Sleep Problems Increased During COVID-19 Pandemic, Possibly Due to Poor Sleep Hygiene

Sleep problems increased significantly between the first and second COVID-19 pandemic waves, and the interindividual variability surrounding this growth could be explained by detrimental sleep hygiene practices, according to a study in the Journal of Sleep Research.

Worse sleep hygiene practices were linked with a more exaggerated growth in sleep problems between spring 2020 and autumn-winter 2020 (b = .191; P = .013), even after controlling for relevant confounders like demographic factors, COVID-19–related information, and psychological distress.

The COVID-19 pandemic significantly affected physical and mental health around the globe, the researchers noted, and a large body of literature emphasized that sleep quality and sleep habits endured relevant changes during the pandemic.

In this study, researchers aimed to analyze changes in sleep problems across 3 waves of the COVID-19 pandemic and to pinpoint possible predictors of the interindividual variability surrounding these changes with a special focus on the role of damaging sleep hygiene practices.

Woman suffering from depression sitting on bed and crying stock photo | © Adobe Stock

The cohort consisted of 352 participants who completed an online survey of self-report questionnaires during 3 distinctive COVID-19 pandemic waves: T1 (Spring 2020); T2 (Autumn-Winter 2020); and T3 (Spring 2021).

Then, the questionnaires obtained information on sociodemographic and COVID-19–related factors, psychological distress (ie, the Depression Anxiety Stress Scale-21), sleep hygiene (ie, the Sleep Hygiene Index), and sleep problems (ie, the Medical Outcomes Study–Sleep Scale).

An average increase in sleep problems between T1 and T2 with significant interindividual variability was unveiled through latent change score modeling. No substantial changes were seen between T2 and T3 on average.

Also, the latent change score (LTS) model emphasized a significant change in sleep problems between the first pandemic wave and the second pandemic wave.

“Importantly, although the average extent of change was small, we identified significant interindividual variability, indicating that the rate of change was not uniform among all individuals,” the researchers wrote.

They noted that their findings also gave empirical support for the main hypothesis about the role of detrimental sleep hygiene practices in describing changes in sleep problems between T1 and T2. Precisely, the conditional LCS model denoted that individuals who reported poor sleep hygiene showed a greater increase in sleep problems.

Conversely, no average changes in sleep disturbances were seen between the second and third waves, which confirmed on the one hand that the COVID-19 pandemic had a significant impact on sleep problems, but the nonexistence of significant average changes between the second and third waves might be related to an “adaptation” to the pandemic, as suggested by previous studies.

Findings indicated that individuals with higher levels of sleep problems at T1 experienced less deteriorating between T1 and T2, while those with fewer sleep disturbances at baseline possessed a higher increase.

Discoveries of this study expand on former research about the detrimental effects of the pandemic on mental health, suggesting that interventions aimed at sleep hygiene practices might be beneficial for mitigating its damaging impact on sleep disruptions.

Due to these results, researchers argue that possessing a reliable tool to identify sleep hygiene behaviors and the ability to estimate future sleep problems could be beneficial for implementing clinical programs concentrated on insomnia and other sleep alterations in the postpandemic time frame.

This is the first study to analyze sleep changes over 3 waves of the COVID-19 pandemic by implementing an LCS modeling approach to the best of the researchers’ knowledge.

There were some limitations in this study. First, there was a considerable dropout rate across the 3 periods of data collection. Additionally, the majority of the sample was made up of female respondents and young adults, which might limit the generalizability and external validity of the results to male and adult individuals. Therefore, future studies should strive for more representation to strengthen finding generalizability.

“This research serves as an essential update and extension of prior studies on the impact of the pandemic on mental health, suggesting that interventions targeting sleep hygiene practices may prove useful in mitigating the worsening of sleep disturbances during such challenging times,” the authors concluded.

Reference

Zagaria A, Serena S, Musetti A. Poor sleep hygiene practices are associated with a higher increase in sleep problems during the COVID-19 pandemic: a latent change score model. J Sleep Res. Published online September 29, 2023. doi:10.1111/jsr.14057