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Background: The 2019 coronavirus disease (COVID-19) outbreak, which was brought on by the SARS-CoV-2 novel coronavirus, has had a significant negative influence on our environment and exposed health-care personnel to a new level of risk. Very few studies have addressed the disturbances in the sleep quality of healthcare workers during COVID-19 pandemic. Aim and Objectives: The primary objective of the study was to examine the sleep quality of frontline healthcare workers during COVID-19 pandemic in a tertiary care center in northern Kerala. Material(s) and Method(s): Healthcare workers belonging to a tertiary care center were invited to participate in the study. An online questionnaire including sociodemographics, Pittsburgh sleep quality index, and Insomnia severity index was used to evaluate sleep disturbances in healthcare workers. Univariate and bivariate analysis of the results were done to identify the predictors of poor sleep quality. Result(s): A total of 250 frontline healthcare workers were enrolled in the study, out of which 243 participants provided usable responses. About 27.6% of health workers showed features of poor sleep quality. The prevalence rate of poor sleep quality was highest among nurses, 55.2% followed by doctors and ambulance drivers, 22.4% and 11.9%, respectively. About 17.7% of the study population had subthreshold insomnia and 1.2% had clinical insomnia of moderate intensity. Conclusion(s): The prevalence of poor sleep quality is high among healthcare workers confronting COVID pandemic. This study emphasizes the need to implement specific protective measures for maintaining the sleep quality and decreasing stress among frontline health care workers during pandemics.Copyright © 2023, Mr Bhawani Singh. All rights reserved.
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The prevalence of psychiatric disorders namely depression, anxiety, and sleep disturbances has been increased worldwide, particularly during the COVID-19 pandemic. In this regard, the interest of recent investigations is moved toward phytomedicines and bioactive substances derived from natural sources. Although Tilia platyphyllos Scop. contains high amounts of phenolic compounds such as quercetin, kaempferol, and catechin, there is no study on the possible effects of its extract on psychological disorders. The present study was carried out to determine the antidepressant-like, anxiolytic, and sedative-hypnotic effects of the hydroethanolic extract of T. platyphyllos leaves using forced swimming test (FST), tail suspension test (TST), elevated plus maze test (EPMT), pentobarbital-induced loss of righting reflex test and open field test (OFT). Following the ethanolic extraction of T. platyphyllos leaves, the extraction yield was 14% and the total phenolic and total flavonoid contents were found to be 135.23 +/- 0.14 mg gallic acid equivalent/g dry extract and 19.02 +/- 0.03 mg rutin equivalent/g dry extract, respectively. Both FTS and TST revealed a significant antidepressant-like activity for the tested extract at 400 mg/kg compared to the control group. In addition, the anxiolytic activity of the extract was proven through OFT and EPMT in the same dose. Finally, T. platyphyllos extract at 200 mg/kg and 400 mg/kg significantly increased the sleeping time when compared to the control group reflecting its potential hypnotic activity. Co-administration of T. platyphyllos extract at 400 mg/kg and flumazenil as the GABA-A receptor antagonist decreased the sleeping time but the observed effect was not statistically significant. Therefore, we cannot completely rule out the GABA-A receptor's involvement in the hypnotic activity of the extract. The biological results presented here led us to conclude that T. platyphyllos extract can be a prominent source of antidepressant, anxiolytic and hypnotic agents. Probably, the main phenolic compounds of T. platyphyllos such as quercetin, kaempferol, and catechin are involved in the observed effects. However, there is still a great need for additional investigations on the exact mechanisms.Copyright © 2022, Iranian Association of Pharmaceutical Scientists. All rights reserved.
