722 Sleep Loss in Healthcare Workers During the COVID-19 Pandemic

Abstract Introduction During the pandemic, healthcare workers have shared their stresses on social media, including regarding sleep disturbances. However, an assessment of sleep using validated measures among healthcare workers on social media is lacking. Methods A restricted, self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days targeting healthcare workers who were clinically active during COVID-19. In addition to demographics and career information, participants completed the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index. Poor sleep quality was defined as PSQI > 5. Moderate-to-severe insomnia was defined as an ISI > 14. Multivariate logistic regression tested the association between demographics and career characteristics and sleep outcomes. Results Of the 983 who clicked our link, 906 completed the survey. Participants were mostly white (70%), female (75%), physicians (64%). Mean sleep duration was 6.1 (SD1.2) hours. Nearly 90% experienced poor sleep (PSQI). One third reported moderate or severe insomnia. Many (60%) reported sleep disruptions due to device usage or due to bad dreams at least once per week (45%). In multivariable regression, non-physicians (OR 3.5, CI: 2.5, 5.0), Hispanic ethnicity (OR 2.2; CI: 1.44, 3.45), being single (1.5, CI: 1.03, 2.21), and youngest age group (18–24) (OR 9.9; CI: 1.44, 68.09) had increased odds of insomnia. In open-ended comments, sleep disruptions mapped to 5 categories: (1) Work demands (“The volume of calls and messages from my patient and caregiver population is through the roof”); (2) Pandemic related (“I never had sleep issues prior to the COVID-19 pandemic. Suddenly I had issues with sleep initiation.”; (3) Children and family (“COVID plus home stress plus stress over my kids, my job, my marriage.”); (4) Personal health (“Insomnia predating COVID, but worsened with COVID.”); (5) Responses to the pandemic (“I worry about how COVID is being managed by the President...This does keep me awake at night.”). Conclusion During the COVID-19 pandemic, 90% of healthcare workers surveyed on social media reported poor sleep, with over one-third of participants reporting moderate-severe insomnia. Online sleep interventions for healthcare workers are urgently needed. Support (if any):

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Sleep in Frontline Healthcare Workers on Social Media During the COVID-19 Pandemic

10.1101/2021.01.19.21250128 ◽

2021 ◽

Author(s):

Nancy H Stewart ◽

Anya L Koza ◽

Serena Dhaon ◽

Christiana Shoushtari ◽

Maylyn Martinez ◽

...

Keyword(s):

Social Media ◽

Sleep Quality ◽

Healthcare Workers ◽

Sleep Disturbances ◽

Severity Index ◽

Poor Sleep ◽

Family Work ◽

Career Information ◽

Self Selection ◽

Frontline Healthcare Workers

AbstractImportanceDuring the pandemic, healthcare workers on social media are sharing their challenges, including sleep disturbances.ObjectiveTo assess sleep using validated measures among frontline healthcare workers on social mediaDesignA self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31-September 15, 2020) targeting healthcare workers (HCW) who were clinically active during the pandemic. Study participants completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and reported demographic/career information. Poor sleep quality was defined as PSQI>5. Moderate-to-severe insomnia was defined as an ISI>14. The mini-Z was used to measure burnout. Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes.SettingOnline self-selection survey on social mediaParticipants963 surveys were completed. Participants were predominantly White (92.8%), female (73.4%), aged 30-49 (71.9%), and physicians (64.4%). Mean sleep duration was 6.1 (SD 1.2) hours. Nearly 90% reported poor sleep (PSQI). One third (33.0%) reported moderate or severe insomnia. Many (60%) experienced sleep disruptions due to device usage or had bad dreams at least once per week (45%). Over 50% reported burnout. In multivariable logistic regressions, non-physician (OR 2.4; CI: 1.7, 3.4), caring for COVID-19 patients (OR 1.8; CI 1.2, 2.8), Hispanic ethnicity (OR 2.2; CI: 1.4, 3.5), being female (OR 1.6; CI 1.1, 2.4), and having a sleep disorder (OR 4.3; CI 2.7,6.9) were associated with increased odds of insomnia. In open-ended comments (n=310), poor sleep mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances.ConclusionDuring the COVID-19 pandemic, 90% of frontline healthcare workers surveyed on social media reported poor sleep, over one-third reported insomnia, and over half reported burnout. Many also reported sleep disruptions due to device usage and nightmares. Sleep interventions for frontline healthcare workers are urgently needed.Key pointsQuestionHow are frontline healthcare workers on social media sleeping during the pandemic?FindingsDuring the COVID-19 pandemic, 90% of frontline healthcare workers on social media are reporting poor sleep, and one third are reporting insomnia. Those who report sleep disturbances were more likely to report burnout.MeaningInterventions aimed at improving the sleep of frontline healthcare workers are warranted.

