Time to Sleep?—A Review of the Impact of the COVID-19 Pandemic on Sleep and Mental Health

Abstract

Sleep is intrinsically tied to mental and overall health. Short sleep duration accompanies the modern lifestyle, possibly reaching epidemic proportions. The pandemic and subsequent lockdowns determined a fundamental shift in the modern lifestyle and had profound effects on sleep and mental health. This paper aims to provide an overview of the relationship between sleep, mental health and COVID-19. Contrasting outcomes on sleep health have been highlighted by most reports during the pandemic in the general population. Consequently, while longer sleep durations have been reported, this change was accompanied by decreases in sleep quality and altered sleep timing. Furthermore, an increased impact of sleep deficiencies and mental health burden was generally reported in health care workers as compared with the adult general population. Although not among the most frequent symptoms during the acute or persistent phase, an increased prevalence of sleep deficiencies has been reported in patients with acute and long COVID. The importance of sleep in immune regulation is well known. Consequently, sleep deficiencies may influence multiple aspects of COVID-19, such as the risk, severity, and prognosis of the infection and even vaccine response.

Socioeconomic Deprivation, Sleep Duration, and Mental Health during the First Year of the COVID-19 Pandemic

“…This finding was consistent with other population-based studies of American adults sleeping less than 7–8 h per night [ 43 , 44 ]. Although sleep time remained unchanged from pre-pandemic, increases in short sleepers have been observed in other studies [ 45 , 46 ]. In an international online survey study (ECLB COVID-19), there was a modest increase in self-reported sleep duration as well as increases in poor sleep quality as measured by the Pittsburgh Sleep Quality Index (4.37 ± 2.71 before the lockdown and 5.32 ± 3.23 after the lockdown) [ 47 ].…”

The Impact of the COVID-19 Pandemic on Inpatient Admissions for Psychotic and Affective Disorders: The Experience of a Large Psychiatric Teaching Hospital in Romania

“…Numerous studies have provided evidence of the profound negative impacts of the COVID-19 pandemic and subsequent lockdown on the general population. The COVID-19 lockdown seems to have elicited an increased burden of psychological and psychiatric problems, which mainly include higher levels of stress, anxiety, and perceived loneliness, depressive symptoms, sleep disturbances, and the disruption of social connectedness [ 7 , 8 , 38 ]. These problems have persisted or even increased in different countries, despite lockdown restrictions being lifted [ 39 , 40 ].…”

“…In addition to introducing serious changes into people’s daily lives, it was predicted from the early stages of the pandemic that the COVID-19 outbreak would have both acute and prolonged impacts on mental health [ 4 , 5 ]. Numerous studies demonstrated that the pandemic increased generic psychological distress, or even the prevalence of anxiety and depressive disorders, insomnia, post-traumatic stress disorder, and eating disorders [ 6 , 7 , 8 , 9 ]. Patients with COVID-19 represent a novel particular group of individuals who are at risk of developing psychiatric disorders, since they experience high levels of stress and use maladaptive coping strategies [ 10 ].…”

Sleep During the COVID-19 Pandemic

“…The core symptoms of COVID-19, i.e., cough, fever, pain, and dyspnea, have, also, negative impact on sleep quality [ 11 ]. Moreover, hospitalization could further impair sleep quality due to noise, exposure to lights, alerted sleep routine, clinical interventions, and medication’s side effects [ 12 ••, 19 ]. A summary of the factors relating to sleep disorders in COVID-19 patients are presented in Fig.…”

“…The new coronavirus may cause persistent physical and mental deficits, affecting the quality of sleep [ 5 ]. Despite the fact that the most common symptom in long COVID-19 is fatigue, a high prevalence of sleep disorders has been described in numerous studies [ 19 ]. In several systematic reviews and meta-analyses, sleep disturbance in post-COVID-19 patients ranged between 27.4 and 47% [ 32 – 39 ].…”