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1.
J Nurs Adm ; 51(11): 543-545, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1504076

ABSTRACT

Sufficient sleep is vital to the health and safety of healthcare workers and patients alike. Despite this, formal sleep promotion programs rarely exist within healthcare. Guidance does exist for how to incorporate strategies within healthcare organizations. Nurse leaders can spearhead efforts by promoting healthy sleep and instituting change through scheduling practices, unit policies, and supporting staff when barriers to healthy sleep develop.


Subject(s)
COVID-19/psychology , Health Personnel/psychology , Nursing Staff, Hospital/psychology , Organizational Innovation , Sleep/physiology , Fatigue/etiology , Humans , Leadership , Organizational Culture
2.
Psychiatry Res ; 301: 113863, 2021 07.
Article in English | MEDLINE | ID: covidwho-1474998

ABSTRACT

The COVID-19 pandemic and its accompanying infection control measures introduced significant disruptions to the routines of many higher education students around the world. It also deprived them of in-person counselling services and social support. These changes have put students at a greater risk of developing mental illness. The objective of this review is to assess the prevalence of depressive symptoms, anxiety symptoms and sleep disturbances in higher education students during the pandemic. A systematic search of English and Chinese databases was conducted current to January 1st, 2021. The quality of included studies was evaluated using a modified Newcastle-Ottawa scale. Prevalence of depressive symptoms, anxiety symptoms and sleep disturbances were pooled using random-effects meta-analysis. Eighty-nine studies (n=1,441,828) were included. The pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances was 34%, 32% and 33%, respectively. The prevalence values differ based on geographical regions, diagnostic criteria, education level, undergraduate year of study, financial situation, living arrangements and gender. Overall, the prevalence of depressive symptoms and anxiety symptoms synthesized in this study was higher compared to pre-pandemic prevalence in similar populations. Evidently, mental health screening and intervention should be a top priority for universities and colleges during the pandemic.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Sleep Wake Disorders/epidemiology , Students/psychology , Anxiety/psychology , COVID-19/epidemiology , Depression/psychology , Female , Humans , Male , Pandemics , Prevalence , SARS-CoV-2 , Sleep/physiology , Universities
3.
PLoS One ; 16(8): e0256063, 2021.
Article in English | MEDLINE | ID: covidwho-1354765

ABSTRACT

The COVID-19 pandemic incited unprecedented restrictions on the behavior of society. The aims of this study were to quantify changes to sleep/wake behavior and exercise behavior, as well as changes in physiological markers of health during COVID-19 physical distancing. A retrospective analysis of 5,436 US-based subscribers to the WHOOP platform (mean age = 40.25 ± 11.33; 1,536 females, 3,900 males) was conducted covering the period from January 1st, 2020 through May 15th, 2020. This time period was separated into a 68-day baseline period and a 67-day physical distancing period. To provide context and allow for potential confounders (e.g., change of season), data were also extracted from the corresponding time periods in 2019. As compared to baseline, during physical distancing, all subjects fell asleep earlier (-0.15 hours), woke up later (0.29 hours), obtained more sleep (+0.21 hours) and reduced social jet lag (-0.13 hours). Contrasting sleep behavior was seen in 2019, with subjects falling asleep and waking up at a similar time (-0.01 hours; -0.03 hours), obtaining less sleep (-0.14 hours) and maintaining social jet lag (+0.06 hours) in corresponding periods. Individuals exercised more intensely during physical distancing by increasing the time spent in high heart rate zones. In 2020, resting heart rate decreased (-0.90 beats per minute) and heart rate variability increased (+0.98 milliseconds) during physical distancing when compared to baseline. However, similar changes were seen in 2019 for RHR (-0.51 beats per minute) and HRV (+2.97 milliseconds), suggesting the variation may not be related to the introduction of physical distancing mandates. The findings suggest that individuals improved health related behavior (i.e., increased exercise intensity and longer sleep duration) during physical distancing restrictions. While positive changes were seen to cardiovascular indicators of health, it is unclear whether these changes were a direct consequence of behavior change.