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Aims. The aim is to study the features of life and the incidence rate of anxiety and depressive disorders among medical faculty students studying remotely during the epidemic of a new coronavirus infection (Covid 19) at the Kabardino-Balkarian State University named after H.M. Berbekov. Materials and methods. We examined 335 students (34% males, 66% females) at the Faculty of Medicine in November- December 2020. The average age of the students examined was 20.3+/-2.3 years. The study included an anonymous mail survey to examine educational conditions, lifestyle, levels of anxiety and depression. Results. 43.8% of the students had insufficient sleep duration, 58.5% had low physical activity, in 24.8% of them we recorded high levels of situational anxiety and in 82.1% of them personal anxiety, in 7.1% of the students we recorded clinically expressed anxiety and 1.8% had clinically expressed depression. During the transition to remote learning, students increased the time use to prepare for classes (51.2%) and the duration of sleep (61.5%), while their physical activity decreased (76.5%). Statistically significant linear correlations were identified between the level of anxiety and depression and the duration of sleep, low physical activity, preparation time for classes, academic performance, and academic debt. Conclusions. The results obtained by us can be used to optimize the educational process, as well as to preserve the mental health of students during the transition to distance learning.Copyright © 2020 Novyi Russkii Universitet. All rights reserved.
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[Background] Sleep is closely related to immune function and human health, and adequate sleep is an important foundation for human health. [Objective] This study investigates the sleep status of the first-line medical staff in Wuhan in a fight against the coronavirus disease 2019 (COVID-19) outbreak, provides reference for improving the sleep quality of the first-line medical staff in public health emergencies. [Methods] Through convenience sampling, 112 medical workers (first-line group) who aided the COVID-19 fight in Wuhan and 134 medical staff (non-first-line group) who did not participate in the fight were selected. The Pittsburgh Sleep Quality Index (PSQI) was employed to collect data on the incidence of sleep disorders, time to fall asleep, duration of sleep, sleep efficiency, sleep disorders, use of sleep aid, and daytime functions. In addition, a self-made questionnaire was used to investigate the common concerns and time allocation characteristics of the first-line medical workers in the context of major infectious disease outbreaks. [Results] There were no significant differences between the two groups in demographic variables such as gender, age, job title, educational background, marriage status, number of children, and working years (P > 0.05). In the first-line group, 62 medical workers (55.36%) reported sleep disorders, while in the non-first-line group, 54 medical workers (40.30%) did;the difference was statistically significant (P=0.008). Among the seven components of the PSQI, the median sleep time (component 3) score of the first-line group was 1.5, which was higher than that of the non-first-line group (median 1.0) (P < 0.001);the median sleep efficiency (component 4) score of the first-line group was 1.0, which was higher than that of the non-first-line group (median 0) (P < 0.001). The actual sleep duration of the first-line group [(5.65+/-1.15) h] was lower than that of the non-first-line group [(7.00+/-1.40) h] (P < 0.001). The distributions of common concerns were different between the two group. The top three concerns were being infected (76.79%), exhausted (37.50%), and overloaded (27.68%) in the first-line group, and family members being infected (53.73%), being infected (45.52%), and child care (33.58%) in the non-first-line group. [Conclusion] The first-line medical team members report poor sleep quality, short sleep time, low sleep efficiency, sleep disorders, and many psychological concerns. It is necessary to take appropriate measures to improve their sleep quality.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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Objective: The COVID-19 pandemic affected the quality of life of the population worldwide. The countries took several protective measures to avoid contagion, including social isolation, teleworking and distance education. As schools closed, teachers took over primarily online teaching. The study main objective was to determine the sleep quality among teachers of a public educational institution in the district of Mancora, Peru, during the COVID-19 pandemic social isolation. Material(s) and Method(s): An observational, cross-sectional and prospective study. The Pittsburgh Sleep Quality Index was used to assess 59 preschool, primary and secondary school teachers who taught through distance education from March to December 2021. Result(s): The average age was 44.3 +/- 8.89 years. Women accounted for 64.4 %, specialist teachers-i.e., those who have expertise in a particular field-55.9 %, secondary school teachers 55.9 %, primary school teachers 30.5 % and preschool teachers 13.6 %. The affected sleep quality parameters were the following: 69.5 % had poor sleep quality, 67.8 % inadequate sleep latency, 61 % sleep duration of less than five hours, 27.1 % habitual sleep efficiency of less than 65 % and 49.2 % sleep disturbances. Moreover, 50.8 % reported using a sleeping medication more than once a week and 39 % severe daytime dysfunction. There was an association between sleep quality and the components subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and daytime dysfunction. Nonetheless, there was no association with sex, educational level and teaching specialty. Conclusion(s): Teachers of an educational institution in Mancora had a high prevalence of poor sleep quality and the most affected components were sleep latency, daytime dysfunction and sleep disturbances.Copyright © La revista. Publicado por la Universidad de San Martin de Porres, Peru.
