La crise sanitaire du Covid-19 et le confinement sont associés à un taux élevé de troubles du sommeil et de prise d'hypnotiques en France

Objectif La crise de la COVID-19 a perturbé les habitudes de milliards de personnes dans le monde. Pour de nombreux pays, le confinement à la maison est obligatoire et les familles sont forcées de vivre ensemble en permanence, dans des environnements souvent petits, avec leurs propres habitudes de sommeil et de veille. Le sommeil est essentiel pour nos vies et crucial pour équilibrer leur système immunitaire, la santé physique et psychologique. Méthodes Pour évaluer les problèmes de sommeil et l'utilisation des somnifères, nous avons réalisé une étude transversale d'un échantillon représentatif de la population générale en France (1005 sujets). Nous avons utilisé les mêmes éléments autodéclarés de plaintes de sommeil au cours des 8 derniers jours, tirés de l'échelle du Duke Health Profile, que ceux utilisés depuis 1995 dans les Baromètres de la santé français, une série d'enquêtes transversales sur diverses questions de santé publique. Résultats Après deux semaines de confinement, 74 % des participants ont signalé des plaintes de sommeil, comparativement à des taux de prévalence de 44 % à 49 % au cours des 25 dernières années. Les femmes ont déclaré plus de problèmes de sommeil que les hommes : 31 % contre 16 %. Les jeunes (18-35 ans) plus fréquemment que leurs aînés (79 % contre 72 % des 35 ans et plus) : 60 % ont déclaré que ces problèmes augmentaient avec le confinement, contre 51 % de leurs aînés. Enfin, 16 % des participants ont déclaré avoir pris des somnifères au cours des 12 derniers mois et 41 % d'entre eux ont déclaré avoir consommé ces médicaments depuis le début du confinement. Conclusion Ces résultats suggèrent que la crise de la COVID-19 est associée à de graves troubles du sommeil au sein de la population française, en particulier chez les jeunes.

The Key Role of Psychosocial Competencies in Evidence-Based Youth Mental Health Promotion: Academic Support in Consolidating a National Strategy in France.

Psychosocial competencies, also known as psychosocial skills or life skills, are essential for the prevention and promotion of mental health. Since the beginning of this century, psychosocial competencies have been defined as the ability to develop positive mental health. Most individual or social mental health protection programs are related to psychosocial competencies. A majority of evidence-based programs that develop mental health explicitly aim at developing psychosocial competencies, either exclusively or with complementary approaches. Many of these programs have demonstrated their effectiveness, with lasting effects on reduced anxiety and depression symptoms, violent and risky behaviors, and improved well-being and academic success. Based on international meta-analyses and on 20 years of French national and local experiences, a national strategy to develop psychosocial competencies was launched in France in 2021 for all children from 3 to 25 years old. Two reports on evidence-based psychosocial competence development were published in 2022 by the national agency for public health-Santé publique France (Public Health France)-to support this deployment strategy and develop a common evidence-based culture in health and education. This article presents the French national strategy as an example of a means of increasing evidence-based mental health promotion while discussing the importance of cultural adaptation of such programs.

Barriers Against and Motivations for Quitting Smoking during the COVID-19 Health Crisis: Results of a Qualitative Study in France.

The COVID-19 epidemic and its psychological, economic and social consequences could have an impact on the evolution of tobacco-smoking prevalence and attitudes towards quitting. The aim of this study is to analyse the specific characteristics of the motivations for and barriers against smoking cessation in this period. The study is based on qualitative data collected from late 2020 to early 2021 in France from 89 smokers with a low or intermediate socio-economic level. Among the motivations for quitting smoking, health concerns and the financial cost of cigarettes carried increased importance among the smokers in this period. Inversely, perceived stress, isolation, and a lack of social or healthcare support prevented some smokers from attempting to quit. These results are useful for explaining the evolution of smoking prevalence and preparing future interventions in the context of the health crisis and its aftermath. They highlight the relevance of educational messages, of the promotion of validated smoking-cessation aids and, in particular, remote support, as well as the implementation of community-based actions.

Incidence of PTSD in the French population a month after the COVID-19 pandemic-related lockdown: evidence from a national longitudinal survey.

