The effects of COVID-19 stay-at-home order on sleep, health, and working patterns: a survey study of US health care workers

Conroy, Deirdre A.; Hadler, Nicole; Cho, Echelle; Moreira, Aliya; MacKenzie, Chamisa; Swanson, Leslie M.; Burgess, Helen J.; Arnedt, J. Todd; Goldstein, Cathy

doi:10.5664/jcsm.8808

Cited by 80 publications

(136 citation statements)

References 20 publications

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“…Furthermore, mothers’ working conditions seem to play a role in disrupting their healthy habits in a pandemic scenario, or helping them to maintain these habits. This is consistent with previous data showing that changes in work conditions during the COVID-19 emergency affected sleep patterns ( Conroy et al., 2020 ; Di Giorgio et al., 2020 ; Staller & Randler, 2020 ). Although mothers who kept working regularly outside of their homes during the lockdown reported more regular sleep patterns, mothers who stopped working showed more emotional symptoms and relevant changes in their time perception.…”

Section: Discussionsupporting

confidence: 93%

Sleep and Psychological Difficulties in Italian School-Age Children During COVID-19 Lockdown

Cellini

Giorgio

Mioni³

et al. 2021

Journal of Pediatric Psychology

101

135

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Objective On March 10, 2020, the Italian Government ordered a national lockdown to limit the viral transmission of coronavirus disease 2019 infections. This study investigated how these restrictive measures have impacted sleep quality, timing, and psychological difficulties in school-age children and their mothers during the lockdown. Methods In an online survey, 299 mothers reported their sleep habits, experience of time, and psychological difficulties as well as those of their children (6–10 years old) during and, retrospectively, before the lockdown. Results During the lockdown, children showed a marked delay in sleep timing—that is, later bedtime and rise time—and a mild worsening in sleep quality. They were less prone to respect daily routines or to keep track of the passage of time. They showed increased emotional, conduct, and hyperactive symptoms, and the increase in these psychological difficulties was predicted by the change in sleep quality, boredom, and mothers’ psychological difficulties. In addition, mothers showed a delayed sleep timing and worsening of sleep quality during the lockdown, in varying degrees depending on their working conditions. Mothers who kept working regularly outside their homes during lockdown reported more regular sleep patterns, whereas mothers who stopped working showed more emotional symptoms and relevant changes in their perception of time. Conclusions Overall, given the evidence of the adverse behavioral and psychological impact of home confinement and social restrictions, effective measures needed to be in place to mitigate long-term effects on children and their mothers, especially those who have had to stop working during lockdown.

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Section: Discussionsupporting

confidence: 93%

Sleep and Psychological Difficulties in Italian School-Age Children During COVID-19 Lockdown

Cellini

Giorgio

Mioni³

et al. 2021

Journal of Pediatric Psychology

101

135

View full text Add to dashboard Cite

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“…In comparing our sample to the general U.S. physicians, we find higher rates of sleep disturbances and insomnia risk than the general population of practicing physicians. 22–24 Our study findings of sleep disruption due to device usage are consistent with findings demonstrating increased nightly screen time in HCW and reports of “doomscrolling.” 3,4…”

Section: Discussionmentioning

confidence: 99%

“…Social media posts suggest that healthcare workers are suffering from bad dreams, insomnia, and also “doomscrolling” - or using mobile devices at night to review social media. 3,4 Given the increased professional and personal responsibilities for healthcare workers during the pandemic, it’s possible that sleep loss or disturbances could also be compounded by additional worries during the pandemic. Moreover, there is mounting evidence demonstrating inadequate physician sleep is associated with burnout and medical errors.…”

Section: Introductionmentioning

confidence: 99%

“…These studies did not utilize validated measures of sleep and were limited to a single institution. 3,12 In the U.S., to our knowledge, no study has yet to evaluate sleep using standardized measures in clinically active frontline HCW during the COVID-19 pandemic. Despite anecdotal observations of sleep loss described via social media platforms, no study yet has explicitly explored the sleep of frontline HCW in the COVID-19 pandemic utilizing social media, an increasingly important and influential voice during the pandemic.…”

Section: Introductionmentioning

confidence: 99%

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

Stewart

Koza

Dhaon

et al. 2021

Preprint

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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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“…In their letter to the editor, Kumari and Mahla 1 highlight several important points about the mood, sleep, and stay-at-home isolation findings described in our study. 2 We thank the authors for their interest and would like to discuss some of the raised topics.…”

mentioning

confidence: 99%

The differential effects of stay-at-home orders on mood and sleep

Conroy

Moreira

Goldstein

2021

Journal of Clinical Sleep Medicine

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The effects of COVID-19 stay-at-home order on sleep, health, and working patterns: a survey study of US health care workers

Cited by 80 publications

References 20 publications

Sleep and Psychological Difficulties in Italian School-Age Children During COVID-19 Lockdown

Sleep and Psychological Difficulties in Italian School-Age Children During COVID-19 Lockdown

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

The differential effects of stay-at-home orders on mood and sleep

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