Subject(s)
Exercise/physiology , Health Behavior , Physical Distancing , Sleep/physiology , Wearable Electronic Devices , Adult , COVID-19 , Female , Health Promotion , Humans , Male , Middle Aged , Pandemics , Retrospective Studies
4.
Thorax ; 76(7): 704-713, 2021 07.
Article in English | MEDLINE | ID: covidwho-1322844

ABSTRACT

BACKGROUND: Poor sleep may contribute to chronic kidney disease (CKD) through several pathways, including hypoxia-induced systemic and intraglomerular pressure, inflammation, oxidative stress and endothelial dysfunction. However, few studies have investigated the association between multiple objectively measured sleep dimensions and CKD. METHODS: We investigated the cross-sectional association between sleep dimensions and CKD among 1895 Multi-Ethnic Study of Atherosclerosis Sleep Ancillary Study participants who completed in-home polysomnography, wrist actigraphy and a sleep questionnaire. Using Poisson regression models with robust variance, we estimated separate prevalence ratios (PR) and 95% CIs for moderate-to-severe CKD (glomerular filtration rate <60 mL/min/1.73 m2 or albuminuria >30 mg/g) among participants according to multiple sleep dimensions, including very short (≤5 hours) sleep, Apnoea-Hypopnoea Index and sleep apnoea-specific hypoxic burden (SASHB) (total area under the respiratory event-related desaturation curve divided by total sleep duration, %min/hour)). Regression models were adjusted for sociodemographic characteristics, health behaviours and clinical characteristics. RESULTS: Of the 1895 participants, mean age was 68.2±9.1 years, 54% were women, 37% were white, 28% black, 24% Hispanic/Latino and 11% Asian. Several sleep metrics were associated with higher adjusted PR of moderate-to-severe CKD: very short versus recommended sleep duration (PR=1.40, 95% CI 1.06 to 1.83); SASHB (Box-Cox transformed SASHB: PR=1.06, 95% CI 1.02 to 1.12); and for participants in the highest quintile of SASHB plus sleep apnoea: PR=1.28, 95% CI 1.01 to 1.63. CONCLUSIONS: Sleep apnoea associated hypoxia and very short sleep, likely representing independent biological mechanisms, were associated with a higher moderate-to-severe CKD prevalence, which highlights the potential role for novel interventions.


Subject(s)
Atherosclerosis/complications , Hypoxia/etiology , Renal Insufficiency, Chronic/complications , Sleep Apnea Syndromes/complications , Sleep/physiology , Actigraphy , Aged , Aged, 80 and over , Atherosclerosis/ethnology , Cross-Sectional Studies , Female , Humans , Hypoxia/physiopathology , Male , Middle Aged , Polysomnography , Prevalence , Renal Insufficiency, Chronic/ethnology , Risk Factors , Self Report , Sleep Apnea Syndromes/ethnology , Sleep Apnea Syndromes/physiopathology , United States/epidemiology
5.
Sci Rep ; 11(1): 14413, 2021 07 13.
Article in English | MEDLINE | ID: covidwho-1309468

ABSTRACT

Lockdowns imposed to stem the spread of COVID-19 massively disrupted the daily routines of many worldwide, but studies to date have been mostly confined to observations within a limited number of countries, based on subjective reports and surveys from specific time periods during the pandemic. We investigated associations between lockdown stringency and objective sleep and resting-heart rate measures in ~ 113,000 users of a consumer sleep tracker across 20 countries from Jan to Jul 2020, compared to an equivalent period in 2019. With stricter lockdown measures, midsleep times were universally delayed, particularly on weekdays, while midsleep variability and resting heart rate declined. These shifts (midsleep: + 0.09 to + 0.58 h; midsleep variability: - 0.12 to - 0.26 h; resting heart rate: - 0.35 to - 2.08 bpm) correlated with the severity of lockdown across different countries (all Ps < 0.001) and highlight the graded influence of stringency lockdowns on human physiology.


Subject(s)
COVID-19 , Communicable Disease Control/statistics & numerical data , Heart Rate/physiology , Sleep/physiology , Humans , Longitudinal Studies , Multilevel Analysis , Quarantine
6.
Medicine (Baltimore) ; 100(27): e26520, 2021 Jul 09.
Article in English | MEDLINE | ID: covidwho-1299018

