Poor Sleep Quality and Its Relationship with Individual Characteristics, Personal Experiences and Mental Health during the COVID-19 Pandemic

While the COVID-19 has dramatically altered our lifestyle and sleep practices, the links between sleep, individual characteristics, personal experiences and mental health during the pandemic require further examination. This cross-sectional, multi-methods study examined differences in language used to describe personal experiences, and mental health, based on sleep quality during the early stages of the pandemic. N = 1745 participants (mean age 42.97 ± 14.46 years) from 63 countries responded to the survey. Sleep quality was assessed using the Pittsburgh Sleep Quality Index and mental health was examined using the Patient Health Questionnaire-9, the State Trait Anxiety Inventory, the Perceived Stress Scale and the UCLA-Loneliness Scale. Quantitative analysis of qualitative, language content of personal experiences was conducted using free-text responses and comments to a question on the survey. Almost 50% of the participants reported poor sleep quality, which was linked to a more negative emotional tone and greater mentions of money or finance related words. Good sleepers reported more positive emotional tone in their experiences. Greater reports of clinical state anxiety, moderate depression and moderate stress were observed in poor sleepers, even after accounting for demographics and pandemic-related factors such as loneliness, financial concerns and risk of contracting COVID-19 disease. Results from this study highlight an urgent need for sleep-related public health interventions. Practitioner education, sleep screening for those with mental health conditions, and encouraging people to adopt digital tools may help to reduce the burden of poor sleep on mental health. While the pandemic itself is a stressful and uncertain time, improving sleep can support positive emotion regulation, improving mood and consequential action.

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The Prevalence and Management of Poor Sleep Quality in a Secondary Care Mental Health Population

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.4452 ◽

2015 ◽

Vol 11 (02) ◽

pp. 111-116 ◽

Cited By ~ 4

Author(s):

Michelle O'Sullivan ◽

Masuma Rahim ◽

Christopher Hall

Keyword(s):

Mental Health ◽

Sleep Quality ◽

Secondary Care ◽

Poor Sleep ◽

Poor Sleep Quality

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Effects of COVID-19 2021 lockdown on the sleep quality and mental health of undergraduate medical and dental students of Pakistan: A cross-sectional study.

10.1101/2021.07.17.21260690 ◽

2021 ◽

Author(s):

Naveen Siddique Sheikh ◽

Aiza Anwar ◽

Iqra Pervaiz ◽

Zunaira Arshad ◽

Huma Saeed Khan ◽

...

Keyword(s):

Mental Health ◽

Sleep Quality ◽

Cross Sectional Study ◽

Dental Students ◽

Depression Symptoms ◽

Poor Sleep ◽

Sectional Study ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Medical And Dental Students

Background and objectives: The COVID-19 pandemic has been recognized as a cause of direct and indirect psychological consequences that impact mental health such as acute stress disorders, anxiety, irritability, poor concentration, and insomnia. This study was planned to evaluate the sleep quality and mental health of undergraduate students amidst the COVID-19 lockdown of 2021. Materials and Methods: This observational cross-sectional study was conducted in Lahore, Pakistan, where 261 undergraduate medical and dental students enrolled at a private medical and dental school were approached from March to May 2021. The Pittsburg Sleep Quality Index (PSQI) was used to identify the sleep quality along with the Generalized Anxiety Disorder Scale (GAD-7) to establish anxiety symptoms and the Physical Health Questionnaire (PHQ-9) for depression symptoms. Results: The results show that 212 (81.2%) female and 49 (18.8%) male students participated in the study. Of the participants 75.1% experienced poor sleep quality, 90% had symptoms of depression, and 85.4% had symptoms of anxiety. The mean score on the PSQI scale was 8.59+4.10, on the GAD-7 scale was 11.36+5.94 and on the PHQ-9 scale was 13.70+6.81. Multiple regression analysis showed that anxiety symptoms (β = 0.315, p = 0.000) and depression symptoms (β = 0.398, p = 0.000) were significant predictors of sleep quality amongst the undergraduate medical and dental students. Conclusion: A high majority of the study participants are experiencing poor sleep quality along with suffering from depression and anxiety amidst the COVID-19 lockdown. It is concluded from the analysis that anxiety and depression symptoms are significant predictors of sleep quality. Relevant authorities need to set up systems that help undergraduate medical students in alleviating and coping with these symptoms midst the COVID-19 pandemic.

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ASSOCIATION OF SLEEP PROBLEMS AND COMMON MENTAL HEALTH PROBLEMS IN ENGINEERING STUDENTS OF SGT UNIVERSITY, GURUGRAM, INDIA

International Journal of Advanced Research ◽

10.21474/ijar01/12136 ◽

2020 ◽

Vol 8 (12) ◽

pp. 148-155

Author(s):

Niyatisheokand a ◽

◽

Nimmi A. Jose ◽

Abhishek Kapoor ◽

Priya Arora ◽

...

