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Difference in sleep episode duration during the COVID-19 pandemic compared to the same month in the previous year in London.
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We regularly consider answering counterfactual questions in practice, such as "Would people with diabetes take a turn for the better had they choose another medication?". Observational studies are growing in significance in answering such questions due to their widespread accumulation and comparatively easier acquisition than Randomized Control Tri...
Introduction:
The profiles of patients with COVID-19 have been widely studied, but little is known about differences in baseline characteristics and in outcomes between subjects with a ceiling of care assigned at hospital admission and subjects without a ceiling of care. The aim of this study is to compare, by ceiling of care, clinical features an...
Citations
... As a result of lockdowns and social restrictions, stress, meal timing, anxiety and depression, social isolation, and the migration to remote working, both increases and decreases in sleep duration as well as changes in sleep timing occurred. [15][16][17] The presence of these factors may allow the development of circadian misalignment which increases risk of cardiovascular and metabolic disorders, and importantly infections. Circadian misalignment is a characteristic of shift workers who have been shown to have an . ...
Objective
This study assesses whether chronotype is related to COVID-19 infection and whether there is an interaction with shift work.
Methods
Cross-sectional survey of 19,821 U.S. adults
Results
COVID-19 infection occurred in 40% of participants, 32.6% morning and 17.2% evening chronotypes. After adjusting for demographic and socioeconomic factors, shift/remote work, sleep duration and comorbidities, morning chronotype was associated with a higher (aOR: 1.15, 95% CI 1.10-1.21) and evening chronotype with a lower (aOR: 0.82, 95% CI: 0.78-0.87) prevalence of COVID-19 infection in comparison to an intermediate chronotype. Working exclusively night shifts was not associated with higher prevalence of COVID-19. Morning chronotype and working some evening shifts was associated with the highest prevalence of previous COVID-19 infection (aOR: 1.87, 95% CI: 1.28-2.74).
Conclusion
Morning chronotype and working a mixture of shifts increase risk of COVID-19 infection.
... Changes in sleep duration during the period of social distancing and stay-at-home orders have been reported in previous studies [15][16][17][18][19][20][21]. Sleep patterns changed in the United States and 16 European countries during the early stages of COVID-19 (Jan-Apr of 2020) [16]. ...
... People in five major metropolitan areas (London, Los Angeles, New York City, Seoul, and Stockholm) increased their average sleep duration in the months after the COVID-19 pandemic onset (Jan-Apr of 2020), compared to the same months in the prior year (Jan-Apr of 2019) [20]. Studies have found that the proportion of individuals who sleep more than the recommended duration of 7 hours has increased [18,21]. ...
... Nevertheless, most previous studies regarding the relationship between COVID-19 and sleep outcomes were conducted in the early stages of the COVID-19 pandemic (i.e., 2020) and did not consider the nationwide population [15,18,20]. Moreover, although sleep duration and its changes can be heterogeneous based on various individual and regional characteristics, they have not been mainly investigated. ...
The adequate quality and quantity of sleep are related to maintaining the immune system and mental well-being; therefore, it is necessary to evaluate sleep duration during COVID-19. This study aimed to investigate the changes in sleep duration during the long-lasting COVID-19 period (2020 and 2021) in South Korea, and to examine the individual and regional disparities. The study population comprised 1,143,460 adults aged ≥19 years who participated in the 2017–2021 Korea Community Health Survey excluding those who did not respond to the daily sleep duration questionnaire. For statistical analysis, we first conducted a multiple regression model for 229 districts to estimate the district-specific changes in sleep duration. We then applied a meta-analysis to pool the 229 estimates and a meta-regression to examine the association between changes in sleep duration and regional characteristics. The sleep duration increased by 9.66 (95% CI: 8.53, 10.80) min in 2020 and 3.66 (95% CI: 2.09, 5.22) min in 2021 compared to the pre-pandemic period (2017–2019). The increase was more prominent in males, younger adults, employed individuals, and those with a high socioeconomic status compared to the general population. Communities with a higher proportion of apartments, lower normalized difference vegetation index in summer, and lower practice rate of moderate exercise were associated with a higher increase in sleep duration during the pandemic. The sleep duration increased during the COVID-19 pandemic, and the increase decreased as the COVID-19 lasted longer. The findings of our study highlight that preventive measures to manage sleep health during a pandemic should be framed in consideration of individual and regional characteristics.
... Previous studies reported that working from home allows individuals to adjust their sleep cycles for better alignment with their natural circadian rhythm, potentially enhancing sleep quality [26,27]. Additionally, it was proposed that working from home may also resolve the issue of lack of sleep, which is a chronic problem that plagues modern society [28]. ...