ABSTRACT

ABSTRACT: The 2019 coronavirus disease (COVID-19) has spread to the whole world. Psychological and sleep problems among confirmed patients have drawn extensive attention which may be highly related to immune function and inflammatory responses of people. The aim of this study is to examine the correlation of mental health status, sleep quality, and inflammatory markers, virus negative conversion time (NCT) among confirmed patients during the COVID-19 outbreak.A cross-sectional survey was conducted in this study. Data from 66 patients assessed with demographic information, anxious symptom, depressive symptom, stress, and sleep quality were collected using a smartphone-based questionnaire platform and then clinical characteristics and laboratory indicators were collected using case review.Nearly 30% of the participants reported depression, anxiety, perceived pressure, and poor sleep quality. Compared with the group without depression, neutrophil count, and ratio of neutrophil count to lymphocyte count (NLR) in the depression disorder group were increased (P = .028, 0.043). There was also a significant difference in NLR and NCT between the anxiety group and the non-anxiety group (P = .021, .024). Similarly, compared with the good sleep quality group, NLR in the poor sleep quality group was increased (P = .011). Correlation analysis indicated that Self-Rating Depression Scale score was positively related to neutrophil count and NLR (r = 0.366, 0.330, P = .016, .031). The total score of Pittsburgh Sleep Quality Index (PSQI) was negatively related to lymphocyte count (r = -0.317, P = .049), and the sleep disturbance as 1 of the 7 dimensions of PSQI scale was positively correlated with NCT and NLR (r = 0.370, 0.340, P = .020, .034).In our study, confirmed patients were prone to have psychological and sleep problems. The level of inflammation in patients with psychological and sleep problems was higher than that in patients without corresponding problems. The inflammatory level increased with the increase of Self-Rating Depression Scale score, and the lymphocyte count decreased with the increase of the PSQI score. NCT was prolonged in the anxiety group and sleep disturbance was positively correlated with NCT.


Subject(s)
COVID-19/epidemiology , Health Status , Mental Health , SARS-CoV-2 , Sleep Wake Disorders/epidemiology , Sleep/physiology , Adolescent , Adult , Aged , China/epidemiology , Cross-Sectional Studies , Female , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Sleep Wake Disorders/physiopathology , Young Adult
7.
Int J Obes (Lond) ; 45(10): 2277-2280, 2021 10.
Article in English | MEDLINE | ID: covidwho-1294445

ABSTRACT

OBJECTIVE AND METHOD: The stay-at-home order during the COVID-19 pandemic has restricted individuals' social behaviors, and therefore, effected their lifestyle including sleep, diet, and physical activity. Using the cross-sectional study design with a large sample size (N = 30,275) from the mobile health App users in Japan, we show age-dependent lifestyle changes during a nonpunitive "mild lockdown" (from April to May 2020). RESULTS: Sleep onset and offset were delayed on work-days but not on free-days with increased sleep duration and decreased social jetlag, and the changes were more evident in the younger population. Although average weight change was close to none because of the users' characteristic (95% of App users try to lose weight), we investigated an association between lifestyle change and body-weight change. Participants who reported advanced sleep phase during mild lockdown described a weight decrease. In contrast, the delayed sleep phase reported a weight gain. The results were significant after adjustment of confounding factors including physical activity and meal changes. CONCLUSIONS: Although there is cumulative evidence showing a relationship between late chronotype and obesity, it is still unclear about the potential benefit of the chronotype management to control body weight. Thus, to the best of our knowledge, this is the first study investigating the association between chronotype and weight changes by leveraging a large cohort.


Subject(s)
Body Weight/physiology , COVID-19/prevention & control , Mobile Applications , Sleep/physiology , Adolescent , Adult , Aged , Child , Communicable Disease Control , Female , Humans , Japan , Male , Middle Aged , Obesity , Telemedicine/instrumentation , Young Adult
8.
Cephalalgia ; 41(13): 1332-1341, 2021 11.
Article in English | MEDLINE | ID: covidwho-1273200

ABSTRACT

OBJECTIVE: To investigate the association of headache during the acute phase of SARS-CoV-2 infection with long-term post-COVID headache and other post-COVID symptoms in hospitalised survivors. METHODS: A case-control study including patients hospitalised during the first wave of the pandemic in Spain was conducted. Patients reporting headache as a symptom during the acute phase and age- and sex-matched patients without headache during the acute phase participated. Hospitalisation and clinical data were collected from medical records. Patients were scheduled for a telephone interview 7 months after hospital discharge. Participants were asked about a list of post-COVID symptoms and were also invited to report any additional symptom they might have. Anxiety/depressive symptoms and sleep quality were assessed with the Hospital Anxiety and Depression Scale and the Pittsburgh Sleep Quality Index. RESULTS: Overall, 205 patients reporting headache and 410 patients without headache at hospitalisation were assessed 7.3 months (Standard Deviation 0.6) after hospital discharge. Patients with headache at onset presented a higher number of post-COVID symptoms (Incident Rate Ratio: 1.16, 95% CI: 1.03-1.30). Headache at onset was associated with a previous history of migraine (Odd Ratio: 2.90, 95% Confidence Interval: 1.41-5.98) and with the development of persistent tension-type like headache as a new post-COVID symptom (Odd Ratio: 2.65, 95% CI: 1.66-4.24). Fatigue as a long-term symptom was also more prevalent in patients with headache at onset (Odd Ratio: 1.55, 95% CI: 1.07-2.24). No between-group differences in the prevalence of anxiety/depressive symptoms or sleep quality were seen. CONCLUSION: Headache in the acute phase of SARS-CoV-2 infection was associated with higher prevalence of headache and fatigue as long-term post-COVID symptoms. Monitoring headache during the acute phase could help to identify patients at risk of developing long-term post-COVID symptoms, including post-COVID headache.


