Are adversities and worries during the COVID-19 pandemic related to sleep quality? Longitudinal analyses of 46,000 UK adults

  1. Liam Wright
  2. Andrew Steptoe
  3. Daisy Fancourt

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Abstract

There are concerns that both the experience of adversities during the COVID-19 pandemic and worries about experiencing adversities will have substantial and lasting effects on mental health. One pathway through which both experience of and worries about adversity may impact health is through effects on sleep.

Methods

We used data from 46,284 UK adults in the COVID-19 Social Study assessed weekly from 01/04/2020-12/05/2020 to study the association between adversities and sleep quality. We studied six categories of adversity including both worries and experiences of: illness with COVID-19, financial difficulty, loss of paid work, difficulties acquiring medication, difficulties accessing food, and threats to personal safety. We used random-effect within-between models to account for all time-invariant confounders.

Results

Both the total number of adversity experiences and total number of adversity worries were associated with lower quality sleep. Each additional experience was associated with a 1.16 (95% CI = 1.10, 1.22) times higher odds of poor quality sleep while each additional worry was associated with a 1.20 (95% CI = 1.17, 1.22) times higher odds of poor quality sleep. When considering specific experiences and worries, all worries and experiences were significantly related to poorer quality sleep except experiences relating to employment and finances. Having a larger social network offered some buffering effects on associations but there was limited further evidence of moderation by other social or psychiatric factors.

Conclusion

Poor sleep may be a mechanism by which COVID-19 adversities are affecting mental health. This highlights the importance of interventions that support adaptive coping strategies during the pandemic.

Article activity feed

  1. Version published to 10.1371/journal.pone.0248919
  2. Version published to 10.1101/2020.06.02.20120311v2 on medRxiv
  3. ScreenIT

    SciScore for 10.1101/2020.06.02.20120311: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study was approved by the UCL Research Ethics Committee [12467/005] and all participants gave informed consent.
    Consent: The study was approved by the UCL Research Ethics Committee [12467/005] and all participants gave informed consent.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    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:
    However, the study has several limitations. First, we are unable to confirm causality. Whilst is appears logical that poor sleep itself cannot cause adverse experiences, there is likely a bidirectional relationship between worries and poor sleep, and worries may pre-date experiences. But our analyses suggest that both worries and experiences are independently associated with poor sleep. Additionally, we used a single item five-category self-report measure of sleep quality, which did not provide detail on which aspect of sleep was most affected (e.g. duration, onset, interruption etc) and may have lacked sufficient variation and validity to accurately estimate effects. Indeed, self-reports of sleep have been found to be worse in psychiatric patients, which may also have biased responses 63. However, single item sleep scales have been shown to possess favourable measurement characteristics to lengthier sleep questionnaires and are widely used in research 64. It is possible that individuals experiencing worries or adversities may have perceived their sleep to be worse, but without substantial variation in the core qualitative parameters of sleep. Further, our sampling was not random. Although we deliberately sampled from groups such as individuals of low socio-economic position and individuals with existing mental illness, it is possible that more extreme experiences were not adequately captured in the study. It is also possible that individual experiencing particularly extreme ...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    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

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  4. Version published to 10.1101/2020.06.02.20120311v1 on medRxiv