Background
Social distancing has been increasingly implemented following the COVID-19 pandemic and more people have been working from home. Consequently, the screen time has increased, which can disrupt the natural sleep-wake cycle and delay sleep onset. Given that studies on the health of employees who work from home remain insufficient, particularly with respect to the risk of sleep disorders including insomnia, this study aimed to assess the relationship between working from home and insomnia among workers using data from the 5th Working Conditions Survey conducted in Korea.
Methods
Of 30,108 wage workers, we enrolled 818 employees who worked from home and 4,090 employees who worked from the office, a 1:5 pair sample based on sex and occupational group. Personal and occupational characteristics, working from home, and insomnia were included in the analysis. Age, education, employment status, working years, working hours per week, work-life balance, self-perceived health, depression, and anxiety were all adjusted as potential confounding variables. Conditional logistic regression analysis was performed using working from home as an independent variable and insomnia as a dependent variable to determine the correlation between working from home and insomnia.
Results
Working from home was associated with sleep onset latency disorder, OR = 3.23 (95% CI: 2.67–3.91), sleep maintenance disorder, OR = 3.67 (95% CI: 3.02–4.45), and non-restorative sleep, OR = 3.01 (95% CI: 2.46–3.67); working from home had a statistically significant relationship with all three types of insomnia.
Conclusions
Within the limits of the study, these findings can be used as a fundamental basis for the implementation of policies and guidelines to prevent insomnia in workers who work from home.
... As a result of lockdowns and social restrictions, stress, meal timing, anxiety and depression, social isolation, and the migration to remote working, both increases and decreases in sleep duration as well as changes in sleep timing occurred. [15][16][17] The presence of these factors may allow the development of circadian misalignment which increases risk of cardiovascular and metabolic disorders, and importantly infections. Circadian misalignment is a characteristic of shift workers who have been shown to have an . ...
Objective: This study assesses whether chronotype is related to COVID-19 infection and whether there is an interaction with shift work.
Methods: Cross-sectional survey of 19,821 U.S. adults
Results: COVID-19 infection occurred in 40% of participants, 32.6% morning and 17.2% evening chronotypes. After adjusting for demographic and socioeconomic factors, shift work, sleep duration and comorbidities, morning chronotype was associated with a higher (aOR: 1.15, 95% CI 1.10-1.21) and evening chronotype with a lower (aOR: 0.82, 95% CI: 0.78-0.87) prevalence of COVID-19 infection in comparison to an intermediate chronotype. Working exclusively night shifts was not associated with higher prevalence of COVID-19. Morning chronotype and working some evening shifts was associated with the highest prevalence of previous COVID-19 infection (aOR: 1.87, 95% CI: 1.28-2.74).
Conclusion: Morning chronotype and working a mixture of shifts increase risk of COVID-19 infection.
... Given the growing evidence linking short and prolonged sleep duration to disease accumulation, carrying out a study with a representative sample of a Brazilian state maybe be helpful to provide evidence to health professionals and managers regarding case management, health promotion, and prevention of chronic diseases. In addition, the COVID-19 pandemic might have changed the time and quality of sleep, 19,20 which can impact the future prevalence of chronic diseases. Thus, we aimed to analyze the association of sleep duration and use of sleeping medication with multimorbidity. ...
Objective To analyze the association of sleep duration and use of sleeping medication with multimorbidity.
Materials and Methods We conducted a cross-sectional study using data from the Prospective Study about Mental and Physical Health (PAMPA) cohort. Multimorbidity was defined as the presence of two or more conditions from a list of twelve health problems. Descriptive analyses were performed considering proportion and its 95% confidence interval (95%CI). We performed logistic regression (to obtain odds ratios, ORs) to estimate the associations, including models adjusted for confounding factors.
Results In total, 2,936 participants were included, 79,1% of them women, 54.2% aged between 18 and 39 years, and 88.9% with white skin color. Compared with regular sleep (seven to eight hours a day), five hours or less of sleep increased the odds of multimorbidity by 145% (95%CI: 1.90–3.14), and 9 hours or more of sleep increased the odds by 49% (95%CI: 1.14–1.95) for the crude model; the results remained significant even in the adjusted models.
Discussion Consumption of sleeping medication was associated with multimorbidity. Short and prolonged sleep duration increased the odds of multimorbidity, regardless of the sociodemographic and behavior characteristics. The regular use of sleeping medication was also associated with multimorbidity. The results of the present study are important but require caution due to reverse causality, and longitudinal studies are needed to confirm the findings.