Keyword(s):

Mental Health ◽

Sleep Quality ◽

Engineering Students ◽

Mental Health Problems ◽

Sleep Problems ◽

General Health Questionnaire ◽

Poor Sleep ◽

Quality Of Sleep ◽

Poor Sleep Quality

Introduction:Sleep is naturally recurring state of mind and body, characterized by altered consciousness, inhibition of nearly all voluntary muscles and reduced interactions with surroundings. Chronic disturbances can lead to poor sleep quality which may manifest as increased irritability, anxiety, tension, depression, confusion. The undergraduate years are a period of vulnerability when considering sleep problems and mental health may tend to worsen over time. Alcohol, tobacco, and stimulant beverages such as tea/ caffeine affect the quality of sleep. Students are more prone to adopt and practice maladaptive sleep hygiene such as irregular bedtime, academic pressure, internet addiction, electronic media exposure, alcohol consumption and smoking, which affects quality of sleep. Material and Methods:The study was a cross sectional, interview based, non-interventional studyconducted on the engineering students at SGT University, Budhera, Gurgaon, Haryana, India. Data was collected through questionnaires such as Pittsburgh Sleep Quality Index, The Epworth `Sleepiness Scale, Depression Anxiety Stress Scale, The general health questionnaire. Results:A total of 274 students were included in the study. The mean age was20.11 Â± 1.30 years and there were more male (77.3%) students as compared to females (22.7%). Alcohol use was present in 43(11.7%) of students, cannabis intake was present in 11(4%), nicotine intake was reported by 39(14.2%) of students and only one student reported of taking opioid. DASS-A, DASS-S, DASS-D, GHQ-12, PSQI were positively correlated with each other when associations were studied individually. Conclusion:In our study,it was established that poor sleep quality in engineering students was significantly associated with poor mental and physical health.

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Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 epidemic in China: a web-based cross-sectional survey

10.21203/rs.3.rs-17172/v1 ◽

2020 ◽

Cited By ~ 7

Author(s):

Yeen Huang ◽

Ning Zhao

Keyword(s):

Mental Health ◽

Depressive Symptoms ◽

Sleep Quality ◽

Healthcare Workers ◽

Influence Factors ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Web Based

Abstract Background China has been severely affected by COVID-19 (Corona Virus Disease 2019) since December, 2019. This study aimed to assess the population mental health burden during the epidemic, and to explore the potential influence factors. Methods Using a web-based cross-sectional survey, we collected data from 7,236 self-selected volunteers assessed with demographic information, COVID-19 related knowledge, Generalized Anxiety Disorder-7 (GAD-7), Center for Epidemiology Scale for Depression (CES-D), and Pittsburgh Sleep Quality Index (PSQI). Logistic regressions were used to identify influence factors associated with mental health problem. Results Of the total sample analyzed, the overall prevalence of GAD, depressive symptoms, and sleep quality were 35.1%, 20.1%, and 18.2%, respectively. Young people reported a higher prevalence of GAD and depressive symptoms than older people ( P <0.001). Compared with other occupational group, healthcare workers have the highest rate of poor sleep quality ( P <0.001). Multivariate logistic regression showed that age (< 35 years) and times to focus on the COVID-19 (≥ 3 hours per day) were associated with GAD, and healthcare workers were associated with poor sleep quality. Conclusions Our study identified a major mental health burden of the public during COVID-19 epidemic in China. Young people, people who spent too much time on the epidemic, and healthcare workers were at high risk for mental illness. Continuous surveillance and monitoring of the psychological consequences for outbreaks should become routine as part of preparedness efforts worldwide.

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Disentangling the Sleep-Pain Relationship in Pediatric Chronic Pain: The Mediating Role of Internalizing Mental Health Symptoms

Pain Research and Management ◽

10.1155/2017/1586921 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 14

Author(s):

Maria Pavlova ◽

Jennifer Ference ◽

Megan Hancock ◽

Melanie Noel

Keyword(s):

Mental Health ◽

Chronic Pain ◽

Depressive Symptoms ◽

Sleep Quality ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Mental Health Symptoms ◽