BACKGROUND: In view of experts' warnings about the potential negative mental health consequences of the sudden nationwide lockdowns implemented in many countries to limit the spread of the COVID-19 pandemic, we sought to study the incidence of posttraumatic stress disorder (PTSD) after traumatic events related to this unprecedented lockdown in the French general population. METHODS: This longitudinal study among adults (aged =18) consisted of two surveys: the first during the last days of the lockdown and the second a month later. We estimated PTSD incidence with the PCL-5 and ran multiple Poisson regression models to identify factors associated with PTSD. RESULTS: Among the 1736 participants, 30.1% reported at least one traumatic event. PTSD incidence was 17.5% (95% confidence interval CI = 15.7-19.3). It was higher in participants who reported multiple traumatic events, who had high COVID-19-related media use, who had general anxiety disorder (GAD-7) during the lockdown, and who had GAD, depression (PHQ-9), or sleep problems 1 month later. In addition, 43.1% of people with PTSD reported suicidal thoughts. CONCLUSIONS: These results should help clinicians to target people who are at high risk of developing PTSD after a pandemic-related lockdown and could benefit from preventive measures. Collaboration between the media and mental health professionals could be envisioned to inform the population about care resources. Follow-up recommendations should also be disseminated to general practitioners to facilitate PTSD screening and ensure that they are aware of the appropriate management.

Adherence and sustainability of interventions informing optimal control against the COVID-19 pandemic.

BACKGROUND: After one year of stop-and-go COVID-19 mitigation, in the spring of 2021 European countries still experienced sustained viral circulation due to the Alpha variant. As the prospect of entering a new pandemic phase through vaccination was drawing closer, a key challenge remained on how to balance the efficacy of long-lasting interventions and their impact on the quality of life. METHODS: Focusing on the third wave in France during spring 2021, we simulate intervention scenarios of varying intensity and duration, with potential waning of adherence over time, based on past mobility data and modeling estimates. We identify optimal strategies by balancing efficacy of interventions with a data-driven "distress" index, integrating intensity and duration of social distancing. RESULTS: We show that moderate interventions would require a much longer time to achieve the same result as high intensity lockdowns, with the additional risk of deteriorating control as adherence wanes. Shorter strict lockdowns are largely more effective than longer moderate lockdowns, for similar intermediate distress and infringement on individual freedom. CONCLUSIONS: Our study shows that favoring milder interventions over more stringent short approaches on the basis of perceived acceptability could be detrimental in the long term, especially with waning adherence.

In the spring of 2021, social distancing measures were strengthened in France to control the third wave of COVID-19 cases. While such measures are needed to slow the spread of the virus, they have a significant impact on the population's quality of life. Here, we use mathematical modelling based on hospital admission data and behavioural and health data (including data on mobility, indicators of social distancing, risk perception, and mental health) to evaluate optimal COVID-19 control strategies. We look at the effects of interventions, their sustainability and the population's adherence to them over time. We find that shorter, more stringent measures are likely to have similar effects on viral circulation and healthcare burden to long-lasting, less stringent but less sustainable interventions. Our findings have implications for the design and implementation of public health measures to control future COVID-19 waves.

La crise sanitaire du Covid-19 et le confinement sont associés à un taux élevé de troubles du sommeil et de prise d’hypnotiques en France

Objectif La crise de la COVID-19 a perturbé les habitudes de milliards de personnes dans le monde. Pour de nombreux pays, le confinement à la maison est obligatoire et les familles sont forcées de vivre ensemble en permanence, dans des environnements souvent petits, avec leurs propres habitudes de sommeil et de veille. Le sommeil est essentiel pour nos vies et crucial pour équilibrer leur système immunitaire, la santé physique et psychologique. Méthodes Pour évaluer les problèmes de sommeil et l’utilisation des somnifères, nous avons réalisé une étude transversale d’un échantillon représentatif de la population générale en France (1005 sujets). Nous avons utilisé les mêmes éléments autodéclarés de plaintes de sommeil au cours des 8 derniers jours, tirés de l’échelle du Duke Health Profile, que ceux utilisés depuis 1995 dans les Baromètres de la santé français, une série d’enquêtes transversales sur diverses questions de santé publique. Résultats Après deux semaines de confinement, 74 % des participants ont signalé des plaintes de sommeil, comparativement à des taux de prévalence de 44 % à 49 % au cours des 25 dernières années. Les femmes ont déclaré plus de problèmes de sommeil que les hommes : 31 % contre 16 %. Les jeunes (18-35 ans) plus fréquemment que leurs aînés (79 % contre 72 % des 35 ans et plus) : 60 % ont déclaré que ces problèmes augmentaient avec le confinement, contre 51 % de leurs aînés. Enfin, 16 % des participants ont déclaré avoir pris des somnifères au cours des 12 derniers mois et 41 % d’entre eux ont déclaré avoir consommé ces médicaments depuis le début du confinement. Conclusion Ces résultats suggèrent que la crise de la COVID-19 est associée à de graves troubles du sommeil au sein de la population française, en particulier chez les jeunes.

