Sleep Science Friday: Sleep and Sleep Disturbances During the COVID-19 Pandemic – What Can Sleep Research and Sleep Medicine Tell Us? A European Perspective
19 February 2021
We are in the midst of a pandemic that has confined billions of people to their homes for months and has directly impacted daily life across Europe and globally. There is new research on the topic coming out weekly so we are once again dedicating this week`s instalment of SSF to COVID-19. Furthermore, ESRS has planned a deep dive via our upcoming live SSF webinar on the topic.
On 19 March, in recognition of World Sleep Day March 19, 2021, Prof. Dr. Dieter Riemann, Editor in Chief of the Journal of Sleep Research, will host a panel of European experts who will present their research on sleep and sleep disturbances during the COVID-19 pandemic.
Intrigued? To prepare for the webinar on 19 March, start now with the February issue of the Journal of Sleep Research (JSR) where you can already work your way through the reading list that inspired the programme. Below, we highlight four articles which will be further explored in the programme of the webinsr. All research in this series was initiated in Europe. We hope you will be able to join us at 14:00 CET on 19 March to learn more. The webinar is planned to last 90 minutes.
The Covid‐19 pandemic has disrupted the habits of billions of people around the world. Lockdown at home is mandatory, forcing many families, each member with their own sleep–wake habits, to spend 24 hr a day together, continuously. Sleep is crucial for maintaining immune systems and contributes deeply to physical and psychological health. To assess sleep problems and use of sleeping pills, we conducted a cross‐sectional study of a representative sample of the general population in France. The self‐reported sleep complaint items, which covered the previous 8 days, have been used in the 2017 French Health Barometer Survey, a cross‐sectional survey on various public health issues. After 2 weeks of confinement, 74% of the participants (1,005 subjects) reported trouble sleeping compared with a prevalence rate of 49% in the last general population survey. Women reported more sleeping problems than men, with greater frequency or severity: 31% vs. 16%. Unusually, young people (aged 18–34 years) reported sleep problems slightly more frequently than elderly people (79% vs. 72% among those aged 35 or older), with 60% of the younger group reporting that these problems increased with confinement (vs. 51% of their elders). Finally, 16% of participants reported they had taken sleeping pills during the last 12 months, and 41% of them reported using these drugs since the lockdown started. These results suggest that the COVID crisis is associated with severe sleep disorders among the French population, especially young people.
Italy is one of the major COVID‐19 hotspots. To reduce the spread of the infections and the pressure on Italian healthcare systems, since March 10, 2020, Italy has been under a total lockdown, forcing people into home confinement. Here we present data from 1,310 people living in the Italian territory (Mage = 23.91 ± 3.60 years, 880 females, 501 workers, 809 university students), who completed an online survey from March 24 to March 28, 2020. In the survey, we asked participants to think about their use of digital media before going to bed, their sleep pattern and their subjective experience of time in the previous week (March 17–23, which was the second week of the lockdown) and up to the first week of February (February 3–10, before any restriction in any Italian area). During the lockdown, people increased the usage of digital media near bedtime, but this change did not affect sleep habits. Nevertheless, during home confinement, sleep timing markedly changed, with people going to bed and waking up later, and spending more time in bed, but, paradoxically, also reporting a lower sleep quality. The increase in sleep difficulties was stronger for people with a higher level of depression, anxiety and stress symptomatology, and associated with the feeling of elongation of time. Considering that the lockdown is likely to continue for weeks, research data are urgently needed to support decision making, to build public awareness and to provide timely and supportive psychosocial interventions.
COVID‐19 has critically impacted the world. Recent works have found substantial changes in sleep and mental health during the COVID‐19 pandemic. Dreams could give us crucial information about people’s well‐being, so here we have directly investigated the consequences of lockdown on the oneiric activity in a large Italian sample: 5,988 adults completed a web‐survey during lockdown. We investigated sociodemographic and COVID‐19‐related information, sleep quality (by the Medical Outcomes Study‐Sleep Scale), mental health (by the Depression, Anxiety, and Stress Scales), dream and nightmare frequency, and related emotional aspects (by the Mannheim Dream Questionnaire). Comparisons between our sample and a population‐based sample revealed that Italians are having more frequent nightmares and dreams during the pandemic. A multiple logistic regression model showed the predictors of high dream recall (young age, female gender, not having children, sleep duration) and high nightmare frequency (young age, female gender, modification of napping, sleep duration, intrasleep wakefulness, sleep problem index, anxiety, depression). Moreover, we found higher emotional features of dream activity in workers who have stopped working, in people who have relatives/friends infected by or who have died from COVID‐19 and in subjects who have changed their sleep habits. Our findings point to the fact that the predictors of high dream recall and nightmares are consistent with the continuity between sleep mentation and daily experiences. According to the arousal‐retrieval model, we found that poor sleep predicts a high nightmare frequency. We suggest monitoring dream changes during the epidemic, and also considering the implications for clinical treatment and prevention of mental and sleep disorders.
