Pre-sleep arousal and sleep quality during the COVID-19 lockdown in Italy

Abstract Introduction Mindfulness-based training has shown potential in reducing anxious and ruminative thoughts before sleep, and improving sleep quality. However, traditional 8-week programs have limited acceptability and uptake. In this study, we aimed to test the effects of a short introductory mindfulness training course on pre-sleep arousal and sleep quality. Methods Enrollees in a 4-week Mindfulness Foundation Course were invited to participate in the study and were allocated to one of two groups: intervention (N = 57) and waitlist control (N = 39). 101 participants enrolled in the experiment and 96 completed the protocol (mean(sd) age = 49.5(1.5), 56 female). Participants completed the Pittsburgh Sleep Quality Inventory (PSQI) and the pre-sleep arousal scale (PSAS), and were monitored by actigraphy for a week at baseline and post-intervention. To test the effect of the intervention, outcome variables were subjected to repeated-measures ANCOVA with group as a between-subject variable, and age, gender, and years of education as covariates using intent-to-treat analysis. Results PSQI scores improved across both groups (treatment: t56=4.25, p<.001, mean(sd) = 6.93(3.25)); waitlist: t38=3.27, p=.002, mean(sd) = 7.15(3.55)); however, there was no significant interaction between group and time. There was a significant group by time interaction in the cognitive arousal subscale of the PSAS (F1,90=4.71, p=.03), Post-hoc tests revealed a significant decrease in the treatment but not the waitlist group (treatment: t50=3.17, p=.001; waitlist: t30=0.20, p=.84). The decrease in cognitive arousal correlated with the decrease in PSQI scores in the treatment group only (r =.3, p=.007). Finally, a statistically significant interaction favoring the treatment group was also observed in actigraphically measured WASO (F1,82=6.18, p=0.015). Conclusion The study suggests that a 4-week introductory mindfulness course has moderate effects on reducing cognitive arousal prior to sleep, and that these effects are correlated with improvements in subjective sleep quality. Support This study was funded from a STaR investigator grant (NMRC/STaR/0015/2013) and the National Research Foundation (Singapore) Science of Learning Grant (NRF2016-SOL002-001).

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Persistence of the Effects of the COVID-19 Lockdown on Sleep: A Longitudinal Study

Brain Sciences ◽

10.3390/brainsci11111520 ◽

2021 ◽

Vol 11 (11) ◽

pp. 1520

Author(s):

Maurizio Gorgoni ◽

Serena Scarpelli ◽

Anastasia Mangiaruga ◽

Valentina Alfonsi ◽

Maria R. Bonsignore ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Online Survey ◽

Sleep Problems ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Final Sample ◽

Sleep Arousal ◽

Related Stress ◽

Restrictive Measures

The effects of the COVID-19 pandemic on sleep have been widely documented, but longitudinal evaluations during different phases of the “COVID-19 era” are needed to disentangle the specific consequences of the r145estrictive measures on sleep variables. The aim of this study was to assess the immediate effect of the lockdown’s end on sleep and sleep-related dimensions in an Italian sample, also considering the stress and depressive symptoms. We used an online survey to longitudinally collect data on sociodemographic, environmental, clinical, sleep, and sleep-related variables in two time points: during and immediately after the lockdown. The final sample included 102 participants. The large prevalence of poor sleep quality, clinically relevant pre-sleep arousal, and depressive symptoms, as well as poor sleep quality and pre-sleep arousal score observed during the lockdown, remained stable after its end. On the other hand, the prevalence of moderate-to-severe event-related stress and intrusive symptom scores exhibited a drastic reduction after the end of home confinement. Both bedtime and rise time were anticipated after the lockdown, while sleep quality exhibited only a trend of post-lockdown sleep disturbance reduction. Our findings point to a reduced stress level (specific for the intrusive symptomatology) after the end of the lockdown and persistence of sleep problems, suggesting two non-mutually exclusive hypotheses: (a) the strict restrictive measures are not the main cause of sleep problems during the pandemic and (b) home confinement induces long-lasting effects on sleep observable after its end, and a longer period of time might be needed to observe an improvement.

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