Sleep quality and sleep patterns among recovered individuals during post-COVID-19 among Jordanian: A cross-sectional national study.

This study aims to investigate sleep patterns and quality in patients who had SARS-CoV-2 (COVID-19) infection and to determine the sleep quality and pattern among patients. A cross-sectional design was used to assess sleeping patterns during the post-COVID-19 era for recovered individuals from April 1st, 2022, to June 1st, 2022. The participants had to meet the following requirements: both genders, ages 18 to 70, and previously infected with COVID-19. The prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was 834 (40.6%), and the prevalence of disturbance in sleep quality was 1308 (63.6%). Lower economic status and younger ages in twenties and thirties experienced more disturbances in sleep patterns than other older ages. Many predictors were determined the quality of sleep. These predictors were age (B = .105, P = .00), income (B = .05, P = .035) and educational level (B = .20, P = .006). To sum up, our study found that the prevalence of low sleep quality among the recovered individuals during post-COVID-19 era was moderate, and the prevalence of disturbance in sleep quality was high. The predictors of quality of sleep were age, income, and educational level. Practitioners should be trained to evaluate and manage sleep disturbances, as this comprehensive approach has the potential to reduce mental distress and prevent the consequences of sleep disturbances.

Relationships Between Remote Learning Modalities and Nursing Students' Perceptions of Their Sleep Quality During the COVID-19 Pandemic.

BACKGROUND: The relationship between learning modalities and nursing students' sleep quality during the coronavirus disease (COVID-19) pandemic is unknown. PURPOSE: This study examined the relationships between remote learning and the sleep quality of nursing students during the COVID-19 pandemic. METHODS: Using a cross-sectional descriptive design, 890 nursing students were surveyed online to identify sleeping habits and learning modalities. RESULTS: There were no significant correlations between remote learning hours, self-reported sleep hours, and sleep quality. The asynchronous-only group reported better sleep quality than the in-person and online hybrid group after controlling for health conditions and grade point average. Students who reported that remote learning had impacted their sleep had poorer sleep quality. CONCLUSIONS: This study provides insight into how different learning modalities impact nursing students' sleep quality during the pandemic.

Effects of COVID-19-related psychological distress and anxiety on quality of sleep and life in healthcare workers in Iran and three European countries.

Introduction: The COVID-19 pandemic has considerably affected human beings most of whom are healthcare workers (HCWs) combating the disease in the front line. Methods: This cross-sectional study aims to explore the effects of stress and anxiety caused by COVID-19 on the quality of sleep and life in HCWs, including physicians, nurses, and other healthcare staff. In this global study, we asked 1,210 HCWs (620 and 590 volunteers from Iran and European countries, including Germany, the Netherlands, and Italy, respectively), who age 21-70, to participate in the test. Several measures of COVID-related stress, anxiety, sleep, and life quality, including the 12-item General Health Questionnaire (GHQ-12), Fear of COVID-19 scale (FCV-19S), Beck Anxiety Inventory (BAI), the Pittsburgh Sleep Quality Index (PSQI), and World Health Organization Quality of Life-BREF (WHOQOL-BREF) are recorded. Results: Volunteers reported high rates of stress and anxiety and poor sleep quality as well as lower quality of life. The correlation analysis between the measures is reported. According to the results, regardless of the location, HCWs, predominantly female nurses, developed anxiety and stress symptoms which consequently resulted in lower sleep and life quality. Both for Iranian and the European HCWs, significant differences existed between nurses and the other two groups, with the p-values equal to 0.0357 and 0.0429 for GHQ-12, 0.0368, and 0.714 for BAI measure. Even though nurses reported the most stress, anxiety, fear of COVID-19, lower quality of life and sleep in both countries, and also an increase in other measures as well, there existed no statistically significant difference in FCV-19S, PSQI, and WHOQOL-BREF. Discussion: This study helps to expand our knowledge the effects of pandemics on HCWs and also for healthcare management to predict HCW's mental health conditions in similar situations.

Sleep quality and the evolution of the COVID-19 pandemic in five European countries.