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Background: School timings could influence teens' sleeping patterns by interrupting their sleep or the timing of light can shift their biological clock. The COVID-19 pandemic has altered teens' sleeping schedule making it important to analyze the effects of long-term social distancing on adolescents' sleep and mood. Objective(s): This study analyzes the effects of long-term social distancing, due to the COVID-19 pandemic, on their sleeping patterns and mood. Method(s): In this cohort study, data from the 2018 - 2020 Korea Youth Risk Behavior Web-based Survey (KYRBS) were used to compare teens' sleep patterns in 2020 with those in 2018 - 2019. The primary outcomes of this study were the sleep duration and sleep time of adolescents throughout the week, between 2018 and 2019, and in 2020. The secondary outcomes were the teens' mood, health perception, and sleep satisfaction, including differences in total sleep time and sleep discrepancies between weekends and weekdays. Result(s): Around 58 - 63 thousand students were surveyed each year, and the participation rate was 94.9 - 95.6%. After exclusion, 132,839 teens participated in the survey. From 2018-2020, the height and body weight of the participants did not change. After adjusting for participants' sex and school year, it was found that more teens felt happy, fewer teens experienced sadness and desperation, and fewer teens had suicidal thoughts in 2020, compared with the previous two years. They also slept 10 minutes later (9.743 (95% confidence interval 7.954-11.530)), with wake-up times of 3 - 5 minutes later on weekdays (4.684 (3.449-5.919)). On weekends during social distancing, they slept 16 minutes later (15.721 (14.077-17.366)), with wake-up times of 12 minutes later (12.309 (10.393-14.225)). Although they slept five minutes less on weekdays (-5.059 (-6.817 to-3.301)) and three minutes less on weekends (-3.413 (-5.419 to-1.407)), their overall sleep satisfaction increased, and differences in sleep duration between weekdays and weekends decreased in 2020. Conclusion(s): During social distancing, the mood and sleep efficiency of teens improved. In the future, once the COVID-19 pandemic subsides, online classes can be included in the curriculum of school systems to ensure healthy sleep patterns in teenagers.Copyright © 2023, Author(s).
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Background: Physical activity has been shown to have a positive impact on cystic fibrosis (CF) symptoms and slows decline in lung function. Additionally, moderate-intensity activities have been shown to improve sputum expectoration and oxygen saturation in children with CF, improving symptoms [1]. This study assessed whether using fitness trackers and providing a daily step goal would increase physical activity in hospitalized children with CF. Method(s): This pre-post pilot study included participants aged 6 to 21 who were admitted to the hospital for a pulmonary exacerbation of CF between October 2020 and November 2021. Garmin vivosmart 4 wrist-based activity trackers were issued, and baseline datawere tracked and analyzed for the first 2 study days. Pre-goal number of steps was defined as average number of steps taken on those 2 days. On study day 3, a step goal and menu of activities designed to increase physical activity were shared with the participants. Steps after goal settingwere defined as average number of steps taken on study day 3 and beyond while hospitalized, excluding day of discharge. Data collected from the medical record and the activity tracker web-based profile included daily oxygen requirement, daily step count, sleep duration, overnight pulse oximetry levels, resting heart rate, calories expended, and intensity minutes. The primary outcome of change in daily steps and attainment of step goals was analyzed using descriptive statistical testing, means, and standard deviations. Outpatient data were collected for 3 months to observe adherence to goals after discharge. Result(s): Eight participants aged 6 to 18 completed the study. Hospital length of stay ranged from 4 to 14 days. Participants took an average of 1508 +/- 1078 steps before goal setting, which increased to an average of 3704 +/- 1555 steps after the intervention. Step goals were met 56% of the time, although these data were highly variable. During the first week after hospital discharge, participants took an average of 6303 +/- 1786 steps per day (Figure 1).