Sleep Disturbances in Frontline Health Care Workers During the COVID-19 Pandemic: Social Media Survey Study

Abstract

Background During the COVID-19 pandemic, health care workers are sharing their challenges, including sleep disturbances, on social media; however, no study has evaluated sleep in predominantly US frontline health care workers during the COVID-19 pandemic. Objective The aim of this study was to assess sleep among a sample of predominantly US frontline health care workers during the COVID-19 pandemic using validated measures through a survey distributed on social media. Methods A self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31 to September 15, 2020), targeting health care workers who were clinically active during the COVID-19 pandemic. Study participants completed the Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI), and they reported their demographic and career information. Poor sleep quality was defined as a PSQI score ≥5. Moderate-to-severe insomnia was defined as an ISI score >14. The Mini-Z Burnout Survey was used to measure burnout. Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes. Results A total of 963 surveys were completed. Participants were predominantly White (894/963, 92.8%), female (707/963, 73.4%), aged 30-49 years (692/963, 71.9%), and physicians (620/963, 64.4%). Mean sleep duration was 6.1 hours (SD 1.2). Nearly 96% (920/963, 95.5%) of participants reported poor sleep (PSQI). One-third (288/963, 30%) reported moderate or severe insomnia. Many participants (554/910, 60.9%) experienced sleep disruptions due to device use or had nightmares at least once per week (420/929, 45.2%). Over 50% (525/932, 56.3%) reported burnout. In multivariable logistic regressions, nonphysician (odds ratio [OR] 2.4, 95% CI 1.7-3.4), caring for patients with COVID-19 (OR 1.8, 95% CI 1.2-2.8), Hispanic ethnicity (OR 2.2, 95% CI 1.4-3.5), female sex (OR 1.6, 95% CI 1.1-2.4), and having a sleep disorder (OR 4.3, 95% CI 2.7-6.9) were associated with increased odds of insomnia. In open-ended comments (n=310), poor sleep was mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances. Conclusions During the COVID-19 pandemic, nearly all the frontline health care workers surveyed on social media reported poor sleep, over one-third reported insomnia, and over half reported burnout. Many also reported sleep disruptions due to device use and nightmares. Sleep interventions for frontline health care workers are urgently needed.

Understanding the Mediating Role of Anxiety and Depression on the Relationship Between Perceived Stress and Sleep Quality Among Health Care Workers in the COVID-19 Response

“…5,6 Moreover, in comparison to the general population, health care workers are facing increased professional and personal responsibilities during the pandemic, which may lead to an additional psychological burden. 7 Multiple work stressors increase the risk of adverse mental health outcomes, including but not limited to psychological distress (fear, stress, anxiety, depression, exhaustion, post-traumatic stress disorder (PTSD)) and sleep dysfunction (poor sleep quality, sleep debt, insomnia). Indeed, during a crisis such as the current COVID-19 pandemic, the quality of sleep of health care workers becomes essential.…”

Sleep quality and related factors in a sample of Turkish healthcare workers during the COVID‐19 pandemic: A cross‐sectional study

“… 4 , 10 , 11 , 12 , 26 , 27 , 28 Several studies have determined that healthcare workers in particular experience sleep problems during the COVID‐19 pandemic. 4 , 14 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 The purpose of this study was to evaluate sleep quality and related factors among healthcare workers during the COVID‐19 pandemic in Turkey.…”

Sleep, Physical Activity, and Diet of Adults during the Second Lockdown of the COVID-19 Pandemic in Greece

“…The COVID-19 pandemic and the accompanying lockdown have impacted many aspects of the daily life of adults, including sleep duration and quality [ 1 , 2 , 3 ]. For instance, a study on U.S. Americans showed that ~37% had increased sleep duration, whereas ~17% had decreased duration [ 2 ], and 45% reported a worsening of sleep quality in research on Italians [ 4 ].…”