Mental health in relation to changes in sleep, exercise, alcohol and diet during the COVID-19 pandemic: examination of four UK cohort studies

Abstract

Background Responses to the COVID-19 pandemic have included lockdowns and social distancing with considerable disruptions to people's lives. These changes may have particularly impacted on those with mental health problems, leading to a worsening of inequalities in the behaviours which influence health. Methods We used data from four national longitudinal British cohort studies (N = 10 666). Respondents reported mental health (psychological distress and anxiety/depression symptoms) and health behaviours (alcohol, diet, physical activity and sleep) before and during the pandemic. Associations between pre-pandemic mental ill-health and pandemic mental ill-health and health behaviours were examined using logistic regression; pooled effects were estimated using meta-analysis. Results Worse mental health was related to adverse health behaviours; effect sizes were largest for sleep, exercise and diet, and weaker for alcohol. The associations between poor mental health and adverse health behaviours were larger during the May lockdown than pre-pandemic. In September, when restrictions had eased, inequalities had largely reverted to pre-pandemic levels. A notable exception was for sleep, where differences by mental health status remained high. Risk differences for adverse sleep for those with the highest level of prior mental ill-health compared to those with the lowest were 21.2% (95% CI 16.2–26.2) before lockdown, 25.5% (20.0–30.3) in May and 28.2% (21.2–35.2) in September. Conclusions Taken together, our findings suggest that mental health is an increasingly important factor in health behaviour inequality in the COVID era. The promotion of mental health may thus be an important component of improving post-COVID population health.

Understanding Whole-Person Health and Resilience During the COVID-19 Pandemic and Beyond: A Cross-sectional and Descriptive Correlation Study

“…The data visualization techniques used to examine whole-person health and the Emotions concept revealed a novel cluster of health-related behaviors (My Self-care) domain concepts ( Sleeping , Nutrition , and Exercising ) with fewer strengths and more challenges and needs. This aligns with the association between sleep, physical activity, and diet during COVID-19 [ 28 - 30 ]. Furthermore, differences in SCN for Sleeping in groups with/without an Emotions challenge aligns with prior research on the impact of sleeping on overall mental health [ 31 , 32 ].…”

1.5 years pandemic – Psychological burden over the course of the COVID-19 pandemic in Germany: A nine-wave longitudinal community study

“…Among the protective factors, the knowledge of where to get psychological support seems to have comparatively the greatest potential to be further improved. Reduced physical activity, on average, seems to be the most pronounced risk factor and should therefore get particular attention in preventive and therapeutic interventions ( Villadsen et al, 2021 ). The extent of increased substance use was, on average rather low, but increments seem to persist slightly longer than changes in other risk-bearing factors.…”

“…Most research on risk-bearing and protective factors focused on sociodemographic variables (e.g., age, gender, and socioeconomic status) and was carried out during the first months of the pandemic ( Dragioti et al, 2022 ; Kunzler et al, 2021 ; Rodríguez-Fernández et al, 2021 ). Only a few studies have investigated potentially modifiable variables, such as self-efficacy and health-related behaviors ( Bendau et al, 2020 ; Bendau et al, 2021b ; Pandey et al, 2021 ; Petzold et al, 2020a ; Villadsen et al, 2021 ). Moreover, most research considered risk and resilience factors as relatively stable variables and there is scarce evidence regarding potential changes of those factors over the course of the pandemic.…”

Health Behaviours among Nursing Students in Poland during the COVID-19 Pandemic

“…An intensification of mental health issues, among both healthcare professionals and the general population, is associated with depression, anxiety, insomnia and PTSD [31][32][33]. Villadsen et al demonstrated (based on four domestic longitudinal cohort studies in the UK) that mental health deterioration in a group of 10,666 participants was associated with detrimental health behaviours-changes in diet, physical activity and sleep quality [34]. Kim et al also surveyed nursing students and found that age, health status, knowledge and risk perception significantly affected preventive health behaviour, which was found to be positively correlated with knowledge and risk perception.…”