The COVID-19 pandemic has led to lifestyle changes across Europe with a likely impact on sleep quality. This investigation considers sleep quality in relation to the evolution of the COVID-19 pandemic in five European countries. Using panel regressions and keeping policy responses to COVID-19 constant, we show that an increase in the four-week average daily COVID-19 deaths/100,000 inhabitants (our proxy for the evolution of the pandemic) significantly reduced sleep quality in France, Germany, Italy, Spain, and Sweden between April 2020 and June 2021. Our results are robust to a battery of sensitivity tests and are larger for women, parents and young adults. Additionally, we show that about half of the reduction in sleep quality caused by the evolution of the pandemic can be attributed to changes in lifestyles, worsened mental health and negative attitudes toward COVID-19 and its management (lower degree of confidence in government, greater fear of being infected). In contrast, changes in one's own infection-status from the SARS-CoV-2 virus or sleep duration are not significant mediators of the relationship between COVID-19-related deaths and sleep quality.

Digital technology and its impacts on the sleep quality and academic performance during the pandemic.

BACKGROUND: Sleep deficits caused by the overuse of digital technology is observed among medical students. Due to the coronavirus disease 2019 (COVID-19) pandemic, an emergency remote teaching method was put into practice, which may have resulted in changes in the sleep-wake cycle. The balance between the influences of external and internal synchronizers can be affected by sudden alterations in daily life, including changes in nightly habits and sleep quality, which can lead to increased levels of anxiety and reduced functional performance, for example. OBJECTIVE: To understand the relationship between the use of digital technology, changes in the circadian cycle, and academic performance during the pandemic. METHODS: The present is an analytical, cross-sectional, observational study in which a sample of 123 medical students filled out an online questionnaire on self-perception regarding sleep quality and academic performance before and during the pandemic. RESULTS: Assessing changes in sleep quality and productivity, the study revealed that 100% of the students made continuous use of screens before bedtime. Thus, during the period of social distancing and remote classes, 77.2% of the students reported "poor" or "very poor academic performance, which was probably related to the fact that 65.9% of these students were unable to maintain their productivity due to daytime sleepiness. CONCLUSIONS: The prolonged use of screens was associated with poor sleep quality and changes in academic performance, with significant psychological impact. Thus, it is worth emphasizing the importance of sleep hygiene in light of the new forms of teaching implemented during the COVID-19 pandemic.

INTRODUçãO: Observa-se um déficit de sono ocasionado pelo uso excessivo de tecnologias digitais entre estudantes de medicina. Em face da pandemia da doença do coronavírus 2019 (coronavirus disease 2019, COVID-19, em inglês), um método de ensino à distância foi adotado, e pode ter acarretado mudanças no ciclo de sono e vigília. O equilíbrio entre as influências dos sincronizadores externos e internos pode ser afetado por mudanças bruscas na vida diária, isto inclui alterações nos hábitos noturnos e na qualidade do sono, que podem causar aumento dos níveis de ansiedade e redução do desempenho funcional. OBJETIVO: Compreender a relação entre o uso de tecnologias digitais, alterações no ciclo circadiano, e desempenho acadêmico durante a pandemia. MéTODOS: Trata-se de um estudo observacional, analítico e transversal, no qual uma amostra de 123 estudantes de medicina responderam a um questionário online sobre a autopercepção referente à qualidade do sono e ao desempenho acadêmico antes e durante a pandemia. RESULTADOS: Com a avaliação das alterações na qualidade do sono e na produtividade, o estudo revelou que 100% dos alunos faziam uso contínuo de telas antes do horário de dormir. Assim, durante o período de distanciamento social e aulas remotas, 77,2% dos alunos relataram que o desempenho acadêmico era "ruim" ou "péssimo", o que provavelmente estava relacionado ao fato de que 65,9% desses alunos que não conseguiram manter sua produtividade por conta de sonolência diurna. CONCLUSõES: O uso de telas por tempo prolongado foi associado a mudanças relacionadas à baixa qualidade do sono e a mudanças no desempenho acadêmico, com impacto psicológico significativo. Assim, vale ressaltar a importância da higiene do sono diante das novas formas de ensino implantadas durante a pandemia da COVID-19.

Association Between Role Overload and Sleep Quality Among Chinese First-Line Nurses During the COVID-19 Outbreak: The Moderating Effect of Mindfulness.

