Unravelling the link between sleep and mental health during the COVID‐19 pandemic

Abstract

The emergence of COVID‐19 brought unparalleled changes in people's lifestyle, including sleep. We aimed to assess the bidirectional association between sleep quality and mental health and describe how sleep and mental health were affected in Sweden during the COVID‐19 pandemic (between June 2020 and September 2021). Data were obtained from the Omtanke2020 study. Participants who completed the baseline survey and each of the 8 monthly follow‐up surveys were included (N = 9035). We described the distribution of sleep and mental health in the different Swedish regions using maps and over the study period with longitudinal graphs adjusting for sex, age, recruitment type (self‐recruitment or invitation), and COVID‐19 status. The inner relationships between mental health, sleep and Covid infection were described through relative importance networks. Finally, we modelled how mental health affects sleep and vice versa using generalized estimating equations with different adjustments. Seasonal and north‐south regional variations were found in sleep and mental health outcomes at baseline and attenuated over time. The seasonal variation of sleep and mental health correlated moderately with the incidence rate of COVID‐19 in the sample. Networks indicate that the relationship between COVID‐19 incidence and mental health varies over time. We observed a bidirectional relationship between sleep quality and quantity at baseline and mental health at follow‐up and vice versa. Sleep quality and quantity at baseline was associated with adverse symptom trajectories of mental health at follow‐up, and vice versa, during the COVID‐19 pandemic. There was also a weak relationship between COVID‐19 incidence, sleep, and mental health.

Prevalence of poor sleep quality in COVID-19 patients: a systematic review and meta-analysis

“…In addition, the strict lockdown measures can influence normal rhythms of the sleep–wake cycle among COVID-19 patients by reducing social activities and supports, increasing time spent in bed and delaying bedtimes ( 67 , 68 ). As a result, depression, anxiety and insomnia are more likely to occur, thereby lowering their sleep quality ( 69 , 70 ).…”

Elevated symptoms of depression and anxiety among family members of critically ill COVID-19 patients - An observational study of five cohorts across four countries

“…18-19 . We excluded participants who did not complete all items of the PHQ-9 and GAD-7 except in Omtanke2020 where, if at least 80% of the items were completed, we imputed the scores as described 20 . Our final analysis included 162,237 participants with data on depressive symptoms and 168,783 participants with data on anxiety symptoms.…”