Background: The emerging novel coronavirus disease 2019 has become one of the leading cause of deaths worldwide in 2020. The present systematic review and meta-analysis estimated the magnitude of sleep problems during the COVID-19 pandemic and its relationship with psychological distress. Methods: Five academic databases (Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and Embase) were searched. Observational studies including case-control studies and cross-sectional studies were included if relevant data relationships were reported (i.e., sleep assessed utilizing the Pittsburgh Sleep Quality Index or Insomnia Severity Index). All the studies were English, peer-reviewed papers published between December 2019 and February 2021. PROSPERO registration number: CRD42020181644. Findings: 168 cross-sectional, four case-control, and five longitudinal design papers comprising 345,270 participants from 39 countries were identified. The corrected pooled estimated prevalence of sleep problems were 31% among healthcare professionals, 18% among the general population, and 57% among COVID-19 patients (all p-values < 0.05). Sleep problems were associated with depression among healthcare professionals, the general population, and COVID-19 patients, with Fisher's Z scores of -0.28, -0.30, and -0.36, respectively. Sleep problems were positively (and moderately) associated with anxiety among healthcare professionals, the general population, and COVID-19 patients, with Fisher's z scores of 0.55, 0.48, and 0.49, respectively. Interpretation: Sleep problems appear to have been common during the ongoing COVID-19 pandemic. Moreover, sleep problems were found to be associated with higher levels of psychological distress. With the use of effective programs treating sleep problems, psychological distress may be reduced. Vice versa, the use of effective programs treating psychological distress, sleep problems may be reduced. Funding: The present study received no funding.

Introduction Due to the serious situation of the novel coronavirus disease 2019 (COVID-19) worldwide, many countries have implemented policies to minimize the spread of COVID-19 infection. However, some of these policies prevent people from physical contact. Consequently, many individuals may rely on social media to obtain information concerning COVID-19. Unfortunately, social media use (especially problematic social media use) may give rise to psychological distress. Therefore, this study thus examined potential psychopathology to explain the association between problematic social media use, psychological distress, and insomnia. Methods Utilizing an online survey, a sample of Iranian young adults (n = 1078 with 628 males; mean age = 26.24 years [SD ± 7.41]) completed questions and psychometric scales concerning psychological distress, insomnia, problematic social media use, fear of COVID-19, and COVID-19 misunderstanding. Results Problematic social media use was significantly associated with psychological distress both directly and indirectly. The indirect effects were through fear of COVID-19 (unstandardized coefficient [B] = 0.177; Bootstrapping SE = 0.026) and COVID-19 misunderstanding (B = 0.060; Bootstrapping SE = 0.014). Problematic social media use was significantly associated with insomnia both directly and indirectly. The indirect effect was through fear of COVID-19 (B = 0.062; Bootstrapping SE = 0.019) but not COVID-19 misunderstanding (B = 0.012; Bootstrapping SE = 0.014). Discussion/conclusion Due to the pressure of the COVID-19 outbreak, individuals are highly likely to develop psychological distress and insomnia. Apart from developing appropriate health policies to minimize the spread of COVID-19 infection, healthcare providers should design appropriate online campaigns to eliminate people's fear of COVID-19 and to diminish misunderstanding concerning COVID-19.

The present cross-sectional study examined the actor-partner interdependence effect of fear of COVID-19 among Iranian pregnant women and their husbands and its association with their mental health and preventive behaviours during the first wave of the COVID-19 pandemic in 2020. A total of 290 pregnant women and their husbands (N = 580) were randomly selected from a list of pregnant women in the Iranian Integrated Health System and were invited to respond to psychometric scales assessing fear of COVID-19, depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. The findings demonstrated significant dyadic relationships between husbands and their pregnant wives' fear of COVID-19, mental health, and preventive behaviours. Pregnant wives’ actor effect of fear of COVID-19 was significantly associated with depression, suicidal intention, mental quality of life, and COVID-19 preventive behaviours but not anxiety. Moreover, a husband actor effect of fear of COVID-19 was significantly associated with depression, anxiety, suicidal intention, mental quality of life, and COVID-19 preventive behaviours. Additionally, there were significant partner effects observed for both the pregnant wives and their husbands concerning all outcomes. The present study used a cross-sectional design and so is unable to determine the mechanism or causal ordering of the effects. Also, the data are mainly based on self-reported measures which have some limitations due to its potential for social desirability and recall biases. Based on the findings, couples may benefit from psychoeducation that focuses on the effect of mental health problems on pregnant women and the foetus.