BACKGROUND: Nurses working during the coronavirus disease 2019 (COVID-19) pandemic have experienced a high incidence of insomnia because of exposure to life-threatening occupational risks. Good sleep is essential for nurses to maintain their ability to care for patients with infectious diseases. PURPOSE: The aim of this study was to assess the influence of role overload on sleep quality and the moderating role of mindfulness. METHODS: A cross-sectional survey design was used in this study, which was conducted between March 20 and April 5, 2020. The survey was completed by 357 nurses who had relocated from Fujian Province to the epicenter of the outbreak in China to treat patients with COVID-19. Role overload, sleep quality, and mindfulness in these nurses were evaluated using the Role Overload Scale, Pittsburgh Sleep Quality Index, and Five-Facet Mindfulness Questionnaire, respectively. RESULTS: Hierarchical regression and other statistical methods were used to analyze the data. Role overload was shown to be positively related to poor sleep quality, and mindfulness was found to be effective in alleviating sleep disorders associated with role overload. CONCLUSIONS: The high risk of sleep disturbance among frontline nurses may be alleviated by reducing their perceived role overload. The identification of mindfulness as a moderating mechanism in the relationship between role overload and sleep quality provides new insights to improve sleep quality in nurses.

Fatigue, sleep quality and mental health symptoms in Brazilian women during the COVID-19 pandemic: longitudinal study.

To assess the impact of the COVID-19 pandemic on the variables of sleep quality, fatigue, anxiety, and depression in healthy Brazilian women. Longitudinal observational study conducted through an online questionnaire with women in 2020 and 2021. The Pittsburgh Sleep Quality Index, the Fatigue Severity Scale and the Hospital Anxiety and Depression Scale were used. The data were analyzed descriptively and the comparison between the data obtained in the first and second evaluation was performed using the McNemar test. A logistic regression was applied to test the association between the variables that showed a significant difference. A total of 235 women responded to the questionnaires. There was a significant increase in fatigue between the two moments (p < 0.05). In the first assessment, depression (OR: 2.39; 95% CI: 1.14-4.99), anxiety (OR: 2.68; 95% CI: 1.37-5.22) and sleep quality (OR: 4.01; 95% CI: 1.71-9.67) were associated with fatigue. In the second assessment, depression (OR: 2.93; 95% CI: 1.19-7.18) and anxiety (OR: 2.69; 95% CI: 1.27-5.71) were associated with fatigue. There was an impact on biopsychosocial aspects during the COVID-19 pandemic, with worsening of fatigue symptoms within a 6-month interval. In addition, fatigue was associated with symptoms of depression and anxiety, and worse sleep quality in the first year of the pandemic, remaining associated with symptoms of depression and anxiety in the second year of the pandemic in the country.

Age-Based Differences in Sleep Quality, Pre-Sleep Arousal, and Psychosocial Factors during the Second Wave Lockdown of the COVID-19 Pandemic in Georgia-A Higher Vulnerability of Younger People.

The COVID-19 pandemic has deeply disrupted sleep and mental health of people around the world. We aimed to investigate age-based differences in the prevalence of and relationship between sleep quality, pre-sleep arousal, and psychosocial factors during the second wave lockdown of the COVID-19 pandemic in Georgia. Data were collected through an online survey (n = 1117). Participants were categorized into four age groups: 18-29, 30-41, 42-53, and 54-70 years. The youngest participants reported the most prevalent disruption of sleep behavior. Overall, 58.3% of respondents were poor sleepers. The Pittsburgh Sleep Quality Index (PSQI) global score was highest in the youngest age group but the difference was not significant. There was a significant difference in the PSQI component scores for subjective sleep quality, sleep latency, and daytime dysfunction, all being worse in young respondents. We also observed a significantly higher prevalence rate of worse sleep quality in the youngest age group, relative to the pre-pandemic period. On the other hand, the oldest respondents showed significantly greater use of sleeping medications. Significantly higher levels of somatic and cognitive pre-sleep arousal, perceived stress, feeling depressed, anxious, and socially isolated were reported by the youngest age group. Study findings indicate a higher vulnerability of younger people to the impact of the COVID-19 pandemic. Assessment of pre-sleep arousal and implementation of specific, age-based interventions may prove beneficial to improve possible consequences of the pandemic on sleep and mental health.

Sleep quality among workers in the health sector exposed to the COVID-19 pandemic.