Subject(s)
Anxiety/etiology , COVID-19/complications , Depression/etiology , Fatigue/etiology , Headache/etiology , Hospitalization/statistics & numerical data , SARS-CoV-2/isolation & purification , Severe Acute Respiratory Syndrome/complications , Anxiety/epidemiology , Anxiety/psychology , COVID-19/diagnosis , COVID-19/epidemiology , Case-Control Studies , Depression/epidemiology , Depression/psychology , Fatigue/diagnosis , Fatigue/epidemiology , Female , Headache/diagnosis , Headache/epidemiology , Humans , Male , Middle Aged , Pandemics , Sleep/physiology , Spain/epidemiology
9.
Sci Rep ; 11(1): 11416, 2021 06 01.
Article in English | MEDLINE | ID: covidwho-1253987

ABSTRACT

The first COVID-19 contagion wave caused unprecedented restraining measures worldwide. In Italy, a period of generalized lockdown involving home confinement of the entire population was imposed for almost two months (9 March-3 May 2020). The present is the most extensive investigation aimed to unravel the demographic, psychological, chronobiological, and work-related predictors of sleep disturbances throughout the pandemic emergency. A total of 13,989 Italians completed a web-based survey during the confinement period (25 March-3 May). We collected demographic and lockdown-related work changes information, and we evaluated sleep quality, insomnia and depression symptoms, chronotype, perceived stress, and anxiety using validated questionnaires. The majority of the respondents reported a negative impact of confinement on their sleep and a delayed sleep phase. We highlighted an alarming prevalence of sleep disturbances during the lockdown. Main predictors of sleep disturbances identified by regression models were: female gender, advanced age, being a healthcare worker, living in southern Italy, confinement duration, and a higher level of depression, stress, and anxiety. The evening chronotype emerged as a vulnerability factor, while morning-type individuals showed a lower predisposition to sleep and psychological problems. Finally, working from home was associated with less severe sleep disturbances. Besides confirming the role of specific demographic and psychological factors in developing sleep disorders during the COVID-19 pandemic, we propose that circadian typologies could react differently to a particular period of reduced social jetlag. Moreover, our results suggest that working from home could play a protective role against the development of sleep disturbances during the current pandemic emergency.


Subject(s)
COVID-19/prevention & control , Pandemics/prevention & control , Sleep Disorders, Circadian Rhythm/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Teleworking , Adolescent , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , COVID-19/psychology , COVID-19/transmission , Circadian Rhythm/physiology , Communicable Disease Control/standards , Female , Humans , Italy/epidemiology , Male , Middle Aged , Photoperiod , Prevalence , SARS-CoV-2/pathogenicity , Sleep/physiology , Sleep Disorders, Circadian Rhythm/etiology , Sleep Disorders, Circadian Rhythm/physiopathology , Sleep Disorders, Circadian Rhythm/psychology , Sleep Initiation and Maintenance Disorders/etiology , Sleep Initiation and Maintenance Disorders/physiopathology , Sleep Initiation and Maintenance Disorders/psychology , Surveys and Questionnaires/statistics & numerical data , Young Adult
10.
Respirology ; 26(7): 700-706, 2021 07.
Article in English | MEDLINE | ID: covidwho-1238471

ABSTRACT

Obstructive sleep apnoea (OSA) now affects one-seventh of the world's population. Treatment of even mild OSA can improve daytime sleepiness and quality of life. Recent modifications to uvulopalatopharyngoplasty may make it a more widely applicable treatment option in selected patients with OSA. Diet and exercise have effects on sleep apnoea severity independent of weight loss. Insomnia has become increasingly common during the coronavirus disease 2019 (COVID-19) pandemic.


