Negative impact of the COVID-19 pandemic on sleep quantitative parameters, quality, and circadian alignment: Implications for psychological well-being and emotional regulation

  1. Mohammad Ali Salehinejad
  2. Maryam Majidinezhad
  3. Elham Ghanavati
  4. Sahar Kouestanian
  5. Carmelo M. Vicario
  6. Michael A. Nitsche
  7. Vahid Nejati

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Background

The COVID-19 pandemic has spread worldwide, affecting millions of people and exposing them to home quarantine, isolation, and social distancing. While recent reports showed increased distress and depressive/anxiety state related to COVID-19 crisis, we investigated how home quarantine affected sleep parameters in healthy individuals.

Methods

160 healthy individuals who were in home quarantine in April 2020 for at least one month participated in this study. Participants rated and compared their quantitative sleep parameters (time to go to bed, sleep duration, getting-up time) and sleep quality factors, pre-and during home quarantine due to the COVID-19 pandemic. Furthermore, participants’ chronotype was determined to see if sleep parameters are differentially affected in different chronotypes.

Results

The time to fall asleep and get-up in the morning were significantly delayed in all participants, indicating a significant circadian misalignment. Sleep quality was reported to be significantly poorer in all participants and chronotypes, and included more daily disturbances (more sleep disturbances, higher daily dysfunctions due to low quality of sleep) and less perceived sleep quality (lower subjective sleep quality, longer time taken to fall asleep at night, more use of sleep medication for improving sleep quality) during home quarantine.

Conclusions

Home quarantine due to COVID-19 pandemic has a detrimental impact on sleep quality. Online interventions including self-help sleep programs, stress management, relaxation practices, stimulus control, sleep hygiene, and mindfulness training are available interventions in the current situation.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.07.09.20149138: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was conducted according to the latest version of the Declaration of Helsinki ethical standards and approved by the Ethical Committee of the Shahid Beheshti University.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableParticipants: One-hundred and sixty healthy volunteers (137 females, mean age = 25.79 ± 7.31) participated in this study.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The majority of females in the sample, and low number of early chronotypes are limitations of this study, which need to be addressed in further studies with larger samples. Furthermore, our results are based on self-report data, and we did not obtain data about intervening psychological conditions which could at least partially account for the observed effects (e.g. anxiety, distress, depressive state). Nevertheless, the current data suggest a remarkable negative impact of the COVID-19 crisis, especially with respect to quarantine, on sleep health and indirectly on psychological health parameters. This calls for targeted interventions for improving sleep parameters, and prevention of associated psychological consequences. Available interventions for improving sleep health are stress management and relaxation practice, stimulus control, sleep hygiene, and exercise (Murawski et al., 2018). These interventions are feasible for home practicing during the COVID-19 crisis when treatment-seeking is not possible. Specifically, sleep hygiene education/programs could be useful for improving sleep health. Sleep hygiene programs include a set of behavior that improves sleep health, such as regular sleep schedules, and avoidance of long naps or the use of caffeine before sleep. These instructions can be trained via public media or offered as online interventions. Previous studies have shown good efficacy of internet-based sleep-promoting programs and mindfulness training for improving sle...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We found bar graphs of continuous data. We recommend replacing bar graphs with more informative graphics, as many different datasets can lead to the same bar graph. The actual data may suggest different conclusions from the summary statistics. For more information, please see Weissgerber et al (2015).

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.07.09.20149138v1 on medRxiv