Acute insomnia disorder in health care workers before and during COVID-19: Rates and predictive factors

ABSTRACT

Introduction: Pandemics such as COVID-19 create population-wide stressors that create a natural laboratory for acute insomnia research. This study investigated risk factors and estimated rates of acute insomnia disorder in health care workers at the onset of the COVID-19 pandemic. Methods: A Qualtrics survey of more than 2300 health care providers was conducted in a single academic health system on May 15th 2020, comprised of practicing attending physicians, residents and fellows in training, advanced practice providers, and nurses. Six hundred and sixty eight responded (29% response rate). The Research Diagnostic Criteria for Insomnia Disorder was used to diagnose Acute Insomnia Disorder. Results: 573 respondent had no missing data pertaining to sleep, with a mean age of 43.4 + 12.5 years and 72% women. The rate of Insomnia Disorder before COVID-19 was 44.5%, while after COVID- 19 it was 64.0% - a statistically significant increase. 10.2% of persons with Insomnia Disorder before COVID-19 stated it had resolved during COVID-19, while 43.4% of persons who did not have Insomnia Disorder before COVID-19 developed Acute Insomnia Disorder during COVID-19 (χ2=145.2;df=1;P<0.0001). New cases of Acute Insomnia Disorder increased with female gender, advancing age, and less time spent in direct patient care. Conclusion: Insomnia Disorder showed high baseline prevalence before COVID-19, followed by a striking increase in incidence in this sample of tertiary care health care workers. The effects of gender and age were similar to what has been previously published as risk factors for insomnia. The surprising finding that less time spent in direct patient care was associated with more cases of Acute Insomnia Disorder might be related to the poorly understood stresses of working from home during COVID-19.