Accept Anxiety to Improve Sleep: The Impact of the COVID-19 Lockdown on the Relationships between Mindfulness, Distress, and Sleep Quality

Abstract

It has been recently proposed that mindfulness can improve sleep quality through the mediating role on psychological distress and that acceptance may play a pivotal role in mindfulness beneficial effects. The aim of the present work was to understand the effects of the COVID-19 lockdown on dispositional mindfulness, sleep, and distress, and on their relationships. In particular, we wanted to test the hypothesis that the detrimental effects of lockdown on sleep depended on mindfulness and distress (including anxiety and depression) and that the acceptance facet of mindfulness played the leading role. A longitudinal study based on self-report questionnaires was conducted on 39 Italian adults (M age = 35.03, SD = 14.02; 21 men) assessing mindfulness, distress, and sleep quality before (23 December 2019–8 March 2020) and during (27 April 2020–10 May 2020) the first Italian COVID-19 lockdown. Lockdown decreased mindfulness while increasing distress and sleep problems. Path analysis showed that the effects of lockdown on sleep were fully mediated by mindfulness and distress. Furthermore, a more detailed analysis showed that these effects were mainly dependent on the acceptance component of mindfulness working through anxiety. The present study confirms, in the context of the COVID-19 lockdown, a model according to which mindfulness, and specifically acceptance, influences sleep through the mediating role of distress.

The Relationship between Acceptance and Sleep–Wake Quality before, during, and after the First Italian COVID-19 Lockdown

“…These findings were further confirmed during the third lockdown that occurred in Italy the following spring (from 15 March to 21 June 2021). On one hand, Conte et al [8] demonstrated the presence of disrupted sleep and increased poor subjective sleep, similar to what had been reported in the previous waves [3][4][5][6][7]. On the other hand, the authors also described that sleep duration was in the normal range, suggesting that the (repetitive) experience of lockdown mainly affected the quality rather than the quantity of sleep.…”

“…However, Simione et al [17] challenged this theory, by demonstrating that acceptance was the only predictor of several benefits of mindfulness, including those regarding sleep quality. Interestingly, Mirolli et al [5] recently confirmed these findings in a longitudinal study by comparing mindfulness traits, general distress, and sleep quality, before and during the first Italian lockdown. In particular, this study demonstrated that acceptance (and not monitoring), influenced sleep through the mediating role of anxiety [5,17].…”

“…Interestingly, Mirolli et al [5] recently confirmed these findings in a longitudinal study by comparing mindfulness traits, general distress, and sleep quality, before and during the first Italian lockdown. In particular, this study demonstrated that acceptance (and not monitoring), influenced sleep through the mediating role of anxiety [5,17]. Hence, the acceptance component of mindfulness could be one of the main psychological variables accountable for a reduction in distress and, in turn, in sleep-wake problems.…”

“…In reaction to the COVID-19 pandemic, the Italian Government implemented a total lockdown during the first wave of the contagion (from 10 March to 3 May 2020); this involved home confinement, social distancing for the entire population, and the closure of most business activities. These measures affected both sleep and mental health, resulting in an increase in sleep difficulties, especially in people with higher levels of depression, anxiety, and stress [5].…”

“…The present research aims to assess the relationships between mindfulness (in particular, its acceptance and monitoring components), distress symptoms, and sleep-wake quality, in a cross-sectional study, involving measurements taken before, during, and after the first Italian lockdown. Considering the literature presented above, we expected two main findings to emerge: (a) compared to the other two phases, the lockdown phase would involve lower acceptance, higher distress, and worsened sleep quality; (b) the model according to which acceptance influences sleep quality through the mediating role of distress [5,13] would persist during all three phases (before, during, and after lockdown).…”