Background
The COVID-19 pandemic imposes a long period of stress on people worldwide and has been shown to significantly affect sleep duration across different populations. However, decreases in sleep quality rather than duration are associated with adverse mental health effects. Additionally, the one third of the general population suffering from poor sleep quality was underrepresented in previous studies. The current study aimed to elucidate effects of the COVID -19 pandemic on sleep quality across different levels of pre-pandemic sleep complaints and as a function of affect and worry.
Method
Participants of the Netherlands Sleep Registry (NSR) were invited for weekly online assessment of the subjective severity of major stressors, insomnia, sleep times, distress, depression, and anxiety using validated scales.
Analysis
To investigate the overall impact of the COVID-19 pandemic on the sleep quality of people with and without a history of insomnia, we performed a mixed model analysis using pre-pandemic insomnia severity, negative affect, and worry as predictors.
Results
The effect of COVID -19 on sleep quality differs critically across participants, and depends on the pre-pandemic sleep quality. Interestingly, a quarter of people with pre-pandemic (clinical) insomnia experienced a meaningful improvement in sleep quality, whereas 20% of pre-pandemic good sleepers experienced worse sleep during the lockdown measures. Additionally, changes in sleep quality throughout the pandemic were associated with negative affect and worry.
Conclusion
Our data suggests that there is no uniform effect of the lockdown on sleep quality. COVID-19 lockdown measures more often worsened sleep complaints in pre-pandemic good sleepers, whereas a subset of people with pre-pandemic severe insomnia symptoms underwent a clinically meaningful alleviation of symptoms in our sample.
When confronted with threatening stimuli, animals typically respond with freezing behavior characterized by reduced movement and heart rate deceleration. Freezing-like responses during threat anticipation have also been observed in humans and are associated with anxiety. Recent evidence yet suggests that freezing does not necessarily reflect helpless immobility but can also aid the preparation of a threat escape. To investigate which further behavioral responses human freezing encompasses, we presented 50 young adults (10 male) with aversive stimuli that could sometimes be avoided while measuring gaze, cardiovascular and electrodermal activity. In trials in which the threat could be escaped, participants displayed reduced heart rate, increased electrodermal activity and reduced visual exploration. Furthermore, heart rate deceleration and restricted visual exploration predicted the speed of flight responses. These results provide evidence for freezing behavior in measures of visual exploration and suggest that such responding is adaptive in preparing the subsequent escape of approaching threats.
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