Racial Disparities in Sleep During the COVID-19 Pandemic

Introduction The purpose of the present study was to estimate average sleep duration and sleep disturbance in the United States during the COVID-19 pandemic. In addition, we investigated whether sleep varied as a function of sociodemographic variables, in particular race. Long standing disparities in condition and available resources between racial demographics often lead to disparities in health. At the advent of a pandemic, which strains these systems further, it is important to assess whether or not racial disparities persist. This is important given that racial groups are likely affected by the pandemic, both directly and indirectly, in various ways. Here, we plan to at least assess whether there are any disparities with regard to sleep. Methods 4,048 adults (Mage = 45.8 years;79% women) completed an online survey during April – June 2020. The final sample's self-reported race/ethnicity consisted of 84% White, 5.1% Black, 3.4% LatinX, 4.2% Asian or Asian American, and 2.9% Multi-racial. Sleep disturbance was assessed using a retrospective sleep diary and the Insomnia Severity Index (ISI). Results Average sleep duration in the sample was 7.1 hours. Participants reported taking on average 32 minutes (SD = 38 mins) to fall asleep and reported waking up for 32 minutes (SD = 53 mins) during the night. Approximately 17% of the sample endorsed clinically elevated insomnia symptoms (based on the ISI ≥ 15 cut-off). With regard to racial differences, shorter total sleep time (TST), longer sleep latencies (SL), and greater total ISI scores were observed in Black (mean TST = 6.4 hours;SL = 37.7 minutes;ISI Total = 9.8) and LatinX (mean TST = 6.9 hours;SL = 37.1 minutes;ISI Total = 9.6) participants relative to White participants (Mean TST = 7.1 hours;SL = 30.9 minutes;ISI Total = 8.4). All p's < 0.05. Conclusion Sociodemographic variables, particularly race, should be considered when estimating the relative impact of sleep on overall health. These findings are significant as they may have implications for a number of health disparities observed in the United States, especially during the COVID-19 pandemic. Support (if any) Vargas: K23HL141581

Insomnia symptoms predict longer COVID-19 symptom duration.

OBJECTIVE: /Background: The goal of the present study was to assess the prevalence and incidence of insomnia in the United States during the COVID-19 pandemic, and whether, among those that contracted COVID-19, insomnia predicted worse outcomes (e.g., symptoms of greater frequency, duration, or severity). METHODS: A nationwide sample of 2980 adults living in the United States were surveyed online at two points during the COVID-19 pandemic (T1 = April-June 2020; T2 = January-March 2021). Insomnia symptoms were assessed at both time points using the Insomnia Severity Index (ISI). The T2 survey also asked questions regarding COVID-19 testing and symptoms. RESULTS: The prevalence of insomnia (defined as ISI ≥15) was 15% at T1 and 13% at T2. The incidence rate of insomnia (i.e., new cases from T1 to T2) was 5.6%. Participants with insomnia were not more likely to contract COVID-19 relative to those participants without insomnia. Among those participants in our sample that contracted the virus during the study interval (n = 149), there were no significant group differences in COVID-19 symptom outcomes, with one exception, participants with insomnia were more likely to report a longer symptom duration (insomnia = 24.8 sick days, no insomnia = 16.1 sick days). CONCLUSIONS: The present study suggests the prevalence of insomnia in the U.S. population remained high during the COVID-19 pandemic. The data also support that insomnia may be related to experiencing more chronic COVID-19 symptoms. These findings have more general implications for the role of sleep and insomnia on immune functioning.

The Relationship Between Pathogen Avoidance and Insomnia Symptoms: Results from a Longitudinal Study Conducted During the COVID-19 Pandemic