The ongoing pandemic of coronavirus disease (COVID-19) is a global health crisis that has posed enormous pressure on workers in the health sector (WHS), having a massive impact on their mental health. In this study, we aimed to evaluate the sleep quality of WHS during the pandemic and compare frontline WHS to those who are not directly engaged in the care of COVID-19 patients. This cross-sectional, self-reported online survey assessed the sleep quality of WHS in Austria using the Pittsburgh Sleep Quality Index (PSQI). The same questionnaire was sent out two times. Due to the unequal sample and anonymity of the study participants, we analyzed the data of each time point separate from each other. The first study was conducted in April/May 2020, during the first lockdown in Austria (Study1), and the second study was conducted in July/August 2020, when the social restrictions were loosened (Study2). T-test was used to compare the mean values of PSQI scores between frontline vs. non-frontline WHS, while two two-way ANCOVAs were used to analyze differences in the PSQI mean scores (controlled for age) for male vs. female between frontline vs. non-frontline WHS. During the first lockdown in Austria (Study1) we identified a shorter sleep duration of frontline WHS compared to the non-frontline group, however the difference in global PSQI score between these groups was statistically not significant. In the period after loosened restrictions (Study2) the sleep quality, sleep latency, sleep duration, sleep efficiency and global PSQI score was worse in frontline WHS compared to the non-frontline WHS. Furthermore, female WHS scored higher in the PSQI indicating a worse sleep than male WHS. In addition, nurses and nursing assistants had a higher prevalence of poor sleep quality than other occupational groups. Our results indicate that the COVID-19 pandemic negatively impacts the sleep of WHS, affecting particularly frontline WHS. Preventive interventions aiming to promote good sleep quality in WHS during a healthcare crisis like this pandemic are essential to enhance resilience and mitigate the vulnerability of this specific population.

Analysis of Sleep Quality, Mood Alterations and modifications of some Habits/Behavior during two different Periods of the COVID-19 Pandemic in Argentina / Análisis de la calidad del sueño, alteraciones del humor y modificaciones de algunos hábitos y conductas durante dos diferentes períodos de la pandemia por COVID-19 en Argentina.

The pandemic caused by COVID-19 in the world, in its different periods, produced many changes in sleep and in various areas of mental health. Objectives: To evaluate and to compare sleep quality and aspects of mental health during two different periods of the COVID-19 pandemic, as well as to analyze some changes in habits/behaviors. Subjects and methods: A cross-sectional study was carried out, through an anonymous survey. Demographic information, sleep quality, depressive and anxiety symptoms were analyzed. Of the total, 998 surveys were selected. The survey focused on 2 time periods, from March to July 2020 and from March to July 2021. Results: When sleep quality was compared during the 2020 versus 2021 periods, the percentage of poor sleepers went from 51% to 59% in the second period. Regarding depressive symptoms, it went from 21.1 to 16.3% and the percentage of anxiety symptoms went from 59.5 to 47.6%. Poor sleep quality affected more people in 2021 compared to 2020. The percentage of participants with symptoms of anxiety and depression decreased in 2021. People changed some habits/behaviors, such as: changing routine schedules, acquiring pets, sharing their dreams more, and remembering them more frequently. This article contributes to knowing various aspects of sleep, mood swings and changes in habits/behaviors that occurred during the pandemic in Argentina.

La pandemia provocada por COVID-19 en el mundo, en sus diferentes períodos, produjo muchos cambios en el sueño y en diversas áreas de la salud mental. Objetivos: Evaluar y comparar calidad de sueño y aspectos de la salud mental durante dos períodos diferentes de la pandemia por COVID-19, como así también analizar algunos cambios en hábitos/conductas. Materiales y métodos: Se realizó un estudio de corte transversal, a través de una encuesta anónima de la que participaron 998 personas. La misma se realizó en dos períodos de tiempo. El primer período comprendió de marzo a julio de 2020, el segundo período abarcó de marzo a julio 2021. El análisis consideró: información demográfica, calidad del sueño, síntomas depresivos y de ansiedad. Resultados: Al comparar la calidad de sueño durante los períodos 2020 versus el 2021, el porcentaje de malos dormidores pasó del el 51% al 59% en el segundo período. En cuanto a los síntomas depresivos pasó del 21,1 al 16,3% y el porcentaje de síntomas de ansiedad pasó del 59,5 al 47,6%. La mala calidad del sueño afectó a un número mayor de personas en el 2021 que en el 2020 mientras que el porcentaje de participantes con síntomas de ansiedad y de depresión disminuyó en el año 2021. En la segunda fase de la encuesta las personas modificaron algunos hábitos/conductas como ser: cambiaron horarios de rutina, adquirieron mascotas, compartieron más sus sueños y recordaban con mayor frecuencia los mismos. Este artículo contribuye a conocer diversos aspectos del sueño, los cambios de humor y modificaciones de hábitos/conductas que ocurrieron durante la pandemia en Argentina.

