Sleep Disturbances, Anxiety, and Burnout during the COVID-19 Pandemic: a nationwide cross-sectional study in Brazilian Healthcare Professionals.

Study objectivesTo evaluate the impact of COVID-19 pandemic on sleep, anxiety, and Burnout in healthcare professionals. MethodsA survey was distributed using social media and organizational emails to Brazilian active healthcare professionals during the COVID-19 outbreak. We explored potential associated factors including age, gender, occupation, workplace, work hours, income, previous infection with COVID-19, recent/current contact with COVID-19 patients, regional number of incident deaths due to COVID-19, anxiety, and burnout. We evaluated new-onset or previous insomnia worsening (primary outcome), sleep quality, and duration (secondary outcomes). ResultsA total of 4,384 health professionals from all regions of the country were included in the analysis (mean age: 44{+/-}12 years, 76% females, 53.8% physicians). Overall, 55.7% were assisting patients with COVID-19, and 9.2% had a previous COVID-19 infection. New-onset insomnia symptoms or previous insomnia worsening occurred in 41.4% of respondents in parallel to 13% (n=572) new pharmacological treatments for insomnia. Prevalent anxiety and burnout during the pandemic were observed in 44.2% and 21% of participants, respectively. Multivariate analyses showed that females (OR:1.756; 95% CI 1.487-2.075), weight change (decrease: OR:1.852; 95% CI 1.531-2.240; increase: OR:1.542; 95% CI 1.323-1.799), prevalent anxiety(OR:3.209; 95% CI 2.796-3.684), new-onset burnout (OR:1.986; 95% CI 1.677-2.352), family income reduction >30% (OR:1.366; 95% CI 1.140-1.636) and assisting patients with COVID-19 (OR:1.293; 95% CI 1.104-1.514) were independently associated with new-onset or worsening of previous insomnia. ConclusionsWe observed a huge burden of insomnia in healthcare professionals during the COVID-19 pandemic. In this scenario, dedicated approaches for sleep health are highly desirable. Statement of SignificanceConsidering the stressful routine and risk of infection by COVID-19 among healthcare professionals, it is conceivable that sleep disturbances are significantly impaired during the pandemic. This nationwide survey conducted in Brazil found that 41.4% developed new-onset or worsening of previous insomnia symptoms. Moreover, 572 (13%) of respondents initiated pharmacological treatments for insomnia. Females, weight change, anxiety, Burnout development, family income reduction >30%, and recent/current care of patients with COVID-19 were independently associated with the development of insomnia or exacerbated previous insomnia symptoms. Considering the potential impact of insomnia on work performance/healthcare decisions as well as the potential long-term dependence of pharmacological treatments for insomnia, this study underscores the need for dedicated sleep and mental health programs for healthcare professionals.

Dormir Bem

Como é a qualidade do seu sono? Você costuma acordar ainda cansado, com aquela sensação de que dormiu mal? Hoje a gente vai entender quais são os fatores que podem prejudicar a sua noite de sono. Vamos falar do tempo de uso de um colchão, das posições na hora de dormir, da alimentação, da prática de exercícios físicos e do ambiente do quarto. Você também vai entender se a quantidade de horas que você dorme é ou não suficiente. E quais são as consequências, a longo prazo, das noites mal dormidas. A apresentadora do Canal Saúde da Fiocruz, Marcela Morato, conversou com Andrea Bacelar, neurologista, especialista de Medicina do Sono da Clínica Carlos Bacelar. Participantes: Patrícia Suassuna, fisioterapeuta do Centro multidisciplinar da Dor.

Tuberculose e AIDS: revisäo atualizada / Tuberculosis and AIDS: current revision

Os autores apresentam aspectos epidemiológicos e os principais tópicos a serem considerados no diagnóstico e tratamento da tuberculose, quando incidente nos pacientes com Aids. Däo ênfase à importância de se estadiar a Aids, pois, como se verá adiante, as apresentaçöes podem diferir, francamente, de acordo com o grau de imunodepressäo em que se encontra o paciente. Ilustram o trabalho com cinco casos selecionados entre os pacientes por eles acompanhados.