A year in review: sleep dysfunction and psychological distress in healthcare workers during the COVID-19 pandemic

Abstract

The Covid-19 outbreak has taken a substantial toll on the mental and physical wellbeing of healthcare workers (HCWs), impacting healthcare systems at a global scale. One year into the pandemic, the need to establish the prevalence of sleep dysfunction and psychological distress in the face of COVID-19, identify risk and protective factors and explore effective countermeasures remains of critical importance. Despite implicit limitations relating to the quality of available studies, a plethora of evidence to-date suggests that a considerable proportion of HCWs experience significant sleep disturbances (estimated to afflict every two in five HCWs) as well as mood symptoms (with more than one in five reporting high levels of depression or anxiety). Younger age, female gender, frontline status, fear or risk of infection, occupation, current or past mental health concerns, and a lower level of social support were all associated with a greater risk of disturbed sleep and adverse psychological outcomes. Furthermore, we discuss the link between sleep deprivation, susceptibility to viral infections and psychosocial wellbeing, in relevance to COVID-19 and summarize the existing evidence regarding the presence and predictors of traumatic stress/PTSD and burnout in HCWs. Finally, we highlight the role of resilience and tailored interventions in order to mitigate vulnerability and prevent long-term physical and psychological implications. Indeed, promoting psychological resilience through an enhanced social support network has proven crucial for HCWs in coping under these strenuous circumstances. Future research should aim to provide high quality information on the long-term consequences and the effectiveness of applied interventions.

A One-Year Longitudinal Study: Changes in Depression and Anxiety in Frontline Emergency Department Healthcare Workers in the COVID-19 Pandemic

“…In the majority of other COVID-19 studies, including our first survey in 2020 [ 12 ], nurses were shown to have worse depression compared to doctors [ 3 , 26 , 27 , 28 , 29 ]. Reasons cited have been that nurses have closer more frequent contact with patients and worked longer hours than usual [ 26 , 27 , 29 ].…”

“…In the majority of other COVID-19 studies, including our first survey in 2020 [ 12 ], nurses were shown to have worse depression compared to doctors [ 3 , 26 , 27 , 28 , 29 ]. Reasons cited have been that nurses have closer more frequent contact with patients and worked longer hours than usual [ 26 , 27 , 29 ]. Interestingly, our cohort of matched doctors had significantly worse depression in 2021 compared to 2020, and their overall depression score in 2021 became worse than our nursing staff’s.…”

Understanding the Mediating Role of Anxiety and Depression on the Relationship Between Perceived Stress and Sleep Quality Among Health Care Workers in the COVID-19 Response

“…The COVID-19 crisis has almost certainly placed a significant strain on health systems across the globe and has exposed health care workers to an unprecedented threat. 3,4 Not surprisingly, health care workers are not only placed at the core of the pandemic but are in a particularly vulnerable position. 4 They are predisposed to a number of risks: heavy workloads, unpredictable work patterns, and a higher risk of infection, which might have consequences on their health and wellbeing.…”

“…3,4 Not surprisingly, health care workers are not only placed at the core of the pandemic but are in a particularly vulnerable position. 4 They are predisposed to a number of risks: heavy workloads, unpredictable work patterns, and a higher risk of infection, which might have consequences on their health and wellbeing. 5,6 Moreover, in comparison to the general population, health care workers are facing increased professional and personal responsibilities during the pandemic, which may lead to an additional psychological burden.…”

“…Indeed, during a crisis such as the current COVID-19 pandemic, the quality of sleep of health care workers becomes essential. 4 However, there is no single perfectly reliable criterion for defining sleep or even sleep quality because it is generally defined as a complex state. 8 Ample sleep, a balanced diet, and physical activity are three fundamental needs.…”