... While our results substantively replicated past findings, the estimates did differ slightly as reported sleep duration increased by 3e7 min in March and April of 2020 (depending on the year of comparison), which is less than previous studies using smartphone data one of which estimating an 13.7 min increase in sleep duration in Western cities [13] and another estimating 11.3e18.6 min increases in Europe [11]. ...
... Third, people had considerably more flexibility in their social schedules early in the pandemic and spent less time socializing but more time sleeping. Likely, the increases in sleep duration, are a mix of these three factors [13,39]. A second contribution is that we found that the increase in sleep duration among Americans was relatively short lived. ...
Recent evidence utilizing online samples indicates that sleep patterns were significantly altered during the initial months of the SARS-CoV-2 (COVID-19) pandemic/lockdown. However, it remains less clear how sleep duration changed in population-based samples, in the later months of 2020, and across subpopulations. Here we used a population-based sample to document sleep duration trends for the entire year of 2020, compared these trends to the previous years of 2013, 2014, 2016, and 2018, and systematically analyzed whether self-reported sleep duration patterns in 2020 varied by sex, race/ethnicity, and educational attainment. Data were from the Behavioral Risk Factor Surveillance System (n = 2,203,861) and focused on Americans aged 18 years and older. Respondents self-reported the hours of sleep they got in a 24-h period. We fit multinomial and linear regression models to predict the category of sleep duration (six or fewer hours, seven to eight h (base), and nine or more hours) and the raw reports of sleep duration, net of demographic, socioeconomic, and behavioral health covariates. Results revealed significant increases in sleep duration during the months directly after the COVID-19 lockdown (March and April in particular). However, these increases were short lived; reports of sleep duration reverted to historical levels by the Fall of 2020. We also found that the changes in sleep duration trends in 2020 were similar by sex, race/ethnicity, and educational attainment, cumulatively leading to little impact to disparities in sleep duration. In a dramatic, but brief, alteration of population-level sleep duration patterns, disparities in self-reported sleep duration remained intractable.
... This finding is also consistent with a growing body of evidence showing that some individuals experienced improvement in their sleep, particularly increases in sleep duration, during the pandemic. [34][35][36] This may be because more individuals were unemployed, underemployed, or had less job responsibilities during the initial shutdown in the peak of the COVID-19 pandemic. In addition, the flexibility of remote working arrangements may have contributed to these observed increases in total sleep time. ...
Objectives
To determine the association between individual, network, and structural COVID-19-related stressors and changes in sleep duration and quality among Black cisgender sexual minority men (SMM) and Black transgender women during the COVID-19 peak infectivity rate in Chicago.
Methods
From April 20, 2020 to July 31, 2020, we conducted the N2 COVID Study in Chicago (n = 226). The survey included questions regarding multi-level COVID-19-related stressors (eg, food unavailability, partner violence, housing instability, concern about neighborhood COVID-19), sleep duration, and sleep quality.
Results
About 19.5% of our sample reported a shorter duration of sleep during the initial peak COVID-19 infectivity, while 41.2% reported more sleep and 38.9% reported about the same. Compared to the prepandemic period, 16.8% reported that their sleep quality worsened in the COVID-19 pandemic, while 27.9% reported their sleep quality had improved and 55.3% reported it was about the same. In multivariable models, we found that ≥1 day of physical stress reaction, worrying about being infected with COVID-19, traveling during COVID-19 being a financial burden, not having enough medication, knowing someone who was diagnosed with COVID-19, partner violence and housing instability were associated with poor sleep health in the COVID-19 pandemic (adjusted risk ratio: 1.82-3.90, p < .05).
Conclusions
These data suggest that COVID-19-related stressors impacted poor sleep duration and quality during the pandemic among this cohort. Multi-level interventions to reduce COVID-19-related stressors (eg, meditation, intimate partner violence prevention and housing programs) may be useful for improving sleep health among Black cisgender sexual minority men and Black transgender women.
... Thus far, most published studies on the impact of the pandemic on sleep health have examined fairly acute, early effects of the pandemic, looking at periods ranging from a few days to months in spring of 2020 22,24,25 . Now that the pandemic has been ongoing for almost two years, it is increasingly important to examine some of the OPEN ...
... While there have been several studies showing reduced sleep quality and duration in healthcare or other essential frontline workers 6,8,10,11 , most studies drawn from the general population have found increases in total sleep duration during the pandemic. Studies analyzing self-reported sleep from different smartphone applications found that the onset of the COVID-19 pandemic was associated with increases in sleep duration 22,24,25 . Similarly, when we looked at the acute effect of the pandemic (March -May) in a global cohort of Sleep As Android users, we found that 32% of people slept more than 20 min longer than their usual sleep duration, although 17% were sleeping more than 20 min less than usual per day on weekdays. ...