Subject(s)
Sleep/physiology , COVID-19/epidemiology , COVID-19/physiopathology , Humans , Narcolepsy/epidemiology , Narcolepsy/physiopathology , Nocturnal Myoclonus Syndrome/epidemiology , Nocturnal Myoclonus Syndrome/physiopathology , Obesity Hypoventilation Syndrome/epidemiology , Obesity Hypoventilation Syndrome/physiopathology , Prevalence , Sleep Initiation and Maintenance Disorders/epidemiology , Sleep Initiation and Maintenance Disorders/physiopathology
11.
Neurosurgery ; 88(4): 785-790, 2021 03 15.
Article in English | MEDLINE | ID: covidwho-1217863

ABSTRACT

BACKGROUND: Retrospective studies have shown high rates of sleep disordered breathing in children with myelomeningocele. However, most patients included in those studies underwent polysomnography because of symptoms, so the prevalence of sleep disordered breathing in this population is unknown. OBJECTIVE: To determine the prevalence of sleep disordered breathing in children with myelomeningocele using screening polysomnography. METHODS: In this cross-sectional study, all children with myelomeningocele seen in a multi-disciplinary spina bifida clinic between 2016 and 2020 were referred for polysomnography regardless of clinical symptoms. Included children had not previously undergone polysomnography. The primary outcome for this study was presence of sleep disordered breathing, defined as Apnea-Hypopnea Index (AHI, number of apnea or hypopnea events per hour of sleep) greater than 2.5. Clinical and demographic variables relevant to myelomeningocele were also prospectively collected and tested for association with presence of sleep apnea. RESULTS: A total of 117 participants underwent polysomnography (age 1 mo to 21 yr, 49% male). The majority were white, non-Hispanic. Median AHI was 1.9 (interquartile range 0.6-4.2). A total of 49 children had AHI 2.5 or greater, yielding a sleep disordered breathing prevalence of 42% (95% CI 33%-51%). In multivariable logistic regression analysis, children with more rostral neurological lesion levels had higher odds of sleep disordered breathing (OR for thoracic, mid-lumbar, and low-lumbar: 7.34, 3.70, 4.04, respectively, compared to sacral level, P = .043). CONCLUSION: Over 40% of a sample of children with myelomeningocele, who underwent screening polysomnography, had significant sleep disordered breathing. Routine screening polysomnography may be indicated in this population.


Subject(s)
Meningomyelocele/diagnosis , Meningomyelocele/epidemiology , Sleep Apnea Syndromes/diagnosis , Sleep Apnea Syndromes/epidemiology , Adolescent , Child , Child, Preschool , Cross-Sectional Studies , Female , Humans , Infant , Male , Meningomyelocele/physiopathology , Polysomnography/methods , Prevalence , Retrospective Studies , Sleep/physiology , Sleep Apnea Syndromes/physiopathology , Young Adult
12.
Sci Rep ; 11(1): 8100, 2021 04 14.
Article in English | MEDLINE | ID: covidwho-1182871

ABSTRACT

Respiratory rhythm (RR) during sniffing is known to couple with hippocampal theta rhythm. However, outside of the short sniffing bouts, a more stable ~ 2 Hz RR was recently shown to rhythmically modulate non-olfactory cognitive processes, as well. The underlying RR coupling with wide-spread forebrain activity was confirmed using advanced techniques, creating solid premise for investigating how higher networks use this mechanism in their communication. Here we show essential differences in the way prefrontal cortex (PFC) and hippocampus (HC) process the RR signal from the olfactory bulb (OB) that may support dynamic, flexible PFC-HC coupling utilizing this input. We used inter-regional coherences and their correlations in rats, breathing at low rate (~ 2 Hz), outside of the short sniffing bouts. We found strong and stable OB-PFC coherence in wake states, contrasting OB-HC coherence which was low but highly variable. Importantly, this variability was essential for establishing PFC-HC synchrony at RR, whereas variations of RRO in OB and PFC had no significant effect. The findings help to understand the mechanism of rhythmic modulation of non-olfactory cognitive processes by the on-going regular respiration, reported in rodents as well as humans. These mechanisms may be impaired when nasal breathing is limited or in OB-pathology, including malfunctions of the olfactory epithelium due to infections, such as in Covid-19.


Subject(s)
Delta Rhythm/physiology , Hippocampus/physiology , Olfactory Bulb/physiology , Prefrontal Cortex/physiology , Respiratory Rate/physiology , Animals , Behavior, Animal/physiology , Electromyography , Male , Motor Activity , Neural Pathways/physiology , Rats , Sleep/physiology , Wakefulness/physiology
13.
Cogn Behav Ther ; 50(3): 246-260, 2021 05.
Article in English | MEDLINE | ID: covidwho-1160475