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Sleep in Frontline Healthcare Workers on Social Media During the COVID-19 Pandemic (Preprint)

10.2196/preprints.27331 ◽

2021 ◽

Author(s):

Nancy H Stewart ◽

Anya Koza ◽

Serena Dhaon ◽

Christiana Shoushtari ◽

Maylyn Martinez ◽

...

Keyword(s):

Social Media ◽

Sleep Quality ◽

Healthcare Workers ◽

Sleep Disturbances ◽

Severity Index ◽

Poor Sleep ◽

Family Work ◽

Career Information ◽

Study Participants ◽

Frontline Healthcare Workers

BACKGROUND During the pandemic, healthcare workers are on social media are sharing their challenges, including sleep disturbances, however no study has evaluated sleep in frontline healthcare workers during the COVID-19 pandemic. OBJECTIVE To assess sleep using validated measures among frontline healthcare workers on social media METHODS An online self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31-September 15, 2020) targeting healthcare workers (HCW) who were clinically active during the pandemic. Study participants completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and reported demographic/career information. Poor sleep quality was defined as PSQI>5. Moderate-to-severe insomnia was defined as an ISI>14. The mini-Z was used to measure burnout. Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes. RESULTS Nine-hundred and sixty-three surveys were completed. Participants were predominantly white (92.8%), female (73.4%), aged 30-49 (71.9%), and physicians (64.4%). Mean sleep duration was 6.1 (SD 1.2) hours. Nearly 90% reported poor sleep (PSQI). One third (33.0%) reported moderate or severe insomnia. Many (60%) experienced sleep disruptions due to device usage or had bad dreams at least once per week (45%). Over 50% reported burnout. In multivariable logistic regressions, non-physician (OR 2.4; CI: 1.7, 3.4), caring for COVID-19 patients (OR 1.8; CI 1.2, 2.8), Hispanic ethnicity (OR 2.2; CI: 1.4, 3.5), being female (OR 1.6; CI 1.1, 2.4), and having a sleep disorder (OR 4.3; CI 2.7,6.9) were associated with increased odds of insomnia. In open-ended comments (n=310), poor sleep mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances. CONCLUSIONS During the COVID-19 pandemic, 90% of frontline healthcare workers surveyed on social media reported poor sleep, over one-third reported insomnia, and over half reported burnout. Many also reported sleep disruptions due to device usage and nightmares. Sleep interventions for frontline healthcare workers are urgently needed. CLINICALTRIAL n/a

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Prevalence of Sleep Disturbances During COVID-19 Pandemic in a Nepalese Population: A Cross-Sectional Study

Journal of Sleep Medicine ◽

10.13078/jsm.210012 ◽

2021 ◽

Vol 18 (3) ◽

pp. 145-153

Author(s):

Avinash Chandra ◽

Pooja Prakash ◽

Nabina Sharma ◽

Ayush Chandra

Keyword(s):

Sleep Quality ◽

Sleep Disturbances ◽

Severity Index ◽

Cross Sectional Study ◽

Descriptive Statistics ◽

Sectional Study ◽

Cross Sectional ◽

Before And After ◽

The Mean ◽

Insomnia Severity

Objectives: The coronavirus disease (COVID-19) pandemic and news of daily increasing cases inside Nepal and worldwide is adding to the fear that leads to anger, anxiety, frustration, and stress, emotions that directly affect sleep quality. This study aimed to assess sleep disturbances during the COVID-19 pandemic in a Nepalese population.Methods: This cross-sectional study recruited 206 Nepali residents who completed anonymous self-administered questionnaires. The Insomnia Severity Index (ISI) questionnaire was used to measure sleep disturbances before and after the COVID-19 pandemic. The gathered data were analyzed using descriptive statistics and inferential statistics using SPSS version 20 statistical software.Results: There was a significant variation in sleep disturbances among Nepalese residents before versus after the COVID-19 pandemic (p<0.001). The prevalence of clinical moderate insomnia has increased tremendously in Nepalese individuals. Before the pandemic’s onset, only 3.9% of the participants had moderate to severe levels of clinical insomnia; after its onset, this value increased to 17.5%. The mean ISI scores were 6.35±4.65 and 8.01±6.01 before and after the pandemic’s onset, respectively.Conclusions: Our study findings suggest that people are suffering tremendously with sleep disturbances and calls for further research and active measures to help increase sleep quality during the COVID-19 pandemic.

