad
- Department of Psychology, Mississippi State University, Mississippi State, MS, USA
- South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Mississippi State, MS, USA
| | - Giuseppe Plazzi
- IRCCS Istituto Delle Scienze Neurologiche di Bologna, Bologna, Italy
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Catia Reis
- Católica Research Centre for Psychological - Family and Social Wellbeing, Universidade Católica Portuguesa, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
- Instituto de Saúde Ambiental, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Juliana Yordanova
- Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Yves Dauvilliers
- Sleep-Wake Disorders Center, Department of Neurology, Gui-de-Chauliac Hospital, Institute for Neurosciences of Montpellier INM, INSERM, University of Montpellier, Montpellier, France
| | - Markku Partinen
- Department of Clinical Neurosciences, University of Helsinki Clinicum Unit, Helsinki, Finland
- Helsinki Sleep Clinic, Terveystalo Healthcare Services, Helsinki, Finland
| | - Yuichi Inoue
- Japan Somnology Center, Institute of Neuropsychiatry, Tokyo, Japan.
- Department of Somnology, Tokyo Medical University, Tokyo, Japan.
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25
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Fichten CS, Wing S, Costin G, Jorgensen M, Havel A, Wileman S, Bailes S, Creti L, Libman E. Sleep and Well-Being during the COVID-19 Remote and In-Person Periods: Experiences of College Faculty and Staff with and without Disabilities. Behav Sci (Basel) 2023; 13:844. [PMID: 37887493 PMCID: PMC10604366 DOI: 10.3390/bs13100844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/07/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
We explored the impacts of the remote and return-to-in-person work periods on sleep and well-being as reported by faculty (n = 22) and non-teaching staff (n = 21) with and without disabilities. Participants were recruited through college platforms and personal contacts. Our results show that contrary to expectations, the COVID-19 remote teaching/working period resulted in better sleep, as well as greater well-being, than the return-to-in-person work period. With respect to sleep, faculty members had slightly more negative outcomes than staff, most evident in heightened anxiety and work aspects. Faculty with disabilities had somewhat worse sleep and well-being during the remote period than faculty without disabilities. During the return to in-person work, both faculty and non-teaching staff reported more negative than positive sleep and well-being outcomes. In particular, during the in-person period, faculty members experienced slightly more negative sleep outcomes related to anxiety and work, while staff members experienced slightly more negative sleep outcomes related to the need to commute and lifestyle. Our findings show that there were benefits and disadvantages to both remote and in-person work periods, suggesting a hybrid work schedule should be considered in more detail, particularly as an optional reasonable accommodation for faculty and staff with disabilities. Our study highlights that training to keep faculty abreast of the latest technological innovations, ways to promote work-life balance, and steps to remedy classroom size and building ventilation to prevent the spread of disease all need urgent attention.
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Affiliation(s)
- Catherine S. Fichten
- Department of Psychology, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Samantha Wing
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- McGill Cognitive Science Program, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Georgiana Costin
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Department of Psychology, McGill University, 845 Rue Sherbrooke O, Montréal, QC H3A 0G4, Canada
| | - Mary Jorgensen
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
| | - Alice Havel
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Susie Wileman
- Adaptech Research Network, 4001 de Maisonneuve W., Montreal, QC H3Z 3G4, Canada; (S.W.); (G.C.); (M.J.); (A.H.); (S.W.)
- Scholars in Residence Program, Dawson College, 3040 Sherbrooke St. W., Montreal, QC H3Z 1A4, Canada
| | - Sally Bailes
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Laura Creti
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
| | - Eva Libman
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC H3A 1A1, Canada; (S.B.); (L.C.); (E.L.)
