ABSTRACT
Burnout is frequent among healthcare workers, and sleep problems are suspected risk factors. The sleep health framework provides a new approach to the promotion of sleep as a health benefit. The aim of this study was to assess good sleep health in a large sample of healthcare workers and to investigate its relationship with the absence of burnout among healthcare workers while considering anxiety and depressive symptoms. A cross-sectional Internet-based survey of French healthcare workers was conducted in summer 2020, at the end of the first COVID-19 lockdown in France (March to May 2020). Sleep health was assessed using the RU-SATED v2.0 scale (RegUlarity, Satisfaction, Alertness, Timing, Efficiency, Duration). Emotional exhaustion was used as a proxy for overall burnout. Of 1069 participating French healthcare workers, 474 (44.3%) reported good sleep health (RU-SATED > 8) and 143 (13.4%) reported emotional exhaustion. Males and nurses had a lower likelihood of emotional exhaustion than females and physicians, respectively. Good sleep health was associated with a 2.5-fold lower likelihood of emotional exhaustion and associations persisted among healthcare workers without significant anxiety and depressive symptoms. Longitudinal studies are needed to explore the preventive role of sleep health promotion in terms of the reduction in burnout risk.
ABSTRACT
BACKGROUND AND OBJECTIVES: To explore the first coronavirus disease 2019 (COVID-19) lockdown effect on sleep symptoms in patients with narcolepsy, idiopathic hypersomnia (IH), and restless legs syndrome (RLS). METHODS: Between March and May 2020, a sample of adult patients regularly followed up in a Reference Hospital Sleep Unit (299 with narcolepsy, 260 with IH, and 254 with RLS) was offered an online survey assessing their sleep-wake habits, daily activities, medication intake, and validated scales: International RLS Study Group questionnaire, Narcolepsy Severity Scale (NSS), IH Severity Scale (IHSS), Epworth Sleepiness Scale (ESS), Insomnia Severity Index, Beck Depression Inventory-II, and European Quality of Life (QoL) scale. The survey was proposed once, and the questions were answered for the prelockdown (recall of the month before the confinement) and the lockdown (time of study) periods. RESULTS: Overall, 331 patients completed the survey (response rate 40.7%): 102 with narcolepsy, 81 with IH, and 148 with RLS. All patients reported later bedtimes, with reduced differences for time in bed (TIB) and total sleep time (TST) over 24 hours between weekdays and weekends. Patients with narcolepsy spent more TIB and increased TST overnight, with more daytime napping. They had more awakenings, higher ESS scores, lower QoL, and no NSS changes. Patients with IH also increased their TIB, TST overnight and 24 hours on weekdays. Nocturnal sleep latency and the number of awakenings increased but with no change in ESS, QoL, and IHSS scores. Patients with RLS reported longer nocturnal sleep latency, more awakenings, more naps, decreased TIB, and TST overnight. RLS severity increased while QoL decreased. A significant portion of patients reported disease worsening during the lockdown (narcolepsy: 39.4%, IH: 43.6%, and RLS: 32.8%), and some patients stopped or lowered their medication (narcolepsy: 22.5%, IH: 28%, and RLS: 9.5%). DISCUSSION: During the lockdown, all patients reported later bedtimes; those with narcolepsy and IH extended their sleep duration unlike patients with RLS. These changes were often associated with negative consequences on QoL. In the current context of recurrent COVID-19 waves, the recent development of teleconsultations should enable physicians to monitor patients with chronic sleep disorders more closely and to recommend optimized sleep schedules and duration, in order to prevent psychological problems and improve their QoL.
Subject(s)
COVID-19 , Disorders of Excessive Somnolence , Idiopathic Hypersomnia , Narcolepsy , Restless Legs Syndrome , Adult , Communicable Disease Control , Disorders of Excessive Somnolence/epidemiology , Humans , Narcolepsy/complications , Narcolepsy/epidemiology , Quality of Life , Restless Legs Syndrome/complications , Restless Legs Syndrome/epidemiology , Severity of Illness Index , SleepABSTRACT
Résumé A la fois le confinement lié au virus Covid-19 et le stress induit par la pandémie peuvent entraîner des perturbations importantes des rythmes et du sommeil. Des experts du sommeil de la section Sommeil et rythmes biologiques en Psychiatrie (SoPsy) de l’Association Française de Psychiatrie Biologique et de Neuropsychopharmacologie (AFPBN) et de la Société Française de Recherche et Médecine du Sommeil (SFRMS), en partenariat avec le Réseau Morphée et l’Institut National du Sommeil et de la Vigilance (INSV), proposent ici des conseils pour bien dormir et garder ses rythmes. Des recommandations spécifiques sont adressées d’une part aux adultes et d’autre part aux parents pour leurs enfants. Les personnes avec un trouble de l’humeur (dépression, trouble bipolaire, etc) doivent particulièrement prêter attention et conserver des routines durant cette période afin de maintenir une humeur stable. Il est proposé des stratégies d’autogestion pour renforcer l’horloge biologique, tous les jours ! Les recommandations comportent des astuces simples et pratiques pour le jour et la nuit, mais aussi des conseils spécifiques à ce contexte pour limiter l’exposition au stress et mieux le gérer. Enfin, quelques sources et liens utiles sont proposés. Both, the confinement itself and the stress induces by the Covid-19 virus pandemic can lead to significant disruptions in habitual rhythms and sleep. Sleep experts from the Sleep and Biological Rhythms in Psychiatry section (SoPsy) of the French Association for Biological Psychiatry and Neuropsychopharmacology (AFPBN) and the French Society of Sleep Research and Medicine (SFRMS), in partnership with the Morphée network and the National Institute of Sleep and Vigilance (INSV), offer recommendations on how to sleep well and to keep your rhythms. Specific recommendations are addressed on the one hand to adults and on the other hand to parents for their children. People affected by mood disorders (depression, bipolar disorder, etc.) should particularly pay attention to maintaining routines during this period in order to maintain a stable mood. Self-management strategies are suggested to strengthen the biological clock, every day! The recommendations include tips for day and night, but also some specific advices for this context, to limit stress exposure and to improve its management. Finally, useful online ressources and links are suggested.