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

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.

Bedtime Procrastination as a Mediator in the Relationship Between Active Emotion Regulation Strategies and Insomnia

Objectives: Bedtime procrastination (BP) is defined as the behavior of voluntarily postponing bedtime without having external reasons for doing so. According to previous studies, people with reduced use of active emotion regulation strategies may use BP to cope with negative emotions. However, research about the relationship among active emotional regulation strategies, BP, and insomnia is lacking. This study aimed to investigate the mediating effect of BP between active emotional regulation strategies and insomnia severity.Methods: In total, 597 adults (female, 81.9%; mean age, 23.18±2.80 years) completed the Emotional Regulation Strategies Checklist, Insomnia Severity Index, and Bedtime Procrastination Scale.Results: There was a significant association between active emotional regulation strategies and BP (r=-0.152, p<0.01), between BP and insomnia severity (r=0.259, p<0.01), and between active emotional regulation strategies and insomnia severity (r=-0.128, p<0.01). BP significantly mediated the relationship between active emotional regulation strategies and insomnia severity (B=-0.024; 95% confidence interval [CI], -0.04 to -0.01).Conclusions: BP may be considered in the relationship between active emotional regulation strategies and insomnia severity. Understanding the mediating role of BP may help prevent insomnia.

Development of Social Media Addiction Scale for COVID-19 Pandemic (SMACOP)

The current COVID-19 pandemic and ‘new normal’ has resulted in much distress worldwide. Social media currently plays an essential role in information gathering. Thus, time spent on social media has increased drastically, further increasing the risk for internet-related addictions, such as social media addiction. This study aimed to develop a COVID-19-related measure of social media addiction based on the Bergen Social Media Addiction Scale (BSMAS) in order to aid in the identification and evaluation of at-risk individuals. Social Media Addiction Scale for COVID-19 Pandemic (SMACOP) was adapted from BSMAS to fit the context of COVID-19 and pilot tested on 20 individuals. A total of 80 participants were subsequently recruited through convenience sampling from the general public of a public university in Malaysia, comprising of patients’ family, visitors, or hospital staff. Construct validity was assessed using the Insomnia Severity Index (ISI), Generalized Anxiety Disorder 7 (GAD7) and Patient Health Questionnaire (PHQ9). A two-factor structure was found for SMACOP, comprising of the factors ‘Desire’ and ‘Distress’. SMACOP shows good internal consistency (α = 0.64) and validity. SMACOP scores were positively correlated with the PHQ9, GAD7, and ISI (p<.01). SMACOP is a psychometrically valid instrument with high internal consistency, which is especially useful during this time in assessing social media addiction in relevance to COVID-19.

Validating Insomnia Severity Index (ISI) in a Bangladeshi Population: Using Classical Test Theory and Rasch Analysis

The COVID-19 outbreak is associated with sleep problems and mental health issues among individuals. Therefore, there is a need to assess sleep efficiency during this tough period. Unfortunately, the commonly used instrument on insomnia severity—the Insomnia Severity Index (ISI)—has never been translated and validated among Bangladeshis. Additionally, the ISI has never been validated during a major protracted disaster (such as the COVID-19 outbreak) when individuals encounter mental health problems. The present study aimed to translate the ISI into Bangla language (ISI-Bangla) and validate its psychometric properties. First, the linguistic validity of the ISI-Bangla was established. Then, 9790 Bangladeshis (mean age = 26.7 years; SD = 8.5; 5489 [56.1%] males) completed the Bangla versions of the following questionnaires: ISI, Fear of COVID-19 Scale (FCV-19S), and Patient Health Questionnaire-9 (PHQ-9). All the participants also answered an item on suicidal ideation. Classical test theory and Rasch analyses were conducted to evaluate the psychometric properties of the ISI-Bangla. Both classical test theory and Rasch analyses support a one-factor structure for the ISI-Bangla. Moreover, no substantial differential item functioning was observed across different subgroups (gender, depression status (determined using PHQ-9), and suicidal ideation). Additionally, concurrent validity of the ISI-Bangla was supported by significant and moderate correlations with FCV-19S and PHQ-9; known-group validity was established by the significant difference of the ISI-Bangla scores between participants who experienced suicidal ideation and those without. The present psychometric validation conducted during the COVID-19 outbreak suggests that the ISI-Bangla is a promising and operationally adequate instrument to assess insomnia in Bangladeshis.