(Figure Presented) Figure 1. During the intervention, patients met their step goal 56% of the time, although this was highly variable. Two patients met their goal 100% of the time (9- year-old boy, 7-year-old girl), two met it 0% of the time (18-year-old boy, 17-year-old girl), one met it 44% of the time (6-year-old boy), and the remaining three met it 67% of the time (10-year-old girl, 17-year-old girl, 14-year-old boy). Conclusion(s): This intervention shows promise, with daily number of steps doubling from baseline during the intervention period. There was great variability among participants, suggesting that the approach helps some more than others. Enrollment was initially planned for 20 patients, but the SARS-CoV-2 pandemic and changes to CF therapy reduced hospitalizations during the study period. Outpatient data were analyzed for only the first week after discharge because of poor adherence to wearing the device. Although our results showa positive impact, further research is needed to determine the effect such an intervention would have on a larger scale. Future directions of research include determining potential clinical benefit from increased activity during hospitalization and prolonged follow-up to assess long-term benefits of intervention.Copyright © 2022, European Cystic Fibrosis Society. All rights reserved
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As consumer sleep technology becomes ubiquitous, sleep clinicians are tasked with navigating these new technologies and must decide if and how to incorporate these technologies into a typical sleep clinical visit. We explore the potential applications of wearables, nearables, and apps in sleep medicine and consider how our acceptance of technology has changed since the COVID-19 pandemic. © 2023 Elsevier Inc. All rights reserved
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Many expectations placed on students by society have made stress a part of their academic lives. Youth are susceptible to the issues brought on by academic stress since they are going through a phase of transitions in both aspects i.e personal and social. Academic stress has been shown to lower academic achievement and lower motivation toward academics. Therefore, it becomes crucial to develop appropriate and effective intervention options. In recent times, due to COVID, the utilization of online health blogs and sites recommending health, exercise, and yoga has been significantly increased. The blog will provide solution to a problem and then provide precautions to common people but they lack the dynamics to suggest yoga that can be done any person or a personalized yoga by considering their health condition and not a static article. This research work intends to develop an AI model to predict the possible practices a student can do to alleviate their problem by considering their BPM, blood pressure (both systole and diastole), sleep time and some questions related to stress. The proposed stress prediction model has achieved an accuracy of 94.4% and the yoga pose recommendation system has achieved an accuracy of 97.3%. © 2022 IEEE.
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Background and Aim: In 2019, the World Health Organization (WHO) recognized the coronavirus outbreak as a pandemic and a public health emergency of global significance. Recent studies have revealed that these restrictions and women's anxiety of the virus itself may have had an adverse effect on their mental health. Children and family members are spending more time at home;thus, society needs to be conscious of how this is affecting working women's emotional and physical health especially in the absence of any assisting maid. Thus, the purpose of this study was to evaluate how the COVID-19 pandemic lockdown affected working women's physical and mental health. Material(s) and Method(s): To examine the effects of COVID-19 on the physical and emotional health of working women, a cross-sectional survey was conducted. Data is collected using an online survey platform. To investigate the impact of lockdown on the women's mental and physical health, a semi-structured questionnaire comprising a number of open-and closed-ended questions was prepared. Additionally, any mental health disorders and emotional difficulties that developed during lockdown or became worse were enlisted. Another goal was to gauge how much family members understood and were sympathetic to the physical and mental strain the working women were under. Result(s): The study involved 200 women from different states of India. The hours spent in the kitchen and other associated activities increased from 1.5 hours to 5.5 hours when the time between before and during the lockdown was compared. The amount of time spent engaging in physical activity, such as yoga and morning and evening walks, significantly decreased during the lockdown are coming to normal after the lockdown. 68 per cent of those surveyed said that women's behaviour had changed. About 58 per cent of the women suffered physical changes such fatigue, headaches, lower back discomfort, and other issues with women's weight gain. Conclusion(s): Additional research is required to better understand the long-term effects of the COVID-19 pandemic on women's mental health, particularly in regard to the identification of additional variables that may be connected to the pandemic's potentially multiplicative effects on women.Copyright © 2023, Institute of Medico-legal Publication. All rights reserved.
