Insomnia During the COVID-19 Pandemic: Prevalence and Correlates in a Multi-ethnic Population Singapore

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2024 Dec 28

PMID 39731067

Authors

Pratika Satghare

Edimansyah Abdin

Saleha Shafie

Fiona Devi

Yun Jue Zhang

Boon Yiang Chua

Shazana Shahwan

Mythily Subramaniam

Affiliations

Soon will be listed here.

Abstract

Background: Globally, the Coronavirus disease 2019 (COVID-19) pandemic had a significant impact on mental health. Sudden lifestyle changes, threatening information received through various sources, fear of infection and other stressors led to sleep disturbances such as insomnia. The current study aimed to assess the prevalence of insomnia and its associated risk factors during the first wave of COVID-19 pandemic among Singapore residents.

Methods: A cross-sectional study conducted online and in person, from May 2020 to June 2021, recruited Singapore citizens and permanent residents, aged 21 years and above, fluent in English, Chinese or Malay language. Respondents answered an interviewer-administered questionnaire, including Insomnia Severity Index (ISI), Generalised Anxiety Disorder-7 (GAD-7), Physical Health Questionnaire (PHQ-9), stress scale of the Depression, Anxiety and Stress Scales (DASS), chronic conditions checklist and COVID-19 related stressors (exposure to COVID-19, current and future perceived risk of infection). Chi-squared test followed by stepwise logistic regression analysis were conducted to determine factors associated with insomnia.

Results: The study recruited 1129 respondents. Prevalence of insomnia was noted to be 7.4% in the sample. Insomnia was significantly associated with psychological distress- depression (p < 0.001) and anxiety (p < 0.001), financial loss as a source of stress (p < 0.012), ever been diagnosed with asthma (p < 0.001) and backache (p < 0.002).

Conclusion: Insomnia was prevalent and associated with higher level of psychological distress among Singapore residents. These findings can be utilised to design effective targeted interventions like cognitive behavioural therapy, therapist assisted relaxation and meditation programs to improve sleep and reduce psychological distress. Interventions like these can be delivered via smartphone applications enabling easy access, delivery, and utilization by the vulnerable groups. Overall, these strategies would not only help people maintain better mental health and sleep quality during a pandemic but also build resilience, enhancing society's ability to cope with future crises.

References

El Abiddine F, Aljaberi M, Gadelrab H, Lin C, Muhammed A . Mediated effects of insomnia in the association between problematic social media use and subjective well-being among university students during COVID-19 pandemic. Sleep Epidemiol. 2022; 2:100030. PMC: 9377837. DOI: 10.1016/j.sleepe.2022.100030. View

Molebatsi K, Motlhatlhedi K, Wambua G . The validity and reliability of the Patient Health Questionnaire-9 for screening depression in primary health care patients in Botswana. BMC Psychiatry. 2020; 20(1):295. PMC: 7291492. DOI: 10.1186/s12888-020-02719-5. View

Moya E, Larson L, Stewart R, Fisher J, Mwangi M, Phiri K . Reliability and validity of depression anxiety stress scale (DASS)-21 in screening for common mental disorders among postpartum women in Malawi. BMC Psychiatry. 2022; 22(1):352. PMC: 9128196. DOI: 10.1186/s12888-022-03994-0. View

Pappa S, Ntella V, Giannakas T, Giannakoulis V, Papoutsi E, Katsaounou P . Prevalence of depression, anxiety, and insomnia among healthcare workers during the COVID-19 pandemic: A systematic review and meta-analysis. Brain Behav Immun. 2020; 88:901-907. PMC: 7206431. DOI: 10.1016/j.bbi.2020.05.026. View

Subramaniam M, Abdin E, Picco L, Vaingankar J, Chong S . Multiple chronic medical conditions: prevalence and risk factors--results from the Singapore Mental Health Study. Gen Hosp Psychiatry. 2014; 36(4):375-81. DOI: 10.1016/j.genhosppsych.2014.03.002. View

