Changes in sleep timing and subjective sleep quality during the COVID-19 lockdown in Italy and Belgium: age, gender and working status as modulating factors

Abstract

Italy and Belgium have been among the first western countries to face the Coronavirus disease 2019 (COVID-19) emergency, imposing a total lockdown over the entire national territories.These limitations have proven effective in slowing down the spread of the infection. However, the benefits obtained in public health have come with huge costs in terms of social, economic, and psychological well-being. In the current study, we aimed at investigating how the period of home confinement affected self-reported sleep characteristics in Italians and Belgians, with special regard to sleep timing and subjective quality. Using an online survey we collected data from 2272 participants, 1622 Italians (Mage=34.1±13.6 years, 1171 F), and 650 Belgian (Mage=43.0±16.8 years, 509 F). Participants reported their sleep pattern (e.g., bedtime, risetime) and perceived sleep quality during and, retrospectively, before the lockdown. During the lockdown, sleep timing was significantly delayed, time spent in bed increased, and sleep quality was markedly impaired in both Italians and Belgians. The most vulnerable individualsappeared to be women, subjects experiencing a more negative mood, and those perceiving the pandemic situation as highly stressful. However, the two samples differed in the subgroups most affected by the changes, possibly because of the different welfare systems of the two countries. In fact, in the Italian sample sleep quality and timing underwent significant modifications especially in unemployed participants, whereas in the Belgian sample this category was the one who suffered less from the restrictions. Considering that the novel coronavirus has spread across the whole globe, involving countries with different types of health and welfare systems, understanding which policy measures have the most effective protecting role on physical and mental health is of primary importance.

Demographic, psychological, chronobiological, and work-related predictors of sleep disturbances during the COVID-19 lockdown in Italy

“…In line with the current literature 4 , 16 , 21 , 22 , we demonstrated a strong relationship between sleep variables and depression, stress, and anxiety. We confirmed the results of other cross-sectional investigations on healthcare workers 19 , 20 and women 14 – 18 , which appeared as the categories experiencing the most severe sleep problems during lockdown worldwide. Furthermore, advanced age predicted more severe sleep disturbances.…”

“…Several cross-sectional studies showed women 14 – 18 and healthcare workers 19 , 20 as the categories suffering the most. Furthermore, literature also revealed a close relationship between psychological well-being and sleep disturbances during the pandemic period 4 , 16 , 21 , 22 .…”

“…The restraining measures impacted the sleep/wake rhythms. People delayed the bedtime and wake-up time during the lockdown 18 , 21 , 23 , 24 , resulting in a reduction of social jetlag 23 – 25 , which could be conceived as a proxy for a challenged circadian system and compromised sleep 26 , 27 . Conventionally, three main chronotypes have been identified 28 : the morning-type (MT), the neither-type (NT), and the evening-type (ET).…”

The Evolution in Anxiety and Depression with the Progression of the Pandemic in Adult Populations from Eight Countries and Four Continents

“…The key driving forces of this psychological crisis have been economic concerns, health implications and social distancing measures [ 8 ]. Researchers in Italy and Belgium found that lockdown delayed sleep timing, increased time spent in bed, and impaired sleep quality, especially for those who perceived the pandemic as highly stressful [ 9 ]. A study in China reported COVID-19-related increases in generalized anxiety, which were more pronounced among younger people (<25 years) compared to older age groups [ 10 ].…”

“…Countries across the globe faced different epidemiological situations, and even those impacted in a similar manner chose to respond to the pandemic in different ways. Early and effective containment measures have decreased infection rates [ 13 ]; however, the benefits come with huge costs in terms of negative psychological outcomes [ 9 ], especially when individuals are affected by specific stressors such as greater duration of confinement, inadequate supplies, difficulty securing medical care and financial losses [ 14 ]. The home confinement of large swaths of the population for indefinite periods, differences among the stay-at-home orders issued by various jurisdictions, and conflicting messages from government and public health authorities have most likely intensified distress.…”