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Introduction: Stress and the ability to cope with stress can influence the health and performance of laboratory technicians. This is especially true in the current circumstances of a global pandemic which has placed a tremendous amount of stress on healthcare professionals, including laboratory technicians. However, there is little to no research in India about the relationship between stress and coping abilities and its influence on health and work performance. Objective(s): To assess the self-reported stress levels, perceived coping effectiveness, coping techniques & health behaviours of lab technicians. Material(s) and Method(s): A cross-sectional observational study was done using a structured questionnaire among 152 lab technicians working in a lab chain across 3 states in Western India. Result(s): The responses indicated that the lab technicians had less than ideal stress levels. 80.3% reported moderate-to-very high stress levels;51.3% slept less than 8 hours of sleep per night;53.3 to 61.2% did not exercise regularly;30.9% consumed less than 2 servings of fruits and vegetables per day;and 9.2% were classified as binge drinkers. When confronted with workplace stress, 34.1% reported that they consumed more food than usual (28.3% reported that they consumed more junk food), 48.1% reported a loss of appetite and eating less food than usual, 45.4% reported losing sleep. Lab technicians in the "high stress and poor coping" group reported a statistically significant higher number of days feeling worried, tense or anxious, sad or depressed. The attitudes of lab technicians to preventive health in the COVID-19 pandemic (especially considering the increased risk of co-morbidities during the COVID-19 pandemic) were also less than ideal: 83.6% did not undergo a preventive health check-up package in the past year, 55.9% had not visited a doctor for a general physical exam in the past year. Conclusion(s): Given the amount of stress and work that has been placed on the diagnostic industry over the past 2 years, it is imperative that we understand the stress levels, coping adequacy and health behaviours of lab technicians who form the backbone of the industry. As the results of this pilot study show, there is an immediate need to implement worksite health promotion programmes focusing on stress reduction, stress management and the development of healthy coping skills.
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COVID-19, more popularly known as novel corona virus, is associated with the respiratory disorder in humans which has been declared as a global epidemic and pandemic in the first quarter of the year 2020 by the world health organization. During the COVID-19 pandemic, young people's education and social networks were severely disrupted. The inquiry on the experiences of the victims will help the health sector to change the strategies of care during such public health emergency. The lockdown and subsequent school closures established a new life routine for adolescents, centred on spending time with family and temporarily interrupting face-to-face peer relationships. In this regard, similar to others, significant autobiographical events. To explore the lived in experiences of the COVID-19 victims. Qualitative approach, with phenomenological research design, was used among 15 COVID 19 victims selected using a non probability convenient sampling technique. A one - one indepth interview was conducted using a semi structured questionnaire with 7 themes. Participants who were affected with severe symptoms for 2-3 days had variant psychological experiences like fear of spread, guilt, scared, anxious. Presence of respiratory and psychological symptoms decreased the sleep. Role change had been identified in the family support. Economic needs were manageable with their savings and monthly salary. Practicing spiritual values were the background for the recovery of the victims. The study has brought the perception of approaching the disease with positive attitude for speedy recovery.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: Physical activity (PA) involves various aspects of daily life and is beneficial for health, however, after a stroke PA is lower, causing a decreased health related quality of life (HRQOL). In turn, subjects who perform less PA sleep more hours than recommended, being a risk factor for stroke. The effects generated by these variables could be enhanced under the current health context associated with SARS-CoV-2. Objective(s): To correlate PA, hours of sleep and HRQOL after a stroke. Method(s): Descriptive cross-sectional design. PA, sleep and HRQOL were measured using ActivPAL for 7 days, home diary and the ECVI-38 scale, respectively. Result(s): The sample made up of 3 men and 3 women walked 4,519 steps/day (SD +/- 2710), made 37.27 seated-standing transitions per day (SD 16.16), spent 7.63 hours sitting/day (SD +/- 3.11), stood 5.18 hours/day (SD +/- 3.21), walked 1.17 hours/day (SD +/- 0.68), slept 8.5 hours/day (SD +/- 1.30). A negative correlation was found between the number of steps per day and ECVI-38. No correlation was found between PA and hours of sleep. Conclusion(s): Increasing PA is essential for HRQOL as a prevention tool for stroke and CVD. The evidence and findings of this study invite consensus to classify PA and consider the hours of sleep, aspects that are closely related to health after a stroke.Copyright © 2023 Authors. All rights reserved.