Dealing with sleep problems during home confinement due to the COVID‐19 outbreak: Practical recommendations from a task force of the European CBT‐I Academy
In the current global home confinement situation due to the COVID‐19 outbreak, most individuals are exposed to an unprecedented stressful situation of unknown duration. This may not only increase daytime stress, anxiety and depression levels, but also disrupt sleep. Importantly, because of the fundamental role that sleep plays in emotion regulation, sleep disturbance can have direct consequences upon next day emotional functioning. In this paper, we summarize what is known about the stress−sleep link and confinement as well as effective insomnia treatment. We discuss those effects of the current home confinement situation that can disrupt sleep but also those that could benefit sleep quality. We suggest adaptions of cognitive behavioural therapy elements that are feasible to implement for those facing changed work schedules and requirements, those with health anxiety and those handling childcare and home‐schooling, whilst also recognizing the general limitations imposed on physical exercise and social interaction. Managing sleep problems as best as possible during home confinement can limit stress and possibly prevent disruptions of social relationships.
We hope that we have set you up with some intriguing reading for this pandemic weekend and that you will join us for the first ever live Sleep Science Friday next month on 19 March. Participating in the webinar is free and only requires an internet connection. Register your interest today via the Facebook event. Official registration and the complete programme will be an announced soon. While you are on the event page, leave us a comment. Let us know what you are looking forward to learning more about, how COVID-19 has impacted your practice or research related to sleep or just say hello.
World Sleep Day 2021
World Sleep Day is an advocacy focused activity of the World Sleep Society. The theme of the 14th annual World Sleep day is “Regular Sleep, Healthy Future”. World Sleep Day is provides an opportunity for sleep professionals to share their message, educate the world about the importance of sleep for improved health and look at steps we can take to achieve a healthy future.
Virtual Sleep and Breathing 2021
Interested in still more research on sleep and COVID-19? Then don`t miss the symposium, Sleep in the New Era of COVID, chaired by A. Simonds and J. Verbraecken. at Sleep and Breathing Virtual this April. This symposium aims to discuss the bidirectional relationship of COVID-19 on patients with Obstructive Sleep Apnea and obesity from pathophysiology to therapeutic implications. Moreover the session will present the potential effect of pandemics/endemics on sleep quality and Sleep Disorders beyond SBD. Last but not least, to discuss the challenges that Sleep medicine faces as a result of the pandemic/endemics and ways to move forward. More information: Sleep and Breathing 2021 – Virtual – Programme (ersnet.org)
As many countries are approaching the one year anniversary of the first COVID-19 cases, the world is starting to pay attention to the impact of social isolation and lockdowns on the mental health of individuals. While mental health has always been important for sleep and life, now more than ever, mental health is at the forefront of many discussions. The ESRS Early Career Researcher Network (ECRN) has chosen mental health as it stheme for 2021.
Next week, on 24 February from 10:30 to 11:45 CET, the ECRN will host a talk with Dr. Marissa Edwards on Mental Health in Academia. Dr. Edwards will discuss some of the latest research nto mental health in academic settings with a focus on doctoral students and early career researchers. She will highlight some main factors that contribute to mental illness, stress and poor well being among junior faculty. Take time to participate in this worthwhile presentation. Register now.
Recent publications from ESRS members:
- Arnaldi D, Chincarini A, Hu MT, Sonka K, Boeve B, Miyamoto T, Puligheddu M, De Cock VC, Terzaghi M, Plazzi G, Tachibana N, Morbelli S, Rolinski M, Dusek P, Lowe V, Miyamoto M, Figorilli M, Verbizier D, Bossert I, Antelmi E, Meli R, Barber TR, Trnka J, Miyagawa T, Serra A, Pizza F, Bauckneht M, Bradley KM, Zogala D, McGowan DR, Jordan L, Manni R, Nobili F. Dopaminergic imaging and clinical predictors for phenoconversion of REM sleep behaviour disorder. Brain. 2021 Feb 12;144(1):278-287. doi: 10.1093/brain/awaa365.
- Edouard P, Campo D, Bartet P, Yang RY, Bruyneel M, Roisman G, Escourrou P. Validation of the Withings Sleep Analyzer, an under-the-mattress device for the detection of moderate-severe sleep apnea syndrome. J Clin Sleep Med. 2021 Feb 16. doi: 10.5664/jcsm.9168.
- Florea C, Topalidis P, Hauser T, Angerer M, Kurapov A, Leon CAB, Brandão DS, Schabus M, Sleep during COVID-19 lockdown: A cross-cultural study investigating job system relevance, Biochemical Pharmacology, 2021, 114463, ISSN 0006-2952.
- Lopez R, Chenini S, Barateau L, Rassu AL, Evangelista E, Abril B, Fanielle J, Vitello N, Jaussent I, Dauvilliers Y. Sleep-related head jerks: toward a new movement disorder. Sleep. 2021 Feb 12;44(2):zsaa165. doi: 10.1093/sleep/zsaa165.
- Pelletier-Fleury N, Le Vaillant M, Goupil F, Paris A, Pigeane T, Gagnadoux F, Meslier N; IRSR Sleep Cohort Group. Risk-seeking attitude in health and safety domain is associated with continuous positive airway pressure discontinuation in patients with obstructive sleep apnea-a multicenter prospective cohort study. Sleep. 2021 Feb 12;44(2):zsaa156. doi: 10.1093/sleep/zsaa156.
- Targa A, Dakterzada F, Benítez I, López R, Pujol M, Dalmases M, Arias A, Sánchez-de-la-Torre M, Zetterberg H, Blennow K, Pamplona R, Jové M, Barbé F, Piñol-Ripoll G. Decrease in sleep depth is associated with higher cerebrospinal fluid neurofilament light levels in patients with Alzheimer’s disease. Sleep. 2021 Feb 12;44(2):zsaa147. doi: 10.1093/sleep/zsaa147.
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