Sleep patterns among Norwegian nurses between the first and second wave of the COVID-19 pandemic

Abstract

Background Nurses are in the frontline and play an important role in the battle against the COrona VIrus Disease-2019 (COVID-19) pandemic. Sleep problems among health care workers are likely to increase due to the pandemic. However, it is conceivable that negative health outcomes related to the pandemic fluctuate with the infection rate waves of the pandemic. The present study aimed to investigate sleep patterns among Norwegian nurses, after the first wave, during a period with very low rates of COVID-19. Methods Data stemmed from the cohort study “SUrvey of Shift work, Sleep and Health (SUSSH)” among Norwegian nurses. A total of 1532 nurses responded one time to a questionnaire between June and September in 2020 including items about demographics and work, information about COVID-19 and quarantine, sleep patterns and changes in sleep patterns due to the pandemic. Descriptive statistics for all relevant variables were calculated and McNemar tests were used to compare categorical variables. Results The majority of nurses (84.2%) reported no change in sleep duration after the first wave of the COVID-19 pandemic compared to before, 11.9% reported less sleep, and 3.9% reported more sleep. Similarly, 82.4% of the nurses reported no change in their sleep quality, whereas 16.2% of the nurses reported poorer sleep quality after the first wave of the pandemic compared to before. The majority of nurses reported no change in their sleep schedule due to the pandemic, although 9.6% of the nurses reported to go to bed later and 9.0% woke up earlier than before the pandemic. Conclusions Most existing literature exploring sleep among health care workers during the COVID-19 pandemic has been carried out during periods with high infection rates. In this study we aimed to investigate sleep patterns among Norwegian nurses following the first wave, during a period of low COVID-19 rates in Norway. Most of the nurses reported no change in neither sleep duration, sleep quality, bedtime, nor wake-up times compared to before the pandemic. Still, nearly 12% reported shorter sleep duration, and about 16% reported poorer sleep quality indicating that some nurses experienced worsening of their sleep following the pandemic.

The Relationship between Acceptance and Sleep–Wake Quality before, during, and after the First Italian COVID-19 Lockdown

“…Regarding sleep and wake factors, we found that the Lockdown group reported poor sleep and wake quality compared to the Pre-Lockdown group, confirming the results of different studies showing the deleterious impact of lockdowns during different waves in different periods of the year [3,[5][6][7][8][9]. However, in contrast with previous studies [10,11], we found that the After-Lockdown group reported even higher sleep-wake disturbances than the Lockdown group. This discrepancy could be explained by the different methodology adopted.…”

“…In particular, in the present study, we assessed sleep-wake problems through a questionnaire (i.e., MSQ) with good psychometric properties [25], while the other studies used ad-hoc questions. Indeed, the MSQ required participants to report sleep and wake difficulties during the past seven days, whereas Beck et al [10] and Waage et al [11] asked participants to rate their sleep-wake quality with specific questions, such as "After the pandemic hit Norway, I sleep (1) much poorer than before, (2) to some degree poorer that before, (3) no change, (4) to some degree better than before and (5) much better than before". This different method could explain why we did not find a "return to baseline" level for sleep-wake quality.…”

“…The prevalence of sleep problems decreased during the last weeks of lockdown, and this trend was further confirmed in the follow-up assessment, with an improvement in sleep quality in 25% of participants. Similarly, Waage et al [11] reported that more than 80% of Norwegian nurses did not show any change in sleep duration or sleep quality after the first wave of the COVID-19 pandemic compared to before (data collected between June and September 2020). These studies may indicate that the distress determined by lockdown (home confinement, social distancing, closure of activities) probably affected the sleep-wake cycle immediately, with a decrease in sleep quality and an increase in sleep problems.…”

“…This influence, however, seems to be temporary, given that after lockdowns, sleep impairment seems to be naturally resolved, probably thanks to a reduction in general distress. However, the amount of time that is needed for this return to baseline is not clear, given that the two studies covered different time windows (e.g., from May to June for [10] and from June to September for [11]). Furthermore, and more importantly, much remains to be understood about which psychological factors are responsible for a reduction in distress symptoms and, consequently, for a "return-to-baseline" of sleep-wake problems.…”

Sleep quality and related factors in a sample of Turkish healthcare workers during the COVID‐19 pandemic: A cross‐sectional study

“… 49 Sleep patterns among Norwegian nurses remained almost unchanged between the first and second waves of the COVID‐19 pandemic. 50 This reveals that poor sleep quality exhibits a dynamic change depending on how the data are collected and on the individuals affected by the pandemic. Healthcare workers thus exhibited a high rate of poor sleep quality before the COVID‐19 pandemic.…”