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Background: People with post-COVID syndrome (PCS) suffer from persisting symptoms, e.g. self-reported sleep disorders (31%). However, sleep has not yet been objectively measured by polysomnography (PSG) in PCS. Objective(s): To examine differences in sleep characteristics between PCS and healthy controls (HC). Method(s): People with PCS and HC were included in this prospective trial. All subjects performed baseline characteristics, 1-minute sit-to-stand test (STST), subjective impairments of sleep and a single night sleep assessment in a sleep lab via PSG and Whoop strap (digital health coach). Post-COVID functional scale (PCFS) and Ordinal Scale for Clinical Improvement (OSCI) were assessed only in PCS. Result(s): To date, 20 PCS patients (49+/-11y, FVC 87+/-12%pred., DLCO: 81+/-19%pred., PCFS: 2.8+/-0.9, OSCI: 2.7+/-1.3pts) and 3 HC (44+/-9y, FVC 92+/-3%pred., DLCO 105+/-25%pred.) completed the trial. Only PCS patients reported an impaired sleep ("Is your sleep impaired since COVID?" [yes: 89%]) mainly due to insomnia in the middle of the night (61%). Total sleep time and the distribution of sleep stages (light, deep, REM) were comparable between PCS and HC. The REM latency trended to be longer in PCS vs. HC (114+/-51 vs. 52+/-17 min.). Apnea-hypopnea index (AHI) trended to be higher in PCS (8.9+/-8.5 vs. 0.9+/-1.2 events/h), 55.6% of PCS reported an AHI>5/h. The individual quality of recovery after the study night was classified to be "adequate" (PCS: 56+/-21%, HC: 52+/-15%). Conclusion(s): In PCS, sleep seems to be subjectively and objectively impaired compared to HC. A significant number of PCS patients (44%) was diagnosed with obstructive sleep apnea. Hence, measuring sleep might be an important diagnostic tool in the management of PCS.
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Introduction: A novel coronavirus disease (COVID-19) was initially reported in China in December 2019. In a few months, the virus spread rapidly across the globe, and on 30 January 2020 the World Health Organization (WHO) declared the outbreak to be a Public Health Emergency of International Concern. Objective(s): The main objective of the study is to find the frustration intolerance, self-efficacy and sleep quality in medical students during pandemic of COVID-19. Material(s) and Method(s): This cross sectional study was conducted in University of Lahore during 2021-2022. The data was collected through questionnaire. The questionnaire covered sleep conditions, stores of infection control supplies, mood and stress, usage of social media and sources of acquiring COVID-19 information, risk perception, and sociodemographic data. Result(s): The data was collected from 200 patients. About half of them were young-aged (55.0%) and married (49.1%). In terms of social media use, 57.8% spent more than 2 h per day. With regard to sleep deterioration after the COVID-19 outbreak, the weighted proportions of those who reported worsening sleep quality, worsening sleep initiation, and shortened sleep duration were 38.3%, 29.8%, and 29.1%, respectively. The weighted prevalence of current clinical insomnia was estimated at 29.9%. Practical implication: This study will help to find out the effect of COVID-19 on sleep quality, sleep initiation and duration among Pakistani population. Conclusion(s): It is concluded that COVID-19 is widely spreading in Pakistan and it effects on their sleep quality, sleep initiation, and sleep duration had worsened since the outbreak of COVID-19. This study identified high prevalence of frustration intolerance and poor sleep quality in medical students during pandemic of Covid-19.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.
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The coronavirus disease 2019 (COVID-19) pandemic has led to considerable stress and anxiety, adversely affecting the quality of the sleep. A study was conducted to evaluate if the COVID-19 pandemic had any effects(s) on the sleeping pattern and on overall sleep quality. Study was conducted as a cross sectional, questionnaire-based survey in Indian population on an online platform utilising Pittsburgh Sleep Quality Index (PSQI) to assess pattern and quality of sleep before and during the pandemic. The survey questionnaire was conducted during pandemic;hence the data collected for "before pandemic” duration was retrospective. A total of 1615 participants' responses were received of which there were 756 female and 859 male participants. The mean PSQI score (global) before the pandemic was 4.68 ± 2.98 while that during the pandemic is 6.02 ± 3.62 indicating a significant change in the sleep quality. The proportion of poor sleepers also increased dramatically from 26.1% pre-covid to 49.3% during covid. Both sleep deprivation and poor-quality of sleep are well-known to produce significant mood disturbances and to lower the immunity. Thus, it can be extrapolated that those individuals who developed significant sleep disturbances during COVID-19 are likely to be at a greater risk for negative health consequences even if they did not develop active COVID-19 infection. As sleep is vital for both mental and physical health of the human body, adequate measures should be taken at an individual level as well as at the community level to maintain quality of the sleep during pandemic or other disasters like war that trigger considerable stress.