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0182 The Sleep Regularity Questionnaire: Development and Preliminary Psychometric Properties

SLEEP ◽

10.1093/sleep/zsaa056.180 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A72-A72

Author(s):

E K Donovan ◽

J M Dzierzewski

Keyword(s):

Factor Analysis ◽

Sleep Quality ◽

Psychometric Properties ◽

Factor Model ◽

Severity Index ◽

National Institutes Of Health ◽

Future Research ◽

Poor Sleep ◽

Negatively Associated ◽

Insomnia Severity

Abstract Introduction Sleep is a critically important behavior which influences diverse aspects of health, functioning, and longevity. An increasing literature suggests the importance of sleep regularity, also referred to as sleep inconsistency, sleep variability, or intraindividual variability in sleep. Given there is no brief, subjective measure of sleep regularity, the purpose of this study was to examine the psychometric properties of an in-development, ten-item Sleep Regularity Questionnaire (SRQ). Methods In an online study of sleep and health, participants (n = 3284; Mage (SD)= 42.74(16.72); 47.8% female; 77.1% white) completed the in-development SRQ, as well as other sleep-related measures including the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI). Results An exploratory factor analysis on a random half of the sample revealed a two factor structure, with four items representing “circadian regularity” and two items representing “sleep disturbance regularity.” A confirmatory factor analysis on the other random half of the sample fit the two factor model with good model fit indices (X2 = 50.9, df = 7, p < .001; RMSEA = .06; CFI= .99; NFI = .99; IFI = .99; TLI = .98). The SRQ was negatively associated with poor sleep quality measured via the PSQI (r = -.37, p < .001) and negatively associated with insomnia severity measured via the ISI (r = -.40, p < .001). Conclusion The SRQ appears to be a valid instrument for the assessment of sleep regularity in adults that is related to, but distinct from, other established sleep constructs. Future research will benefit from examining test-retest reliability of the measure as well as assessing the validity of the SRQ as a measure of objective sleep regularity by comparing it to conventional diary, actigraphy, and/or polysomnography methods of sleep assessment. Support This work was supported by the National Institute on Aging of the National Institutes of Health under Award Number K23AG049955 (PI: Dzierzewski). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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698 Sleep quality, depression and anxiety in a community sample of Habana, Cuba during the 2020 COVID-19 pandemic

SLEEP ◽

10.1093/sleep/zsab072.696 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A273-A273

Author(s):

Justa González ◽

Alcibiades Rodriguez

Keyword(s):

Sleep Quality ◽

Sleep Disturbances ◽

Community Sample ◽

Severity Index ◽

The Elderly ◽

Anxiety And Depression ◽

Poor Sleep ◽

Depression And Anxiety ◽

Sleep Habits ◽

Cross Sectional

Abstract Introduction The 2020 Coronavirus disease 19 (COVID-19) pandemic has infected and killed millions of persons. To avoid virus spread, stay-at-home orders and social distancing measures were implemented worldwide. These measures have caused changes in work schedules and, subsequently, sleep habits. This study aims to examine sleep disturbances, anxiety and depression in a random community in Havana, Cuba during the pandemic lockdown period. Methods This a descriptive cross-sectional study performed in a randomly selected neighbourhood, via direct door-to-door survey. We applied four different surveys:1) Pittsburgh Sleep Quality Index (PSQI);2) Insomnia Severity Index (ISI);3) Epworth Sleepiness Scale (ESS) and 4) Hospital Anxiety and Depression Scales (HADS) questionnaire. Descriptive statistics will be applied using StatSoft, Inc. (2011) STATISTICA (data analysis software system), version 10. HYPERLINK “http://www.statsoft.com” www.statsoft.com Results A total of 366 adult subjects were surveyed and abnormal values were observed in the following percentages: 60.65% in the PSQI, 34.51% in the ISI, 14.74% in the ESS and 36.61% in the HADS for depression and 40.43% in the HADS for anxiety. Poorer sleepers and depression were more common women and elderly (p<0.05 for all comparisons). Anxiety and insomnia were seen mostly in subjects with higher education and working during this period (p<0.05 for all comparisons). Poor sleep correlated with insomnia, depression and anxiety (p < 0.001 for all comparisons). Conclusion There were sleep quality disruption in large percentage of subjects during the COVID-19 pandemic lockdown. Poor sleep and depression were worse in women and the elderly. Insomnia and anxiety were seen more in younger subjects that continue to work during this time. Support (if any):

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Mindfulness-based therapy for insomnia for older adults with sleep difficulties: a randomized clinical trial

Psychological Medicine ◽

10.1017/s0033291721002476 ◽

2021 ◽

pp. 1-11

Author(s):

Francesca Perini ◽

Kian Foong Wong ◽

Jia Lin ◽

Zuriel Hassirim ◽

Ju Lynn Ong ◽

...