Introduction Pathogen avoidance has intensified during the past two years because of fear related to the high transmissibility of SARS-CoV-2. This trend aligns with previous research that found increases in pathogen avoidance as a result of impaired immune system functioning, such as in the case of autoimmune disease. Another link to compromised immunity is the presence of insomnia symptoms, which may interfere with a healthy immune response to pathogens. It is not clear, however, if insomnia could be an immuno-compromising factor that leads to a compensatory increase in pathogen avoidance. Therefore, the purpose of the present study was to explore the relationship between situational pathogen avoidance and insomnia symptoms during the COVID-19 pandemic. Methods A national online survey was conducted at two time points: April-June 2020 (baseline) and January-March 2021 (follow-up). Insomnia symptoms were assessed using the Insomnia Severity Index (ISI). Affective, cognitive, and behavioral responses that comprise pathogen avoidance psychology, especially as it pertains to avoidance of potentially pathogenic social stimuli, were assessed with the Situational Pathogen Avoidance (SPA) scale. Results 2,980 adults (mean age = 47 years) completed both surveys. Overall, the means on the SPA scale at both time points were higher than previously published norms (mean at both timepoints = 5.4), suggesting that average pathogen avoidance increased since the onset of the pandemic. The mean differences in the SPA scale varied by insomnia symptoms (at both time points), with participants who endorsed clinically elevated insomnia (ISI >14) reporting higher pathogen avoidance (baseline, F(1,2972) =10.4, p = 0.001;follow-up, F(1,2918) =26.6, p < 0.001).The mean differences in the SPA scale by insomnia were greater at follow-up compared to baseline (mean difference at baseline = 0.19;mean difference at follow-up = 0.33). This suggests that, compared to the initial months of the pandemic (Apr–June 2020), the relationship between insomnia and situational pathogen avoidance was stronger post-pandemic peak (Jan–Mar 2021). Conclusion Our findings suggest that there is a positive correlation between insomnia symptoms and situational pathogen avoidance. Furthermore, results indicated that this relationship became stronger as the pandemic went on. Support (If Any) K23HL141581 (PI: Vargas);R25HL10544 (PI: Jean-Louis);K24AG055602 (PI: Perlis)

Does Social Media Use Before Bed Lead to Sleep Continuity Disturbance?

Introduction Research shows that the use of electronics before bed can negatively impact the circadian rhythm and sleep. Less is known, however, about social media use in relation to sleep continuity disturbance (i.e., insomnia). In the early months of the COVID-19 pandemic, social media use increased and updates about the pandemic were easily accessible online. It is possible that social media use before bed could introduce additional psychological stressors due to availability of negative content online and known correlations to depression and anxiety. Thus, the aim of this research was to examine how social media use before bed influenced different subtypes of insomnia during the initial months of the pandemic. Methods 4,138 adults (mean age = 45.8 years;79% women) completed a national online survey during April – June 2020. Social media use before bed was measured using the first item on the Social Media Engagement questionnaire (i.e., “How often do you use social media in the 15 minutes before you go to sleep?”). Participants responded to this item based on how many days per week (range = 1-7). Sleep disturbance was assessed using a retrospective sleep diary and the Insomnia Severity Index (ISI). The sleep diary asked about sleep continuity (e.g., sleep latency, wake after sleep onset, total sleep time) during the past month. Results Results from separate regression analyses supported that social media use before bed was positively related to greater ISI scores, b = 0.25, t = 8.0, p < 0.001. For example, those who use social media before bed every day reported greater mean ISI scores and sleep latency times (mean ISI = 9.5;SL = 37.5 minutes) compared to those who reported never using social media before bed (mean ISI = 7.7;SL = 27.9 minutes). In contrast, social media use before bed was not related to other sleep continuity variables. Conclusion The present data supports that social media use before bed is related to insomnia symptoms, specifically difficulty with sleep initiation. These findings are significant as they may help us understand which aspects of insomnia are most vulnerable to the negative impact of online social interactions, especially during a highly stressful period, such as the COVID-19 pandemic. Support (If Any) K23HL141581 (PI: Vargas);R25HL10544 (PI: Jean-Louis);K24AG055602 (PI: Perlis)

Measuring the Effects of Social Isolation and Dissatisfaction on Depressive Symptoms during the COVID-19 Pandemic: The Moderating Role of Sleep and Physical Activity.

Social distancing was universally implemented to reduce the spread of the COVID-19 virus. Long-term social distancing can lead to increased feelings of social isolation or dissatisfaction with one's daily interpersonal interactions, which can subsequently result in reduced psychological health (e.g., greater depression). The present study quantified this association, and the extent to which it was moderated by measures of sleep and physical activity, by surveying 3658 adults (mean age = 46.0 years) from across the United States. Participants answered questions related to their social experiences, sleep, physical activity, and depressive symptoms during the early stages of the pandemic (March-June 2020). Results showed that social isolation and social dissatisfaction were associated with greater depressive symptoms. As predicted, self-reported sleep quality and physical activity moderated these associations, such that lower sleep quality and physical activity exacerbated their effect on depressive symptoms.