Would we recover better sleep at the end of Covid-19? A relative improvement observed at the population level with the end of the lockdown in France.

BACKGROUND: The outbreak of the Covid-19 pandemic and the accompanying lockdown measures have had a major impact on societies around the world, leading to sleep problems for a large part of the population. In order to assess the sustainability of sleeping troubles related to the sanitary crisis, it was crucial to measure its prevalence after the end of the Covid-19 confinement. METHODS: As part of an epidemiological survey on Covid and Confinement (COCONEL), we enquired on sleep disorders using two items in 4 repetitive cross-sectional surveys. The first took place during the first week of the French confinement (March 31 to April 2; N = 1005 participants). The second took place in the middle of this period (April 15-17; N = 1005). The two last surveys were held at the end of the confinement (May 7-10; N = 2003) and one month after the end (June 10-12; N = 1736). Using a random constant, the mixed model took into account the longitudinal character of the last two waves (intra-individual correlations for individuals surveyed in waves 3 and 4). RESULTS: The prevalence of sleep problems significantly decreased during the last weeks of the confinement, and this trend was confirmed one month after the end of confinement. One quarter of the population reported that their sleep was better one month after the end of the confinement. Sleep improvement was reported more often by women and people aged less than 65. Such improvement was less frequent among those who were still highly exposed to the pandemic's media coverage after the end of the confinement. CONCLUSION: The possibility of recovering a good sleep largely depends on the type of sleep disorder. The decrease in sleep problems occurred mainly among people with mild sleep problems during the confinement. Further research is needed to assess the long-term effects of the Covid-19 pandemic and its confinement period on sleep quality in the general population.

Attitudes about COVID-19 Lockdown among General Population, France, March 2020.

Because the effectiveness of a coronavirus disease lockdown in curbing coronavirus disease spread depends on public support, acquiring real-time information about the way populations reacted to the lockdown is crucial. In France, such public support remained fragile among low-income persons, probably because the lockdown exacerbated preexisting social inequalities and conflicts.

Covid-19 health crisis and lockdown associated with high level of sleep complaints and hypnotic uptake at the population level.

The Covid-19 pandemic has disrupted the habits of billions of people around the world. Lockdown at home is mandatory, forcing many families, each member with their own sleep-wake habits, to spend 24 hr a day together, continuously. Sleep is crucial for maintaining immune systems and contributes deeply to physical and psychological health. To assess sleep problems and use of sleeping pills, we conducted a cross-sectional study of a representative sample of the general population in France. The self-reported sleep complaint items, which covered the previous 8 days, have been used in the 2017 French Health Barometer Survey, a cross-sectional survey on various public health issues. After 2 weeks of confinement, 74% of the participants (1,005 subjects) reported trouble sleeping compared with a prevalence rate of 49% in the last general population survey. Women reported more sleeping problems than men, with greater frequency or severity: 31% vs. 16%. Unusually, young people (aged 18-34 years) reported sleep problems slightly more frequently than elderly people (79% vs. 72% among those aged 35 or older), with 60% of the younger group reporting that these problems increased with confinement (vs. 51% of their elders). Finally, 16% of participants reported they had taken sleeping pills during the last 12 months, and 41% of them reported using these drugs since the lockdown started. These results suggest that the COVID crisis is associated with severe sleep disorders among the French population, especially young people.