ABSTRACT

The COVID-19 pandemic has resulted in dramatic changes to sleep patterns and higher prevalence of insomnia, which threaten overall mental and physical health. We examined whether safety behaviors in response to COVID-19, worry in response to COVID-19, and depression predicted insomnia, with age, race, and sex as covariates. A community sample from the United States (n = 321, Mage = 40.02, SD = 10.54; 53.6% female) recruited using online crowdsourcing completed self-report measures in May of 2020 and again three months later. At baseline, our model accounted for 68.1% of the variance in insomnia, with depression as the only significant predictor (ß = .70, p < .001). In the longitudinal analyses, only baseline insomnia symptoms predicted 3-month follow-up insomnia symptoms (ß = .70, p < .001; 67.1% of variance). Of note, COVID-19 worry and some COVID-19 safety behaviors were related to 3-month follow-up safety behaviors, but not insomnia. Our findings demonstrated that depression is an important factor to consider for concurrent insomnia symptoms. Our results have implications regarding the development of interventions for insomnia during the COVID-19 pandemic and suggest that clinicians should consider depression when assessing for and treating insomnia symptoms.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Sleep Initiation and Maintenance Disorders/epidemiology , Adult , Anxiety/physiopathology , Depression/psychology , Female , Humans , Male , Middle Aged , Pandemics , Prevalence , Risk Factors , Self Report , Sleep/physiology , Sleep Initiation and Maintenance Disorders/psychology
14.
J Orthop Surg (Hong Kong) ; 29(1): 23094990211001621, 2021.
Article in English | MEDLINE | ID: covidwho-1156055

ABSTRACT

PURPOSE: The aim of this study was to assess the effects of the COVID-19 pandemic on anxiety, sleep outcomes and change in clinical management practices among orthopaedic surgeons following a nation-wide lockdown. METHODS: We conducted an online cross-sectional study using piloted structured questionnaires with self-reported responses from Indian orthopaedic surgeons. Study participants were identified through social networking sites: Facebook and WhatsApp. The extent of anxiety and sleep quality was assessed by the standardised seven-item Generalised Anxiety Disorder (GAD-7) scale, single-item sleep quality scale, questions on unavailability of personal protective equipment, training module on COVID-19 and change in orthopaedic patient management. RESULTS: One hundred male orthopaedic surgeons responded to the survey with majority (79%) in 30-44 years age group. Severe anxiety scores were observed in 8%; moderate, mild and minimal anxiety was observed in 12%, 27% and 53% surgeons respectively. Changes in management practice due to the pandemic was admitted by 65% respondents. We also observed an association between higher anxiety among surgeons and primary or secondary level of healthcare facility: (p = 0.04). Sleep disturbance was significantly associated with change in management practice to non-operative procedures (p = 0.03). CONCLUSION: Anxiety among orthopaedic surgeons during the COVID-19 pandemic is related to factors like younger age group, working in a primary or secondary healthcare facility. Early recognition of anxiety is essential to prevent serious psychological sequelae.


Subject(s)
Anxiety/etiology , COVID-19/complications , Orthopedic Surgeons/statistics & numerical data , Pandemics , Sleep/physiology , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Comorbidity , Cross-Sectional Studies , Female , Humans , India/epidemiology , Male , Middle Aged , SARS-CoV-2 , Surveys and Questionnaires
15.
Sleep Health ; 7(3): 303-313, 2021 06.
Article in English | MEDLINE | ID: covidwho-1152669

ABSTRACT

The COVID-19 pandemic has resulted in societal-level changes to sleep and other behavioral patterns. Objective data would allow for a greater understanding of sleep-related changes at the population level. About 163,524 active Fitbit users from 6 major US cities contributed data, representing areas particularly hard-hit by the pandemic (Chicago, Houston, Los Angeles, New York, San Francisco, and Miami). Sleep variables extracted include nightly and weekly mean sleep duration and bedtime, and variability (standard deviation) of sleep duration and bedtime. Deviation from similar timeframes in 2018 and 2019 were examined, as were changes in these sleep metrics during the pandemic, relationships to changes in resting heart rate, and changes during re-opening in May and June. Overall, compared to 2019, mean sleep duration in 2020 was higher among nearly all groups, mean sleep phase shifted later for nearly all groups, and mean sleep duration and bedtime variability decreased for nearly all groups (owing to decreased weekday-weekend differences). Over the course of January to April 2020, mean sleep duration increased, mean bedtime shifted later, and mean sleep duration variability decreased. Changes in observed resting heart rate correlated positively with changes in sleep and negatively with activity levels. In later months (May and June), many of these changes started to drift back to historical norms.