Keyword(s):

Older Adults ◽

Sleep Quality ◽

Behavioral Therapy ◽

Sleep Onset ◽

Exercise Program ◽

Severity Index ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Post Intervention ◽

Insomnia Severity

Abstract Objective Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. Methods We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50–80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI (n = 65) or SHEEP (n = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). Results Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size d = −1.27, 95% confidence interval (CI) −1.61 to −0.89; SHEEP: d = −0.69, 95% CI −0.96 to −0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: d = −1.19; SHEEP: d = −1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASOactigraphy (MBTI: d = −0.30; SHEEP: d = 0.02), SOLactigraphy (MBTI: d = −0.25; SHEEP: d = −0.09), and WASOPSG (MBTI: d = −0.26; SHEEP (d = −0.18). There was no change in SOLPSG. No participants withdrew because of adverse effects. Conclusions MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.

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THE RELATIONSHIP BETWEEN SMART PHONE USAGE AND SLEEP DISTURBANCES AND PSYCHOLOGICAL DISSTRESS AMONG STUDENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.4.19 ◽

2017 ◽

pp. 125-130

Author(s):

Minh Tam Nguyen ◽

Phuc Thanh Nhan Nguyen ◽

Thi Thuy Hang Nguyen

Keyword(s):

High School ◽

High School Students ◽

University Students ◽

Sleep Quality ◽

Sleep Disturbances ◽

Public Health Problem ◽

Smartphone Addiction ◽

Poor Sleep ◽

School Students ◽

The Relationship

The increasing use of smartphone among young people is creating negative effects and is an important public health problem in many countries. Smartphone abuse and addiction may cause physical and psychological disorders among users. However, the awarenes on this issue has been inadequate due to lacking of evidence. Objectives: To describe the current situation of smartphone using among students at highschools and universities in Hue city and to examine the relationship between smartphone using and sleep disturbances and psychological disstress among participants. Methods: A cross-sectional study with a randomly selected sample of 1,150 students at highschools and universities in Hue city. SAS-SV scale was used to evaluate phone addiction status, K10 scale was used for psychological distress assessment and PSQI scale was used to examine the sleep quality. Results: The proportion of students at highschools and universities having smartphones was 78.0%. The rate of smartphone addiction among high school students was 49.1% and that among university students was 43.7%. There was 57.3% of high school students had poor sleep quality, and that of university students was 51.6%. There was a statistically significant association between smartphone addiction and sleep disturbances and psychological disstress among participants (p <0.05). Conclusion: The prevalence of smartphone addiction among students at highschools and universities is alarming and is related to sleep disturbances and psychological disstress among participants. There is a strong call to develop intervention to help students to aware and manage the use of smartphone effectively.

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Sleep Disturbances in Individuals Quarantined Due to SARS-CoV-2 Pandemic in Poland: A Mixed Methods Design Study

Global Advances in Health and Medicine ◽

10.1177/21649561211020707 ◽

2021 ◽

Vol 10 ◽

pp. 216495612110207

Author(s):

Sabina Krupa ◽

Witt Paweł ◽

Wioletta Mędrzycka-Dąbrowska ◽

Agnieszka Lintowska ◽

Dorota Ozga

Keyword(s):

Mixed Methods ◽

Sleep Disturbances ◽

Acute Stress ◽

Sleep Problems ◽

Severity Index ◽

Structured Interview ◽

Mixed Methods Design ◽

Design Study ◽

Insomnia Severity Index ◽

Insomnia Severity

Objectives The study aimed to assess sleep disturbances in patients subjected to home quarantine due to suspected SARS-CoV-2 infection. The study used a mixed methods design study as a research methodology. Methods A semi-structured interview and the scale for Insomnia Severity Index (ISI) were used to achieve the aim of the study. The survey was conducted from 16 to 20 April 2020 and 1 to 2 September 2020 in Poland, at the during of SARS-CoV-2 epidemic in this country. The data were coded and cross-processed. The (COREQ) checklist was followed. Results Interviews with patients and a thorough analysis of recordings revealed commonly used phrases in the following categories: “anxiety”, “ Am I going crazy?”, “Sleep problems”. 10 out of 11 respondents reported sleep disorders of varying severity according to the Insomnia Severity Index scale. Patients presented a fear related to the return to society and normal functioning after quarantine. Additionally, some study participants voiced concerns related to their mental health; some cases of hallucinations were reported. Conclusions Further global population studies should be conducted to analyse this phenomenon. Acute Stress Disorder should be understood as a threat to life and health of an isolated society in quarantine. Further research in this area should be promoted and the need for global guidelines for the entire population should be developed.