Risk factors for the prevalence of poor sleep quality in lecturers during COVID-19 pandemic in Ethiopia: an institution-based cross-sectional study.

OBJECTIVE: This study was conducted to assess the prevalence and risk factors of poor sleep quality (SQ) among the academic staff at the University of Gondar, Northwestern Ethiopia. DESIGN: An institution-based cross-sectional study was conducted from March to April 2021. A validated, self-administered, standardised Pittsburgh Sleep Quality Index (PSQI) was used to quantify the amount of self-reported poor SQ. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14 software. Binary logistic regressions were computed to determine the association between variables. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05. SETTING: The study was conducted at the University of Gondar, Northwestern Ethiopia. PARTICIPANTS: A total of 607 lecturers participated in this study. OUTCOME MEASURES: The primary outcome is the prevalence of poor SQ, which was measured using the PSQI. RESULTS: Overall response rate was 95.60% (N=607). The age of the participants ranges from 21 to 70 with a mean of 32.39 (SD±6.80) years. The magnitude of poor SQ during the COVID-19 pandemic in the last month was 60.30% (95% CI (56.28% to 64.21%)). Working greater than 10 hours per day (AOR=2.19, 95% CI (1.16 to 4.27)), electronic device use before bedtime (AOR=1.53, 95% CI (1.04 to 2.27)), high-risk perception of COVID-19 infections (AOR=1.60, 95% CI (1.04 to 2.46)) and perceived job stress (AOR=2.15 (95% CI (1.50 to 3.08)) were risk factors for poor SQ. CONCLUSION: The study revealed that the prevalence of poor SQ was high during the COVID-19 pandemic. The finding highlights the importance of optimising the working hours per day, minimising electronic device use before bedtime, promoting risk perception toward COVID-19 infection and developing workplace coping strategies for stress, which play a substantial role in minimising poor SQ.

A study on the changes in life habits, mental health, and sleep quality of college students due to COVID-19.

BACKGROUND: In early 2020, the coronavirus 2019 (COVID-19) pandemic necessitated changes in social behavior to prevent its spread, including holding online classes, implementing social distancing, and allowing employees to telecommute. However, these changes have had a negative impact on people's sleep patterns and mental health, particularly for college students. OBJECTIVE: This study investigated the relationship between mental health and sleep quality according to the changes in lifestyle of college students in the periods before and after COVID-19. METHODS: The study subjects were 164 college students from Korea who had both face-to-face and non-face-to-face college experiences before and after COVID-19. The experiment was conducted using a Google survey, and the participants were recruited from the college community. The general features and lifestyle habits for the individuals were assessed using the AUDIT-K, Delphi method, KGHQ (General Mental Health Scale), and PSQI-K (Pittsburg Sleep Quality Index). RESULTS: The KGHQ and PSQI scores increased with the spread of COVID-19, which means that the mental health and sleep quality of college students deteriorated. 11 categories of variables were further investigated to evaluate changes in lifestyle, and the results indicate significant changes in the number of private meetings per week, monthly drinking, outdoor activity time, electronic device usage time, weekly food delivery, weekly late-night snacks, daily snacks, and daily coffee intake and no significant changes in exercise, smoking, and fast food intake. CONCLUSION: COVID-19 caused many changes in the lifestyle of college students, which adversely affected mental health and sleep.

Changes in life satisfaction, depression, general health and sleep quality of Spanish older women during COVID-19 lockdown and their relationship with lifestyle: an observational follow-up study.