Subject(s)
Actigraphy/instrumentation , COVID-19/prevention & control , Physical Distancing , Quarantine , Sleep/physiology , Urban Population/statistics & numerical data , Adolescent , Adult , Aged , Chicago , Female , Florida , Humans , Los Angeles , Male , Middle Aged , New York City , Pandemics , SARS-CoV-2 , San Francisco , Texas , Time Factors , Young Adult
16.
Sensors (Basel) ; 21(6)2021 Mar 13.
Article in English | MEDLINE | ID: covidwho-1136536

ABSTRACT

In the midst of the COVID-19 pandemic, Remote Patient Monitoring technologies are highly important for clinicians and researchers. These connected-health technologies enable monitoring of patients and facilitate remote clinical trial research while reducing the potential for the spread of the novel coronavirus. There is a growing requirement for monitoring of the full 24 h spectrum of behaviours with a single research-grade sensor. This research describes a free-living and supervised protocol comparison study of the Verisense inertial measurement unit to assess physical activity and sleep parameters and compares it with the Actiwatch 2 actigraph. Fifteen adults (11 males, 23.4 ± 3.4 years and 4 females, 29 ± 12.6 years) wore both monitors for 2 consecutive days and nights in the free-living study while twelve adults (11 males, 23.4 ± 3.4 years and 1 female, 22 ± 0 years) wore both monitors for the duration of a gym-based supervised protocol study. Agreement of physical activity epoch-by-epoch data with activity classification of sedentary, light and moderate-to-vigorous activity and sleep metrics were evaluated using Spearman's rank-order correlation coefficients and Bland-Altman plots. For all activity, Verisense showed high agreement for both free-living and supervised protocol of r = 0.85 and r = 0.78, respectively. For physical activity classification, Verisense showed high agreement of sedentary activity of r = 0.72 for free-living but low agreement of r = 0.36 for supervised protocol; low agreement of light activity of r = 0.42 for free-living and negligible agreement of r = -0.04 for supervised protocol; and moderate agreement of moderate-to-vigorous activity of r = 0.52 for free-living with low agreement of r = 0.49 for supervised protocol. For sleep metrics, Verisense showed moderate agreement for sleep time and total sleep time of r = 0.66 and 0.54, respectively, but demonstrated high agreement for determination of wake time of r = 0.83. Overall, our results showed moderate-high agreement of Verisense with Actiwatch 2 for assessing epoch-by-epoch physical activity and sleep, but a lack of agreement for activity classifications. Future validation work of Verisense for activity cut-point potentially holds promise for 24 h continuous remote patient monitoring.


Subject(s)
Accelerometry/instrumentation , Actigraphy/instrumentation , Exercise/physiology , Monitoring, Ambulatory/instrumentation , Sleep/physiology , Telemedicine , Telemetry/standards , Adolescent , Adult , COVID-19 , Female , Humans , Male , Middle Aged , Monitoring, Ambulatory/standards , Pandemics , Reproducibility of Results , SARS-CoV-2
17.
Med Sci Monit ; 27: e930447, 2021 Apr 15.
Article in English | MEDLINE | ID: covidwho-1134483

ABSTRACT

BACKGROUND The present study was designed to reveal the trajectory of self-reported somatic symptom burden and sleep quality over time in patients with COVID-19 and to identify prognostic factors for greater somatic symptom burden and sleep disturbance. MATERIAL AND METHODS Seventy-four patients with COVID-19 were prospectively followed for longitudinal assessment of somatic symptom burden and sleep quality. We used the 8-item Somatic Symptom Scale (SSS-8) and the modified Medical Research Council (mMRC) scale for somatic symptom burden and the Pittsburgh Sleep Quality Index for sleep quality investigation. Univariate and multivariate analyses were performed to identify independent factors associated with somatic symptom burden and sleep quality. RESULTS Although the degree of physical discomfort and sleep quality issues tended to decline during self-quarantine, patients still experienced these problems to a certain degree. Univariate and multivariate analyses showed that SSS-8 scores at admission (relative risk [RR] 1.234, 95% CI 1.075-1.417, P=0.003) and mMRC scores at discharge (RR 2.420, 95% CI 1.251-4.682, P=0.009) were 2 independent prognostic indicators of somatic symptom burden. In addition, muscle pain as a chief complaint (RR 4.682, 95% CI 1.247-17.580, P<0.022) and history of use of hypnotic drugs (RR 0.148, 95% CI 0.029-0.749, P<0.019) were 2 independent indicators of patient sleep quality during hospitalization. CONCLUSIONS To the best of our knowledge, the present study was the first dynamic assessment of the somatic symptom burden and sleep quality in patients with COVID-19 during hospitalization and quarantine after discharge. Patients with high somatic symptom burden at admission, especially muscle pain as the chief complaint, are prone to having a higher physical burden and more sleep disturbance at discharge.


