Sleep, Diet, Physical Activity, and Stress during the COVID-19 Pandemic: A Qualitative Analysis

Abstract

The COVID-19 pandemic has changed routines and habits, raising stress and anxiety levels of individuals worldwide. The goal of this qualitative study was to advance the understanding of how pandemic-related changes affected sleep, diet, physical activity (PA), and stress among adults. We conducted semi-structured, qualitative interviews with 185 participants and selected 33 interviews from a represented sample based on age, race, and gender for coding and analysis of themes. After coding for thematic analysis, results demonstrated four primary themes: sleep, diet, PA, and stress. Sleep sub-themes such as poorer sleep quality were reported by 36% of our participants, and 12% reported increased an frequency of vivid dreams and nightmares. PA was decreased in 52% of our participants, while 33% experienced an increase and 15% experienced no change in PA. Participants also reported having an improved diet, mostly among women. Stress was elevated in 79% of our participants and was more likely to be discussed by women. Many participants reported how stress was involved in precipitating health behavior change, especially for sleep. Increased stress was also linked to elevated anxiety and depression among participants. The results of this qualitative study demonstrate how managing stress could have a beneficial effect on promoting health behaviors and mental health during the COVID-19 pandemic and beyond.

The impact of the COVID-19 pandemic on Mediterranean diet adherence: A narrative systematic review

“…In contrast, an American qualitative study (Orr et al, 2022) reported improvements in females’ diet during lockdown, despite decreased sleep quality and increased stress. Interestingly, participants reported stress and poor sleep quality as the key factors that led them to improve their diets; hence, the importance of managing stress as part of a holistic lifestyle intervention.…”

“…Globalisation created a progressive cessation of the diet with a concurrent shift to the Western diet, which promotes weight gain, cancer and cardio-metabolic traits (Obeid et al, 2022). With more time at home during the COVID-19 lockdown periods, one would anticipate that individuals had more time to improve their health (Orr et al, 2022). However, impaired mental health and boredom may decrease the motivation for healthy lifestyle choices (Hossain et al, 2020).…”

Long-Term Effects of COVID-19 on Sleep Patterns

“…Although COVID-19 has not been associated with increase risk of narcolepsy (25), it has been suggested that infection with SARS-CoV2 may provide an opportunity to investigate mechanisms related to the development of narcolepsy (26). In a previous study examining the interaction between COVID-19 and multiple health behaviors (sleep, diet, and physical activity), the authors demonstrated increased vivid dreams and nightmares among 12% of participants and the majority were linked to increased stress and anxiety (75%) (27). These symptoms were predominantly reported by women.…”

“Life will never be the same”: a qualitative analysis of the impact of COVID-19 on adults with a history of insomnia

“…Indeed, qualitative methods give a voice to participants, allowing researchers to take a closer look at people’s lived experiences and the factors surrounding them [ 27 ]. Qualitative methods have been used to understand the effect of the pandemic on sleep and uncovered insights that contextualized the findings of various epidemiological studies [ 28 ]. The pandemic engendered the opportunity to explore medical conditions against a unique backdrop.…”