Lee Y, Lau J, Vaingankar J, Sambasivam R, Shafie S, Chua B . Sleep quality of Singapore residents: findings from the 2016 Singapore mental health study. Sleep Med X. 2022; 4:100043. PMC: 8861160. DOI: 10.1016/j.sleepx.2022.100043. View

Jahrami H, BaHammam A, Algahtani H, Ebrahim A, Faris M, AlEid K . The examination of sleep quality for frontline healthcare workers during the outbreak of COVID-19. Sleep Breath. 2020; 25(1):503-511. PMC: 7319604. DOI: 10.1007/s11325-020-02135-9. View

Gonzalez-Sanguino C, Ausin B, Castellanos M, Saiz J, Lopez-Gomez A, Ugidos C . Mental health consequences during the initial stage of the 2020 Coronavirus pandemic (COVID-19) in Spain. Brain Behav Immun. 2020; 87:172-176. PMC: 7219372. DOI: 10.1016/j.bbi.2020.05.040. View

Baglioni C, Nanovska S, Regen W, Spiegelhalder K, Feige B, Nissen C . Sleep and mental disorders: A meta-analysis of polysomnographic research. Psychol Bull. 2016; 142(9):969-990. PMC: 5110386. DOI: 10.1037/bul0000053. View

10.

Miner B, Kryger M . Sleep in the Aging Population. Sleep Med Clin. 2017; 12(1):31-38. PMC: 5300306. DOI: 10.1016/j.jsmc.2016.10.008. View

11.

Wong S, Ng B . Review of sleep studies of patients with chronic insomnia at a sleep disorder unit. Singapore Med J. 2015; 56(6):317-23. PMC: 4469849. DOI: 10.11622/smedj.2015089. View

12.

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

13.

Dzierzewski J, Dautovich N, Ravyts S, Perez E, Soto P, Donovan E . Insomnia symptoms during the COVID-19 pandemic: an examination of biopsychosocial moderators. Sleep Med. 2021; 91:175-178. PMC: 8364920. DOI: 10.1016/j.sleep.2021.02.018. View

14.

Kumar N, Gupta R . Disrupted Sleep During a Pandemic. Sleep Med Clin. 2022; 17(1):41-52. PMC: 8863400. DOI: 10.1016/j.jsmc.2021.10.006. View

15.

Cellini N, Canale N, Mioni G, Costa S . Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J Sleep Res. 2020; 29(4):e13074. PMC: 7235482. DOI: 10.1111/jsr.13074. View

16.

Xiong J, Lipsitz O, Nasri F, Lui L, Gill H, Phan L . Impact of COVID-19 pandemic on mental health in the general population: A systematic review. J Affect Disord. 2020; 277:55-64. PMC: 7413844. DOI: 10.1016/j.jad.2020.08.001. View

17.

Choudhry A, Shahzeen F, Choudhry S, Batool N, Murtaza F, Dilip A . Impact of COVID-19 Infection on Quality of Sleep. Cureus. 2021; 13(9):e18182. PMC: 8544642. DOI: 10.7759/cureus.18182. View

18.

Kalmbach D, Fang Y, Arnedt J, Cochran A, Deldin P, Kaplin A . Effects of Sleep, Physical Activity, and Shift Work on Daily Mood: a Prospective Mobile Monitoring Study of Medical Interns. J Gen Intern Med. 2018; 33(6):914-920. PMC: 5975162. DOI: 10.1007/s11606-018-4373-2. View

19.

Garg S, Kim L, Whitaker M, OHalloran A, Cummings C, Holstein R . Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 - COVID-NET, 14 States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(15):458-464. PMC: 7755063. DOI: 10.15585/mmwr.mm6915e3. View

20.

Salari N, Hosseinian-Far A, Jalali R, Vaisi-Raygani A, Rasoulpoor S, Mohammadi M . Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Global Health. 2020; 16(1):57. PMC: 7338126. DOI: 10.1186/s12992-020-00589-w. View