Subject(s)
COVID-19/complications , Cost of Illness , Medically Unexplained Symptoms , Myalgia/epidemiology , Sleep Wake Disorders/epidemiology , Adult , Aged , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/prevention & control , China/epidemiology , Female , Humans , Longitudinal Studies , Male , Middle Aged , Myalgia/diagnosis , Myalgia/etiology , Myalgia/physiopathology , Patient Admission/statistics & numerical data , Patient Discharge/statistics & numerical data , Prognosis , Prospective Studies , Quarantine/statistics & numerical data , Risk Assessment/statistics & numerical data , SARS-CoV-2/isolation & purification , Self Report/statistics & numerical data , Severity of Illness Index , Sleep/physiology , Sleep Wake Disorders/diagnosis , Sleep Wake Disorders/etiology
19.
Diabet Med ; 38(10): e14549, 2021 10.
Article in English | MEDLINE | ID: covidwho-1109524

ABSTRACT

AIMS: Restrictions during the COVID-19 crisis will have impacted on opportunities to be active. We aimed to (a) quantify the impact of COVID-19 restrictions on accelerometer-assessed physical activity and sleep in people with type 2 diabetes and (b) identify predictors of physical activity during COVID-19 restrictions. METHODS: Participants were from the UK Chronotype of Patients with type 2 diabetes and Effect on Glycaemic Control (CODEC) observational study. Participants wore an accelerometer on their wrist for 8 days before and during COVID-19 restrictions. Accelerometer outcomes included the following: overall physical activity, moderate-to-vigorous physical activity (MVPA), time spent inactive, days/week with ≥30-minute continuous MVPA and sleep. Predictors of change in physical activity taken pre-COVID included the following: age, sex, ethnicity, body mass index (BMI), socio-economic status and medical history. RESULTS: In all, 165 participants (age (mean±S.D = 64.2 ± 8.3 years, BMI=31.4 ± 5.4 kg/m2 , 45% women) were included. During restrictions, overall physical activity was lower by 1.7 mg (~800 steps/day) and inactive time 21.9 minutes/day higher, but time in MVPA and sleep did not statistically significantly change. In contrast, the percentage of people with ≥1 day/week with ≥30-minute continuous MVPA was higher (34% cf. 24%). Consistent predictors of lower physical activity and/or higher inactive time were higher BMI and/or being a woman. Being older and/or from ethnic minorities groups was associated with higher inactive time. CONCLUSIONS: Overall physical activity, but not MVPA, was lower in adults with type 2 diabetes during COVID-19 restrictions. Women and individuals who were heavier, older, inactive and/or from ethnic minority groups were most at risk of lower physical activity during restrictions.


Subject(s)
COVID-19/prevention & control , Communicable Disease Control , Diabetes Mellitus, Type 2/physiopathology , Motor Activity/physiology , Sleep/physiology , Accelerometry , Adolescent , Adult , Aged , COVID-19/epidemiology , Communicable Disease Control/methods , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/therapy , Female , Humans , Male , Middle Aged , SARS-CoV-2/physiology , Young Adult
20.
Appl Psychol Health Well Being ; 13(2): 394-405, 2021 05.
Article in English | MEDLINE | ID: covidwho-1093691

ABSTRACT

Previous studies identified the effects of daytime activity, sleep quality and ambient light exposure on individual well-being. These factors have been greatly changed as people are required to stay home during the COVID-19 pandemic; thus, it is necessary to verify whether these factors effect well-being during the pandemic. We recruited 70 adults (females: 46; age range: 31-60) during a high incidence of COVID-19 in China (17-27 February 2020). Both subjective measurements based on self-report scales and objective measurements collected using wrist actigraphy were employed to investigate the effects of night-time sleep and daytime activity on subjective well-being. The actigraphy data show that participants' total sleep time (>8 hr) is sufficient. Self-reported sleep quality was significantly worse than pre-pandemic, and self-reported daytime activity levels significantly decreased during the pandemic. Physical activity was positively related to well-being, both for self-reported daytime activity (r = .346, p = .003) and for objective measurements (r = .234, p = .051). Our study found that sleep and daytime activity levels were negatively affected by the pandemic. However, increased daytime physical activity could potentially reduce these negative effects.


Subject(s)
COVID-19/epidemiology , Emotional Adjustment , Exercise , Sleep , Actigraphy , Adult , China/epidemiology , Exercise/physiology , Exercise/psychology , Female , Humans , Male , Middle Aged , Sleep/physiology , Surveys and Questionnaires , Wrist
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