Health Symptoms ◽

Pediatric Chronic Pain ◽

Pain Outcomes

Background. Pediatric chronic pain often emerges in adolescence and cooccurs with internalizing mental health issues and sleep impairments. Emerging evidence suggests that sleep problems may precede the onset of chronic pain as well as anxiety and depression. Studies conducted in pediatric populations with pain-related chronic illnesses suggest that internalizing mental health symptoms may mediate the sleep-pain relationship; however, this has not been examined in youth with primary pain disorders.Objective. To examine whether anxiety and depressive symptoms mediated relationships between sleep quality and pain outcomes among youth with chronic pain.Methods. Participants included 147 youth (66.7% female) aged 8–18 years who were referred to a tertiary-level chronic pain program. At intake, the youth completed psychometrically sound measures of sleep quality, pain intensity, pain interference, and anxiety and depressive symptoms.Results. As hypothesized, poor sleep quality was associated with increased pain intensity and pain interference, and anxiety and depressive symptoms mediated these sleep-pain relationships.Discussion. For youth with chronic pain, poor sleep quality may worsen pain through alterations in mood and anxiety; however, prospective research using objective measures is needed. Future research should examine whether targeting sleep and internalizing mental health symptoms in treatments improve pain outcomes in these youth.

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The prevalence and risk factors for anxiety in frontline nurses under COVID-19 pandemic based on a large cross-sectional study using the propensity score-matched method

10.21203/rs.3.rs-143726/v1 ◽

2021 ◽

Author(s):

Qingyun Zhao ◽

Zichuan Yao ◽

Xianqing Zhu ◽

Yunzhong Jiang ◽

Chunyu Pan

Keyword(s):

Mental Health ◽

Risk Factors ◽

Sleep Quality ◽

Psychological Capital ◽

Cross Sectional Study ◽

Poor Sleep ◽

Sectional Study ◽

Poor Sleep Quality ◽

Related Factors ◽

Cross Sectional

Abstract Introduction: We determined the prevalence of anxiety and the associated risk factors in in frontline nurses under COVID-19 pandemic. Methods: This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 532 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, anxiety, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression.Results: Of the nurses enrolled in the study, 33.60% had anxiety. Five independent risk factors were identified for anxiety: poor sleep quality (OR=1.235), experienced major events (OR=1.653), lower resilience and optimism of psychological capital (OR=0.906, and OR=0.909) and no visiting friend constantly (OR=0.629). Conclusions: This study revealed a considerable high prevalence of anxiety in frontline nurses during the COVID-19 outbreak, and identified five risk factors, which were poor sleep quality, experienced major events, lower resilience and optimism of psychological capital, and no visiting friend rarely. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of anxiety and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.

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The effect of mental health on sleep quality of front-line medical staff during the COVID-19 outbreak in China: A cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0253753 ◽

2021 ◽

Vol 16 (6) ◽

pp. e0253753

Author(s):

Leiyu Yue ◽

Rui Zhao ◽

Qingqing Xiao ◽

Yu Zhuo ◽

Jianying Yu ◽

...

Keyword(s):

Mental Health ◽

Sleep Quality ◽

Medical Staff ◽

Cross Sectional Study ◽

Anxiety And Depression ◽

Poor Sleep ◽

Front Line ◽

Poor Sleep Quality ◽

Cross Sectional

Background The 2019 coronavirus disease (COVID-19) pandemic is a public health emergency of international concern and poses a challenge to the mental health and sleep quality of front-line medical staff (FMS). The aim of this study was to investigate the sleep quality of FMS during the COVID-19 outbreak in China and analyze the relationship between mental health and sleep quality of FMS. Methods From February 24, 2020 to March 22, 2020, a cross-sectional study was performed with 543 FMS from a medical center in Western China. A self-reported questionnaire was used to collect data anonymously. The following tests were used: The Self-Rating Anxiety Scale (SAS) for symptoms of anxiety, the Beck Depression Inventory (BDI) for depressive symptoms, and the Pittsburgh Sleep Quality Index (PSQI) for sleep quality assessment. Results Of the 543 FMS, 216 (39.8%) were classified as subjects with poor sleep quality. Anxiety (P<0.001), depression (P<0.001), and the prevalence of those divorced or widowed (P<0.05) were more common in FMS with poor sleep quality than in participants with good sleep quality. The FMS exhibiting co-occurrence of anxiety and depression were associated with worse scores on sleep quality than those medical staff in the other three groups/categories. The difference in sleep quality between the FMS with only depression and the FMS experiencing co-occurrence of anxiety and depression was statistically significant (P<0.05). However, there was no significant difference in sleep quality between the FMS experiencing only anxiety and the FMS with co-occurrence of anxiety and depression (P > 0.05). Conclusions During the COVID-19 pandemic, there was a noteworthy increase in the prevalence of negative emotions and sentiments among the medical staff, along with poor overall sleep quality. We anticipate that this study can stimulate more research into the mental state of FMS during outbreaks and other public health emergencies. In addition, particular attention must be paid to enhance the sleep quality of FMS, along with better planning and support for FMS who are continuously exposed to the existing viral epidemic by virtue of the nature of their profession.

