Poor sleep hygiene practices are associated with a higher increase in sleep problems during the COVID-19 pandemic: A latent change score model.

The Coronavirus 2019 (COVID-19) pandemic significantly influenced physical and mental health worldwide. The present study aimed to investigate changes in sleep problems across three waves of the COVID-19 pandemic, and to identify potential predictors of the inter-individual variability around these changes, with a particular focus on the role of detrimental sleep hygiene practices. A total of 352 participants completed an online survey of self-report questionnaires at three different waves of the COVID-19 pandemic: T1 (Spring 2020); T2 (Autumn-Winter 2020); and T3 (Spring 2021). The questionnaires collected information on socio-demographic and COVID-19-related variables, psychological distress (i.e. the Depression Anxiety Stress Scale-21), sleep hygiene (i.e. the Sleep Hygiene Index) and sleep problems (i.e. the Medical Outcomes Study-Sleep Scale). Latent change score modelling revealed an average increase in sleep problems between T1 and T2 with significant inter-individual variability. No substantial changes were observed on average between T2 and T3. Notably, poorer sleep hygiene practices were associated with a more pronounced increase in sleep problems between T1 and T2 (ß = 0.191, p = 0.013), even after controlling for relevant confounders such as demographic factors, COVID-19-related information and psychological distress. These findings expand on previous research regarding the detrimental effects of the pandemic on mental health, suggesting that interventions targeting sleep hygiene practices may be beneficial for mitigating its negative impact on sleep disruptions.

Two years after lockdown: longitudinal trajectories of sleep disturbances and mental health over the COVID-19 pandemic and the effects of age, gender, and chronotype.

Since the first lockdown of Spring 2020, the COVID-19 contagion waves pervasively disrupted the sleep and mental health of the worldwide population. Notwithstanding the largest vaccination campaign in human history, the pandemic has continued to impact the everyday life of the general population for two years now. The present study provides the first evidence of the longitudinal trajectories of sleep disturbances and mental health throughout the pandemic in Italy, also describing the differential time course of age groups, genders, and chronotypes. A total of 1062 Italians participated in a three-time points longitudinal study covering two critical stages of the emergency [the first lockdown (April 2020) and the second lockdown (December 2020)] and providing a long-term overview two years after the pandemic outbreak (April 2022). We administered validated questionnaires to evaluate sleep quality/habits, insomnia, depression, stress, and anxiety symptoms. Analyses showed a gradual improvement in sleep disturbances, depression, and anxiety. Conversely, sleep duration progressively decreased, particularly in evening-type and younger people. Participants reported substantial earlier bedtime and get-up time. Stress levels increased during December 2020 and then stabilised. This effect was stronger in the population groups apparently more resilient during the first lockdown (older people, men, and morning-types). Our results describe a promising scenario two years after the pandemic onset. However, the improvements were relatively small, the perceived stress increased, and the re-establishment of pre-existing social/working dynamics led to general sleep curtailment. Further long-term monitoring is required to claim the end of the COVID-19 emergency on Italians sleep and mental health.

Working from home due to the COVID-19 pandemic abolished the sleep disturbance vulnerability of late chronotypes relieving their predisposition to depression

Background and aimsEveningness is distinctively associated with sleep disturbances and depression symptoms due to the misalignment between biological and social clock. The widespread imposition of remote working due to the COVID-19 pandemic allowed a more flexible sleep schedule. This scenario could promote sleep and mental health of evening-type subjects. We investigated the effect of working from home on sleep quality/quantity and insomnia symptoms within the morningness-eveningness continuum, and its indirect repercussions on depressive symptomatology. Methods610 Italian office workers (mean age {+/-} standard deviation, 35.47 {+/-} 10.17 yrs) and 265 remote workers (40.31 {+/-} 10.69 yrs) participated in a web-based survey during the second contagion wave of COVID-19 (28 November-11 December 2020). We evaluated chronotype, sleep quality/duration, insomnia, and depression symptoms through validated questionnaires. Three moderated mediation models were performed, testing the mediation effect of sleep variables on the association between morningness-eveningness continuum and depression symptoms, with working modality (office vs. remote working) as moderator of the relationship between chronotype and sleep variables. ResultsRemote working led to delayed bedtime and get-up time. Working modality moderated the chronotype effect on sleep variables, as eveningness was related to worse sleep disturbances and shorter sleep duration only among the office workers. Working modality moderated the mediation of sleep variables between chronotype and depression. The above mediation vanished among remote workers. ConclusionsRemote working strikingly abolished the vulnerability to sleep problems of evening-type subjects, relieving their predisposition to depressive symptomatology. A working environment complying with individual circadian preferences might ensure an adequate sleep quantity/quality to late chronotypes, promoting their mental health. Statement of SignificanceThe present study is the first to evaluate the different effect of pandemic-related remote working on sleep health/habits depending on the chronotype. We found longer sleep duration and improved sleep disturbances among evening-type subjects when working from home. This outcome could be ascribable to a better alignment between the endogenous circadian phase and the working schedule, as remote workers reported later bedtimes and get-up times. Moreover, we showed how improved sleep weakened the susceptibility to depressive symptomatology of evening-type people, highlighting an intriguing implication of working remotely on mental health in this category. Morningness-eveningness predisposition should be considered when designing remote working policies, in order to promote sleep and mental health of late chronotypes during the pandemic emergency, as well as in the post-covid era.