Insomnia, anxiety, and depression during the COVID-19 pandemic: an international collaborative study

Abstract

Importance and study objective The COVID-19 pandemic has produced unprecedented changes in social, work, and leisure activities, which all have had major impact on sleep and psychological well-being. This study documented the prevalence of clinical cases of insomnia, anxiety, and depression and selected risk factors (COVID-19, confinement, financial burden, social isolation) during the first wave of the pandemic in 13 countries throughout the world. Design and participants International, multi-center, harmonized survey of 22 330 adults (mean age = 41.9 years old, range 18–95; 65.6% women) from the general population in 13 countries and four continents. Participants were invited to complete a standardized web-based survey about sleep and psychological symptoms during the first wave of the COVID-19 pandemic from May to August 2020. Results Clinical insomnia symptoms were reported by 36.7% (95% CI, 36.0–37.4) of respondents and 17.4% (95% CI, 16.9–17.9) met criteria for a probable insomnia disorder. There were 25.6% (95% CI, 25.0–26.2) with probable anxiety and 23.1% (95% CI, 22.5–23.6) with probable depression. Rates of insomnia symptoms (>40%) and insomnia disorder (>25%) were significantly higher in women, younger age groups, and in residents of Brazil, Canada, Norway, Poland, USA, and United Kingdom compared to residents from Asian countries (China and Japan, 8% for disorder and 22%–25% for symptoms) (all Ps < 0.01). Proportions of insomnia cases were significantly higher among participants who completed the survey earlier in the first wave of the pandemic relative to those who completed it later. Risks of insomnia were higher among participants who reported having had COVID-19, who reported greater financial burden, were in confinement for a period of four to five weeks, and living alone or with more than five people in same household. These associations remained significant after controlling for age, sex, and psychological symptoms. Conclusion and relevance Insomnia, anxiety, and depression were very prevalent during the first wave of the COVID-19 pandemic. Public health prevention programs are needed to prevent chronicity and reduce long-term adverse outcomes associated with chronic insomnia and mental health problems.

Anxiety and Depression during COVID-19 in Elite Rugby Players: The Role of Mindfulness Skills

“…Addressing the first aim of the study, our results showed that, in general, symptoms of anxiety and depression were lower in elite rugby players than the general population over this time period, and considerably lower than those aged 18-34 (29.6% anxiety, 31.5% depression), the group most similar by age to the study sample [5]. This aligns with the findings from other research that reported elite athletes had lower stress and higher biopsychosocial functioning scores than novice athletes during the early stages of the pandemic [39], and that professional athletes who were forced to self-isolate had better mental health status than non-athletes [40].…”

“…The COVID-19 pandemic has been associated with increased levels of psychological distress globally, although there appears to be significant demographic and geographic variability [3]. In the UK, during the first six months of the pandemic, the mental health of most adults remained close to pre-pandemic levels [4], but younger adults were found to be at greater risk of anxiety and depression [5]. Elite athletes are predominantly younger adults, and their careers overlap with the age range most commonly associated with the development of mental health disorders [6].…”

Dreams and Nightmares during the First and Second Wave of the COVID-19 Infection: A Longitudinal Study

“…Against this background, a growing number of research papers were showing that the outbreak was associated with relevant psychological symptoms [3,4] and sleep quality was significantly worsened [4][5][6]. Many investigations also explored oneiric activity during the pandemic [7][8][9][10][11][12][13][14][15][16].…”

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

“…The spread of COVID-19 resulted in a high prevalence of sleep problems not only in COVID-19 patients, but also in healthcare workers and in the general population [ 1 , 2 ]. In Italy, the first lockdown, which involved home confinement and social distancing for the entire population from 10 March to 3 May 2020, affected both sleep and mental health, with an increase in sleep difficulties, especially in people with a higher level of depression, anxiety, and stress [ 3 , 4 ].…”