Sleep and Awakening Quality during COVID-19 Confinement: Complexity and Relevance for Health and Behavior

Abstract

Objective: The aim of this study was to evaluate sleep and awakening quality (SQ and AQ) during COVID-19 in a large and diversified population in order to identify significant associations and risks in terms of demography, health and health-related behaviors, sleep variables, mental health, and attitudes. Methods/Results:Online surveys were used for data collection, received from 5479 individuals from the general population, sleep disorder patients, and COVID-involved (medical doctors (MDs) and nurses) and COVID-affected professionals (teachers, psychologists, and dentists). SQ and AQ were worse in adults, females, and high-education subjects. Feeling worse, having economic problems, depression, anxiety, irritability, and a high Calamity Experience Check List (CECL) score during COVID were significantly associated with poor SQ and AQ. Shorter sleep duration, increased latency, poor nutrition, low physical activity, increased mobile and social network use, more negative and less positive attitudes and behaviors were associated with poor AQ. Conclusions: The SQ logistic regression showed gender, morbidities, CECL, and awakenings as relevant, whereas, for AQ, relevant variables further included age and physical activity. Aiming to have a high stress compliance, each individual should sleep well, have important control of their mood, practice positive behaviors while dismissing negative behaviors and attitudes, practice exercise, have adequate nutrition, and beware of technologies and dependences.

Stress, coping, resilience, and sleep during the COVID‐19 pandemic: A representative survey study of US adults

“…In contrast, greater primary control engagement coping and resilience were associated with better sleep quality. In addition, consistent with past research, gender was associated with sleep quality, such that women experienced worse sleep quality compared with men during the COVID‐19 pandemic (Cellini et al., 2021 ; Foster et al., 2017 ; Franceschini et al., 2020 ; Hajali et al., 2019 ; Mong & Cusmano, 2016 ; Paiva et al., 2021 ; Salfi et al., 2020 ; Siddique et al., 2021 ). Thus, the results of our study confirm prior research to demonstrate that gender disparities in sleep persist during pandemics while addressing robust sociodemographic and contextual controls.…”

“…The emerging literature has explored gender differences in sleep quality during the COVID‐19 pandemic. Similar to non‐pandemic conditions (Baker et al., 2007 ; Mallampalli & Carter, 2014 ; Ohayon et al., 2013 ), the literature indicates that women report worse sleep quality than men during the COVID‐19 pandemic in diverse populations (Cellini et al., 2021 ; Franceschini et al., 2020 ; Paiva et al., 2021 ; Salfi et al., 2020 ; Siddique et al., 2021 ). Moreover, women report greater insomnia, including longer latencies to fall asleep and more sleep disturbances, compared to men during the COVID‐19 pandemic (Casagrande et al., 2020 ; Del Río‐Casanova et al., 2021 ; Lin et al., 2021 ).…”

“…Conversely, we hypothesized that higher resilience and greater use of adaptive coping strategies such as primary control engagement coping would be associated with better global sleep quality, shorter sleep latency, and better subjective sleep quality. Lastly, given the recent literature demonstrating gender disparities in sleep quality during the COVID‐19 pandemic (Casagrande et al., 2020 ; Cellini et al., 2021 ; Del Río‐Casanova et al., 2021 ; Franceschini et al., 2020 ; Lin et al., 2021 ; Paiva et al., 2021 ; Salfi et al., 2020 ; Siddique et al., 2021 ), we hypothesized that women would experience lower global sleep quality, longer latency to fall asleep, and lower subjective sleep quality than men. As high‐quality sleep boosts physical and mental health, a better understanding of how stress, coping, and resilience are associated with sleep quality is vital to improving health outcomes, particularly during public health crises (Gentile et al., 2017 ; Hale et al., 2010 ; Milojevich & Lukowski, 2016 ; Peach et al., 2016 ; Tanaka & Shirakawa, 2004 ).…”

Circadian disturbances, sleep difficulties and the COVID-19 pandemic

“…Pre-pandemic good sleepers most often experienced worse sleep during the lockdown [ 79 ]. On the other hand, some demographic and environmental factors appear to predict pandemic-related sleep difficulties including race, socioeconomic status, marital status, anxiety symptoms, depressive symptoms, physical somatization, and social loneliness, but not age, gender, or education although results regarding these variables have been mixed [ 63 , 64 , 80 , 81 ]. In addition to overall impaired sleep quality, specific sleep disorders are also reported to be enhanced during the COVID-19 pandemic, including insomnia [ 56 , 57 , 63 ], nightmares [ 58 ], sleep apnea [ 59 ], and restless legs syndrome [ 82 ].…”

Sleep Habits during COVID-19 Confinement: An Exploratory Analysis from Portugal

“…This is the reason the sleep consequences of the pandemic period can be different depending on the country. In Portugal, we highlight three studies carried out related to sleep and confinement: one of them assesses the quality of sleep of respiratory patients [23], another evaluates sleep disorders among children during social distancing, and its association with parental perception of child's oral hygiene [24] and another one evaluates sleep and awakening quality during COVID-19 [25]. We thought it was important that a study be done with the Portuguese population during the confinement, in a comprehensive way and not focused on a specific population, doing it to examine the Portuguese population broadly, rather than looking at specific subgroups.…”