Epidemiology of Sleep Disturbances and Their Effect on Psychological Distress During the COVID-19 Outbreak: A Large National Study in China

Abstract

Background: The purpose of the current study was to assess the prevalence of sleep disturbances among Chinese people during the COVID-19 pandemic in a large national survey, analyze the relationship between sleep disturbances and mental health status, and explore the influencing factors of the relationship between sleep disturbances and mental health status.Methods: An online survey was accessed by 19,740 people throughout China from February 14 to 21, 2020. The survey included the Depression Anxiety Stress Scale-21 (DASS-21) to measure psychological distress and two questions about sleep disturbances. Logistic regression analyses and moderation analysis were performed.Results: (1) Among the 14,505 respondents included in analyses, 3,783 (26.08%) reported sleep disturbances at least 3 days during the past week. (2) Sleep disturbances increased the risk of depression, anxiety, and stress (p < 0.05). (3) Gender, age, education, occupation, frequency of attending to epidemic information, nervousness about supplies, receiving provisions of living necessities from the service department during the outbreak, number of correct responses to questions about the epidemic, and isolation/quarantine affected the risk of mental health problems among participants experiencing sleep disturbances (p < 0.05). (4) A moderation analysis found that sleep problems were more likely to affect depression, anxiety, and stress scores in men than women during the COVID-19 outbreak.Conclusion: During the COVID-19 outbreak, 26.08% people surveyed experienced sleep disturbances, and the presence of sleep disturbances was positively related to depression, anxiety, and stress, especially among front-line anti-epidemic workers, younger people, people living in isolation/quarantine, people with a college or greater education, and males.

Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

“…As a global phenomenon, decreases in sleep health (both quantity, quality and timing) have also been observed in multiple other large population-based studies, of which most employed online questionnaires. The reported effects on sleep range from altered timing of sleep [ 75 , 76 , 77 , 78 ], decreases in sleep quality [ 75 , 76 , 77 , 78 , 79 , 80 , 81 ], shortened sleep duration [ 79 ], prolonged sleep duration or increased time spent in bed [ 76 , 77 , 78 ] and increased prevalence of insomnia or insomnia-related symptoms [ 79 , 82 , 83 ].…”

Impact of the COVID-19 Pandemic and Lockdown on Anxiety, Depression and Nursing Burden of Caregivers in Alzheimer's Disease, Dementia With Lewy Bodies and Mild Cognitive Impairment in China: A 1-Year Follow-Up Study

“…Family caregivers, especially those tending individuals suffering from cognition impairment, were more prone to suffering anxiety, depression and heavy nursing burdens ( 11 , 12 ). There are only limited studies on the effects of COVID-19 quarantine on the psychological status (anxiety, depression) and care burden of caregivers that include follow-up for at least 1 year during the COVID-19 pandemic ( 13 , 14 ). Such studies have not discussed the differences among such effects according to the cognitive impairment subtypes of the individuals caregivers care for.…”

Cross-lagged relationship between anxiety, depression, and sleep disturbance among college students during and after collective isolation

“…Containment measures, including social distance, quarantine, or even city lockdown, are effective in disease containment, whereas stringent measures have introduced a greater risk of mental illness to the public (2). Evidence shows that the prevalence of mental illness during the pandemic was higher than in pre-pandemic (2)(3)(4). For college students, the impact of the pandemic on mental and physical health was worse (3,5).…”

“…Evidence shows that the prevalence of mental illness during the pandemic was higher than in pre-pandemic ( 2 – 4 ). For college students, the impact of the pandemic on mental and physical health was worse ( 3 , 5 ). Among mental health problems, depression and anxiety are the most prevalent in college students ( 6 ), negatively affecting mental health and daily performance ( 7 ).…”

“…Previous research has established that anxiety, depression, and sleep disturbance are intertwined ( 8 , 9 ). However, due to different measurements, no longitudinal studies, whether the relationship between anxiety, depression, and sleep disturbance alters with time is not yet clear ( 3 , 10 ), as if the interpretation of this relationship will benefit the prevention and intervention of anxiety, depression, and sleep disturbance after the pandemic. Given this, our study aims to reveal the relationship between anxiety, depression, and sleep disturbance.…”