Sleep problems during COVID-19 pandemic and its’ association to psychological distress: A systematic review and meta-analysis

Abstract

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.

Understanding the Impact of the COVID-19 Pandemic, Lockdowns and Social Isolation on Sleep Quality

“…1 A meta-analysis of 177 published studies revealed that insomnia symptoms were most prevalent in healthcare professionals (43%), which further indicated that age, gender, country and marital status did not impact prevalence rates. 71 As already mentioned, health professionals, especially frontline workers who regularly care for COVID-19 infected patients, may be at higher risk of insomnia, because of increased fear of risk of infection and death, as well as irregular and more frequent work schedules. [73][74][75] For other "essential" workers besides healthcare, earlier wake times, and reduced total sleep times were also seen, when compared to "non-essential" workers.…”

COVID-19 vaccines and mental distress

“…The improvement in economic conditions and the release of public economic support in the form of unemployment insurance and stimulus checks may have been a factor in the recovery of mental health since April 2020. Studies show that sleep problems were common during the COVID-19 crisis and this was associated with depression among the general population [ 5 ].…”

The Differential Impact of COVID-19 Lockdown on Sleep Quality, Insomnia, Depression, Stress, and Anxiety among Late Adolescents and Elderly in Italy

“…Conversely, other investigations identified advanced age as a risk factor for sleep disturbances [16], being associated with a decline of sleep quality [17], especially in older individuals with depressive and anxiety symptoms [18]. A recent study also showed that older age represented a significant predictor of a higher association between sleep problems and psychological distress [19]. Moreover, social isolation could exacerbate feelings of loneliness which, in turn, could compromise sleep and psychological health among the older population [20,21].…”