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Insufficient sleep during adolescence might pose a risk for later depression and anxiety

10.13056/acamh.13677 ◽

2020 ◽

Keyword(s):

Mental Health ◽

At Risk ◽

Young People ◽

Sleep Quality ◽

Early Adulthood ◽

Child Psychology ◽

Poor Mental Health ◽

Poor Sleep ◽

Depression And Anxiety ◽

Poor Sleep Quality

A new study published in the Journal of Child Psychology and Psychiatry has found that young people who have poor sleep quality and quantity might be at risk of poor mental health later in adolescence and early adulthood.

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Depression, Anxiety and Stress among Swedish University Students Before and During Six Months of the COVID-19 Pandemic: A Cohort Study.

10.21203/rs.3.rs-70620/v2 ◽

2021 ◽

Author(s):

Fred Johansson ◽

Pierre Côté ◽

Sheilah Hogg-Johnson ◽

Ann Rudman ◽

Lena W. Holm ◽

...

Keyword(s):

Mental Health ◽

Cohort Study ◽

University Students ◽

Sleep Quality ◽

Mental Health Problems ◽

Potential Effect ◽

Health Problems ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Over Time

Abstract The COVID-19 pandemic has a profound effect on societies and citizens worldwide, raising concerns about potential mental health impacts. We aimed to describe trajectories of depression, anxiety, and stress symptoms during the COVID-19 outbreak compared to before, and determine if trajectories were modified by pre-pandemic loneliness, poor sleep quality and mental health problems. We conducted a cohort study with 1836 Swedish university students entering before the onset of the pandemic, March 13, 2020, with follow-ups within three (FU1) and six months (FU2) of the outbreak. Generalized Estimating Equations were used to estimate mean differences in symptom levels over time-periods, and to estimate potential effect modifications. We found small differences in mean levels of the Depression, Anxiety and Stress Scale (DASS-21) over time. Compared to before the pandemic, depression increased by 0.25 points of 21 (95% CI: 0.04 to 0.45) at FU1 and decreased by -0.75/21 (95% CI: -0.97 to -0.53) at FU2. Anxiety decreased from baseline to FU1 by -0.09/21 (95% CI: -0.24 to 0.07) and by -0.77/21 (95% CI: -0.93 to -0.61) to FU2. Stress decreased from baseline to FU1 by -0.30/21 (95% CI: -0.52 to -0.09) and by -1.32/21 (95% CI: -1.55 to -1.09) to FU2. Students with pre-pandemic loneliness, poor sleep quality and pre-pandemic mental health problems did not show worse trajectories of mean mental health symptoms. In conclusion, symptom levels were relatively stable during the first three months of the pandemic, while there was a slight decrease during the summer months, probably due to seasonality effects.

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Poor Sleep Quality among Medical Students in International Islamic University Malaysia (IIUM) and Its Association with Mental Health and other Factors

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v19i2.1564 ◽

2020 ◽

Vol 19 (2) ◽

Author(s):

Said AH ◽

Yusof MZ ◽

Mohd FN ◽

Azmi MANH ◽

Mohd Hanapiah H ◽

...

Keyword(s):

Mental Health ◽

Logistic Regression ◽

Medical Students ◽

Sleep Quality ◽

Multiple Logistic Regression Analysis ◽

Cross Sectional Study ◽

Poor Sleep ◽

Multiple Logistic Regression ◽

Poor Sleep Quality ◽

Cross Sectional

INTRODUCTION: Poor sleep quality is a common problem experienced by medical students worldwide. Therefore, this study aimed to measure the prevalence of poor sleep quality among medical students in International Islamic University Malaysia (IIUM) and its association with mental health and other factors. MATERIALS AND METHODS: A cross-sectional study using convenience sampling was conducted among 500 medical students in IIUM Kuantan. A validated self-reported questionnaire including sociodemographic, socioeconomic, lifestyle, Pittsburgh Sleep Quality Index and Depression Anxiety Stress Score 21 was distributed from 15th July to 31st August 2019. Descriptive statistics were used to measure the prevalence of poor sleep quality. Chi- square test, Fisher’s exact test, independent sample T-test, and multiple logistic regression were used to measure the association between risk factors and sleep quality. RESULT: The response rate was 91.2%. The prevalence of poor sleep quality was 59.6%. Multiple logistic regression analysis revealed level of study (clinical year (AOR=0.44, 95% CI: 0.29 - 0.66) and depression (yes (AOR: 1.71, 95% CI 1.03-2.83) contributed independently on poor sleep quality among medical students. There was no significant relationship between tahajjud practice and poor sleep quality. CONCLUSION: More than half of IIUM medical students have poor sleep quality. Those students who were in the pre-clinical year and had depression were independently associated with the occurrence of poor sleep quality. Early intervention is compulsory to overcome this problem among medical students in IIUM.

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