OBJETIVES: To analyse the effects of COVID-19 lockdown on mental well-being variables of older women, and to determine the influence of lifestyle and age on such effects. The hypothesis of the study was that all parameters related to mental well-being would worsen in older women during the COVID-19 lockdown. DESIGN: Observational follow-up study. Pre lockdown measurements were taken before the lockdown. Post lockdown measurements were taken as soon as began the de-escalation. SETTING: Senior centres in the Region of Murcia (Spain). PARTICIPANTS: The sample was composed of 40 older women volunteers, over 54 years of age (mean age=62.35±8.15 years). PRIMARY AND SECONDARY OUTCOME MEASURES: Pre lockdown and post lockdown evaluations were carried out face to face. The following questionnaires were completed: Satisfaction with Life Scale, The Center for Epidemiologic Studies Depression Scale, The Short Form 36 Health Survey, The Pittsburgh Sleep Quality Index, the Global Physical Activity Questionnaire and Prevention with Mediterranean Diet. RESULTS: Post lockdown, a worsening was found in the variables of life satisfaction (p=0.001); depression (p<0.001), quality of life in physical role (p=0.006), pain (p=0.004), emotional role (p<0.001) and mental health (p<0.001); and sleep quality (p=0.018), sleep latency (p=0.004), sleep disturbances (p=0.002) and global sleep quality score (p=0.002). It was found how age influenced the variables of pain (p=0.003) and social role (p=0.047), as well as the influence of a healthy lifestyle on the variables analysed (F=6.214; p=0.017). Adherence to the Mediterranean diet was shown to be a protective factor against increased depression (p=0.03). Spending time sitting was shown to be a risk factor for physical role health (p=0.002), as was advanced age on health due to worsening pain (p=0.005), or an unhealthy lifestyle on increased consumption of sleeping aids (p=0.017). CONCLUSION: The lockdown had a great negative impact on Spanish older women on mental well-being variables. TRIAL REGISTRATION NUMBER: NCT04958499.

Sleep quality, latency, and sleepiness are positively correlated with depression symptoms of Brazilians facing the pandemic-associated stressors of COVID-19.

The severe acute respiratory syndrome coronavirus has implicated on mental health and psychopathological sequelae through viral infection. Suggestively, the pandemic-associated stressors (e.g., isolation, fear of illness, inadequate information and supply) may affect the sleep and feedback the depression symptoms, ultimately decreasing the immune system and offering further opportunities for severe acute respiratory syndrome coronavirus infection. Nevertheless, this association still requires investigation. Therefore, this study aimed to correlate the depression symptoms with sleep variables from subjects facing the restrictions of the ongoing pandemic in Brazil. One hundred sixty-two volunteers (age = 31 ± 13 years; body mass = 69.8 ± 14.9 kg; height = 168 ± 9 cm) answered the Beck Depression Inventory, Pittsburgh Sleep Quality Index/Epworth Sleepiness Scale for determination of depression symptoms and sleep variables, respectively. Significant and positive correlations were obtained between Beck score and sleep quality (r = 0.53; P = .000), sleep latency (r = 0.29; P = .000), and sleepiness (r = 0.22; P = .003), but not with sleep time (r = -0.10; P = .175). This report concluded that Brazilians struggling with pandemic-associated stressors with high depression symptoms may have negative impacts on sleep, mainly regarding its quality, latency, and sleepiness.

Association of depression symptoms and sleep quality with state-trait anxiety in medical university students in Anhui Province, China: a mediation analysis.

BACKGROUND: The prevalence of depression symptoms among medical students is particularly high, and it has increased during the COVID-19 epidemic. Sleep quality and state-trait anxiety are risk factors for depression, but no study has yet investigated the mediating role of state-trait anxiety in the relationship between poor sleep quality and depression symptoms in medical students. This study aims to investigate the relationship among depression symptoms, sleep quality and state-trait anxiety in medical university students in Anhui Province. METHODS: This was a cross-sectional survey of 1227 students' online questionnaires collected from four medical universities in Anhui Province using a convenience sampling method. We measured respondents' sleep quality, state-trait anxiety, and depression symptoms using three scales: the Pittsburgh Sleep Quality Index (PSQI), the State-Trait Anxiety Inventory (STAI) and the Self-rating Depression Scale (SDS). We analysed the mediating role of STAI scores on the association between PSQI scores and SDS scores through the Sobel-Goodman Mediation Test while controlling for covariates. P < 0.05 was considered statistically significant. RESULTS: A total of 74.33% (912) and 41.40% (518) of the respondents reported suffering from poor sleep quality and depression symptoms. Sleep quality, state-trait anxiety, and depression symptoms were positively associated with each other (ß = 0.381 ~ 0.775, P < 0.001). State-trait anxiety partially mediated the association between sleep quality and depression symptoms (Sobel test Z = 15.090, P < 0.001), and this mediating variable accounted for 83.79% of the association when adjusting for potential confounders. Subgroup analysis further revealed that STAI scores partially mediated the association between PSQI scores and SDS scores in females and rural students and fully mediated the association between PSQI scores and SDS scores in males and urban students. CONCLUSIONS: This study found that sleep quality and state-trait anxiety have a significant predictive effect on depression symptoms. State-trait anxiety mediated the relationship between sleep quality and depression symptoms, with a more complex mechanism observed among rural and female medical students. Multiple pathways of intervention should be adopted, such as encouraging students to self-adjust, providing professional psychological intervention and timely monitoring, enriching extracurricular activities, and making changes in policies regarding long shifts and working hours.