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Introduction: COVID-related lockdown led to a radical modification of daily activities and routines which are known to affect sleep. Compared to the general population, participants with autism may be particularly vulnerable to the repercussions of lockdown on sleep, given their intrinsic inflexible adherence to routines and the high overall prevalence of sleep disturbances in this population. Method(s): The study is a French nation-wide online survey assessing sleep-wake rhythms and behaviours known to affect sleep (daily screen time, daylight exposure, physical activity), before and during COVID-related lockdown. Respondents were 207 adults with autism (56% female) and 1652 adults of the general population (77% female), with a mean age 35.3 years (SD 11.3). Between group comparison (before, during and difference between before and during lockdown) were conducted using logistic regressions adjusted on age and sex. Within group comparison (comparing before and during lockdown) were conducted using paired analyses (Mantel-Haenszel or Wilcoxon rank test accordingly). Result(s): Before lockdown, the adults with autism displayed on average later chronotype, lower sleep quality, more evening screen time, less exposure to daylight and less exercise (all p < 0.01). Lockdown affected all studied measures of sleep and related exposures in a similar way in both groups: Poorer self-rated sleep quality as well as a less regular and delayed sleep-wake rhythm, longer screen time in the evening and less exposure to daylight (all p < 0.001). However, modification in sleep duration was not linear, with an increase of extremes (less than 6 h and more than 10 h) in both groups. Conclusion(s): Adults with autism displayed significantly higher levels of sleep and circadian rhythm disturbances and less favourable daily routines known to regulate sleep. While the effect of confinement on sleep and sleep related behaviours was similar in both groups, the results highlight that the pre-existing shift in circadian rhythms and lifestyles in adults with ASD further deteriorated during lockdown.
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Objectives/Introduction: Insomnia is the most prevalent sleep disorder worldwide and cognitive behavioural therapy is the front-line treatment. Digital health technologies have a role to play in screening and delivering interventions remotely and without the need for human intervention. The KANOPEE app, which provides a screening and behavioural intervention for insomnia symptoms through an interaction with a virtual agent, showed encouraging results in previous studies during and after the COVID-19 lockdown, but has not yet been evaluated in a controlled study. This study aims at comparing the benefits of KANOPEE, a smartphone application proposing repeated interactions with a virtual companion to screen and deliver personalized recommendations to deal with insomnia complaints;with another application proposing an electronic sleep diary and named "My Sleep Diary". The acceptance and potential benefits of these digital solutions are demonstrated in real-life settings (i.e., without soliciting human medical resources) and in the general population. Method(s): Subjects were included if they downloaded one of the apps between December 2020 and October 2021;and were of legal age. Both apps are available on downloading platforms in France and both groups were equivalent in terms of baseline characteristics. Primary outcome was Insomnia Severity Index (ISI) and secondary outcomes were Total Sleep Time (TST) and Sleep Efficiency (SE). Result(s): 535 users completed the 17-day intervention with KANOPEE and 489 users completed My Sleep Diary for 17 days. A differential effect was obtained for KANOPEE users compared to My Sleep Diary users regarding ISI score (interaction Time x Group: F [2,2014] = 16.9, p < 0.001) and TST (KANOPEE users gained 48 min of sleep after intervention, while My Sleep Diary users gained only 16 min of sleep). Patients with the most severe ISI score (>15) benefited the most from KANOPEE (interaction severity x Time: F [4,2014] = 26.3, p < 0.001). Conclusion(s): KANOPEE provides significantly greater benefits than an electronic sleep diary regarding reduction of insomnia complaints in a self-selected sample of the general population.