- Behavioural Psychotherapy and Research Unit, Jewish General Hospital, 4333 Cote Ste Catherine Road, Montreal, QC H3T 1E4, Canada
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26
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Mangot-Sala L, Smidt N, Liefbroer AC. Changes in anxiety and depression symptoms during the Covid-19 lockdown in the Netherlands. The moderating role of pre-existing mental health, employment situation and alcohol consumption. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1561-1571. [PMID: 37024616 PMCID: PMC10079151 DOI: 10.1007/s00127-023-02480-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/30/2023] [Indexed: 04/08/2023]
Abstract
PURPOSE Evidence suggests an increase of depression and anxiety symptoms during the Covid-19 pandemic but most studies relied on cross-sectional designs and/or small samples, and they often overlooked subgroup effects in the impact of the lockdown. We investigated the effect of the pandemic on depression and anxiety symptoms, and whether it differed by employment situation and alcohol consumption. METHODS This longitudinal study used 23 waves of the Covid-Questionnaire (April 2020-July 2021), within the Lifelines cohort from the Netherlands (n = 76,254). Depression and anxiety symptoms were combined in a "mental health score". Linear fixed-effects models were fitted to analyse trends in mental health throughout the observation period. The moderating role of pre-existing mental health, employment situation, and alcohol consumption was tested. RESULTS Depression and anxiety symptoms fluctuated considerably during the observation period, with clear peaks in winter 2021, during the strictest lockdown period. Moreover, temporal patterns differed by employment situation and alcohol consumption patterns, suggesting that various subgroups reacted to the pandemic and the lockdown in different ways. CONCLUSION Lockdowns increased depression and anxiety symptoms in the Netherlands. The effect was particularly strong for unemployed individuals, those with risky alcohol consumption patterns and those with pre-existing mental health disorders.
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Affiliation(s)
- Lluís Mangot-Sala
- Netherlands Interdisciplinary Demographic Institute (NIDI)-Royal Netherlands Academy of Sciences (KNAW), Lange Houtstraat 19, 2511 CV, The Hague, The Netherlands.
- Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands.
| | - Nynke Smidt
- Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
| | - Aart C Liefbroer
- Netherlands Interdisciplinary Demographic Institute (NIDI)-Royal Netherlands Academy of Sciences (KNAW), Lange Houtstraat 19, 2511 CV, The Hague, The Netherlands
- Department of Epidemiology, University Medical Center Groningen (UMCG), University of Groningen (RUG), Groningen, The Netherlands
- Department of Sociology, Vrije Universiteit Amsterdam (VU), Amsterdam, The Netherlands
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Massar SAA, Ong JL, Lau T, Ng BKL, Chan LF, Koek D, Cheong K, Chee MWL. Working-from-home persistently influences sleep and physical activity 2 years after the Covid-19 pandemic onset: a longitudinal sleep tracker and electronic diary-based study. Front Psychol 2023; 14:1145893. [PMID: 37213365 PMCID: PMC10196619 DOI: 10.3389/fpsyg.2023.1145893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/21/2023] [Indexed: 05/23/2023] Open
Abstract
Objective Working from home (WFH) has become common place since the Covid-19 pandemic. Early studies observed population-level shifts in sleep patterns (later and longer sleep) and physical activity (reduced PA), during home confinement. Other studies found these changes to depend on the proportion of days that individuals WFH (vs. work from office; WFO). Here, we examined the effects of WFH on sleep and activity patterns in the transition to normality during the later stages of the Covid-19 pandemic (Aug 2021-Jan 2022). Methods Two-hundred and twenty-five working adults enrolled in a public health study were followed for 22 weeks. Sleep and activity data were collected with a consumer fitness tracker (Fitbit Versa 2). Over three 2-week periods (Phase 1/week 1-2: August 16-29, 2021; Phase 2/week 11-12: October 25-November 7, 2021; Phase 3/week 21-22: January 3-16, 2022), participants provided daily Fitbit sleep and activity records. Additionally, they completed daily phone-based ecological momentary assessment (EMA), providing ratings of sleep quality, wellbeing (mood, stress, motivation), and information on daily work arrangements (WFH, WFO, no work). Work arrangement data were used to examine the effects of WFH vs. WFO on sleep, activity, and wellbeing. Results The proportion of WFH vs. WFO days fluctuated over the three measurement periods, mirroring evolving Covid restrictions. Across all three measurement periods WFH days were robustly associated with later bedtimes (+14.7 min), later wake times (+42.3 min), and longer Total Sleep Time (+20.2 min), compared to WFO days. Sleep efficiency was not affected. WFH was further associated with lower daily step count than WFO (-2,471 steps/day). WFH was associated with higher wellbeing ratings compared to WFO for those participants who had no children. However, for participants with children, these differences were not present. Conclusion Pandemic-initiated changes in sleep and physical activity were sustained during the later stage of the pandemic. These changes could have longer term effects, and conscious effort is encouraged to harness the benefits (i.e., longer sleep), and mitigate the pitfalls (i.e., less physical activity). These findings are relevant for public health as hybrid WHF is likely to persist in a post-pandemic world.
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Affiliation(s)
- Stijn A. A. Massar
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - TeYang Lau
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | | | - Daphne Koek
- Health Promotion Board, Singapore, Singapore
| | | | - Michael W. L. Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- *Correspondence: Michael W. L. Chee,
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