Sleep Quality Impairment Is Associated With Pandemic Attitudes During the Coronavirus Disease 2019 (COVID-19) Circuit Breaker Lockdown in England: A Cross-Sectional Study.

Objectives: The COVID-19 pandemic has been associated with sleep quality impairment and psychological distress, and the general public has responded to the pandemic and quarantine requirements in a variety of ways. We aimed to investigate whether sleep quality is low during a short-term (circuit break) quarantine restriction, and whether sleep quality is associated with respondents' overall attitudes to the pandemic using a validated scale. Design and Setting: Online cross-sectional study in England in November 2020. Participants: The study included 502 respondents over the age of 18. Measurements: Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and pandemic attitudes were assessed using the Oxford Pandemic Attitudes Scale-COVID-19 (OPAS-C), a validated 20-item, 7-domain scale that assesses pandemic-related stress, fear, loneliness, sense of community, sense of exaggerated concern, non-pharmaceutical interventions, and vaccine hesitancy. Unadjusted and multivariable logistic regression odds ratios of association were assessed between the dependent variable of poor sleep quality (PSQI>5) and risk factors, including OPAS-C score, age, sex, educational status, and income. Results: The mean (SD) PSQI score was 7.62 (3.49). Overall, 68.9% of respondents met criteria for poor sleep quality using the PSQI cutoff of >5. The mean (SD) OPAS-C score was 60.3 (9.1). There was a significantly increased odds of poor sleep quality in the highest vs. lowest OPAS-C quartiles (OR 4.94, 95% CI [2.67, 9.13], p < 0.0001). Age, sex, income, political leaning, employment status, and education attainment were not associated with poor sleep quality. Conclusions: More than two-thirds of respondents met criteria for poor sleep quality. The odds of poor sleep quality increased in a dose-response relationship with pandemic attitudes (such as higher levels of pandemic-related stress, fear, or loneliness). The association between poor sleep quality and pandemic attitudes suggests opportunities for public health and sleep medicine interventions, and highlights the need for further research.

Effects of COVID-19 lockdown on sleep duration, sleep quality and burnout in faculty members of higher education in Mexico.

This paper aims to assess the differences and associations of the effect of COVID-19 on sleep habits, sleep quality, and burnout symptoms among faculty members of higher education in Mexico. This was a cross-sectional study with a total sample of 214 faculty members of higher education from Mexico between May 18th and June 10th of 2020. We applied questionnaires containing sociodemographic and specific questions regarding sleep habits, sleep quality, and burnout symptoms. The results show that during COVID-19 faculty members delayed their bedtime and rise time. No change was found with weekdays time in bed, however, during weekends, time in bed was more than an hour shorter. Social jetlag decreased significantly during COVID-19. Furthermore, during COVID-19, those who reported low sleep quality were more likely to report higher symptoms of emotional exhaustion and those who slept less on weekends were more likely to report higher symptoms of depersonalization. These results suggest that the COVID-19 pandemic may have an effect on sleep and sleep quality and burnout symptoms of faculty members from higher education in Mexico.

Evaluation of Depression, Anxiety, and Sleep Quality in Children Diagnosed With COVID-19.

ABSTRACT: COVID-19 has affected individuals of all age groups, both physically and mentally. We aimed to determine anxiety and depression in children diagnosed with COVID-19. Fifty children aged 8 to 18 years diagnosed with COVID-19 were included in the study. The children were evaluated the revised Child Anxiety and Depression Scale, STAI form TX-I (state anxiety inventory), and STAI form TX-II (trait anxiety inventory). Child Sleep Habits Questionnaire was applied for one of the parents according to three different periods. The periods were established as before the pandemic, during the illness-quarantine process, and after the quarantine. We observed the highest scores for depression-anxiety and the poorest sleep quality during the quarantine period. The scores for depression-anxiety were lower, and sleep quality scores were higher in the prepandemic period compared with after the quarantine period. Measures should be taken to protect mental health for children with COVID-19.