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Objectives/Introduction: Sleep regulation in humans is tightly linked to social time pressure (STP) that assigns local time to meals, work, family time, and additional daily activities. The impact of the STP decrease on daily rest-activity cycles during COVID-19-mandated social restrictions (SR) has been studied epidemiologically by our and other research groups. These studies consistently showed that nocturnal sleep duration (SD) increased, social jetlag (SJL) decreased, and mid-sleep times on free days (MST, a proxy for chronotype) delayed during SRs. Here, we investigated in the Global Chrono Corona Survey (GCCS) dataset changes in the interrelationships between the temporal organization of daily sleep-wake and fasting parameters under regular, strict (before the SRs) and relaxed (during SR) STP in the general population. Method(s): The GCCS was conducted during the first wave of SRs between April 4 and May 6, 2020 in 40 countries. The final sample consisted of 7,517 respondents (68.2% females), who did not contract COVID-19 virus, and had been on average 32.7 +/- 9.1 days under SRs. Daily eating patterns were quantified in terms of fasting duration from the last to the first meal (FD) and its timing represented by the midfasting time (MFT). To assess the magnitude of fasting and sleep cycles (mis)alignment, we introduced two new factors: The difference in fasting and sleep duration (DELTAFDSD) and the difference between the two midpoints (DELTAMFMS). Result(s): Before SRs, sleep and fasting parameters showed multiple robust correlations, both in their timing (rho = 0.45), and their duration (rho = 0.25). DELTAMFMS correlated negatively with MST (chronotype), indicating that the later chronotype the larger fasting-sleep misalignment. DELTAMFMS correlated also with the SJL (rho = -0.47). During SRs, FD became longer by 41 min, mainly driven by later breakfast times. SD increased on average by 15 min. Mean DELTAFDSD increased by 15 min, while DELTAMFMS remained unchanged. The correlation between MST and MFT was substantially strengthened (rho = 0.65);MST became correlated with FD (rho = 0.21). Conclusion(s): During weeks-long reduced social time pressure, induced by social restrictions, sleep and fasting parameters became more tightly linked. Relaxed STP may promote co-alignment of daily fasting and sleep cycles and benefit overall health.
ABSTRACT
Objectives/Introduction: Fatigue in airline pilots can arise from multiple sources, including human factors, environmental factors such as weather or noise, busy schedules, unforeseen day-of-operation changes like flight delays, or COVID-related precautions like maskwearing. Fatigue from multiple sources creates a compound safety risk. Job experience or sleep debt may affect how individual pilots experience fatigue during operations. Neither multi-source fatigue factors nor the role of individual differences been examined in the context in medium-haul flights. Method(s): Pilots working medium-haul rosters for a major European airline were asked to rank the level of fatigue they experience from 30 separate factors across five domains: (1) Human;(2) Environmental;(3) Scheduling;(4) Day-of-Operation;and (5) COVID-related. Pilots were also asked to provide experience information-total flight h, age, rank-and to indicate their normal sleep duration and minimum sleep need to perform. Sleep debt was computed as normal sleep - minimum sleep need. Rank differences in flight h, age, and sleep debt were examined using t-tests. One-way analysis of variance (ANOVA) was used to examine the role of experience and sleep debt on overall fatigue, as well as fatigue for each fatigue sub-domain. Result(s): N = 135 medium-haul pilots (64 Captains;71 First Officers (FO);mean age: 43 +/- 2 years) completed the online survey. Pilots reported needing a minimum of 5.5 +/- 1 h of sleep;sleep debt did not differ by rank (t = 1.22;p = 0.22). Captains were ~11 years older than FOs (t = 11.28;p < 0.001) and had 7801 +/- 860 more flight h (t = 17.88;p < 0.001). Captains reported more human factors (F = 9.53;p = 0.002), environment (F = 9.32;p = 0.003), day-of-operation (F = 7.48;p < 0.001), and overall fatigue (t = 3.20, p = 0.002) compared to FOs. Greater sleep debt predicted greater human factors (F = 4.20;p = 0.042), scheduling (F = 8.95;p = 0.003), and day-of-operation fatigue (all p <= 0.04). COVID fatigue was not related to experience or sleep debt (all p > 0.09). Conclusion(s): Captains may experience more fatigue than FOs, particularly in domains related to executive decision-making (human, environment, day-of-operation). Pilots with greater sleep debt may experience more fatigue related to circadian (scheduling, day-ofoperation) or interpersonal factors (human) regardless of rank. COVID-related fatigue is not predicted by sleep or rank. These findings provide targets for fatigue mitigation due to compound risk.