Many studies have examined how the 2019 Coronavirus Disease (COVID-19) has impacted sleep health. Early evidence suggests that lockdown policies worldwide have led to changes in sleep timing, duration, and quality; however, few studies have attempted to look at the longer-term effects across multiple countries in a large data set. This study uses self-reported data from 64,858 users of the Sleep As Android smartphone application from around the world over a 24-month period in 2019 to 2020. We found a significant but modest increase in time in bed (TIB), as well as a significant delay in sleep timing that was especially prominent on weekdays. While this effect persisted throughout the year, differences in sleep timing were more widespread and pronounced in the earlier months of the pandemic. We observed a small overall increase in TIB when comparing 2020 to 2019, but these changes depended on location and time of year, suggesting that sleep duration may have more closely tracked the progression of the pandemic in each country. Our findings suggest that pandemic-induced changes in lifestyle, such as remote work and lockdown policies, may have facilitated later sleep timing but that these changes may diminish as restrictions are lifted.
... Previous research on sleep duration during the COVID-19 pandemic conducted in five cities (Seoul, Stockholm, London, Los Angeles, and New York) found that the average sleep duration of respondents is less than 8 hours [55]. This short sleep duration is due to increased stress during the COVID-19 pandemic [56]. ...
Background: Adolescents are susceptible to nutritional status issues, both undernutrition, and over-nutrition, becoming a public health concern promptly. There were 912 junior and high-school adolescents who were obese and 249 high-school adolescents who had low body mass index (BMI) in Samarinda City. During the COVID-19 pandemic, adolescents experienced changes in sleep duration, and many adolescents were skipping breakfast. Sleep duration and breakfast can affect the nutritional condition of adolescents.
Objectives: The purpose of this study was to determine the association between sleep duration, breakfast routine and BMI in Samarinda, Indonesian adolescents during COVID-19 pandemic.
Materials and Methods: A total of 340 adolescents was sampled and assessed using a cross-sectional technique to ascertain their sleep duration, breakfast routine, and nutritional status. Nutritional status was classified based on BMI-for-age and z-value BMI. The amount of sleep duration was calculated by the average wake time and sleep time. Breakfast routine was obtained from seven days of breakfast before 9 am. Then, using multivariate analyses were tested for sleep duration, BMI z-value, breakfast routine, and nutritional status.
Results: This study revealed that 68.5% had good nutrition, with an average sleep duration of 8 hours (65.9%) and irregular breakfast (59.1%). Nutritional status was significantly influenced by breakfast routine (p=0.044), gender (p
... To our knowledge, no studies on changes in sleep duration and mental health outcomes among cancer survivors during the COVID-19 virus pandemic have been published to date. The results of our secondary analysis concur with large studies among the general adult population that observed both increases [33][34][35] and decreases 33 in sleep duration and studies that observed significant associations with depression and anxiety for decreasing sleep duration. 33 However, the present study contrasts findings of significant associations with depression and anxiety for increasing sleep duration. ...
Purpose:
Several studies have reported sleep disturbances during the COVID-19 virus pandemic. Little data exist about the impact of the pandemic on sleep and mental health among older women with breast cancer. We sought to examine whether women with and without breast cancer who experienced new sleep problems during the pandemic had worsening depression and anxiety.
Methods:
Breast cancer survivors aged ≥60 years with a history of nonmetastatic breast cancer (n = 242) and frequency-matched noncancer controls (n = 158) active in a longitudinal cohort study completed a COVID-19 virus pandemic survey from May to September 2020 (response rate 83%). Incident sleep disturbance was measured using the restless sleep item from the Center for Epidemiological Studies-Depression Scale (CES-D). CES-D score (minus the sleep item) captured depressive symptoms; the State-Anxiety subscale of the State Trait Anxiety Inventory measured anxiety symptoms. Multivariable linear regression models examined how the development of sleep disturbance affected changes in depressive or anxiety symptoms from the most recent prepandemic survey to the pandemic survey, controlling for covariates.
Results:
The prevalence of sleep disturbance during the pandemic was 22.3%, with incident sleep disturbance in 10% and 13.5% of survivors and controls, respectively. Depressive and anxiety symptoms significantly increased during the pandemic among women with incident sleep disturbance (vs. no disturbance) (β = 8.16, p < 0.01 and β = 6.14, p < 0.01, respectively), but there were no survivor-control differences in the effect.
Conclusion:
Development of sleep disturbances during the COVID-19 virus pandemic may negatively affect older women's mental health, but breast cancer survivors diagnosed with the nonmetastatic disease had similar experiences as women without cancer.
