Insomnia and nightmare profiles during the COVID-19 pandemic in Portugal: characterization and associated factors.

ABSTRACT

OBJECTIVE/BACKGROUND: To describe and characterize insomnia symptoms and nightmare profiles in Portugal during the first six weeks of a national lockdown due to COVID-19. PATIENTS/METHODS: An open cohort study was conducted to collect information of the general population during the first wave of SARS-CoV-2/COVID-19 pandemic in Portugal. We analyzed data from 5011 participants (≥16 years) who answered a weekly questionnaire about their well-being. Two questions about the frequency of insomnia and nightmares about COVID-19 were consecutively applied during six weeks (March-May 2020). Latent class analysis was conducted and different insomnia and nightmare profiles were identified. Associations between individual characteristics and both profiles were estimated using odds ratios (ORs) and 95% confidence intervals (CI). RESULTS: Five insomnia (No insomnia, Stable-mild, Decreasing-moderate, Stable-severe, Increasing-severe) and three nightmares profiles (Stable-mild, Stable-moderate, Stable-severe) were identified. Being female, younger, perceiving their income as insufficient and feelings of fear towards COVID-19 were associated with higher odds of insomnia (Women OR = 6.98 95%CI 4.18-11.64; ≥60 years OR = 0.30 95%CI 0.18-0.53; Insufficient income adjusted OR (aOR) = 8.413 95%CI 3.93-16.84; Often presenting fear of being infected with SARS-CoV-2 infection aOR = 9.13 95%CI 6.36-13.11), and nightmares (Women OR = 2.60 95%CI 1.74-3.86; ≥60 years OR = 0.45 95%CI 0.28-0.74; Insufficient income aOR = 2.60 95%CI 1.20-5.20; Often/almost always presenting fear of being infected with SARS-CoV-2 infection aOR = 6.62 95%CI 5.01-8.74). Having a diagnosis of SARS-CoV-2 virus infection was associated with worse patterns of nightmares about the pandemic. CONCLUSIONS: Social and psychological individual factors are important characteristics to consider in the development of therapeutic strategies to support people with sleep problems during the COVID-19 pandemic.