Sleep in Frontline Healthcare Workers on Social Media During the COVID-19 Pandemic

Abstract

ImportanceDuring the pandemic, healthcare workers on social media are sharing their challenges, including sleep disturbances.ObjectiveTo assess sleep using validated measures among frontline healthcare workers on social mediaDesignA self-selection survey was distributed on Facebook, Twitter, and Instagram for 16 days (August 31-September 15, 2020) targeting healthcare workers (HCW) who were clinically active during the pandemic. Study participants completed the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and reported demographic/career information. Poor sleep quality was defined as PSQI>5. Moderate-to-severe insomnia was defined as an ISI>14. The mini-Z was used to measure burnout. Multivariate logistic regression tested associations between demographics, career characteristics, and sleep outcomes.SettingOnline self-selection survey on social mediaParticipants963 surveys were completed. Participants were predominantly White (92.8%), female (73.4%), aged 30-49 (71.9%), and physicians (64.4%). Mean sleep duration was 6.1 (SD 1.2) hours. Nearly 90% reported poor sleep (PSQI). One third (33.0%) reported moderate or severe insomnia. Many (60%) experienced sleep disruptions due to device usage or had bad dreams at least once per week (45%). Over 50% reported burnout. In multivariable logistic regressions, non-physician (OR 2.4; CI: 1.7, 3.4), caring for COVID-19 patients (OR 1.8; CI 1.2, 2.8), Hispanic ethnicity (OR 2.2; CI: 1.4, 3.5), being female (OR 1.6; CI 1.1, 2.4), and having a sleep disorder (OR 4.3; CI 2.7,6.9) were associated with increased odds of insomnia. In open-ended comments (n=310), poor sleep mapped to four categories: children and family, work demands, personal health, and pandemic-related sleep disturbances.ConclusionDuring the COVID-19 pandemic, 90% of frontline healthcare 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 usage and nightmares. Sleep interventions for frontline healthcare workers are urgently needed.Key pointsQuestionHow are frontline healthcare workers on social media sleeping during the pandemic?FindingsDuring the COVID-19 pandemic, 90% of frontline healthcare workers on social media are reporting poor sleep, and one third are reporting insomnia. Those who report sleep disturbances were more likely to report burnout.MeaningInterventions aimed at improving the sleep of frontline healthcare workers are warranted.

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