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Sleep symptomatology is associated with greater subjective cognitive concerns: Findings from the community-based Healthy Brain Project

SLEEP ◽

10.1093/sleep/zsab097 ◽

2021 ◽

Author(s):

Jessica Nicolazzo ◽

Katharine Xu ◽

Alexandra Lavale ◽

Rachel Buckley ◽

Nawaf Yassi ◽

...

Keyword(s):

Cognitive Function ◽

Sleep Quality ◽

Cognitive Performance ◽

Sex Education ◽

Severity Index ◽

Analysis Of Covariance ◽

Psychomotor Function ◽

Community Based ◽

The Relationship ◽

Insomnia Severity

Abstract Study objectives To examine if sleep symptomatology was associated with subjective cognitive concerns or objective cognitive performance in a dementia-free community-based sample. Methods A total of 1421 middle-aged participants (mean±standard deviation = 57±7; 77% female) from the Healthy Brain Project completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) to measure sleep quality, insomnia symptom severity, and daytime sleepiness, respectively. Participants were classified as having no sleep symptomatology (normal scores on each sleep measure), moderate sleep symptomatology (abnormal scores on one sleep measure), or high sleep symptomatology (abnormal scores on at least two sleep measures), using established cut-off values. Analysis of covariance was used to compare objective cognitive function (Cogstate Brief Battery) and subjective cognitive concerns (Modified Cognitive Function Instrument) across groups. Results Following adjustments for age, sex, education, mood, and vascular risk factors, persons classified as having high sleep symptomatology, versus none, displayed more subjective cognitive concerns (d=0.24) but no differences in objective cognitive performance (d=0.00-0.18). Subjective cognitive concerns modified the association between sleep symptomatology and psychomotor function. The strength of the relationship between high sleep symptomatology (versus none) and psychomotor function was significantly greater in persons with high as compared with low cognitive concerns (β±SE =-0.37±0.16; p=0.02). Conclusions More severe sleep symptomatology was associated with greater subjective cognitive concerns. Persons reporting high levels of sleep symptomatology may be more likely to display poorer objective cognitive function in the presence of subjective cognitive concerns.

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Association between depression and sleep quality in patients with systemic lupus erythematosus: a systematic review and meta-analysis

Sleep And Breathing ◽

10.1007/s11325-021-02405-0 ◽

2021 ◽

Author(s):

Rulan Yin ◽

Lin Li ◽

Lan Xu ◽

Wenjie Sui ◽

Mei’e Niu ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Sleep Quality ◽

Lupus Erythematosus ◽

Sleep Disturbances ◽

Cochrane Library ◽

Poor Sleep ◽

Moderate Correlation ◽

Systemic Lupus ◽

Poor Sleep Quality ◽

Subjective Sleep Quality

Abstract Background Currently, there is no consistent understanding of the relationship between depression and sleep quality in patients with systemic lupus erythematosus (SLE). This study aimed to explore the correlation between depression and sleep quality in SLE patients. Methods Five English (PubMed, Web of Science, EMBASE, Cochrane Library, and CINAHL) databases were systematically searched from inception to January 12, 2021. Two authors independently screened publications and extracted data according to set inclusion and exclusion criteria. Statistical analyses were performed with STATA 16.0. Data were pooled using a random-effects model. Results A total of 9 identified studies matched the inclusion criteria, reporting on 514 patients with SLE in the analysis. A moderate correlation of depression with sleep quality was found (pooled r = 0.580 [0.473, 0.670]). Compared to good sleepers, patients with SLE and poor sleep quality had higher levels of depression (standardized mean difference = − 1.28 [− 1.87, − 0.69]). Depression was associated with subjective sleep quality (r = 0.332 [0.009, 0.592]), sleep latency (r = 0.412 [0.101, 0.649]), sleep disturbances (r = 0.405 [0.094, 0.645]), daytime dysfunction (r = 0.503 [0.214, 0.711]), the four dimensions of Pittsburgh Sleep Quality Index (PSQI), while no significant correlation was found in the other three PSQI dimensions. Conclusion Depression had a moderate correlation with sleep quality in patients with SLE. Patients with poor sleep quality tended to have higher level of depression than that of good sleepers. Awareness of the correlation may help rheumatology physicians and nurses to assess and prevent depression and improve sleep quality in patients with SLE.

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