Stress and sleep: impact of the main contributing factors to poor sleep experiences during the COVID-19 pandemic

Introduction: The COVID-19 (Coronavirus Disease 2019) pandemic is associated with several stressful factors that can negatively affect peoples' sleep quality and mental health. Objective(s): The aim of the current study was to prospectively identify decreased sleep quality and associated risk factors in general population during COVID-19 pandemic. Method(s): We conducted a prospective, observational online study on a Romanian sample of 667 respondents aged >18 years. Sleep quality and quantity was evaluated with Athens Insomnia scale (AIS) and the main concerns associated with the pandemic context were evaluated through a multiple-choice question. Result(s): The data collected identified important evidence regarding the prevalence and intensity of insomnia. The average score for AIS was 6.13 (cut-off point for was set at 8). However, it is worth noting that 179 respondents (26.8%) meet the criteria for insomnia. Of the 8 self-assessment items, daytime sleepiness was the criterion evaluated with the highest average score (1.01), all other items getting subunit values. A low quality of sleep was linearly related with fear of illness/death (p=0.053), fear of illness/death of close people (p=0.032), social isolation (p<0.001), economic impact (p=0.003), losing the job (p<0.001) and social stigma associated with COVID-19 infection (p=0.009). Conclusion(s): More than a qurter of respondes scored above the threshold of 8 at the insomnia scale, while losing the job, social stigma associated with COVID-19 infection and social isolation are the main risk factors for a low quality and quantity of sleep.

Prevalence of anxiety and depression among students and employees during the COVID-19 pandemic

Introduction: Facing the COVID-19 pandemic, individuals are experiencing severe mental distress. Following social distancing and economic insecurity, significant increases in mental health concerns have developed. Objective(s): The aims of this study was to report the levels of depressive and anxiety within active population in Romania, and to identify possible risk and protective factors for mental health. Method(s): Data collection occurred between February-March 2021. The online survey included questions regarding socio-demographic characteristics and Hospital Anxiety and Depression Scale (HADS). 620 responses were validated (331 students and 289 workers). Result(s): Among active population, risk of anxiety symptoms is lower in those who already were infected with SARS-Cov2 (p=0.026, df=2, Phi=0.109), while positive screening for anxiety or depression in this study was statistically significant associated with younger age (p=0.026, df=4, Phi=0.134) and female gender (p=<0.001, df=2, Phi=0.166). Even though anxiety and depression scores are similar among students and employees, there are different aspects regarding symptomatology between these two groups. Students have experienced more frequently tendency to worry and sudden feelings of panic (p=0.004, df=3, Phi=0.146). Also, their ability to laugh and see the funny side of things is affected (p=0.019, df=3, Phi=0.127) and they feel less enthusiasm about future (p=0.001, df=3, Phi=0.159). Participants living with someone else scored lower on anxiety and depression subscales and those are not influenced by the person with whom they are cohabitating or residing (p=0.020, df=3, Phi=0.138). Conclusion(s): Findings from the current study offer initial insights into the rates of anxiety and depression within active population in Romania, one year after the onset of the COVID-19 pandemic.

P.0187 Impact of covid-19 pandemic on sleep quality in students and employees

Introduction: Facing the COVID-19 pandemic, individuals are experiencing severe mental distress [1]. Thus, during the last year, drastic changes occurred in everyday life of every human being. Following social distancing and economic insecurity, significant increases in mental health concerns (loneliness, anxiety, depression, or insomnia) have developed [2]. Aims: The objective of this study was to explore the sleep quality in students and employees, during the COVID-19 pandemic. Methods: Data collection occurred between February and March 2021. The online survey included questions regarding socio-demographic characteristics, COVID-19 status, and Athens Insomnia Scale (AIS) [3]. Snowball sampling was conducted to recruit participants and the survey was shared through social media networking. 620 responses were validated. The analysis was carried out using SPSS Statistics. The Chi-Square test, the corresponding corrections (when the criteria were not met - Likelihood ratio, Fisher test) and Phi and Cramer V parameters were used to verify the interval combinations;the t-independent test with the reporting of the degrees of release, the difference of the means, the Levene′s test for the homogeneity test, the Kolmogorov-Smirnov and Shapiro-Wilk normality tests for the subgroups under 30 respondents and the confidence interval set at 95%. Results: 74.8% of the respondents were female and most of them were young adults (18 and 35 years - 82.4%). 53.4% were students, while 46.6% were employees. 91.8% lived in urban areas. The average working hours per week was 20-40 hours (32.9%). Regarding COVID-19 disease, 16% were infected, of which 65% had a mild form. Women reported more frequent by impairment of total sleep duration (p=0.032, df=3, Phi=0.119, moderate correlation) and overall poorer quality of sleep (p=0.042, df=3, Phi=0.115, moderate correlation). AIS scores were significantly higher for women, (Mean Differences-1,027: women's mean score=6.39, men’ s mean score =5.37), p=0.007. The frequency of awakenings during night increase with age (p<0.001, df=6, Phi=0.248, strong correlation), as well as awakenings earlier than the desired time (p=0.004, df=6, Phi=0.202, strong correlation). Drowsiness during the day is more prevalent at younger ages (p<0.001, df=6, Phi=0.251, large association). In student population, the sleep induction is more affected (p=0.013, df=3, Phi=0.132, moderate association). Also, the perception of physical and mental functioning (p<0.001, df=3, Phi=0.206, strong association) and sleepiness during daytime (p<0.001, df=3, Phi=0.189, strong association) are more prevalent. In contrast, awakenings during the night are more prevalent among employees (p<0.001, df=3, Phi=0.185, strong association). The final awakening was found to be earlier than desired (p=0.002, df=3, Phi=0.155, strong association). Overall, the AIS results are not significant by different between groups (p=0.140, df=1). Conclusion: Students have experienced more frequently next day consequences of insomnia, while for workers awakenings during the night and early morning awakening were more prevalent. Regarding sociodemographic factors, AIS score was significantly higher among women and awakenings during the night were a sleep disturbance associated with ageing. This online survey suffers from two methodological limitations: limited access to certain portals, and participation biases (respondents may select themselves into the sample), thus more research on insomnia during a pandemic crisis is necessary. No conflict of interest