Insomnia in the Italian Population During Covid-19 Outbreak: A Snapshot on One Major Risk Factor for Depression and Anxiety

Abstract

Objectives: One of the largest clusters of Covid-19 infections was observed in Italy. The population was forced to home confinement, exposing individuals to increased risk for insomnia, which is, in turn, associated with depression and anxiety. Through a cross-sectional online survey targeting all Italian adult population (≥18 yrs), insomnia prevalence and its interactions with relevant factors were investigated.Methods: The survey was distributed from 1st April to 4th May 2020. We collected information on insomnia severity, depression, anxiety, sleep hygiene behaviors, dysfunctional beliefs about sleep, circadian preference, emotion regulation, cognitive flexibility, perceived stress, health habits, self-report of mental disorders, and variables related to individual difference in life changes due to the pandemic's outbreak.Results: The final sample comprised 1,989 persons (38.4 ± 12.8 yrs). Prevalence of clinical insomnia was 18.6%. Results from multivariable linear regression showed that insomnia severity was associated with poor sleep hygiene behaviors [β = 0.11, 95% CI (0.07–0.14)]; dysfunctional beliefs about sleep [β = 0.09, 95% CI (0.08–0.11)]; self-reported mental disorder [β = 2.51, 95% CI (1.8–3.1)]; anxiety [β = 0.33, 95% CI (0.25–0.42)]; and depression [β = 0.24, 95% CI (0.16–0.32)] symptoms.Conclusion: An alarming high prevalence of clinical insomnia was observed. Results suggest that clinical attention should be devoted to problems of insomnia in the Italian population with respect to both prevention and treatment.

Mental Health Outcomes in Northern Italian Workers during the COVID-19 Outbreak: The Role of Demands and Resources in Predicting Depression

“…This result confirms the conclusions of many longitudinal studies on the topic, in which people with sleep problems are more likely to develop depressive symptomatology [10][11][12]. Our findings are also consistent with evidence from international [54][55][56][57] and Italian [58][59][60][61] studies which observed a strong positive relationship between poor sleep quality and depression during the COVID-19 epidemic.…”

Diurnal preference and depressive symptomatology: a meta-analysis

“…Following article screening, a total of 51 studies were entered into the initial random effects model. Outlier analyses identified a total of ten studies 49 – 58 and these were subsequently excluded from the analysis (See Supplemental S2 for details of these studies including the 95% CI for each excluded effect size). Heterogeneity was reduced after excluding these studies (prior to exclusion I 2 = 77.9%, Q(52) = 235.11, p < 0.001, after exclusion I 2 = 60.2%, Q(42) = 105.5, p < 0.001) but remained substantial and significant.…”

More than 50 long-term effects of COVID-19: a systematic review and meta-analysis

“…Adults have a double risk of being newly diagnosed with a psychiatric disorder after the COVID-19 diagnosis 37 , and the most common psychiatric conditions presented were anxiety disorders, insomnia, and dementia. Sleep disturbances might contribute to the presentation of psychiatric disorders 38 . Prompt diagnosis and intervention of any neuropsychiatric care is recommended for all patients recovering from COVID-19.…”