Prevalent, incident, and persistent insomnia in a population-based cohort tested before (2018) and during the first-wave of COVID-19 pandemic (2020)
Open accessAbstract
Study Objectives: High rates of sleep and mental health problems have been reported during the COVID-19 pandemic, but most of the evidence is retrospective without pre-pandemic data. This study documented rates of prevalent, incident, and persistent insomnia and psychological symptoms during the COVID-19 pandemic (2020) compared to pre-pandemic data (2018). Methods: Data were derived from a longitudinal, population-based study of insomnia in Canada. When the first lockdown started in the province of Quebec, a subsample of participants who had completed the latest 2018 follow-up were surveyed (April to May 2020) about their sleep, insomnia, and psychological symptoms since the beginning of the pandemic. Prevalence, incidence, and persistence rates of insomnia, and severity of stress, anxiety, and depressive symptoms were estimated, as well as their associations with confinement, loneliness, social support, use of electronics, and other lifestyle changes occurring during the pandemic. A sleep/health survey and validated questionnaires of insomnia, sleep quality, stress, fatigue, anxiety, and depression were administered at both assessments. Results: The sample consisted of 594 adults (mean age: 48.3 ± 13.1 years; 64.0% women). Prevalence of insomnia increased from 25.4% to 32.2% (symptoms) and from 16.8% to 19% (syndrome) from 2018 to 2020, for an overall 26.7% increase in insomnia rates. Of those classified as good sleepers in 2018 (n = 343), 32.6% (n = 112) had developed new insomnia during the COVID-19 pandemic. Among participants who had insomnia in 2018, the persistence rate was 76.5% 2 years later. There was a significant worsening of sleep quality, fatigue, anxiety, and depression (all ps < .005) during the COVID-19 pandemic compared to 2018. Significant associations were found between sleep and psychological symptoms and with living alone and being in confinement, lower social support, increased time using electronic devices, reduced physical exercise, and higher financial stress. Conclusions: The COVID-19 pandemic is associated with significant increases in insomnia and psychological symptoms compared to the pre-pandemic period. Large scale public sleep and mental health intervention programs should be prioritized during and after a pandemic such as the COVID-19.
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Insomnia disorder is often persistent and it is essential to consider the long-term effects.
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- Authors
- Morin, C. M., Vézina-Im, L.-A., Ivers, H., Micoulaud-Franchi, J.-A., Philip, P., Lamy, M., & Savard, J.
- Affiliations
- Université Laval (CA)
- École de psychologie et Centre d’étude des troubles du sommeil, Université Laval , Québec, Canada
- Service de médecine universitaire du sommeil, CHU de Bordeaux, Place Amélie Raba-Leon , Bordeaux , France
- Université de Bordeaux (FR)
- Corresponding author
- Morin, Charles M
- Venue
- Sleep
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-10-26
- Volume
- 45
- Issue
- 1
- ISSN
- 0161-8105 (ISSN-L)
- 1550-9109
- PMC
- PMC8574325
- OpenAlex
- W3210339563
- Cited by
- 117
- References
- 18
- Citations by year
- 2026: 10 · 2025: 24 · 2024: 27 · 2023: 35 · 2022: 19 · 2021: 2
- FWCI
- 20.03
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- SLEEP (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Corpus Université Laval (Université Laval) (submittedVersion)
- Funders
- Canadian Institutes of Health Research (42504, 353509)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- insomnia, COVID-19 pandemic, psychological symptoms, anxiety, depression, stress, sleep quality, fatigue, lockdown, confinement, social support, loneliness, digital technology use, physical activity, financial stress, living alone, insomnia prevalence, mental health, Quebec, adults, lifestyle modification, sleep and mental health, pre-pandemic comparison
- MeSH terms
- COVID-19, SARS-CoV-2, Sleep Quality, Home Environment, Adult, Anxiety, Communicable Disease Control, Depression, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Retrospective Studies, Pandemics
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