Can an E-Mail-Delivered CBT for Insomnia Validated in the West Be Effective in the East? A Randomized Controlled Trial

This study examined the effects of an e-mail-delivered cognitive behavioral therapy for insomnia (CBT-I), validated in Western countries, on insomnia severity, anxiety, and depression in young adults with insomnia in Eastern countries, particularly Japan. This prospective parallel-group randomized clinical trial included college students with Insomnia Severity Index (ISI) scores of ten or higher. Participants were recruited via advertising on a university campus and randomized to an e-mail-delivered CBT-I (REFRESH) or self-monitoring (SM) with sleep diaries group. The primary outcomes were insomnia severity, anxiety, and depression; secondary outcomes were sleep hygiene practices, dysfunctional beliefs, sleep reactivity, and pre-sleep arousal. All measurements were assessed before and after the intervention. A total of 48 participants (mean (SD) age, 19.56 (1.86) years; 67% female) were randomized and included in the analysis. The results of the intent-to-treat analysis showed a significant interaction effect for insomnia severity, anxiety, depression, sleep hygiene practice, and pre-sleep arousal. Compared with the SM group, the REFRESH group was more effective in reducing insomnia severity (Hedges’ g = 1.50), anxiety (g = 0.97), and depression (g = 0.61) post-intervention. These findings suggest that an e-mail-delivered CBT-I may be an effective treatment for young adults with elevated insomnia symptoms living in Japan.

Association between Insomnia and Irritable Bowel Syndrome among Adolescents in South Korea: A Quantitative Cross-Sectional Study

Insomnia refers to having difficulty sleeping even when given the opportunity and environment to sleep. Irritable bowel syndrome is a functional bowel disease that is accompanied by abdominal pain and irregular defecation but not organic lesions. Although insomnia and irritable bowel syndrome are pathophysiologically related, studies on their relationship among adolescents are lacking. This study aimed to determine the prevalence of insomnia and irritable bowel syndrome among adolescents and the association between them. In May 2021, a survey was conducted among high school adolescents from Daegu Metropolitan City, South Korea, using the Korean version of the Insomnia Severity Index and the Rome IV diagnostic criteria for irritable bowel syndrome. Data were analyzed using chi-square and Mann–Whitney tests and logistic regression analyses. The incidence of insomnia (Insomnia Severity Index score ≥ 10) was 18.4% (n = 74) while that of irritable bowel syndrome was 10.7% (n = 43). Irritable bowel syndrome was strongly associated with an increased incidence of insomnia (odds ratio = 3.30, 95% confidence interval: 1.66–6.53). Therefore, the association between insomnia and irritable bowel syndrome has relevance in the treatment of insomnia in adolescents.

Sleep in post-COVID-19 recovery period and its impact on different domains of quality of life

Background COVID-19 pandemic became a global health problem affecting the life of millions of people all over the world. The effects of this pandemic were not only on the physical and medical aspects but also on the psychological issues including anxiety disorders, depressive manifestations, sleep problems and others. Sleep disorders were very commonly reported during the novel Coronavirus-19 pandemic either in the acute phase of COVID-19 infection or after recovery. These sleep problems might have a drastic burden on the recovered patients’ life. This study aimed to investigate the sleep in the post-Coronavirus-19 period and if has an impact on the different items of patients’ quality of life. This cross-sectional observational study investigated the sleep problems in 500 patients in the post recovery period using Insomnia Severity Index and Pittsburgh sleep quality index (PSQI), their relation to this critical period and their impact on different domains of Quality of Life which was assessed by the SF36 Health Survey. Results Socio-demographic characteristics of 500 post-Coronavirus-19 patients were collected; the insomnia severity index and Pittsburgh sleep quality index evaluated the sleep pattern. The quality of life was investigated using Short Form 36 scale. The study revealed high scores of insomnia severity index (13.01 ± 4.9), Pittsburgh sleep quality index (15.37 ± 4.43), also high scores of different items of scale of quality of life in the studied group. Conclusion Post-COVID-19 sleep disturbances were commonly reported in the recovery period, also these sleep deficits had an impact on the physical and mental aspects of quality of life, so these sleep problems must be managed properly especially in this critical pandemic era.