The Association between Sleep and Psychological Distress among New York City Healthcare Workers during the COVID-19 Pandemic

ABSTRACT

Background Healthcare workers (HCWs) treating patients with COVID-19 report psychological distress. We examined whether disturbed sleep was associated with psychological distress in New York City (NYC) HCWs during the initial peak of the COVID-19 pandemic (April-May 2020). Methods HCWs completed a survey screening for acute stress (4-item Primary Care PTSD screen), depressive (Patient Health Questionaire-2), and anxiety (2-item Generalized Anxiety Disorder scale) symptoms. Insomnia symptoms (modified item from the Insomnia Severity Index) and short sleep (SS, sleep duration <6 hours/day) were assessed. Poisson regression analyses predicting psychological distress from SS and insomnia symptoms, adjusting for demographics, clinical role/setting, redeployment status, shifts worked, and multiple comparisons were performed. Results Among 813 HCWs (80.6% female, 59.0% white) mean sleep duration was 5.8±1.2 hours/night. Prevalence of SS, insomnia, acute stress, depressive, and anxiety symptoms were 38.8%, 72.8%, 57.9%, 33.8%, and 48.2%, respectively. Insomnia symptoms was associated with acute stress (adjusted prevalence ratio [PR] 1.51, 95% CI 1.35, 1.69), depressive (PR 2.04, 95% CI 1.78, 2.33), and anxiety (PR 1.74, 95% CI 1.55, 1.94) symptoms. SS was also associated with acute stress (PR 1.17, 95% CI 1.07, 1.29), depressive (PR 1.36, 95% CI 1.233, 1.51), and anxiety (PR 1.38, 95% CI 1.26, 1.50) symptoms. Limitations Our cross-sectional analysis may preclude the identification of temporal associations and limit causal claims. Conclusions In our study, SS and insomnia were associated with psychological distress symptoms in NYC HCWs during the COVID-19 pandemic. Sleep may be a target for interventions to decrease psychological distress among HCWs.