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

Abstract

The first COVID-19 contagion wave caused unprecedented restraining measures worldwide. In Italy, a period of generalized lockdown involving home confinement of the entire population was imposed for almost two months (9 March–3 May 2020). The present is the most extensive investigation aimed to unravel the demographic, psychological, chronobiological, and work-related predictors of sleep disturbances throughout the pandemic emergency. A total of 13,989 Italians completed a web-based survey during the confinement period (25 March–3 May). We collected demographic and lockdown-related work changes information, and we evaluated sleep quality, insomnia and depression symptoms, chronotype, perceived stress, and anxiety using validated questionnaires. The majority of the respondents reported a negative impact of confinement on their sleep and a delayed sleep phase. We highlighted an alarming prevalence of sleep disturbances during the lockdown. Main predictors of sleep disturbances identified by regression models were: female gender, advanced age, being a healthcare worker, living in southern Italy, confinement duration, and a higher level of depression, stress, and anxiety. The evening chronotype emerged as a vulnerability factor, while morning-type individuals showed a lower predisposition to sleep and psychological problems. Finally, working from home was associated with less severe sleep disturbances. Besides confirming the role of specific demographic and psychological factors in developing sleep disorders during the COVID-19 pandemic, we propose that circadian typologies could react differently to a particular period of reduced social jetlag. Moreover, our results suggest that working from home could play a protective role against the development of sleep disturbances during the current pandemic emergency.

The Differential Impact of COVID-19 Lockdown on Sleep Quality, Insomnia, Depression, Stress, and Anxiety among Late Adolescents and Elderly in Italy

“…This evidence could constitute a protective factor of older people, as morningness was associated with higher resilience [51][52][53], lower perceived stress [54], and a lower tendency to develop post-traumatic stress disorder (PTSD) [55,56]. In this regard, we recently proposed the evening chronotype as a vulnerability factor during the lockdown period [4,57].…”

“…The present study belongs to a larger research project aimed at identifying and understanding the sleep-related and psychological consequences of the COVID-19 pandemic on the Italian population [4].…”

“…The pandemic emergency was marked by increased stress and an exacerbation of anxiety and depressive symptoms among the general population. Moreover, the COVID-19 outbreak pervasively altered sleep patterns, as evidenced by poorer sleep quality and increased insomnia levels [3][4][5].…”

Understanding the Impact of the COVID-19 Pandemic, Lockdowns and Social Isolation on Sleep Quality

“…11,12,[34][35][36][37] Such positive changes are most likely due to alterations in pressurized social and environmental factors, including changes in employment practices, such as remote and flexible working. 38,39 Smartphone data of 2.9 million nights of sleep recordings taken from participants across different continents indicated a sudden increase in sleep duration during the early stages of the pandemic, compared to the same time a year earlier. 36 In addition to increases in sleep duration, changes to sleep timing have also been observed.…”

Access to Mental Health Care during the First Wave of the COVID-19 Pandemic in Italy: Results from the COMET Multicentric Study

“…Furthermore, the SARS-CoV-2 also presents neurotropism and may thus directly trigger possible neuropsychiatric manifestations [ 12 , 13 , 14 ]. The effects of the COVID-19 pandemic on mental health include the rise of anxiety and depressive symptoms, somatic complaints [ 6 , 15 , 16 ], disruption of circadian rhythms, with frequent sleep disorders [ 17 ], phobias, cognitive deficits, and traumatic experiences.…”